Part 3 - Osseointegration – The Trials, Tribulations And Successes
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During the early 1970's while Brånemark was deep into his research into osseointegration, other Europeans followed suit. They included André Schröeder at Switzerland's Berne University who was working on a similar implant for clinical application in conjunction with the renowned Straumann Institute. Around the same time, Smithloff and Fritz were also working on a particular style of blade-vent implant which they hoped would improve osseointegration rates. However, in all cases, results were deemed 'patchy' at best. This prompted the ADA in 1974 to take the stance that dental implants were not to be recommended as part of normal clinical practice.
Meanwhile, in the years that followed, more and more information was being gathered as long-term studies continued. By 1977 the criteria for successful osseointegration had been published and by 1985 a 20-year follow-up study of implant cases was released. This coincided with the first application for the commercial use of dental implants in the US by Nobel-pharma AB (now Nobel Biocare).
So what did the trails indicate?
By now a total of 4636 dental implants had been placed into the jaws of 700 edentulous patients at the University of Göteborg between 1965 and 1985
- In the upper jaw, 95% of patients maintained prosthetic stability after 10 years and....
- After 15 years the figure dropped only slightly to 92%
- In lower jaws, 99% of all prosthesis remained stable after 5, 10, and 15 years, and...
- In the final routine group (studied from July 1981 – June 1985) 100% stability was achieved.
The results concurred with earlier testing that Brånemark and others had carried out. Once these findings were published, the academic establishment realised that they needed to sit up and take note. When they finally did, things started to move at a rapid pace...
The pace of change
By 1986 Nobel-Pharma's application for commercially manufactured dental implants had been granted and that same year, the Academy of Osseointegration was set up in the US. In addition, Tomas Abrekktson who worked with Brånemark for many years published an article on the Myriad of Dental Implant Systems. This laid the foundation for future successful implant placement.
Over the next two decades, the balance shifted from a focus on osseointegration with little regard for implant position; through to 'crown down' prosthetic driven, implant planning. In addition 'roughened surface' components had evolved to improve anchorage, and by the mid 90's the development of modern aesthetic-enhancing ceramics was also well underway.
By the dawn of the 21st-century virtual reality dentistry was coming to the fore and before long, complete assimilation of implant treatment was possible. Nowadays of course, the focus is on ideal implant placement allowing dentists to do the 'hard work' virtually via computer rather than chair side. In addition, virtual dentistry allows dentists to highlight any short comings in alveolar bone function before implant placement, thus minimising risk.
In the future, we can expect to see faster completion, shorter recovery periods, and better bone graft materials that speed up the process.
In 2006, Gösta Laarson, the world's first edentulous implant patient died having successfully used his implants for over 40 years. By 2017 over 7 million Brånemark system implants had been placed and now, over 450,000 osseointegrated dental implants are fitted every single year.
That's 7 million people worldwide who have experienced restored confidence in the way they look, feel, and act!
It could be suggested that all of this is down to the curiosity of one man, or rather, one event that he turned from a temporary set-back into a massive clinical breakthrough. But whatever you think, arguably there has never been anything as ground-breaking as the discovery of osseointegration in the field of dentistry; and there probably never will be again!