History of Dental Implants
Dental implants have been around for thousands of years going back to ancient Egypt. In the U.S. over the past 100 years, there has been an erratic evolution of dental implants involving the materials used to make them and instruments and protocols used to place them.
In the early 1900’s the first dental handpieces were belt driven and most implants were made of precious metals, cobalt chromium, stainless steel, etc. These treatments had varying success, but usually less than 60% with failures involving infection and bone loss. With the introduction of the air turbine handpiece in the 60’s, dental implants seemed to have a drop in success rates. What we have since learned, is that drilling the bone at high speeds overheats and damages the remaining bone. Almost all of the procedures during this time were also done without gloves or proper sterile technique.
It wasn’t until titanium root form implants were introduced to the U.S. by I.P. Branemark in the early 1980’s that they began to enjoy tremendous success. Branemark not only introduced titanium (a material able to integrate to bone) but also the sterile technique. Sterile drapes, gloves, masks, and instruments as well as sterile and particle free implants were made mandatory to place Branemarks new dental implants. The first Branemark courses provided at that time in the U.S. were mandatory in order to purchase the implants, kits, and drills and to place them. In order to take the course, it was originally required that it was a dental team of a prosthodontist and oral surgeon.
At that time, there was a large portion of the population that was completely edentulous as well as partially edentulous. Many young adults in the first half of the century were treated with full mouth extractions and complete dentures. For many of these patients, they were willing to try anything to improve their quality of life. The lack of taste, sores, gagging, difficulty chewing and social compromises were and still are big factors for denture patients. A good number of these patients had the sub-periosteal and ramus frame implants done in the 60’s and 70’s and later converted to root form implants over the following two decades.
Because of the high failures and associated problems with implants up until Branemark, many dentists were strongly opposed to even considering dental implants, therefor it wasn’t until the late 80’s and early 90’s that dental implants began to take hold in mainstream dentistry. By this time, dental implants were enjoying success rates in the high 90th percentile for almost a decade. As a result there began to be a large number of different implant systems entering the market, and thus no longer limitations on who could place and restore dental implants. This also lead to somewhat of a “turf” war over implants. There were and still are conflicting ideas on who should be considered the best suited specialists for dental implants. This was nearly impossible to establish at that time, because dental implants have two distinct aspects:
- Surgical placement
- Restorative phase (putting on the tooth or teeth)
The second aspect (restorative) is easily established under prosthodontics, however surgical placement of dental implants can fall under oral surgery, periodontics, and now to a lesser extent prosthodontics. In short, each specialty has a lot to offer in the success in dental implants.
Today, all aspects are beginning to blend more and more with some oral surgeons and periodontist becoming more involved in the restorative aspect and more general dentists and prosthodontists surgically placing dental implants. It should be noted that every year, more implants are placed and restored by general dentists than all specialties combined.
As dental implant popularity grew in the early 1990’s, more and more implant systems entered the market with each having something a little different to prevent patent infringement. Some of the protocols such as healing time and number of implants to support bridgework were also getting tested. As a result, some of these systems or aggressive protocols might not have enjoyed some of the more traditional success rates. It does seem, however, that most of these “kinks” have been worked out with more of the focus being on the restorative aspect of dental implants. CAD/CAM, Zirconia, and other materials are helping lead the way to more economical and lasting restorations.
What might be the only downside to dental implants today is their over utilization. Many of the techniques used to restore existing teeth are being abandoned in favor of dental implant therapy. Each patient certainly has their own set of options as to saving their teeth or electing to have them extracted in favor of dental implants to serve as root replacements.
However, to the patient trying to decide whether saving his or her teeth versus extraction and implant placement, can often be presented with little or no options for saving any teeth. This occurs when the practitioner may be less skilled or acquainted with more complex restorative techniques. It is obvious that the overall success of dental implants has distorted the general consensus among dentists of which teeth are worth retaining and restoration. The point of this discussion is to let it be known that there should be options presented. There are , of course, situations when a tooth or teeth simply should not be retained and restored. These points are centered around cost of restoration, benefits both long and short term, current medical health issues of the patient, age, time in treatment, manual dexterity, understanding, and prognosis.
It is the responsibility of your dental professional to offer guidance and options for treatment with an explanation of the benefits and drawbacks for each approach. We strive to offer each patient these options and choices upon examination and rendering diagnostics and treatment planning.
Dental implants, when properly incorporated into a dental restoration treatment plan, are changing the way people live. With them, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life. A person’s quality of life is greatly enhanced to a normal basis and personal relationships are no longer compromised.
For more information about dental implants or to schedule a consultation appointment, call our office in San Antonio, TX at South Texas Dental Implants & Prosthodontics Phone Number 210-692-0136.