Dental Implants: Part 1

As I write this, Bramer and I are sitting in the airport in Miami waiting for our return flight home after a very long, but fulfilling surgery and implant training program in Santo Domingo, Dominican Republic. You guys are my witnesses, that on this trip my husband agreed that we should spend months at a time in the Dominican doing humanitarian dentistry and soaking up the Dominican charm. My close friends know that I have a dream that once my girls are self-sufficient (stop laughing), I could volunteer in a dental clinic by day, and hit up some beachfront yoga by evening! We loved reuniting with the beautiful beaches of Punta Cana where we were blessed to have honeymooned 12 years ago. The island of Hispaniola has flown many flags, and the culture and history are rich, but like many previous colonies there is a distinct prosperous minority that coexists with an impoverished majority. I was drawn to this particular implant program because it beautifully combined advanced dental training with restorative dental treatment for the people of Santo Domingo.

Most people in America have a basic idea of what dental implants are. I am often asked about the “all new implant teeth in a day” commercials and billboards that seem to be everywhere these days.  Often times, these promises are great marketing, leaving out a lot of fine print.

Historically, different cultures have used common materials to “replace” missing teeth. For instance, 4,000 years ago the Chinese used bamboo pegs to replace missing teeth.     In addition, 2,300 and 3,000 year old French and the Egyptian skulls have been found with metal prosthetic teeth, which were intended to improve the individual’s post-death smile. There have also been historical attempts to reimplant another human’s teeth or animal teeth into a missing space in a person’s smile (unfortunately, these attempts fail due to infection and host rejection).

The mental image I hold of ancient implants is featured in a famous Implantology textbook that most dentists are familiar with. It is a photo of a skull with carved tooth-shaped shells in the lower jawbone that was excavated from Mayan ruins. This book notes that the implants appeared to be integrated into the bone, and that they showed signs of calculus formation. This most likely means these ancient implants were functional replacements for every day use, and not simply for post death vanity.  Luckily, implants have come a long way since bamboo pegs and seashells.

The father of modern dental implantology was an orthopedic surgeon, Dr. Per-Ingvar Branemark. In 1952, he unintentionally discovered the osteo-integrative (bone anchoring) properties of titanium, when he was unable to remove a titanium cylinder he had placed in a rabbit femur during a study on bone healing and regeneration.  In 1965, Dr. Branemark placed his first titanium dental implant. Since then, implant technology has gone from a “pet” project to the treatment standard for many patients with missing teeth.

In the next part of this Implant piece, I’ll explain some of the history and science behind Zirconia Implants- I know you are on the edge of your seat!

The heart of the discerning acquires knowledge, for the ears of the wise seek it out. Proverbs 18:15