When one of our ancestors had the formidable idea of inserting an artificial tooth, probably an artifact, in an alveolus to replace a fallen tooth, he began the history of implantology!
We do not have the name of the genius but today we have a new and interesting historical reference that takes us back in time of about four centuries, it is the dating attributed to a dental prosthesis found in Lucca in the tomb of the Guinigi family and now under consideration by researchers of the University of Pisa.
The prosthesis was associated with one of the many jaws found in the tomb, belonging to as many bodies buried in a single common grave.
The prosthesis is made up of five mandibular teeth: three central incisors and two lateral canines tied together by a gold band inserted in the roots to replace the anterior arch of the jaw.
The date of its origin can be placed around 1600 and the presence of tartar on the prosthesis testifies that it has been worn for quite a long time: it could be linked to one of the first implantology interventions in Italy. The in-depth analysis of the historical find revealed in the structure of the prosthesis two small golden pins inserted in the teeth to fix them to the gold band.
The dental implant found in Lucca constitutes an important archaeological find for the history of implantology which until now had always collected historical sources in the literature and never concrete evidence such as the latter and sensational discovery.
La storia dell’implantologia dimostra la necessità fondamentale dell’uomo di mantenere la funzione masticatoria e estetica dei suoi denti
If already in 1600 the man tried with wit and technique to solve the problem of fallen teeth, it is clear that edentulism was already a serious problem to be faced at the time.
The mouth, since the dawn of the centuries, has been the main tool for communication and interpersonal interaction and before that it represents the organ that guarantees sustenance because the nourishment process starts from chewing. During the 19th century, implantology interventions began to be tested frequently but the absence of adequate materials, the lack of surgical and medicinal instruments such as anesthetics and antibiotics made implant failure very likely.
It was in the second half of the 1900s that numerous patents were registered which in a short time made implantology safer and more reliable and moved it from pioneering experiments to the scientific method.
It is the merit of the Italian dentist Stefano Tramonte if in 1961 the first implant specifically designed for immediate loading with an area of biological respect appeared and it was he himself in 1964 who introduced titanium into implantology, actually creating the first osteointegrative event.
Osseointegration and immediate loading: the history of implantology from 1970 to the present day
The Swedish orthopedic surgeon and researcher Branemark thoroughly studied the close link between the surface of the implant and the bone, de facto coining the term osseointegration. In particular, his team paid attention to the biocompatibility of titanium and the very stable bond that this material was creating with the bone. Thus was born the deferred load implantology which provided for the insertion of dental implants in three or four months for the jaw and five or six months for the upper jaw bone. A period of time considered essential to allow the implant to osseointegrate into the bone.
In the early 1990s, new advances in the field of dental implantology supported the thesis that it was not always necessary to wait for the times suggested by Branemark for the osseointegration process. In fact, guaranteeing a good primary stability it would have been possible to fix the prosthesis to the implant after a very short time: it is the beginning ofimmediate loading implantology, that is, an intervention performed in a single surgical time with the insertion of the fixed prosthesis within 24 hours.
We owe this innovation in dentistry to the Portuguese dentist Paul Malò.
Thanks to the technique he promoted, the possibility of avoiding complex and invasive interventions such as bone grafts was also feared. By tilting the implants and evaluating the length of the same it is in fact possible to anchor the dental implants permanently in the patient’s residual bone even in cases where the bone is very little. In fact, Dr. Malò is the promoter of the “all on 4” technique, ie the use of only four implants for partial or total replacement of the teeth.
The evolution and history of implantology is enriched today by specialized centers, such as Sanident, where innovation continues thanks to the support of the best technology.
Immediate loading implantology interventions designed in detail thanks to 3D software, customized implants for each patient and much more allow us to add small pieces to the progress of dental care every day.
