A summary on the evolution of Dental Implants...

1. 50 Years of Dental
Implants &
Osseointegration
Summary from Modern implant dentistry based
on osseointegration: 50 years of
progress, current trends and
open questions
DANIEL BUSER,LARS SENNERBY &HUGO DE BRUYN
Periodontology 2000, Vol. 73, 2017, 7–21
Summarized by Dr Neil Pandé

2. 1960 to present…
From an experimental treatment to a highly
predictable option to replace missing teeth
Offering significant functional and biologic
advantages
Numerous 10-year studies with success and
survival rates above 95%

3. Branemark & Schroeder
Early 1960’s: Professor P. I. Branemark from
the University of Gothenburg (Sweden)
performed the first preclinical and clinical
studies
Late 1960s: Professor Andre Schroeder from
the University of Bern (Switzerland), started to
examine the tissue integration

4. Until Mid 1980’s
Basic surgical guidelines established
Included a low-trauma surgical technique for implant
bed preparation
to avoid overheating of the bone during preparation,
implant insertion with sufficient primary stability and
a healing period of 3–6 months without functional
loading

5. Phases of Development
Scientific Quest (1960 - 1985)
Major Progress (1985 - 2000)
Fine Tuning (2000 - 2010)
Current Trends and Open Questions (2010 -
present)

6. 1965 to 1985: the scientific
quest
Mid 1980’s First Guidelines Published
Branemark: Machined Surface / Submerged
Healing
Schroeder: Plasma sprayed (Rough & Micro-
porous) / Non-submerged (Transmucosal) Healing
Focussed on development and engineering,
precise manufacturing, marketing and sales

7. 1985 to 2000: major
progress
Focus not only on function but also on aesthetics
Prosthetic implant components, angulated abutments, and
esthetic single-tooth and cementable abutments
Bone Augmentation
Sinus Floor Elevation
Paradigm shift on surface technology
Socket Preservation

8. 2000 to 2010:
The Fine-tuning Phase
Based on Primary and Secondary Objectives
Significant progress on aesthetics improvements in implant
components and surgical and prosthetic protocols
3 Dimensional Implant Positioning
Platform Switching
Zirconia Abutments
Immediate Implants
CBCT

9. Primary Objective
The primary objectives of implant therapy are two-
fold:
first, to achieve successful treatment outcomes from
a functional, esthetic and phonetic point of view with
high predictability and good long-term stability; and,
second, to have a low risk of complications during
healing and during the follow-up period.

10. Secondary Objectives
The fewest possible number of surgical
interventions,
low pain and morbidity during healing,
short healing periods,
short overall treatment time and
acceptable good-effectiveness

11. Socket Preservation
To compensate for post-extraction bone
resorption, bone augmentation must be
performed in the majority of esthetic implant
sites, in particular on the facial aspect
Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla:
anatomic and surgical considerations. Int J Oral Maxillofac Implants 2004: 19 (Suppl): 43–61.
Grunder U, Gracis S, Capelli M. Influence of the 3-D bone-to-implant relationship on esthetics. Int
J Periodontics Restorative Dent 2005: 25: 113–119.

12. Bovine Bone Fillers
A bovine bone filler demonstrated a low
substitution rate and is widely used, not only
for contour augmentation in early implant
placement but also for internal augmentation
in immediate implant placement.

13. 2010 and Beyond
Challenges
Peri-Implantitis
Smokers with a history of periodontal disease: prone to additional
bone loss, as confirmed in a recent 9-year follow-up study Vervaeke S,
Collaert B, Cosyn J, De Bruyn H. A 9-year prospective case series using multivariate analyses to identify predictors of early
and late peri-implant bone loss. Clin Implant Dent Relat Res 2016: 18: 30–39.
Screw vs Cement Retained
Crestal Bone Loss
Guided Surgery and CAD CAM