The History of Dental Implants

The Beginning of Dental Implants

During the 1960s and 1970s, dental implants were being designed and developed simultaneously in Sweden and Switzerland.

Scientists in both countries tested titanium implants for commercial production. Titanium was selected because of its unique ability to integrate with bone cells without causing signs of inflammation.

The Development of a Philosophy

Clinicians initially adopted a philosophy of “the longer, the wider, the better.” This meant dental implants were expected to be as long and wide as possible to achieve successful results.

Manufacturers produced implants measuring 12, 14, 16, and even 18 millimeters in length. Implants measuring 10 millimeters or less were generally reserved for special cases.

However, dentists encountered a problem with this approach. Many patients who lost teeth because of periodontal disease had insufficient bone remaining to accommodate implants of the preferred size.

For many clinicians, the solution was to add—or graft—bone into these deficient areas of the jaw so the patient could receive longer and wider implants.

This approach contributed to the development of several bone-grafting procedures. One example is a sinus lift, during which bone-grafting material is added beneath the sinus. Another is ridge augmentation, which adds bone to deficient areas of the jaw to create sufficient support for an implant.

Reevaluating the Philosophy

Because these procedures can be invasive, some patients have been told they are not eligible for dental implants. However, as scientists continued studying how implants distribute pressure to the surrounding bone, their findings challenged the traditional approach.

Evidence from multiple research groups suggested that only the first few millimeters of an implant transfer significant chewing forces to the surrounding bone. The longstanding belief that longer implants were always better began to change.

Research indicated that, regardless of the implant’s total length, approximately the first four millimeters of surrounding bone absorbed much of the stress created during use.

Based on this research, four-millimeter implants were developed and tested in Europe. The results indicated that these short implants could remain stable and function successfully under normal chewing conditions.

Although four-millimeter implants had not yet been approved for use in the United States at the time of this article, six-millimeter implants were available. These shorter implants performed well in appropriately selected patients.

Short implants have helped many patients avoid invasive bone-grafting procedures and, in some cases, provided an alternative to wearing dentures.