Implant Dentistry: Then and Now

all-on-4 implant dentistry
Written by Megan Rose, Physician Assistant.For thousands of years, humankind has been replacing missing teeth using dental implants in one form or another.  Ancient Egyptians as early as 2500BC used ligature wire made of gold to stabilize loose teeth1.  They also used pieces of sea shells and stones as primitive implanted teeth2.  Later, in 500BC Etruscans manufactured customized gold bands to restore chewing function for themselves.  They also made human shaped teeth from oxen bones to use as replacements.The first evidence of successful implant dentistry dates to 600AD when a Mayan jaw bone was found with osseo-integrated seashells as a replacement for mandibular teeth.  When the jaw bone was discovered in the 1970s, radiographic imaging confirmed that compact bone formation had occurred around the Mayan implants, just like we expect from our modern day titanium implants1
sea shells successful implant dentistry
Sea shells were actually the first successful dental implants.

Implant Dentistry Today

Today, the vast majority of dental implants are osseo-integrated and screw-shaped.  They are either made of pure grade 4 commercial titanium or an alloy of titanium containing aluminum and vanadium to improve strength3.
Photo Credit: American Academy of Implant Dentistry
 The American Association of Oral and Maxillofacial Surgeons have collected data that shows 69% of American adults aged 35-44 have lost at least one permanent tooth to either gum disease, failed root canal, accident or dental decay.Moreover, 26% of American adults over the age of 74 have lost all of their permanent teeth4.  An estimated 100,000 to 300,000 dental implants are placed each year, which verges on the total number of artificial hip and knee joint replaced every year5

A Permanent Replacement for Missing Teeth

Dental implants are the most permanent replacement for missing teeth.  One study6 which was done in 2015 sought to review all of the journal articles which published the long term success rates of implants.  The authors analyzed longitudinal studies that had follow up data from dental implants at least 10 years after they had been placed.Of all their reviews, they had a total of 7,711 implants across 23 different studies.  The average success rate after an average of 13.3 years was 94.6%.  Some studies included data from up to 20 year follow up periods, but all were at least a ten year minimum. 

Alternatives to Dental Implants

There are other ways to replace missing teeth.  If the missing tooth is situated between two existing teeth, a dentist can fabricate a bridge which is a set of three to five crowns cemented together that connect between the two existing teeth.If several teeth are missing, it may be more cost effective for the patient’s general dentist to manufacture a partial denture.  This is a device which resembles a retainer that has teeth into the spaces that are missing in the patient’s mouth.  It hooks to the adjacent teeth and can provide some extra chewing function for the patient.
nobel biocare partial-denture
A partial denture is sometimes used to replace several missing teeth. Source: Nobel Biocare
 Finally, there is always the patient’s option to do nothing to replace a missing tooth.  Many people opt for this method if it is one of their second molars, or one of the four teeth all the way in the back of their mouths that they don’t mind going without. Of course, we don’t recommend replacing third molars, or wisdom teeth, either.Dental implants remain the next best thing to natural teeth, both in chewing function and long term success. Talk to your general dentist or oral surgeon today about which option is best for you! 
  1. Ring Malvin E, editor. 2nd ed. Abradale Press; 1985. Dentistry: an illustrated history.
  2. Lee JH, Frias V, Lee KW, Wright RF. Effect of implant size and shape on implant success rates: a literature review. J Prosthet Dent 2005;94:377-81.
  3. Gaviria L, Salcido JP, Guda T. Current Trends in Dental Implants. J Korean Assoc Oral Maxillofac Surg 2014;40:50-60.
  4. Oral and maxillofacial surgeons: the experts in face, mouth and jaw surgery [Internet]. Rosemont (IL): American Association of Oral and Maxillofacial Surgeons [cited 2014 Apr 21]. Available from:
  5. Gupta A, Dhanraj M, Sivagami G. Status of surface treatment in endosseous implant: a literary overview. Indian J Dent Res 2010;21:433-8.
  6. Moraschini V, Poubel LA, V. Ferreira VF. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int. J. Oral Maxillofac. Surg. 2015; 44: 377–388

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