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History and Composition of Dental Implants

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History and Composition of Dental Implants

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Since the introduction of dental implants over the last 40 years, they are becoming the first choice for the replacement of missing teeth. Read to know more.

Medically reviewed by

Dr. Chithranjali Ravichandran

Published At May 13, 2021
Reviewed AtAugust 1, 2023

Introduction

The material surface and design of an implant play a crucial role in osseointegration (when the implant fuses with the natural bone rendering it stable, also termed as bone-implant anchorage). Apart from the material used for manufacturing the implant itself, surface modifications by physical and chemical means are adopted to roughen the surface of the implant for proper integration into the bone. Increased surface roughness of the implant leads to good bone apposition and a reduction in the healing time post-implant surgery.

What Is the Material Used for Implants?

As for the material of choice for manufacturing a dental implant-

Titanium and titanium alloys are widely used in the fabrication of modern-day dental implants, even though some manufacturing companies have started to adopt zirconia as an alternative material.

Aluminum oxide implants were also used in the early 1990s prior to the introduction of zirconia as alternative implant material in the market.

The recent material for manufacturing dental implants commercially has now been pure titanium because of its excellent biomechanical and biocompatible properties.

What Is the History of Dental Implants?

The discovery of dental implant material was in 1791 when Revered Geologist or mineralogist from Cornwall-William Gregor discovered Ilmenite, which Gregor deemed as a mysterious metal that was found at a stream bottom of Manaccan village in the United Kingdom (UK). Gregor then published it through reports, suggesting that this unidentified material was a new element. But it was not until four years later that German chemist Martin Heinrich Klaproth returned to the investigation of Ilmenite and isolated this new element. Martin suggested the name of titanium be given to this element in honor of titans (mythical giants who ruled the earth until they were overthrown by the Greek gods). When the research process started almost a century later in 1952 by Per Ingvar “Branemark” (The modern founder who was a pioneer in dental implantology by coining the term-Osteointegration) on Rabit femurs. It was Branemark, who illustrated that bone growth was very close and firm around the titanium alloy. This was the benchmark when the titanium screws soon began to be manufactured. By the year 1965, the first dental implant patient got the titanium screw implanted in the lower jaw when the field of dental implantology officially began.

Other materials that were initially discovered, like tantalum, also gained momentum initially to be manufactured for implants but lost pace later after the full-fledged implementation of titanium alloys. Branemark, who originally experimented with tantalum after the observation of osseointegration (because of titanium integration to the bone) in Rabit femurs, switched over to titanium, which began the story of modern-day implants.

Currently, more than 600 different implant companies exist in the UK and Indian markets that cater to the demand-supply of dental needs as per the quality and pricing of dental implants.

What Are the Pros and Cons of Titanium Screw and Zirconia Implants?

Titanium Screw Implants:

The shape of implants has had a similar evolution through history ranging from being bladed to subperiosteal (implants made of metal framework that are placed onto the bone rather than inside the bone) to the screw-shaped titanium implants that were predominantly used till they finally were implemented that way.

Zirconia vs. Titanium Implants:

Histologic results show good bone contact for zirconia and titanium, especially given that zirconia resembles tooth color more and has excellent biocompatibility with bone. But still, the cons of zirconia outweigh the pros for using it as a full-fledged material choice in dental implants. So, look into the pros and cons of zirconia and Titanium implants in this table of comparison.

Zirconia Implants:

  • Excellent human tissue.
  • Compatibility.
  • Low bacterial attraction or adhesion.
  • High fracture resistance.
  • Good corrosion and wear resistance.
  • Excellent aesthetics as it resembles tooth color.
  • Over time the material may crack or deteriorate.
  • Typically available only as one-piece implants. If the patient needs two-piece implants, then the abutment will have to choose a metal option. Adjusting the height of the implant prosthesis after fitting is difficult in zirconia because any grinding or trimming of the surface can weaken the fracture resistance.
  • Zirconia implants have excellent biocompatibility in the patient’s mouth irrespective of the autoimmune conditions a patient might be having.
  • No reported allergy to zirconia implants.
  • Zirconia implants hence are biocompatible, inert, and non-resorbable metal oxides that have superior mechanical properties over ceramic materials.
  • Higher failure rates compared to titanium.

In fact, studies also suggest those surface modifications physically and chemically also make them more stable in integrating with the bone, just like titanium implants. But due to commercial usage of titanium from the last few decades and a reported increase in the implant failure rates (on experimentation with zirconia as an alternate prosthesis and its disadvantage of material deterioration with time) has led to zirconia not being used for mainstream implant manufacturing purposes. However, the promising results for zirconium definitely give scope for its application in future dental implant prosthetics.

Titanium Implants:

  • Excellent human tissue compatibility.
  • Comparatively higher bacterial adhesion (requires proper oral hygiene).
  • High fracture resistance.
  • High corrosion and wear resistance.
  • Moderate aesthetics as it does not resemble the tooth color.
  • The material remains strong as it does not deteriorate over time.
  • Available as two-piece implants that are really beneficial in cases of angled implants for proper alignment and positioning. After the prosthesis is fit on top of the titanium implant, it can be further adjusted and trimmed to suit the patient’s occlusion (bite) without weakening the fracture resistance of the prosthesis.
  • In patients with certain autoimmune conditions like Crohn’s disease, diabetes, or rheumatoid arthritis -the metal ions released from the titanium implant can cause localized inflammation and irritation, according to research by some toxicologists. Allergies would be reported in patients with a history of metal allergies.
  • Lower failure rate and most preferred material of choice for implant manufacturing.

Conclusion

To conclude, discussing the material of choice for dental implants with your dental surgeon is a good decision. However, titanium continues to be the present material of choice after a long evolution of materials in implant dentistry. To increase the lifespan of your dental implants, it is pivotal to maintain oral hygiene, avoid smoking and periodically visit your dental surgeon or implantologist for best results.

Frequently Asked Questions

1.

When Was the Dental Implant Started?

The Mayans provided the first evidence of dental implants around 600 AD when they used pieces of shell as implants to replace mandibular teeth.

2.

What Type of Material Is Utilized in Implants?

Titanium or titanium alloys are most commonly used for dental implants since they create a permanent fixture in the bone. When dental implants are implanted into the jawbone, the surrounding bone will develop around them and fuse, much like real bone.

3.

How Long Do Dental Implants Last?

The implant screw (inside the jaw) can last a lifetime with proper brushing and flossing around the crown, provided the patient visits a dentist regularly every six months. However, the crown typically must be replaced after only 10 to 15 years due to wear and tear.

4.

Are You Aware of the Facts Regarding Dental Implants?

Dental implants are the only tooth replacement option that comes close to matching natural teeth in terms of strength and longevity. People with dental implants can chew their food, similar to people with natural teeth. Surgery for the placement of dental implants is not a difficult or invasive procedure, with a success rate of more than 98 percent.

5.

Which Dental Implant Is Most Commonly Used?

The most popular form of dental implant currently used is made out of titanium. They have a lengthy history of achievement. They have evolved into the most flexible technique for replacing teeth. They enable the restoration of numerous complex cases due to their metal substructures and components.

6.

Which Implant System Is the Best?

In the year 1954 Straumann dental implant system was established. It is the world's finest and most reputable dental implant company offering solutions for implants, tissue repair goods, and other restorative, surgical, and regenerative products.

7.

What Is the Most Secure Material for Dental Implants?

Since zirconia is generally hypoallergenic, it will not cause skin redness, itching, or inflammation. If zirconia implants are placed into the bone, they have a greater chance of osseointegration, decreasing implant failure. If the patient is allergic to metal implants made up of zirconia is the most reliable.

8.

Which Heavy Metals Are Present in Implants?

Due to its mechanical strength, biocompatibility, and extensive history of use, titanium is one of the most commonly used metals for dental implants.

9.

What Is the Purpose of Titanium in Implants?

Due to its superior corrosion resistance and hard-tissue compatibility, titanium (Ti) and its alloys are extensively employed for medical and dental implant devices, including artificial joints, bone fixators, spinal fixators, and dental implants (bone formation and bone-bonding ability).

10.

What Are the Various Dental Implant Systems?

 - Endosteal, subperiosteal, and Zygomatic are the three most popular varieties available.
 - Endosteal - These dental implants are placed in the jawbone.
 - Subperiosteal - These dental implants are positioned on or above the jawbone but beneath the gum line. 
 - Zygomatic - These dental implants are placed into the Zygomatic bone.
 - Subperiosteal is the second most frequent and safest, followed by zygomatic, the final and most complicated. It's rarely employed.

11.

What Are the Myths Regarding Dental Implants?

 - The placement of implants is extremely painful and uncomfortable, and it requires a long healing time.
 - Most patients believe dental implants are costly.
 - Implants require utmost care - Patients should brush and floss around their dental implants. 
 - Implants do not look like natural teeth.

12.

What Are the Drawbacks of Dental Implants?

The rate of complications is only five to ten percent on average. Dental implants are associated with various risks and possible complications, such as infection, injury to healthy teeth, fractures of the jaw, delayed bone healing, damage to the nerves, prolonged bleeding, and more.

13.

What Are the Reasons for Dental Implant Failure?

Irradiated bone, a rise in the temperature of the bone during installation of the dental due to failure of the proper cooling system, and necrosis of the supporting bone around the implant are all signs of dental implants failing.

14.

What Are Dental Implants?

The dental implant is a titanium device that resembles the root portion of the missing tooth. An artificial tooth (crown) is fixed to the dental implant with the help of the abutment, giving you the appearance of a natural tooth.
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Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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