CATEGORY 74 AUSTRALASIAN DENTIST Wednesday the 3rd of May 2023 was the third Brånemark Osseointegration day held in recognition of Professor P-I Brånemark, his contribution to Osseointegration and what has become dental implantology today. I was invited to give the international address and thought it appropriate to write a few words not only in reflection of his achievements but also to observe where dental implantology is today. In the 1950 and early 1960’s dental implants were utilised in the restoration of missing teeth. A wide variety of materials and designs were used including endosseous, transosseous and sub periosteal. These were not successful and failed to integrate to the surrounding bone, implants commonly being encapsulated in fibrous and chronic inflammatory tissue. research relationship with an American engineer, Richard Skalak. Brånemark formed a substantial team of outstanding researchers and clinicians and commenced development and production of a dental implant system. In 1965 they felt they had gathered enough information to commence human trials andGosta Larssonwas the first patient to receive Osseointegrated implants which were successful throughout his life. The key to Brånemarks success was not a single factor but a treatment protocol comprising a number of key features; 1. The use of a threaded implant made of a biocompatible material; Commercially Pure Titanium 2. A placement site in bone of adequate quality and quantity to support the implants and distribute loading. 3. A gentle surgical technique without overheating the bone site. 4. Delayed loading; burying the implants beneath the gingivae unloaded for three months in the mandible and six months in the maxilla. Professor Brånemark and his team had developed ‘Osseointegration’, the ability of dental implants to form a firm and lasting relationship with intimate contact to the surrounding bone. Unfortunately, because of the poor success of dental implants historically the scientific world was very reluctant to accept these findings. However, with tremendous tenacity andperseverance P-I and his colleagues received recognition and acceptance by the Swedish Academia in 1978. This was in no small part because of the vast amount of carefully documented studies and publications that the team had produced over many years. Many researchers, clinicians academics and engineers have contributed to what Osseointegration is today and although they are worthy of substantive recognition it is impossible to name them all. However, such a discussion would not be complete without mentioning Tomas Albrektsson. Tomas started as a young researcher working with P-I and has been known for many years in his research on Osseointegration and especially for the precision and meticulous histology that confirmed to the World that titanium implants truly formed an intimate contact with bone. LINICAL A celebration of Osseointegration By Professor Neil Meredith Dean, Postgraduate Institute of Dental Surgery Professor Neil Meredith Figure 1. A multiple implant case comprising blades, hollow baskets and solid implants Figure 2. A bone anchored microscopy chamber to study blood flow Figure 3. Histological ground section of osseointegrated implant in bone (Albrektsson et al. 1987) So the academic world was very reluctant to accept Brånemarks research and protocols; at least initially. Professor Brånemarks research interest began in the early 1960‘s with the invivo study of blood flow through soft and hard tissues. He and his team developed precision machined inspection chambers that were anchored in bone and could be connected to a microscope. It was soon realised that if these chambers were made of Titanium the bone chambers anchored or fused to the bone and could not be removed. Brånemark realised that this material was biocompatible and could be used for medical devices. He also had a keen interest in engineering and developed a strong Key milestones in the evolution of modern dental implantology include the first commercial development of the Brånemark implant with a relationshipwith the Bofors company, a division of Nobel Industries (famous for Alfred Nobel and the invention of dynamite). This relationship was very positive for Bofors in becoming a healthcare as well as a munitions company. Although Sweden was convinced of the efficacy of Osseointegration it was unknown around the world. Professor Brånemark set out to inform and educate and did so by identifying a number of brilliant academics and clinicians around the globe.
RkJQdWJsaXNoZXIy MTc3NDk3Mw==