.................
 |
 |
|
|
Curriculum
Bibliografia |
| Dental
implantodontics is that branch of dentistry that someone who has lost
some or all of his/her teeth is referred to for the sake of having them
back again by means of artificial tooth root insertions replacing those
missing, and which teeth are then fixed upon.
The method has many years of study behind it. In fact, the search for a means to substitute lost teeth goes right back to the remote past, with the use of various systems and materials. The difficulty of the task may be better understood by considering it is only with our own times that we have finally arrived at the fine-tuning of the techniques that, in most cases, resolve the problem. The Aztecs, Egyptians, Chinese, Etruscans, up to the more “modern” times of the Moors in Spain, just to mention some of the peoples involved in such research over the centuries, all attempted to dabble in dental implantodontics. Archeological excavating and tomb discoveries have unearthed skulls and jawbones in which, in the place of some missing teeth, there were insertions of elements imitating the shape, more or less well-modeled, of human teeth. The materials used for these teeth were sometimes extracted from shells, other times from rocks or even, as in one case reported in Nature magazine (January “98), the inserted root in the empty alveolus was found to be made of tempered and pounded iron. The doubt naturally arose among researchers that, given the veneration of the dead that was abound in ancient times, such dental implants would have been post-mortem additions. However, it would seem from various discovered cases that they had in fact been inserted in life and had functioned for a certain period. Setting aside the historical aspects, it can now be affirmed that the last 70/80 years or more have seen a frenzy of serious study in this dentistry discipline. Though it may be compared to other medical and surgical specialties seeking cures for life-threatening infirmities, this dental research in implantodontics is, nevertheless, of utmost usefulness. For our good fortune, there have been professionals who have applied themselves with almost religious fervor to tracking down the system for re-implanting teeth in way that they would be just as stable as natural ones. Even if the references are brief, we are duty-bound to recall some of the steps along the journey in dental implantodontics in recent times. It is particularly because we Italians are often ardent admirers of everything foreign that I want to point out that it was an Italian who started off this line of research which, in recent decades, has led to the recognition of this method. This was Dr. Formiggini from Modena who, in the latter 1940s, devised a “spiral-shaped” metallic implant to be inserted into the alveoli of extracted teeth. He reckoned that fibrous or bone tissue would be generated in and around the various twists, which would then allow the fixing of teeth onto the part of this very particular root emerging from the gum line. In reality, well before Dr. Formiggini, other researchers like the American Strock or the Swede Dahl (in the early 1900s) had sought, respectively, either to insert deeply into the bone tissue or to support above, some special metallic roots, upon which artificial teeth would then be fixed. There were deep-set implants and “juxta-osseous” if instead they were just laid against the bone tissue when this was insufficient to allow deep insertions. However, probably because of the times (unsuitable equipment, lack of appropriate materials), the hoped-for outcomes did not occur. With the advent of a more recent age (around the 1950s and 60s), the first successes began to be achieved. Thanks are due to those forerunners (Cherchev, Muratori, Tramonte, Pasqualini, Linkow, Scialon, the above-mentioned Formiggini and several others), many of whom are now departed, who pushed the research forward; because of them, implantodontics began to take hold in Italy too, apart from America, France and Argentina, and to become widespread with the achievement of satisfactory outcomes. Unfortunately, none of these researchers ever agreed among themselves to make their discoveries official and credible. It may be said in their defense that they were often (indeed almost always) harshly opposed by the universities and the scientific Establishment, perhaps because it was not considered seriously that some private individuals could bring such a great discovery to a conclusion, which at the time had something miraculous about it. And this hostility that these forerunners faced has still not fully dispersed: there is still an absurd diatribe between those that practice both traditional and modern methods, and those who only avail of the latter. As already recalled, implantodontics was much contested in the past and even when it had to be accepted - given that it had become an uncontestable reality - the accusations continued to fly that serious research had never been carried out on the discipline. According to badly founded opinion, implantodontics should be accepted because a Swedish discoverer (who, apart from anything else, is not even a dentist) has made known that which the researchers of old had long sought in vain to make known. And that is to say, that artificial roots (made of inert metals, of course, so as not to cause reactions), if placed in bone tissue and kept fixed and stable right from the first moment of their insertion, would be perfectly included within it. Then, the expression “osteo-integration” was immediately coined, rather than the “osteo-inclusion” of the old researchers! Currently, we are asked to believe that it is only with the latest generation of implants (i.e. those created by the Swedish inventor and similar) that the so-called “osteo-integration” can be obtained. But this is not true! Most implantations, if well executed, “osteo-include” themselves, since the principles of the procedures, both modern and traditional, remain the same. In a more correct light, in fact, the various existing implants and techniques (whether traditional or modern) are complementary to each other. Indeed, given the anatomic variants of the mandible and maxilla, knowing more methods and using several kinds of implant makes it possible to resolve almost all the cases that present themselves in professional practice in a more complete and satisfactory way. As
a corollary to what I have set out in synthesis, it has to be unfortunately
said that all traditional implantodontics - by means of which some 99%
of edentulous (without teeth) cases can be resolved with excellent results
- if continually repressed and opposed, will die away in the near future.
In its place will be the latest method to emerge, the one wrongly called
“osteo-integration alone”, which is good and, moreover, very simple
to carry out, when there is an abundance of bone tissue in which to
insert the quite bulky cylindrical implants proposed with this system.
|
|
