My topic here is the development of dental implantology and the important concepts. When is the first dental implant in the human history? It is about 2,000 years ago. This is a general of the Roman Empire. At that time, after loosing one tooth, could dentist provide him with flippers or a fixed bridge? No, they cannot. For this General, after losing several teeth, no one can restore for him. He cannot bite food, and he cannot get strength to fight for his king. He could be fired. At that time, one of his friend, a blacksmith, put iron root in his maxilla. He’s lucky. This iron root survived and was being used for one year until the death of the General. This is the first successful dental implant in the human history. And this is about 1,500 years ago. People put shells into the bone to support the crown to bite food. I think no one will do it now. This is current dental implant restoration. This is the Chinese history of dental implantology. We are the one of first departments to import this technology and distribute the knowledge all over through China. We have the first publication and have successful cases over 20 years. About the current technology, we have to talk about Professor Branemark. He placed his first implant in 1965. It was successful but he didn't tell anyone at that time and did very good research over 15 years in hundreds of patients. In 1980, he finally published his work, and with his help, osseointegration is established as a successful criterion for dental implants. Professor Branemark was not a dentist at that time. He placed titanium post in the animal mandible, trying to study blood flow. After several months he tried to take it out, but he failed. He was kind of disappointed because he cannot do his original study. But he wanted to see how strong this titanium post. He tightened a wire to the titanium post. We can see it can withstand the whole weight of the dog. That's the strength of the dental implant. We call that osseointegration. The definition of osseointegration is direct structural and functional connection between living bone and the surface of a load-bearing artificial implant. How could we achieve osseointegration? We can achieve ossesointegration in two steps. The first one is the primary stability. If we insert implants into the bone, the mechanical interlocking between the implant and the bone could achieve stability. It's just like the fracture of the bone. If we want two segments of the bone to fuse together, we have to make them stable. How could we achieve the primary stability? This is the dental implant and this is the final drill. How about their size? Are they the same? No. The implant should be a little bit larger than the final drill. So if we drill the bone, we can see its smooth surface in the bone. If we insert the implant and take it out, we can see the screw in the bone. That is the way we get stability. But that is the mechanical interlocking of the bone and the implant. We want implant to fuse into the bone, just like the two segments of the bone fracture. We want the new bone attachment, the osseointegration, and that is the process of osseointegration. This is an implant with hydrophilic surface and this is the rough surface of implant. And the first step, it absorbs proteins to the rough surface, and then the platelet activated. We can see the dense fibre network formed, and send messenger molecules to attract bigger cells. What are these cells? They are pre-osteoblast. They are also activated to be the bone forming osteoblast. And finally, several days later, we can see the new bone attachment to the implant. We call it osseointegration. That is the histological analysis of dental implant. We can see the screw and there is no gap between the bone and implant. After this video, do you know what osseointegration is and the process of osseointegration? Thanks very much for your attention.
