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Introduction and Speaker Credentials
01:59 - 03:48
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1
The Discovery of Osseointegration
03:48 - 06:29
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2
First Clinical Cases and Early Challenges
06:29 - 09:23
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3
The Toronto Conference & International Acceptance
09:23 - 11:40
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4
The Titanium Shortage Crisis
11:40 - 13:00
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5
Success Criteria and Modern Developments
13:00 - 17:00
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The Future of Osseointegration
17:00 - 20:00
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7
Q&A Session
20:00 - 50:19
- 8 Community questions
60 Years of Osseointegration
Video highlights
- The Accidental Discovery: Learn how Professor Brånemark's research on microcirculation in rabbits led to the unexpected discovery of osseointegration.
- The First Patient: Hear the story of the first-ever patient to receive osseointegrated dental implants in 1965 and their long-term success.
- The Battle for Acceptance: Understand the intense academic and clinical opposition to osseointegration in its early years.
- The Toronto Turning Point: Discover how the 1982 Toronto conference was the pivotal moment that led to the global acceptance of osseointegration.
- The Albrektsson Criteria: Gain insight into the development of the original, evidence-based criteria for determining the success of dental implants.
60 Years of Osseointegration: A Journey Through the History of Modern Implant Dentistry with Professor Tomas Albrektsson
This comprehensive webinar, presented by the esteemed Professor Tomas Albrektsson of the University of Gothenburg, offers an unparalleled journey through the 60-year history of osseointegration, the cornerstone of modern implant dentistry. As a direct mentee of the legendary Professor Per-Ingvar Brånemark, Albrektsson provides a unique, firsthand perspective on the discovery, challenges, and ultimate triumph of a concept that has revolutionized the treatment of tooth loss. This detailed summary follows Professor Albrektsson's lecture, exploring the key milestones, scientific breakthroughs, and personal anecdotes that shaped the field.
The Serendipitous Discovery: A Rabbit, a Microscope, and a Fused Implant
The story of osseointegration begins not in a dental clinic, but in a laboratory in 1952 with a young physician named Per-Ingvar Brånemark. While studying microcirculation and bone healing, Brånemark and his team inserted a small, custom-made titanium chamber into the fibula of a rabbit. The chamber, equipped with a glass window, allowed them to observe the living bone tissue through a microscope. The experiment was a success, but a significant challenge arose when it was time to remove the expensive titanium device. To their astonishment, the chamber could not be retrieved. The bone had grown in such direct and intimate contact with the titanium that the two had effectively fused together.
While many researchers might have dismissed this as a failed experiment, Brånemark's genius was in recognizing the profound implications of this accidental finding. He immediately understood that if bone could so predictably and permanently anchor to titanium, this principle could be the solution to one of medicine's most challenging problems: the replacement of lost body parts. This phenomenon, which he would later coin osseointegration, was defined as a direct structural and functional connection between ordered, living bone and the surface of a load-bearing artificial implant.
From the Lab to the Jaw: The Birth of the Dental Implant
Professor Albrektsson recounts how Brånemark's focus shifted towards solving the problem of edentulism, a mission sparked by a chance encounter with a nurse who had lost her dentures. Driven by this clinical need, Brånemark began experimenting with oral applications. In 1962, the first dental implants were placed in dogs, and by 1965, the first human patient, Gösta Larsson, received his set of osseointegrated implants. This pioneering case was a resounding success; Mr. Larsson's implants remained functional for the rest of his life, lasting over 40 years until his passing in 2006. This provided the first long-term evidence that osseointegration was a viable and durable clinical reality.
Professor Albrektsson himself joined Brånemark's laboratory in 1967 and witnessed these early successes firsthand. He describes seeing the original dogs from the 1962 study, still alive and with fully functional implants, providing undeniable proof of the concept's long-term stability.
The "Dental War": A Decade of Opposition and Skepticism
Despite the mounting evidence, the path to acceptance was anything but smooth. As Professor Albrektsson vividly describes, the 1960s and 1970s were marked by what he calls a "dental war." The established dental community in Sweden, and indeed worldwide, was deeply skeptical. The prevailing dogma at the time was that any foreign body inserted into bone would inevitably become encapsulated by fibrous tissue, leading to mobility and failure. The idea of a direct bone-to-implant connection was considered impossible.
Brånemark's work was heavily criticized, and he was largely isolated academically. The fact that he was a physician, not a dentist, was often used to discredit his research. Albrektsson shares a poignant story from a 1973 dental meeting in Stockholm where only one external dentist dared to publicly defend the implant concept. Tragically, this lone supporter died just weeks later, leaving Brånemark's team to face the opposition alone.
Validation and Global Breakthrough: The Toronto Conference
The turning point finally came in 1977 when the Swedish Board of Welfare mandated an independent review of Brånemark's work. A team of professors from an outside university was sent to Gothenburg to examine the patients. Their subsequent report was the first positive academic statement on the success of osseointegrated implants, effectively ending the academic feud in Sweden.
With domestic validation secured, the stage was set for international recognition. This occurred in 1982 at a landmark conference in Toronto, organized by the influential Professor George Zarb. For the first time, Brånemark's team presented their extensive long-term data to a global audience. The meticulous documentation, radiographic evidence, and high success rates were so compelling that the conference is now universally regarded as the pivotal moment that launched osseointegration onto the world stage.
In a fascinating aside, Professor Albrektsson recounts a bizarre geopolitical hurdle the team faced: a global titanium shortage. The Soviet Union, the primary source of the commercially pure titanium required for the implants, had diverted all its resources to construct a massive titanium statue of cosmonaut Yuri Gagarin. For a period, the production of implants came to a complete halt until the statue was finished and the titanium supply resumed.
Defining Success: The Albrektsson Criteria
As osseointegration gained widespread acceptance, the need for a standardized, evidence-based definition of success became critical. In 1986, Tomas Albrektsson, along with George Zarb and others, published a seminal paper that proposed clear criteria for evaluating the long-term efficacy of dental implants. These Albrektsson Criteria included:
•The absence of clinical mobility.
•No evidence of peri-implant radiolucency on radiographs.
•Marginal bone loss of less than 1.5 mm during the first year of function.
•Subsequent annual bone loss of less than 0.2 mm.
•The absence of persistent and/or irreversible signs and symptoms such as pain, infections, neuropathies, paresthesia, or violation of the mandibular canal.
This publication established a gold standard for research and clinical practice, allowing for objective comparison of different implant systems and techniques. It remains one of the most cited papers in all of dentistry and a cornerstone of evidence-based implantology.
Professor Albrektsson's lecture is more than a historical narrative; it is a powerful testament to scientific curiosity, the courage to challenge established dogma, and the profound impact that a single, well-observed phenomenon can have on medicine. It underscores the importance of rigorous documentation and evidence-based practice—principles that Professor Brånemark championed and that continue to guide the field of implant dentistry into the future.
References
References
You can purchase the new book by Prof. Albrektsson and Co-Authors on our Partner's Website. All proceeds go to the Medal of Excellence Award (Nobel Biocare). Click the link to access the web shop, where you can purchase the book.
