Oral implantology :: ORAL IMPLANTOLOGY: THE BEGINNING - Part I
The beginning was back in 1972 when I was still in my fourth year as a dental university student. I was admitted together with nine of my colleagues to an internship programme in the former German Democratic Republic. The programme took place near Leipzig, in the small town of Thallwitz, where an old castle was hosting a super modern maxillofacial surgery clinic. Professor Bettmann, a very kind, caring and warm-hearted person, was in charge of the clinic.
The castle was very well maintained, surrounded by a vast park with woods, meadows and a lake with swans. The park was also very clean and well cared for. Knights’ armor and masterpieces by great artists were displayed around the castle’s hallways.
This was the setting where I had my first experience related to dental implants. Implants were not available in Bulgaria then and it was almost illegal to work with them. As I think back about that time I realize how different and even naïve our understanding of implantology was and what immense development it has undergone since. Professor Bettmann’s clinic worked with blade implants – the Linkow type – made of chrome-cobalt-molybdenum alloy. Long years of scientific and empirical research have now led to the conclusion that titanium is the best implant material. From current perspective we could say that chrome-cobalt-molybdenum alloys are outdated and that this particular type of blade implants is no longer used due to the subsequent fibrous integration. The internship however took us on a journey to a fantastic world where we stood agape watching slides and videos showing implantology techniques. Professor Bettmann was one of the most prominent names in implantology worldwide.
During the internship we had the opportunity to watch a surgical intervention live. Publications were already available reporting of very good results of the use of this type of implants.
Then I thought to myself that upon my return to Bulgaria I would find a way to produce implants myself as I could not buy them in Germany and would attempt to use them in my practice. It was really difficult to access any professional scientific information in Bulgaria especially if it was printed in the West. I followed very closely the German Dentistry magazine which was delivered to the polyclinic I worked at. There I found some articles on implantology.
Luckily I started working at the Neurosurgery department of what was then the Regional hospital in Sliven. We shared the operating theatre with the orthopedists in the hospital so I learned a lot from them about the Kuentscher nail. These nails are used for osteosynthesis (surgical treatment) in the restoration of long bone fractures and often are not removed after the healing as some patients would not submit to a follow up surgical intervention. So a Kuentscher nail would harmlessly remain within a person’s body for the rest of their life. Some patients though would consent to a second surgical intervention after the healing of the fracture and then the Kuentscher nail would be removed and discarded as it is not reusable.
So I thought to myself, here is the implant material. If it could remain life-long in the arms and legs of people why would not it stay in their jaw? I could easily get hold of some of the discarded Kuentscher nails.
Together with my dental technician we cut a Kuentscher nail into pieces (some of the Kuentscher nails are as long as 52 cm), modeled and cast the implants and the only task left was to find a suitable patient willing to experiment with these implants. It was not a difficult task. The patient who showed up was a very adventurous person. Very healthy and with strong spirit he had a job in mining. The only teeth he had were in the upper and lower front of his jaw and he would do anything to have teeth again that would not need to be removed and to revert to normal eating.
Following the Adapta procedure we performed the surgical interventions for placing end supports and bridges with plastic-embedded blend crowns (the only available option at the time). The year was 1978.