In other words, history shows that it has always made sense to replace a tooth with an implant in the approximate shape of a tooth. Incas from Central America took pieces of sea shells and, similar to the ancient Chinese, tapped them into the bone to replace missing teeth 5 ( Figure 2-1). A skull was found in Europe with a ferrous metal tooth inserted into a skull with a tooth peg design that dated back to the time of Christ. The Egyptians, 2000 years ago, used precious metals with a similar peg design. Root form implant history dates back thousands of years and includes civilizations such as the ancient Chinese who, 4000 years ago, carved bamboo sticks in the shape of pegs and drove them into the bone for fixed tooth replacement. Implant dentistry is the second oldest discipline in dentistry (oral surgery is the oldest). The desire has always been to replace missing teeth with something similar to the root of a tooth. 3, 4 Today, an endosteal implant in the shape of a tooth root is the design most often used in the restoration of partial or complete edentulous patients. Many endosteal implant designs have been used in the past, including tapered pegs, pin shapes, and plate forms. However, endosteal, periosteal, and transosteal are preferred. The term endosseous is also used in the literature, and because the term osseous also indicates bone, either term is acceptable. 1 The prefix endo means “within,” and osteal means “bone.” 2 The major subcategory of endosteal implants covered in this text are root form implants. An endosteal implant is an alloplastic material surgically inserted into a residual bony ridge, primarily as a prosthodontic foundation.
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