Background. The field of modern dental implantology is almost one century old. Its history reveals an evolution not only of implant design and placement techniques, but also of the definitions of clinical success and failure. The use of implants predates the universal concept of osseointegration as a benchmark for success. Some implants in clinical function today would not meet the commonly accepted standards of success currently used.
Case Description. The authors present a case of a patient who received a blade implant and a subsequent restoration in her maxilla in 1971. They describe placement and restorative techniques that were typical of the time, and are of historical interest. On the patient’s death in 1989, the implant and surrounding tissues were retrieved, and a histologic examination was performed. Osseointegration had not been achieved, yet the implant functioned successfully for 28 years, most likely because it was well-supported by fibrous connective tissue with associated bone support, as well as because of the design of the restoration.
Clinical Implications. The clinical outcome of an implant and associated restoration might not always be accurately predicted from a histologic perspective. An implant exhibiting biotolerance rather than classical osseointegration occasionally can exhibit a surprising degree of clinical success when looked at retrospectively.
