The history of oro-maxillofacial implantology: from ancient attempts to modern clinical applications

Abstract

Oro-maxillofacial implantology has evolved from empirical attempts to replace missing teeth in ancient civilizations to a mature, evidence-based discipline that supports dental rehabilitation and complex craniofacial reconstruction. This narrative review retraces the field’s historical trajectory and highlights the scientific milestones that enabled the achievement of predictable outcomes. Early archaeological findings suggest that pre-Columbian populations experimented with shell or stone substitutes placed into extraction sockets. Still, long-term stability was generally limited by infection and lack of biological fixation. During the nineteenth and early twentieth centuries, clinicians explored metals and designs such as cages, posts, and subperiosteal frameworks; however, fibrous encapsulation and mechanical failure were standard. The discovery of osseointegration and its clinical translation to titanium endosseous implants constituted a paradigm shift, providing reproducible bone anchorage and establishing modern success criteria. Subsequent advances in biomaterials, surface engineering, imaging, guided surgery, and additive manufacturing expanded indications to oncology, trauma, and congenital defects, while also increasing demands for maintenance and prevention of peri-implant disease. Emerging directions include patient-specific implants, bioactive and drug-eluting surfaces, sensor-enabled “smart” systems, and artificial intelligence–supported planning and monitoring. Understanding the historical drivers of progress helps contextualize current practice and identify the most plausible pathways for future innovation.