The World's Longest Functioning Implant: A Verified Case Report
Satisfactory function, esthetics, and phonetics together with long-term stability and minimal complications are all considered as metrics that define a successful outcome. The current case report is documentation of a mandibular subperiosteal implant with a successful follow-up of 56 years. Numerous issues can be credited for the long-term successful outcome including selection of the patient, heedfulness of basic anatomic and physiologic principles, design of the implant and superstructure, surgical execution, application of sound restorative principles, conscientious hygiene, and clockwork recare. The case demonstrates intense cooperation and coordination among the surgeon, restorative dentist, and laboratory technical staff, together with long-lasting patient compliance. Execution of the treatment with a mandibular subperiosteal implant helped this patient overcome the status of a dental cripple. The highlight of the case is that it is the longest success ever documented in the history of any type of implant treatment.
Immediate treatment outcome (year 1958). (a) Intraoral view of abutment posts on the implants; (b) Frontal view in maximum intercuspation; (c) Panoramic view of subperiosteal implant and abutment posts; (d) Extraoral frontal view.
Follow-up at 26 years (year 1984) and 28 years (year 1986). (a) Extraoral (lateral) view of follow-up done in 1984. (b) Extraoral view at 26 years of follow-up. (c) Intraoral view of abutment posts connected to subperiosteal implants at 26 years follow-up. (d) Panoramic view of subperiosteal implants and abutment posts at 26 years of treatment. The overdenture has been placed over the abutments. (e) Clinical presentation of mucositis on the permucosal site of distal most abutment on left side at 28-year follow-up. (f) Panoramic view of subperiosteal implants and abutment posts at 28 years of treatment, showing bone growth over the distal struts of implant on the left side.
Follow-up at 32 years (year 1990). (a) Extraoral view of follow-up done in 1990; (b) Intraoral view with the bar over the abutment posts; (c) Intraoral view of mandibular overdenture; (d) Frontal view in intercuspation; (e) Panoramic view of subperiosteal implants and abutment posts at 32 years of treatment.
Follow-up at 40 years (year 1998). (a) Extra oral view; (b) Intraoral view in maximum intercuspation; (c) Intraoral view of mandibular bar on abutment posts of the subperiosteal implant; (d) Intraoral view of mandibular overdenture.
Follow-up at 49 years (year 2007). (a) Intraoral view of the bar on abutment posts of subperiosteal implants; (b) Intaglio surface of the prosthesis; (c) Occlusal view of the prosthesis; (d) Intraoral view of mandibular overdenture; (e–g) Intraoral view of the prosthesis in intercuspation with maxillary denture; (h) Panoramic view with mandibular overdenture on the bar connected to abutment posts of the subperiosteal implants.
Close adaptation of the subperiosteal implant after 52 years as observed in cone beam computerized tomography.
Appearance of the patient over the 58 years of follow-up.
Subperiosteal implant, the bar with ball abutments, and the overdenture with O-ring housings. (a) The 3 units as individually seen; (b) Assembled units (with overdenture in occlusal view showing Hardy's teeth).
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