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  • 28 September, 2019

Pioneering Work on Dental Implants | Prof. Dr. Firoze. Dara. Mirza

Prof. Dr. Firoze. Dara. Mirza
L.D.Sc. (Bom) M.D.S. (Tufts. U.S.A.) , F.I.C.D., F.I.C.O.I. (U.S.A.) ,C.I.R.I.L. Hon. (Paris) M.H.S.D.R. (Greece), F.A.D.I Diplomate, ICOI, Board (U.S.A.) ,Diplomate, ISOI (India)
Dr. Goldberg & Dr. Gershkoff started Sub-periosteal Implants and gave a participation course for the first time in Boston, U.S.A. at Tufts University College of Dental Medicine in 1956-1957. This was conducted on weekends. I took this course and placed my first sub-periosteal implant in the lower mandible in 1956. At the same time Dr. Dahl in Sweden put his first implant.

I did my first Sub-Periosteal Implant ever done in India in the

Lower jaw in Bombay in 1962 at the Breach Candy Dental Clinic and presented this case to the Faculty at the Nair Hospital Dental College, Bombay University.

In those formative days some more dentists in the U.S.A. started sub-periosteal implants as well as end-osseous Blade-Vent Implants. Blade-Vent Implants were made by Dr. Charles Weis in the 60’s & 70’s in U.S.A. There were no didactic studies made by Implantologists in the early years. Some papers were published in the U.S.A. which were post the follow up on Implant cases in their patient’s mouths. Before 1955 only animal experiments were reported on Implants which were a total failure.

In 1961 I wrote an essay on Dental Implants in the

essay competition in the “Quintessence Journal” in Germany.

I got a prize that gave me more encouragement to pursue Implant treatments in the mouth of my patients.

From 1970 onwards more Blade-Vent Implant treatments were done in U.S.A. after Dr. Leonard Linkow published his books of two volumes. Many cases were successful with reports being published in the U.S.A. These blades were inserted in the jaw bones after making channels. Some were made too wide, so these implants failed. They failed because fibrous tissues were formed in between the implant and osseous structures. This carried the bad name for Blade-Vent Implants. When channels were made narrow, implants were fully OSTEOINTEGRATED.

In 1988 there was a didactic study published in the

Swedish Journal by Dr. Branemark, an “Orthopedic Surgeon”,

on Implants. They were placed in the mouths of several patients and followed up successfully after some years. But this study only included cases where Implants were in the mouth for one year successfully. Those Implants done in one year which were not successful, were not counted in this study. However, Dr. Branemark and his team became famous in the U.S.A. In 1988 the American Health Ministry in Bethesda, Maryland i.e. in Washington passed the

a law on safe Dental Implant procedure. Food & Drug Administration of U.S.A too passed laws on Dental Implant practice. After this event more dentists got interested all over the world doing dental implants successfully in healthy patients. Nobel Biocare gave several Academic courses on Cylinder Implants. Dr. Branemark became famous for coining the word “OSTEOINTEGRATION”.

In 1988 Dr. Ronald Cullen invited me to British Implant Society’s first Conference in London, U.K. I presented 35 cases of my practice in Bombay, which were successful. They were all Blade-Vent Implants done on healthy patient’s mouth. Post 1988, due to Dr. Branemark Cylinder Implants became popular. Dental Implants were promoted world-wide by Nobel Biocare Company which were mainly cylindrical in shape.

While I was in London in 1988, I met Prof. Grafelmann from Germany and invited him to Bombay, but he refused to come because of the fear of “Bombay Belly”. Many foreigners coming to Bombay were subjected to Diarrhea in those days & were reluctant to visit Bombay. Professor Grafelmann and his wife were making Blades in 5 different generations of Implant designs. I used many of his constructed Blades which had a strong neck. Prof. Grafelmann also made cylinder implants and screw implants. Screw Implants were safely inserted surgically and had the ability to load the implant with a crown on top on the same day. Therefore, these implants became popular in Dentist’s hands. Also, they were cheaper implants and were easy, but they had their own limitations.

I finally succeeded in 1988 in getting Prof. Grafelmann to Bombay. The German Consulate was very kind to sponsor for the First Conference of Bombay Society of Oral Implantology which took place at Hotel Holiday Inn. I gathered 75 dentists and I also made a committee along with some interested dentists from Bombay. This was the birth of the “Bombay Society of Oral Implantologists”. In that conference I made Prof. Grafelmann put Implants in dead calf bones where I assisted him. Thereafter I got a big response from the Dental Fraternity to promote Implantology in a big way, others with me were Dr. Chitre, Dr.Ajit Shetty, Dr. Daruwalla & Dr. Jayashree V Dikshit.

In 1989 BSOI Society became all India body and was called as the “Indian Society of Oral Implantologists”. I was made the Founder President of ISOI in 1989. I had to be active for the first ten years to observe the growth of ISOI without any controversies. All deliberations were done jointly so that we grow peacefully as per the constitution laid down. This was the most difficult part to play in India.

Today, I can boast that there are more than 20,000 members in our Society giving several academic short courses to young dentists of our country. I can proudly say that some Indian Implantologist’s are second to none in this modern world.

Before 1988, I must say I was very active in giving several lectures whenever I was invited by other European Implant Societies as well as all Asian Implant Societies. I have visited about 20 countries only to speak at various conferences on Implantology. In Jersey, U.K., I was even paid $500 for one of my lectures in their annual conference. At that time, it was a lot of money and I took pride in it.

Today, I am 87 years old and I still practice actively for 3 hours because my patients want me and that keeps me going. I believe in waging a war against weakness and launching a campaign against fearfulness. I had put in a blade-vent implant in a cancer bone on one of my private patients. A lady patient had lost half of her jaw due to cancer. The other half of the mandible had no teeth and she had undergone “Brachy therapy” (radiation treatment). The lower jaw was deviating on one side due to muscle pull on closure. I made the training flange in such a way that she could close in proper midline. For the first time two blade-vent implants were placed in the remaining irradiated edentulous alveolar bone. A fixed PFM bridge was constructed and cemented to occlude with upper teeth present. She was free of any cancer recurrence because no removable denture was constructed which would have caused recurrence of cancer. This case was published in an American Journal in 1978 where an implant was inserted in a cancer patient. New bone had formed around the implant. In various lectures I had presented that case. Today many titanium implants are placed in cancer patients without fear of any recurrence.

From 1996 to 1998 (2 years) I was invited by the President of Sri Lanka Dental Association to start Implant Therapy for the first time in Sri Lanka. Dr. Ratnayake along with the PERADENIYA University made a program where I put in dental implants in her clinic patients in front of dental surgeons of Colombo. I treated 52 patients with Implant Fixtures with fixed bridges and crowns on them. I was given a temporary Registered License to treat dental patients in Colombo. I visited Sri Lanka 10 times to complete these cases in Colombo and followed them up successfully. Believe me that was a big Challenge. While I was in the U.S.A. for 7 years I was teaching and reading a lot about basic principles of Bone Biology. This helped me immensely in Clinical Cases from India.

Another interesting case is of “Ectodermal Dysplasia”. The patient was a young American boy who was 15 years old and had a “Bird Face” appearance and was treated having no teeth in the lower jaw and four teeth in the upper jaw, four incisors only. I placed six Blade-Vent Implants in the lower jaw where the bone was underdeveloped. After 15 years he came back to Bombay with his father to tell me that he is a well-known singer and because of his Endosseous implant the alveolar bones had developed. Those days many Americans resided in Tarapore for building Tarapore Atomic Energy plant under General Electric and Bachtel India companies. That was in the seventies & eighties.

To conclude I humbly say that I was lucky to fulfill my mission in promoting good dental treatment to not only my patients but to many patients that are treated by my students all over India and abroad.

I was successful in getting big names in Oral Implantology. Drs. Charles Weis, Gerald Niznick of Basket Implants, Carl Misch, Kenneth Judy, Leonard Linkow of Blade Implants, Krishan Kapur, Deporter of “Endopore Implants”, Don Seok Song of South Korea, Jean Mark Juilet, Hilt Tatum of Sinus Lift, Summers, Lo Bello, Feni Roumelioti Margarity, Branemark of Nobel Biocare, Vincent Morgan of a unique implant system “BICON”, and many others.

In the end I cannot forget my clinic team which consists of Dr. Jayashree.V. Dikshit, Mr. Kiran.G. Naik, my Secretary Ms. Benafsha H Merchant and other secretaries as without them I could not have survived in my dental practice for the last 60 years at the same place at Breach Candy Dental Clinic.

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