The History of Prosthodontics

Photos: Wellcome Collection

Etruscan prosthetic appliance intended to avoid the bad effects of convergence, or, perhaps to support a purely ornamental artificial substitute. In the Museum of Conte Brushi at Cornet.o

Etruscan appliance for supporting three artificial teeth.

Ancient Beginnings

2000 BCE: The Etruscans in Italy were among the first to create dental prosthetics using gold bands and animal teeth.

700 BCE: Early dentures and bridges were made by carving ivory or using human or animal teeth.

Classical Era

The Romans and Egyptians crafted rudimentary bridges and crowns from precious metals.

Galen (129–216 CE) provided descriptions of tooth anatomy, aiding future developments.

Galen. Line engraving.

Galen of Pergamon (129–216 CE), a prominent Greek physician and anatomist, made significant contributions to the understanding of human anatomy, including detailed observations of dental structures.

Contributions to Dental Anatomy:

Classification of Teeth: Galen identified three distinct types of teeth: incisors, canines, and molars. He described incisors as wide and sharp, suitable for cutting food, with four located at the front of each jaw. Canines, named for their resemblance to dog teeth, were noted to be fewer in number, with one on each side of the jaws. Molars were recognized for their grinding function, though Galen did not distinguish between molars and premolars.

Tooth Development: Galen posited that tooth formation begins in utero and continues postnatally, completing after the skull bones have formed. He believed that teeth were the only innervated hard tissues in the body, a perspective that underscores the complexity he attributed to dental structures.

Functional Anatomy: In his exploration of the digestive system, Galen emphasized the role of teeth in mechanical digestion, noting that they break down food into smaller pieces, aided by saliva, to facilitate further digestion.

Medieval and Renaissance Periods (500–1700 CE)

Dentistry was intertwined with general medicine. Prosthetic teeth were made of materials like bone, ivory, or human teeth.

Ambroise Paré (1510–1590): A French surgeon, Paré designed obturators (early maxillofacial prostheses) for patients with palatal defects.

Ambrose Pare

Ambroise Paré (1510–1590), a distinguished French barber-surgeon, is often regarded as the father of modern surgery. His extensive contributions spanned various medical fields, including dentistry, where he introduced innovative techniques and instruments that significantly advanced dental care during the Renaissance.

Contributions to Dentistry:

Dental Prosthetics: Paré was among the early practitioners to design and implement dental prostheses. He crafted dentures and artificial teeth to replace lost dentition, enhancing both function and aesthetics for patients.

Innovative Dental Instruments: He developed specialized tools for dental procedures, such as tooth extractors and scalers, facilitating more effective and less painful treatments.

Surgical Techniques: Paré's expertise in surgery extended to dental care, where he applied his knowledge to treat oral and maxillofacial conditions, laying the groundwork for modern oral surgery practices.

18th Century

Advancements in materials like porcelain revolutionized denture making.

Pierre Fauchard: In addition to periodontal contributions, he improved denture design by introducing springs and metal bases.

19th Century

Vulcanized rubber replaced ivory and bone as a base material for dentures, making them more affordable.

The invention of dental amalgam provided reliable fillings for decayed teeth.

Teaching Methods to Maintain Their Cleanliness and Health, Enhance Their Appearance, Restore Lost Teeth, Treat Their Diseases, Address Gum Ailments, and Manage Issues Affecting the Surrounding Areas of the Mouth... BY Pierre Fauchard. Fauchard, Pierre, 1678-1761.

20th Century

1920s–1940s: Prosthodontics was formally recognized as a dental specialty. The American College of Prosthodontists (ACP) was established in 1970.

Advances in materials, like acrylic resins and ceramics, enhanced aesthetics and durability.

Introduction of osseointegration by Per-Ingvar Brånemark in the 1950s revolutionized dental implants, providing a permanent solution for tooth loss.

21st Century

CAD/CAM technology, 3D printing, and digital impressions transformed prosthodontic practices.

Biocompatible materials like zirconia and advancements in implantology continue to push boundaries.

Esthetic and functional rehabilitation now incorporates interdisciplinary approaches, combining prosthodontics with periodontics, orthodontics, and oral surgery.