Eur Arch Otorhinolaryngol (2016) 273:1329–1330 DOI 10.1007/s00405-015-3829-9
LETTER TO THE EDITOR
Bra˚nemark’s legacy Andrea Corrado Profeta1,2
Received: 11 August 2015 / Accepted: 29 October 2015 / Published online: 6 November 2015 Ó Springer-Verlag Berlin Heidelberg 2015
Research, in its most traditional sense, has been considered a task belonging exclusively to university environments. This perspective has essentially labeled academic knowledge as theoretical, out of context with professional practice, and too systematic and rigid to be adapted to daily clinical problems or offer solutions in the professional context. At conceptual level, problems and interests within the academic knowledge sector have seemed far from those defined by the sector of professional knowledge. Academic researchers define objects of study and use methods, which have been unknown or not adequately understood by practicing professionals. Likewise, professional knowledge, constructed ‘‘in situ’’, has been considered more important by professionals than that generated by the academic community even if those who carry out research in their applied professional context are still few. Meanwhile, theoretical and practical evidence continues to show, rather consistently, that in professional practice nothing can take the place of research as an exercise in reflection to address the descriptive analysis of problems, evaluation of their characteristics, intervention for their resolution, and assessment to determine the effectiveness & Andrea Corrado Profeta andrea.profeta@kcl.ac.uk 1
Biomaterials Science, Biomimetics and Biophotonics (B3) Research Group, Department of Restorative Dentistry, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, Great Maze Pond, London SE1 9RT, England, UK
2
Guy’s and St Thomas’s Hospital NHS Foundation Trust, Department of Oral and Maxillofacial Surgery, Floor 23, Tower Wing, Guy’s Dental Hospital, Great Maze Pond, London SE1 9RT, England, UK
or appropriateness of the process undertaken. Furthermore, the reflection process contributed by the filter of practice is extremely valuable for empirical validation. Not infrequently, advancements in medicine are initiated by the ideas and work of independents rather than by grant supported university-based research. An example is represented by the studies of Per-Ingvar Bra˚nemark, a researcher and clinician who dedicated his life to opening up and pushing back the boundaries of the implantology field. His name is today synonymous with osseointegration and a vast body of research that reaches back over decades [1]. Bra˚nemark’s initial research focus was on how blood affects bone healing, this led him to a serendipitous discovery that when optical devices encased in titanium were placed into the lower legs of rabbits, the titanium fused with the bone and could not be removed. He saw the possibilities, if well tolerated by the body over lengthy periods of time, for permanent dental replacements using titanium. Under Bra˚nemark’s leadership, surgeons developed techniques to show the greatest possible degree of respect to living bone tissues during implant insertion. At the same time, scientist studied the metal’s surface and how the design of the implant might have an effect on bone healing and growth. His technique was first applied in the edentulous mandible, before encompassing the maxilla and going on to develop treatment methods to manage partial edentulism with implant-supported prostheses. It was many decades, however, before the principle of osseointegration gained acceptance by the medical community, but once established it proved to be a springboard for a broader range of applications within the body [2]. What more than 50 years ago seemed a pure casual finding and just a fashionable topic for discussion, has
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today received support from a great number of studies and has been rigorously documented [3, 4]. Countless patients continue to benefit from Bra˚nemark’s groundbreaking work that has been taken up by researchers and clinicians all over the world. Some Bra˚nemark-inspired research teams now focus on trying to better understand how the processes of healing and immune defense interact [5]. Others concentrate on the surface structure and chemistry of titanium implants, in attempts to tweak the surface properties just enough to give the body an even better chance for rapid and safe healing [6]. The remarkable nature of his research should inspire future interprofessional approaches as we continue our efforts to make a difference in understanding diseases, restoring function and enhancing health. Compliance with ethical standards Conflict of interest The author has nothing to disclose. The author reports no conflicts of interest related to this study.
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References 1. Tjellstro¨m A (2015) The father of Osseointegration and the godfather of the BAHA: Professor Per-Ingvar Bra˚nemark, Go¨teborg Sweden has passed away in his 86th year. Eur Arch Otorhinolaryngol 272:779–780 2. Wiggins A, Austerberry R, Morrison D, Ho KM, Honeybul S (2013) Cranioplasty with custom-made titanium plate—–14 years experience. Neurosurgery. 72:248–256 (discussion 56) 3. Moraschini V, Poubel LA, Ferreira VF, Barboza Edos S (2015) Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg 44:377–388 4. Moraschini V, Velloso G, Luz D, Porto Barboza E (2015) Implant survival rates, marginal bone level changes, and complications in full-mouth rehabilitation with flapless computer-guided surgery: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 44:892–901 5. Joos U, Wiesmann HP, Szuwart T, Meyer U (2006) Mineralization at the interface of implants. Int J Oral Maxillofac Surg 35:783–790 6. Goiato MC, dos Santos DM, Santiago JF Jr, Moreno A, Pellizzer EP (2014) Longevity of dental implants in type IV bone: a systematic review. Int J Oral Maxillofac Surg 43:1108–1116