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A 44-year success story

by: Christer Dagnelid

Sven Johansson has had oral implants longer than anyone else on Earth.

Longevity comes from careful planning, quality products and treatment, and conscientious follow-up.

Gösta Larsson of Gothenburg, Sweden, was the first patient to be treated with implants by Professor Per-Ingvar Brånemark. That was in 1965. When Larsson passed away in 2006, he had had his implants— still in place and fully functioning— for more than forty years.

Brånemark’s second patient, Sven Johansson, also of Gothenburg, received his implants in 1967. This year will mark the 45th anniversary of his treatment, which makes him a part of living history in the field of osseointegration. Sven’s missing dentition was restored with two full-arch gold/ acrylic bridges supported by a total of 11 Brånemark System implants in the upper and lower jaw. Further developed by Nobel Biocare, this signature system is still widely used and much appreciated today.

All too common story

Like so many other members of his generation, Sven had had problems with his teeth from an early age. Born in 1925, by the time he was in his 40s, he was completely edentulous. The usual prosthetic solution at that time—the 1960s—was treatment with full dentures.

Dentures didn’t suit Sven well, however, and he experienced major problems in his relationships to other people as a result.As with so many other denture wearers, he had difficulty eating and he felt insecure in many common social situations.

At the time, Sven was a cab owner and driver in Mölndal, a small town on the outskirts of Gothenburg. One day he received a call to drive a patient to the Brånemark Clinic, which was located there, and the passenger turned out to be none other than Gösta Larsson—Patient No. 1—who had not only been the first to be treated with Brånemark System implants, but had also been treated in both jaws.

Gösta Larsson spoke highly of the professionalism of the people he had met at the clinic, the care he had received there, and the dramatic change he had seen in his life because of the results. His driver, Sven Johansson, decided immediately to book a consultation. After careful X-ray examinations, a thorough evaluation of the amount of remaining jawbone and a psychological exam, Sven was deemed suitable for treatment.

A bold decision paid off

Sven, by nature, is a brave soul. When he decided to subject himself to implant surgery, it had only been carried out once before, after all. When I asked him at a routine check-up this December if he hadn’t been anxious about submitting to the procedure, he simply shook his head and replied, “Not at all!” As it turned out, he had no reason to worry, of course. Always a man of few words, he explained succinctly, “The surgeries went very well. I had no problems.”

Before 1967 came to an end, Sven felt secure once again in social situations that he had tried to avoid ever since becoming edentulous.

His diet improved too. Sven had dreamed for years of once again being able to take a bite out of a large green apple, and that dream came true before the new year as well. In Sven’s own words, “Everything worked perfectly from the first moment.”

In 1976, I took over Professor Brånemark’s dental practice in Mölndal, and thus inherited Sven Johansson as a patient. A good patient, Sven has rarely missed a regularly scheduled dental check-up throughout the 44+ years his implants have been in place. He has practiced good oral hygiene and problems such as peri-implantitis have never been a concern.

Prerequisites for longevity

From our side, as dentists, it is essential to create the conditions for good oral hygiene through the proper design of bone-anchored prosthetic reconstructions. Well-designed occlusion and articulation are also important prerequisites for optimal loading of the implants and essential for implant longevity.

Sven, and thousands of other patients since Sven was first treated, have received instructions in good oral hygiene practices by my wife, Dental Hygienist Eva Dagnelid. From the moment he first received his Brånemark System implants, Sven has never missed a booked recall visit and he has conscientiously followed the oral hygiene advice that we’ve given him.

To ensure longevity, it is also a good idea to follow up every implant patient in an individualized recall program. In as much as the implant treatment amounts to a major investment for the patient, our objective is uncompromising: “Life-long service.”

Over the last 30 years, I have participated in and performed thousands of Brånemark System dental implant cases. High-quality products, skilled clinicians, good teamwork and an individualized recall system have led to great success and implant longevity for me, my colleagues and— most importantly—for our patients.

The experience we have gained since Gösta Larsson and Sven Johansson were first treated by Professor Brånemark has taught us that good implant-related dental care must be based on a long-standing relationship between the patient and dentist, where the number and frequency of return visits are tailored to the different stages of life.

I take my hat off to Sven Johansson, who is rapidly approaching 90, and Professor Per-Ingvar Brånemark. Through a combination of boldness and insight they have helped millions of orally handicapped people return to a life of dignity over the last half-acentury.