30/04/2026
George Zarb was an acquaintance of my father’s in Toronto. They were linked, among other things, by the Italian language: Zarb was Maltese, and my father was one of the first Italian doctors in Toronto in the early 1950s.
What I think is often missed in the history of implant dentistry is that Zarb was not simply a later collaborator of Brånemark. Before that collaboration, after his Fulbright scholarship in Chicago and once he became a professor of prosthetics at the University of Toronto, he was already working with Canadian grants on one of the great unsolved problems of the time: how to attach full dentures reliably to bone.
This was still a period of trial and error. Different materials, screws, fixtures, and implant designs were being tested. Some worked partially, many did not. Surgical steel and other materials could sometimes give moderate results, but predictability was poor, often below what would be acceptable today. It was similar to what was happening in orthopedics at the time with early knee and hip replacements: there was progress, but the biological principles were not yet fully understood.
Then came Brånemark’s discovery of osseointegration, and that changed everything. The breakthrough was not simply a new screw or a new material, but a new biological concept: the possibility that bone could truly integrate with commercially pure titanium under the right conditions.
George Zarb’s importance was that he helped translate that discovery into clinical reality, especially in North America. He contributed to the prosthetic protocols, the treatment planning, the academic validation, the long-term clinical documentation, and the training of generations of dentists and specialists. In many ways, Toronto became one of the places where implant dentistry moved from experimental treatment to predictable therapy.
One thing I have always found remarkable is that, years later, when Zarb received one of Canada’s highest civilian honors, he was asked why, after working with the Brånemark system and contributing so much to its development, he never went on to create or promote another implant system.
His answer was essentially: because it was already perfect.
That statement says a lot. It was not a lack of ambition. It was the recognition that the fundamental problem had already been solved. Of course, implant dentistry has evolved enormously since then: surface treatments, internal connections, platform switching, immediate loading, digital workflows, guided surgery, short implants, narrow implants, and many other refinements.
But these are refinements. The basic principle remains the same: a threaded titanium implant, placed according to biological rules, relying on osseointegration.
And when we look today at how many implant companies still produce designs that are, in many ways, very close to the original Brånemark implant, I think George Zarb was right. The core idea was already there, and it was extraordinarily powerful.
For me, this history is not only professional. It is also personal. Through my father’s acquaintance with George Zarb, I feel connected to a remarkable moment in dentistry, when a scientific discovery, clinical discipline, and academic courage came together to change the lives of millions of patients.
