History of dentistry
The history of dentistry or the history of dentistry encompasses the developments in dentistry including the contributions of people who influenced dentistry of their time. It is part of medical history and goes back to prehistory . The conservative treatment of teeth was established in a 14,000 year old male from the rock cave of Riparo Villabruna near Sovramonte in northern Italy, and also for the period around 5500 to 7000 BC. With farmers in Pakistan . Carious teeth were precisely drilled open , possibly combined with a subsequent filling of the cavity. Also from the Neolithic Age comes a molar tooth from Denmark that was trepanated . The first dental work was done in the middle of the 1st millennium BC. Made by Etruscans and Phoenicians . The influence of Roman and Greek scholars was decisive in the Middle Ages in both Christian and Arab countries. The Arabic knowledge, along with many ancient ones, came through the translation school in Toledo and via Salerno to the occidental region, where dentistry was practiced by the barbers .
From the Sumerians to modern times, the belief that a toothworm is the cause of tooth decay has persisted. Science laid the foundation for modern dentistry at the beginning of the 18th century, primarily through the French Pierre Fauchard . From the 19th century, dental treatment under anesthesia was carried out with nitrous oxide , which was synthesized as early as 1776. Ether and chloroform anesthesia followed the nitrous oxide. The US dentist William Thomas Green Morton was able to relieve a patient of their suffering for the first time without pain.
In November 1895, Wilhelm Conrad Röntgen discovered the X-rays , later named after him , which simplified the examination of the jaw. The local anesthetic procaine was developed in 1905 by the German chemists Alfred Einhorn and Emil Uhlfelder , who assigned the active ingredient the name novocaine (Latin word for "new cocaine") as a local anesthetic for toothache . This laid the foundations for modern diagnostics and therapy. Dentistry then experienced rapid progress: from the development of numerous oral surgical procedures to the manufacture of dentures using CAD / CAM processes. In parallel with the progress of scientific dentistry, the job description developed, which is represented in the history of the dental profession . In addition, animal dentistry developed, which uses modified methods of general dentistry.
The Danish Hedvig Lidforss Strömgren (1877–1967) and the German Walter Hoffmann-Axthelm are among the most important researchers on the history of dentistry .
Preliminary remark
The history of medicine (including that of dentistry, also called dentistry and outdated dental art ) is researched using historical and sometimes ethnological methods. The main sources used are medical texts, medical records, historiography or diaries, letters, literary texts and ethnographic records and interviews. The examination of human remains and ancient pathogens does not fall into the methodology of medical history, but rather paleopathology , but is considered for the sake of completeness.
prehistory
For a long time it was believed that because of diet, hunters and gatherers were not affected by tooth decay . From the Middle Paleolithic of Europe and Western Asia, i.e. the time of the Neanderthals , hardly any cases of tooth decay are known, if so as a result of a diet-related enamel fracture . In September 2013, however, the results of investigations on 52 skeletons in the Grotto des Pigeons in eastern Morocco from 15,000 to 13,700 years ago were published, which shows that these hunters and gatherers were already suffering from tooth decay. This is in contrast to the previous assumption that this dental disease only arose through the consumption of carbohydrates from grain production , i.e. only in the Neolithic Age. Apparently this goes back to acorns of the holm oak , pine nuts of the maritime pine and pistachios of the turpentine pistachio . In view of the widespread, probably ritual removal of the anterior teeth , it is all the more surprising that there was no evidence of the removal of carious teeth, even if painful abscesses had developed.
In 2015, a carious molar tooth of a 14,000-year-old male was examined, the remains of which were found in 1988 in the rock cave of Riparo Villabruna near Sovramonte in northern Italy. The results show that the hole in the tooth was machined with a very small, pointed stone blade to remove infected tissue. Until then, dental treatments were known about 7,500 to 9,000 years ago in today's Pakistan , as evidenced by finds in Mehrgarh ( Balochistan ), one of the most important archaeological sites for a prehistoric settlement group in South Asia . The residents appear to have been skilled jewelry makers and also used their skills to drill small carious cavities with stone tools such as those used to make pearl necklaces. The reconstruction of the origins of dentistry shows that the methods of treatment of the time were apparently very effective. The earliest tooth filling made from beeswax was discovered in Slovenia and is around 6,500 years old. A fractured canine was restored with it.
Very early evidence is also available for trephination : During excavations in Denmark, an approximately 5000 year old trepanned molar (molar) was found.
Finds from Italy and Tunisia prove tooth removal in the early Mediterranean region. Apparently, teeth were removed frequently, at least in every third adult woman. However, since there are no other traces of violence in the facial area, this was probably due to cosmetic, ritual or social reasons, such as status reasons. The distance may have been related to growing up. The presumption of a ritual function is suggested by ethnological comparisons. Ritual tooth extraction was common among many Australian Aboriginal tribes . The Himba people living in Namibia and the Surma people from Ethiopia had the custom of breaking out the lower four incisors of children between the ages of seven and nine. Originally, this “gap” was supposed to serve as a counter bearing for a lip plug or a disc. Both African tribes have a cultural element in common, which can be explained by their common descent from the Herero , an East African, semi-nomadic people.
The development of ideas about the development of tooth decay
Medicinal belief in the toothworm
A Sumerian text from around 5000 BC. BC, so claimed Suddick and Harris 1990, describes the toothworm as the cause of tooth decay for the first time . The authors misinterpret a publication by Hermann Prinz from 1945. If one follows Astrid Hubmann's dissertation, it becomes apparent that four sources, the oldest from around 1800 BC. BC dates to prove the belief in the toothworm. It is a sheet of Nippur .
A plaque discovered at Assur suggests that toothworm and toothache were treated differently, which could suggest an understanding of them as different diseases. From the library of the Assyrian king Assurbanipal (669–631 / 627 BC) comes the work of a Nabunadinirbu, which is entitled When a person has a toothache . Possibly it is a copy of a considerably older Babylonian text in which, in addition to the description of a treatment, a ritual incantation is of particular importance. In this, the worm, probably a demon or evil spirit, rejects the gifts of the highest god Anu , namely ripe figs , apricot and apple juice, and prefers the blood of the teeth.
In the scriptures it says: “When Anu created heaven, heaven created earth,… the swamp created the worm, then the worm went crying to Shamash (the sun god)… Lift me up and let me dwell between teeth and gums! I want to drink the blood of the teeth, I want to eat the roots of the gums! ”Then follows an incantation which is supposed to banish the“ demon toothworm ”:“ Because you said this, worm, may the god Ea strike you with his strong hand! “This text has to be spoken three times. Then a pain-relieving mixture of different herbs is placed on or in the tooth. The personal physician of the Roman emperor Claudius , Scribonius Largus, recommended in the 1st century AD to kill the toothworm by smoking it with the narcotic black henbane ( Hyoscyamus niger ). He describes his experiences here: "Sometimes something that looks like small worms is brought out."
Other recommendations were to mix emmer mixed beer, broken malt and sesame oil and apply to the affected tooth. Basically, it was believed that worms could emerge from rotten juices anywhere in the body. Since ancient times it has been believed that an imbalance of the four body fluids - blood (sanguis), mucus (phlegma), yellow bile (cholera or chole, Greek: χολή), black bile (melancholia, from Greek melanos and chole: μέλανος , χολή) - would cause diseases. In order to cure a patient, one had to remove excess or spoiled juices. This happened, for example, by bloodletting , sweating, urine and stool regulating agents. The doctrine of the juices represented a substantial advance over earlier views, which had seen man's condition as determined by the gods alone. With the humoral pathology , the ancient doctors began to systematically describe the specific tendencies towards illness.
Also in ancient India (around 650), in Egypt - here it is the papyrus Anastasi IV , 13, 7 (around 1400 or around 1200/1100 BC) - as in Japan and China , a sick tooth was a "worm tooth" , but also among the Aztecs - there, for example, tobacco was put into the cavity - and the Maya , indications were found that the toothworm was the cause of tooth decay. The legend of the toothworm can also be found in the writings of Homer, and in the 14th century the surgeon Guy de Chauliac believed that worms caused tooth decay.
The Compositiones medicamentorum by Scribonius Largus , the personal physician of Emperor Claudius , had a strong influence in the Old World . For the treatment he recommended Zahnräucherungen and conditioners, as well as deposits and chew and fumigation with henbane seeds , which for this reason as herba dentaria were called. He indicates that some worms are sometimes spit out during treatment. So people continued to believe in the worm, but also tried to accelerate the falling out of diseased teeth by laying on worms. Pliny the Elder, however, did not believe in the existence of the toothworm, but in a similar healing effect. Pliny also mentions the ingredients of the tooth cleaning powder he recommends called "Dentifricium" (ὀδοντότριμμα): powdered or burned bones , horn or mussel shells , pumice powder , soda , mixed with myrrh . Celsus, on the other hand, recommended ground salt. Tooth salt is still used today, especially in Asia.
In the Arabic-speaking world, toothworms were believed to be based on older traditions. This is shown by the work of Muhammad ibn Zakarīyā ar-Rāzī , who saw the relationship between body and soul as determined by the soul, as well as the works of Avicenna or Abulcasis . ʽ Umar ad-Dimašqi , who taught in Damascus around 1200 , rejected the toothworm, especially the charlatanry carried on with worms , in his book The Chosen One about revealing secrets and tearing the veil .
Around this time, Hildegard von Bingen (1098–1179) also believed in worms, but recognized poor hygiene as the cause. The purpose of rinsing with water was to avoid the livor , a deposit that could settle around the tooth and produce the dreaded worms. She recommended aloe and myrrh and coal smoke. Constantinus Africanus , who came to Salerno from Tunisia , made the medical university there famous in the early 11th century. He brought ancient knowledge and also the theory of humours to the north, but also confirmed the tooth worm, which had also found its way into conventional medical works. For example, in the tract Practica brevis by Johannes Platearius from Salerno, written in the 12th century, which describes the (humoral pathological) causes and therapeutic options for toothache, but also the toothworm, the development of which he attributes to the putrefaction of juices in holes in molars and its treatment he recommends centaury juice, myrrh and opium as a topping or as an awl, and henbane smoke. Medieval dentistry reports on the use of frog fat to allegedly facilitate tooth removal by Petrus Hispanus and John of Gaddesden (1280–1348 / 49 or 1361), writings on rubbing in with milkweed for toothache or the recommendation of earthworm oil by Arnaldus de Villanova (~ 1235-1311). The famous West Flemish surgeon Jan Yperman (1269/65 to around 1350) also explained the pus formation that occasionally occurs in diseased teeth with the movement of worms. Sometimes charlatans took over the worm theory. For example, they hid earthworms in food that the pain-afflicted person was supposed to suck to "numb" them. They then removed the worm that had emerged from their mouths to the applause of the amazed crowd.
Scientific theories
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It was not until the 19th century that various theories about the development of tooth decay were developed that replaced the ideas based on humoral pathology . In 1843 the worm theory was developed into a parasite theory by the Munich anatomist Michael Pius Erdl (1815–1848) . It was followed by the inflammation theory according to Leonhard Koecker or special metabolic products of the chemical conversion of food components were made responsible for the development of caries. In 1825, London dentist Andrew Clark saw dental disease as a result of the diet of wealthy people and concluded that simpler people who were used to a hard life usually had healthy, caries-free teeth.
The American Willoughby D. Miller (1890), who during his thirty years of activity in Germany also received bacteriological training from Robert Koch (1843–1910) at Berlin University , developed the "chemoparasitic theory", according to which lactic acid bacteria continued into the 1960s Years were seen as the cause. Miller was president of the Central Association of German Dentists (CVdZ) for six years . At the 4th International Meeting of Dentists in St. Louis in 1904, he was elected President of the Fédération Dentaire Internationale . The Miller needle he developed , a probe used in dentistry to find and probe root canals, is named after him. His saying went down in history: “ A clean tooth never decays. ”(Loosely translated:“ A clean tooth doesn't get sick. ”) Paul Keyes finally discovered in 1960 that Streptococcus mutans is the cause of caries.
The most diverse theories followed one after the other:
- the "tooth lymph theory" (Charles F. Bodecker, 1929)
- the " proteolysis theory" ( Bernhard Gottlieb , 1944)
- the "ulciphilia theory" (Sten Forshufvud, 1950)
- the "organotropic caries theory" (Charles Leimgruber, 1951)
- the "resistance theory" (Adolph Knappwost, 1952)
- the "Corrosion Theory" (Ulrich Rheinwald, 1956)
- the "pulp phosphatase theory" (Julius Csernyei, 1956)
- the "glycogen theory" (Peter Egyedi, 1956)
- the "non-acidic caries theory" (Halfdan Eggers-Lura, 1962)
- the "proteolysis- chelation theory" (Albert Schatz and Joseph J. Martin, 1962)
- the "unspecific plaque hypothesis" (Walter Joseph Loesche, 1976), with which the development of periodontitis was also discussed
- the "specific plaque hypothesis", (RC Page, HE Schroeder, 1976)
Ecological plaque hypothesis
Only subsequently was made a paradigm shift by Philip D. Marsh (1994), which led to the "ecological plaque hypothesis." Due to several pathogenic factors, the hard tooth tissue is destroyed in several stages: A continuous availability of fermentable carbohydrates , which leads to a permanently lowered pH value , is the driving force behind the destruction of a bacterial homeostasis of plaque (dental plaque). The acidic environment stimulates the reproduction of acid-producing and acid-tolerant germs such as mutans streptococci and lactobacilli . There is also an interaction between Streptococcus mutans and the fungus Candida albicans , which causes the bacterium to change its virulence . The fungus produces signaling molecules that stimulate the bacterium's genes to produce antibiotics in the cell . The bacterium can absorb foreign genetic material through the fungus.
By the end of the 20th century, however, the belief in the toothworm as the cause of pain was preserved in rural areas of China and was exploited by many quacks . Three of these scams from 1985, 1987 and 1993 are also reported in Taiwan.
If the macroscopic "toothworm" is ridiculed in modern times, the bacteria and fungi undoubtedly appear worm-like in modern microscopes .
Early dentistry
Orient
Predynastics :
3 periapical granuloma
Macedonian period :
2 abrasion teeth
Roman period :
5 osteolysis
Coptic period :
1 palatal perforation, 4 cyst
The first dentist known by name in world history (and at the same time a doctor) is said to have been Hesire in ancient Egypt (around 2700 BC), who was honored with the title wr-ibḥ-swnw as "the great of dentists and doctors". A basalt statue of Psammetich-Seneb (around 600 BC) in the Vatican Museum shows that he was called the "chief physician of the dentists at court". However, his title as a doctor is just one of his many titles and may have been symbolic rather than practical. The translation of the title is also not certain, alternatives such as “the great ivory and arrow carver” have been suggested.
The Ebers papyrus , a medical papyrus from ancient Egypt, describes around 1600 BC. In addition to the Edwin Smith papyrus (1550 BC), which is one of the oldest surviving texts on medical topics, measures for the treatment of various dental diseases, in particular caries and periodontitis . It is believed that the Smith Papyrus is just a copy of a script that is at least 1,000 years older. The Smith Papyrus describes the treatment of mandibular fractures by means of manual reduction and a subsequent splint. With numerous archaeological finds, one can assume that some of the measures to be assessed as “therapy” took place post mortem as part of the mummification , as Egyptians placed great value on moving into the Osiris realm as intact as possible .
The grain was ground with stone mills . The bread was stained with stone grains. The teeth were chewed off by this and by the rough food. The tooth was partially ground down to the pulp . Cariogenic bacteria did the rest and the tooth became infected. Tooth extractions (tooth removals) were the exception. Stone flour , resins , malachite and plant seeds were used as tooth filling .
Dentistry is not mentioned in the Torah , but parts of the mouth are also mentioned in the context of the explanations in the 3rd book of Moses on anatomy . In a remarkable passage, the salivary glands are compared with water sources and the salivary duct is described as “duct (Ammat ha-mayim) that runs under the tongue” (Lev R. 16: 4.). This is interesting insofar as the salivary ducts of the salivary glands were not exactly described in the scientific literature until the 16th and 17th centuries (Lehi; Ar 15b). The position of the tongue (lashon) is described, which would lie between two “walls” made up of the jawbone (leset) and the cheek flesh.
Toothbrushes
In ancient times, dental hygiene began using twigs that were chewed with fibers, such as the miswāk , which was used as a toothbrush . The branch from the toothbrush tree ( Salvador persica ) contains cleaning agents, disinfectants and even fluoride . It was found in the ancient Indian collection of medical knowledge of the surgeon Sushruta (सुश्रुत, Suśruta) around 500 BC. Recommended. In addition, Sushruta is considered a pioneer of anesthesia , which he carried out with cannabis indica , among other things . Miswāk is also mentioned in the ancient Indian code of Manu ( Sanskrit , f., मनुस्मृति, manusmṛti ) at the turn of the ages. In the Islamic world, Mohammed is said to have used it regularly, according to the hadith literature . Also from other wood brushing rods were made, so in the Western Sahara , the Maerua crassifolia (from the family of capparaceae ). In Mauritania he is called (in the Arabic dialect Hassania ) as atīle . The toothbrush tree is called tiǧṭaīye there , and in this region the Commiphora africana from the balsam tree family , adreṣaīe and desert date ( Balanites aegyptiaca , in Hassania: tišṭāye ) are used to clean teeth. In southern Burkina Faso , teeth are cleaned with Zanthoxylum zanthoxyloides . In India, branches of the neem tree are used to brush teeth. In addition to toothbrushes, toothpicks have also been used since ancient times .
Greeks and Romans
Greek scholars such as Hippocrates (around 460-370 BC) and Apollonios von Kition (In: Περὶ ἄρθρων ( Perì árthrōn )) described the dentition (tooth eruption ). Hippocrates suggested head and chin bandages made of leather for jaw fractures and the fixation of the teeth adjacent to the fracture gap with gold wire. At the end of the 5th century, the Corpus Hippocraticum also mentions the removal of loose teeth for dental pain therapy.
Around 450 BC A commission in Rome was commissioned to draw up a constitution known as the Twelve Tables Act . There it says in Plate X , “One should not add gold to 'the corpse'. But anyone who has dentures on the basis of gold wire bandages, with which missing teeth are attached to the neighboring teeth by human or animal teeth with gold wire or gold bands, should not be an offense to bury or burn them, ”from which it can be deduced that back then Dentures were already widespread.
In Martial's epigrams (40–102 / 104), dentures are also mentioned: Sic dentata sibi videtur Aegle emptis ossibus indicoque cornu (“This is how Aegle sees himself toothed, thanks to purchased bones made from Indian horn.”) In the Roman Empire they were used So already the ivory ("Indian horn") for the production of artificial teeth.
Dental practitioners in ancient Rome were mostly Greek slaves who, with successful treatment, that is, pain-relieving treatment, were able to achieve their freedom and even rise up socially. Investigations of the remains of Romans demonstrated attempts in dental prosthetics and oral surgery . The importance of the teeth with the Romans around the turn of the times is shown by votive offerings , which consisted of clay-made dentures, but also by the dental care habits of the Romans, which are strange from today's perspective, who brushed their teeth with their urine.
Aulus Cornelius Celsus , a Roman medical writer, extensively described oral diseases as well as dental treatments including narcotics and astringents . The description of the four signs of inflammation ( rubor, tumor, calor, dolor , Latin: redness, swelling, warming, pain) also goes back to Celsus . In his Latin treatise De Medicina , he summarized the medical knowledge of the Alexandrian school in eight books. A section in the sixth book is devoted to the teeth, and the eighth book also provides initial information on orthodontic treatment .
Pliny the Elder compiled the natural history knowledge in his 37-volume work Naturalis historia and presented it to Emperor Titus in AD 77. In this work he devotes himself to dentistry in 169 scattered places. He also describes the dentition including its deviations, but these are not examined for their cause, but interpreted. Infants born with broken teeth were of particular importance. The spectators of the Valeria Messalina prophesied that she would lead her state to ruin. (The prophecy is said to have been fulfilled in Suessa Pometia ). Agrippina the elder is fortunate because she has two canine teeth ( dog teeth ) at the top right . More than 32 teeth would mean a long life. Pliny describes several dozen tinctures and remedies from the plant, animal and stone kingdoms. The naming of the tooth grates (odontītis) as a remedy for toothache is said to go back to him. He describes a teething aid , a mixture of honey and the ashes of dolphin teeth, various other tinctures or, for example, the teething aid consisting of a wolf's tooth or horse's tooth, which should alleviate teething problems in children through its magic. The history of the pacifier began with the development of artificial baby feeding , like a relief from around 900 BC. Shows from the palace of King Sardanapal of Nineveh . In Europe, pacifiers have been known at least since the Middle Ages, as can be seen from the illustrations. Unhygienic sucking bags were used as fabric pacifiers from the late Middle Ages to the 18th century. They were only replaced by rubber pacifiers in the second half of the 19th century.
From the time of Pliny there is also a description of the treatment of carious teeth and gum disease and how tooth extractions are to be carried out. Aristotle also describes extraction forceps for this purpose . There are also explanations on how to fix loosened teeth with tweezers and thin wires and how to splint jaw fractures .
Archigenes , (Ἀρχιγένης), a Greek military doctor under Trajan , came from Apamea , ( Syria ) and was a representative of a medical school known as the eclectic school. He was the son of Philippos (Φίλιππος) and pupil of Agathinos (Ἀγαθῖνος), the founder of the eclectic school, and developed the drill around 100 AD . After this used as a trephine for boring the skull, he came up with the idea to also have a sore tooth trepan to relieve the inflamed pulp. However, he never got the idea of drilling out carious dentin .
The physician Emperor Marcus Aurelius , Galen of Pergamon (ca. 130-210), attacked the orthodontic idea of Celsus and describes how teeth narrowed by filing and shaping, to reduce crowding. Galenos expanded the four signs of inflammation to include the feature of the functio laesa , the "disturbed function". In his work De ossibus ad tirones , he wrote that the lower jaw consists of two bones, which can be seen from the fact that it falls apart in the middle when cooking. The Arab doctor Abd al-Latif al-Baghdadi had the opportunity to examine the remains of people who had starved to death during a famine in Cairo 1,000 years later. In his book Al-Ifada w-al-Itibar fi al-Umar al Mushahadah w-al-Hawadith al-Muayanah bi Ard Misr (Book of Instruction and Admonition on Seen Things and Recorded Events in the Land of Egypt) he contradicts Galenus that he did can only see the lower jaw as a single, seamless bone. Celsus and Galenus were the authoritative medical writers of the 1st and 2nd centuries AD. Their influence was still decisive in the Middle Ages in both Christian and Arab countries.
Protection and relief through invocation of the saints
Dentistry initially became part of folk medicine and magic again . Toothache was one of the numerous ailments for whose relief and protection individual saints were invoked, who were believed to have a corresponding influence. In many cases, saints were chosen who, according to tradition, had suffered as martyrs from the same parts of the body.
Holy Apollonia
According to tradition, Apollonia of Alexandria , who died a martyr under Emperor Philip Arabs (244-249) , had her teeth torn out with pliers before she threw herself into the stake . Her feast day in the Catholic and Orthodox Churches is February 9th. Pope John XXI. (1276–1277) advised believers to say a prayer to Apollonia if they had a toothache. So she became a protector against toothache, but also the patron saint of dentists and all other professions in the dental field. Apollonia was canonized in 1634 by Pope Urban VII.
Grains of the common peony lined up on chains were called Apollonia grains in southern Germany and given to teething toddlers to chew. In France they were known as Herbe de St. Antoine . Other pain-relieving plants were also given corresponding names, such as the Apollonia root in Salzburgerland as the name for the wolf monkshood , a name that was also found in Bavaria, or the Apollonia herb ( henbane ).
Toothache god
The so-called "Toothache Lord God" from St. Stephen's Cathedral in Vienna is one of the few stone depictions of the Man of Sorrows still preserved in Austria . It was made around 1420 by an unknown artist and shows the half-length figure of Christ clad in an apron with a crown of thorns and wounds. As was customary in cultic veneration at that time, the figure was adorned with flowers that were attached to the head with a cloth. According to legend, three drunken boys saw Christ wearing this cloth and blasphemed that Jesus had a toothache . That same night the three boys themselves got in great pain. It was only when they returned to the cathedral the next day to apologize that their pain disappeared again. Since that time, the "toothache god" has been sought out by numerous Viennese to ask for relief from toothache.
Priests and barbers
In the Middle Ages, after the Migration Period , the level of healers in antiquity had not yet been reached, as demonstrated by a small prosthesis to replace one's own, previously fallen out central incisors , which was found in the Slavic burial ground of Sanzkow (Demmin district).
At the beginning of the Middle Ages, monks and priests performed medical and dental activities. Bader assisted them. The Second Lateran Council in 1139 threatened priests with severe sanctions if they engaged in treating. Pope Alexander III made a far-reaching decision at the Council of Tours in 1163 that bloody interventions were incompatible with the priestly office: Ecclesia abhorret a sanguine ("The Church shrinks from blood"). The Fourth Lateran Council in 1215 finally forbade the medical profession in priestly garb from the practice of surgical measures, because guilt for the death of a person made the priesthood unfit. The medical science of the European Middle Ages then took a development that was only reversed in the 19th century.
The bather (lat. Balnĕator) was the owner or head of a bathing room, also known as the bathhouse . He was authorized to practice minor surgery and to shave. Since not every trained bather could afford a bathing room for financial reasons, a new profession of barbers emerged over time , who basically offered the same range of treatments, but without a bath. The barbers (from French barbe , "beard") were artisans according to their status and profession . Barbers are mentioned for the first time in an official letter from Cologne in 1397. But a relief on St. Mark's Basilica in Venice, which was made as early as the 13th century, shows a tooth extraction performed by a barber. Anything significant about dentistry could only be found in the Latin word for surgeons. the bathers couldn't read that. Superstition, alchemy and astrology therefore dominated the minds of most of the dentatores of the time, who were often not tied to a particular location .
In 1450, according to a decision by Parliament, barbers in England were only allowed to perform bloodletting , pull teeth and care for the hair. Until 1745 the surgeons' associations existed parallel to the barber's associations. By a decision of the British King George II , the associations were separated and the barbers could devote themselves to hair care. The French King Louis XV. made the same decision a few years later.
In 1858 the Odontological Society of Great Britain and then the Institute of Dentists, i.e. the dentists of England, were founded. The dentists Horace Hayden and Chapin A. Harris founded the first dental school in Baltimore (USA) in 1840. In the same year, the important American Society of Dental Surgeons and in 1845 the French Société de Chirurgie dentaire de Paris , whose first president was the Parisian doctor and especially dentist Louis Nicolas Regnart (1780-1847) was. In 1859 the London School of Dentistry was founded. The first exam also took place this year. Registration was introduced for licensed dentists in 1878 and control of those who were not licensed in 1921.
In Belgium , the first statutory provisions governing the practice of dentistry can be established in 1818, including an examination by a Provencial Commission. New regulations followed from 1880. In 1815, only a kind of examination before the medical supervisory authority took place in Sweden. In 1860, the Svenska Tandläkaresellskapet (Swedish Dental Association) was founded in Sweden and in 1885 a polyclinic was created as a teaching institution. Dental treatment in Russia was born around 1760–1770, when the German Obel was one of the first dentists to be awarded the right to practice after an examination at the Medical College in Saint Petersburg . According to a law published in 1810, these foreign specialists had the right to train pupils in a manual manner who, after passing an examination, worked as dentists.
In 1779 the barbers and bathers were united by the German imperial laws. On May 25, 1804, the Danish king issued the “276. Patent for the establishment of a medical college ”. The new Prussian trade legislation abolished the guilds in 1811 and the practice of surgery was separated from the barber trade. As a result, surgery was able to develop independently of the barber / hairdressing trade, especially after freedom of establishment for healers was introduced in 1818.
In Germany, dentistry and other medical-surgical subjects were unworthy of an academically trained doctor. Barbers took over most of the dental care of the population. According to Grosch, the job title Bader was the same in southern Germany as a barber was in northern Germany. However, both guilds could exercise different functions, depending on the region and time period. They gave themselves a wide variety of job titles, such as dental technician, dental artist, dentist, dentist, dental surgeon, dentist licensed in America, doctor, doctor, dentist, specialist for dentists, docent, teacher of modern dental technology, American doctor of dental surgery, Swiss dentist or traded as Atelier for dental operations or dental atelier . Beside them the tooth breakers were out and about at fairs.
The barbers tried to meet the demand for lighter teeth with aqua fortis (nitric acid). However, it should take to 1989, to a method of bleaching ( engl .: Bleeching) to VB Haywood and Heyman by means of hydrogen peroxide (H 2 O 2 found) distribution.
Johann Andreas Eisenbarth (1663–1727), a highly privileged medicus from Magdeburg , “cured” the people in his own way. In Bavaria, such a vagabond doctor, with official permission, drove his mischief until 1772, even longer without permission. In Saxony , under Friedrich August II. (1696–1773), the Collegium medico-chirurgicum was opened in 1748, three years later the first surgical clinic, where a teacher of dentistry was also employed in 1777.
At the beginning of the 18th century, technical terms that had disappeared were in use in modern times. The names for tartar were tartar , Tartarus dentium (after Paracelsus Tartarus , "deposits and concrements") or Odontolithus (Greek: ὀδόντ- odont- "tooth"; λίθος lithos "stone"). When a tooth was "burned out", the tooth pulp was treated with a hot probe. The "filing" of a tooth was used to remove caries from the tooth so that the caries would not spread any further. This created unsightly gaps between the teeth, which were avoided by only filing the teeth distally (backwards) and adding a filling material to the filed teeth. An abscess was opened by “scarifying the gums” ( cupping ) .
In addition to numerous tooth wash, tooth tinctures and JA Rieses's widow tooth wool or Kropp's tooth cotton (20% carvacrol cotton ), the silk plaster with cantharids (Emplastrum mezerei cantharidatum, Drouotisches plaster) against toothache, which had to be worn behind the ear, was offered. To produce it, “30 parts of Spanish fly and 10 parts of daphne bark are soaked for eight days with 100 parts of vinegar ether ; 4 parts of Sandarach , 2 parts of Elemi and 2 parts of rosin are dissolved in the filtered tincture and then spread on taffeta that has previously been coated with a solution of 20 parts of isinglass in 200 parts of water and 50 parts of alcohol ”. In 1895 “ amber tooth pearls for teething children” were offered, which were touted as “more effective than tooth collars”.
On December 1, 1820, the medical college in Kiel issued the fee schedule for all medical professions. Since the barbers were also authorized to pull teeth, they could fall back on the dentists' tax .
Since the beginning of the 19th century, the barbers developed more and more into the profession of hairdresser . With the new journeyman's examination regulations of March 20, 1901, the separation between hair and healing arts took place. The job title “barber” finally disappeared in 1934. However, they were still allowed to pull teeth until the Dentistry Act was passed in 1952.
Recourse to ancient teachings, Arab-Persian influence, new assumptions
The acceptance and revival of ancient notions of illness and treatment methods in Christian Europe took place via Salerno . The school in Salerno, supervised by the Benedictines , was one of the first medical universities in Europe and integrated specialist knowledge from the Arab, Greek, Jewish and Western-Latin cultures. Thus, at the beginning of their appearance, the monasteries took on a social task for the general public, with Constantinus Africanus (1017-1087) being of central importance. He translated Arabic compendia into Latin, making them accessible to scholars. On the one hand, the humoral pathology of antiquity, which attributed toothache to juices flowing downwards, and on the other hand, the idea of a divided lower jaw. Constantinus recommended an arsenic application to combat toothache. The use of arsenic to treat a sore tooth in Chinese healing art is said to have been described by Huang-Ti (黃 鈦) in his work Net Ching as early as 2700 BC . The Chinese knew nine causes of toothache (Chinese: Ya-Tong ) plus seven forms of gum disease. In contrast, they used acupuncture , the technique of which was described on 388 pages, including 26 pages of acupuncture measures for toothache.
In Liber Regius , published in the middle of the 10th century, the Persian doctor Haly Abbas (ʿAli ibn al-ʿAbbās; † 944) also recommended the use of arsenic for devitalization (dying) of the pulp. Arsenic (III) oxide was used until modern times to devitalize the tooth pulp and disappeared from the range of therapies in the 1970s because of its carcinogenic effects, inflammation of the gums , the loss of one or more teeth including necrosis of the surrounding alveolar bone , allergies and symptoms of poisoning.
A few references to the treatment of tooth and gum problems can be found in the greatest Jewish scholar of the Middle Ages, Maimonides (1135 / 38–1202). He could only refer to a few Talmudic passages. One of them forbids a priest ( Kohen ) to worship if he is missing teeth, as such a Kohen is unsightly. At the same time, the importance of teeth from the Bible quote eye for eye becomes clear ( Hebrew : עין תּחת עין ajin tachat ajin), often quoted as "an eye for an eye, a tooth for a tooth". With reference to the Codex Hammurabi , the partial quotation is usually understood to mean that the perpetrator should be rewarded with the same with the same. However, the biblical context of the Torah contradicts this interpretation. According to the predominant rabbinical and historical-critical view, it is about appropriate compensation ( Talion formula ), which is to be paid by the perpetrator in cases of bodily harm . ( "If an eye is lost, replace what is worth to the eye, if a tooth is lost, what is worth to the tooth - eye for eye, tooth for tooth." ). This was intended to contain the blood feud that was widespread in the ancient Orient and to replace it with a proportionality of offense and punishment.
The School of Salerno produced Roger Frugardi , who wrote articles on dentistry, and Gilbertus Anglicus († 1240), who differentiated between two causes of toothache, namely weak teeth and bad juices and food particles between the teeth.
Another region through which Arabic knowledge found its way north was the Toledo School of Translators . The Qānūn fī ṭ-Ṭibb ( Arabic القانون في الطب, Canon of Medicine) of Avicenna as a template for surgeons such as Bruno da Longoburgo , Teodorico Borgognoni or Wilhelm von Saliceto . The term wisdom tooth is derived from Avicenna's translation into Latin as dentes intellectus . The work, of which 15 to 30 Latin editions existed throughout the West in 1470, was considered an important textbook in medicine until the 17th century. In the Arab Empire, ancient Greek scriptures were translated into Arabic and formed the basis of the healing arts, which were supplemented by the rules of the Koran . In Toledo, Saliceto again adopted the treatment methods derived from the prescriptions of the Koran in his translations from Arabic into Latin, which, however, imposed considerable restrictions on anatomy and surgery. The shedding of blood was forbidden in Islam, so developed one bloodless there treatments: caustics were to tooth extraction previously applied to the gum to the tooth by the subsequent inflammation of the periodontal apparatus was loosens enough that it by hand - without bloodshed and thus " “- could remove. This correlated with the above-mentioned edict of Pope Alexander III that bloody interventions were incompatible with the priestly office. However, Bernhard von Gordon warned against appropriate treatment of the front teeth. He also recognized in his Lilium medicinae (around 1303) that chewing on one side led to tartar and plaque formation on the unused side. The fixation of a fractured lower jaw on the intact upper jaw ( intermaxillary fixation ) can also be traced back to Saliceto. It was not until the 19th century that this idea was taken up again and further developed.
Abu l-Qasim (936–1013), known in the West as Albucasis , attests to Kitāb at-Taṣrīf ( Arabic كتاب التصريف) his extensive knowledge and skills in tooth surgery, tooth stabilization with gold and silver wire and in the treatment of gum problems, including dental prophylaxis. Abulcasis perfected many dental instruments, as can be seen from his sketches.
About 500 years later Ambroise Paré (1510–1590) wrote numerous and widespread articles in French, and thus also non-academically trained surgeons and barbers, understandable language on dental treatment. Paré considered the principles that superfluous items had to be removed, a rotten tooth extracted and missing parts replaced (reimplanted) to be important. He developed stabilizing ligatures for jaw fractures, experimented with reattaching chipped teeth and designed simple, fixed dentures. He coined the term "obturator". Obturators were used to close defects in the palate, which were often a result of tertiary syphilis . They were made of leather, silver, ivory, or a sponge attached to a metal holder.
Guy de Chauliac listed various extraction instruments such as levers and forceps in his Chirurgia Magna of 1363, but otherwise referred to Avicenna and Abulcasis. Like him, he mentions the dentures made from bovine bones. He also confirmed that barbers and traveling tooth breakers performed most of the extractions. Despite various other writings, the medieval-ancient tradition lasted until the 18th century.
anatomy
Leonardo da Vinci (1452–1512) made the first modern anatomical drawings of the jaw, teeth and masticatory muscles . He also created sketches for the anatomy of the face and the maxillary sinus. One of the founders of anatomy was Andreas Vesalius , who with his anatomy De humani corporis fabrica libri septem of 1543 questioned the views of the ancient authority Galen of Pergamon. Vesal relied on the dissection of human corpses for his anatomical findings, which founded modern anatomy , while Galen gained his (incorrect) knowledge by dissecting animals. It was through him that the joint ligaments and inter- joint cartilage of the temporomandibular joint were first described . He also discussed the function of the muscles of the face and cheek in great detail, gave an exact anatomy of the tooth roots and was the first to recognize the pulp cavity , but not its function. Bartolomeo Eustachi (1500 / 1513–1574) was the first to examine the first and second dentition in more detail and, in 1550, also described the function of the pulp cavity.
Vesal's successor, Gabriele Falloppio , recognized the morphological independence of the two sets of teeth , who was also the first to name the tooth follicle. The first dental treatise in German, largely independent of other medical disciplines, was published by Walther Hermann Ryff around 1548 in Würzburg.
histology
In the 16th century, in contrast to Vesal and his acquaintances Eustachi and Falloppio , Volcher Coiter no longer interpreted the tooth as bone. In the pre-microscopic era of the 16th and 17th centuries, in addition to Bartholomaeus Eustachius, Marcello Malpighi (1628–1694) and Johann Jakob Rau (1668–1719) researched the structures of hard dental tissue and their origins. With the development of optical magnification aids, especially by Antoni van Leeuwenhoek (1632–1723), more precise histological examinations of the tooth structure and discoveries in the area of the histological processes during the embryonic phase of the teeth are possible. Malpighi postulates the secretion theory of melt formation by means of an ossifying juice; Eustachius mentions the conversion theory for the first time. Alexander Nasmyth (1789–1848), Richard Owen (1804–1892), Anders Adolf Retzius (1796–1860), Jan Evangelista Purkyně (1787–1869), Albert von Kölliker (1816–1905), Wilhelm von Waldeyer (1836–1921 ), Viktor von Ebner-Rofenstein (1842–1925), Gustav Preiswerk (1866–1908), John Tomes (1815–1895) as well as his son Charles (1846–1928) and many other researchers gave dental histology a thorough study of the the entire area has a broad scientific basis.
Leonardo da Vinci skull sketch
Ambroise Paré
Extraction instruments
Prostheses
Guy de Chauliac
Chirurgia magna
Vesalius
Tabulae anatomicae
So far, only a few studies have been carried out on medieval corpses in order to determine , for example, periodontal pathogens. As part of a study, it was possible to isolate and decipher large amounts of genetic material from the tartar of a 1000-year-old skeleton . It is tartar from a man who lived in Dalheim Monastery (Lichtenau) . Substantial parts of the genome of a periodontal bacterium could be reconstructed, and the genetic material of food components was found for the first time, including 40 opportunistic pathogens , antibiotic resistance genes , the genome of the periodontal pathogen Tannerella forsythia was successfully reconstructed from 239 bacterial and 43 human proteins . The discovery paves the way to a better understanding of tooth and gum disease and shows how the human oral flora and common diseases have developed and adapted in human evolution.
Changes were only introduced again through Pierre Fauchard.
Protagonists of dentistry in the 17th and 18th centuries
While academically educated doctors described physiological and anatomical conditions in their publications, the practical practice of dentistry in the 17th century was mainly practiced by barbers, tooth breakers, barkers and quacks. In the 18th century, independent dentistry developed and, as a result, an increasing establishment of the dental profession, especially in the larger European cities. However, recognition as an academic subject began only gradually in the 18th century.
Pierre Fauchard
Dentistry was first introduced in Europe as an independent medical discipline in France. Louis XIV. (1638–1715) issued the edict Expert pour les dents (“Specialist for teeth”), which forbade the barbers to extract teeth and introduced a profession of surgeon dentiste , the “dental surgeon”, which was equal to the surgeon . As a result, Pierre Fauchard (1678–1761) published the book Le Chirurgien Dentiste ou Traite des dents ("The dentist or the treatment of teeth") in 1723 . With this publication, Fauchard is regarded as the father of modern dentistry. His book was the first to provide a comprehensive description of dentistry, including the basics of oral anatomy and functioning, as well as surgical, conservative, and prosthetic treatments. His thoughts were completely new. He rejected the cause of tooth decay, which he called the “German toothworm theory”, as wrong. He often looked through a microscope and found no worms. Sugar harms both gums and teeth. One should limit the consumption of sugar in daily food. The milk teeth seem to separate from their roots. However, it is wrong for some dentists to claim that they have no roots. (The false claim was based on the fact that deciduous teeth no longer have roots because they are resorbed before the tooth change.) The first authentic case report of a homoplastic tooth transplant (from person to person) was written in 1728 by Pierre Fauchard. In 1746 he first described the clinical symptoms of periodontitis . In 1889 Théophile M. David (1851-1892) suggested naming the disease described as "Maladie de Fauchard" after its author. It was known especially in the Anglo-Saxon-speaking area as Rigg's disease (English: Riggs disease), after the American dentist John Mankey Riggs ( see below ).
Fauchard recommended lead, tin or gold for filling carious teeth. Teeth should be cleaned regularly by a dentist. He described tooth alignment, recommending that if the teeth were irregularly positioned, creating space between them by filing, loosening the teeth with tweezers, and using wires to fix the teeth in their new position until they became firm again. If a tooth is knocked out, it can be replanted ( replanted ) and it will still be able to serve for many years. He was a vehement opponent of dental charlatans and criticized their unsuitable or fraudulent procedures.
For example, he refused to allow nitric acid and sulfuric acid to be applied to the teeth to remove tartar , which would only seriously damage the teeth and subsequently have to be extracted. Fauchard criticized the use of horsehair in toothbrushes, which were too soft to be able to remove plaque, and instead called for the toothbrushes made from pig bristles, which had been used in China since the beginning of the 16th century, to be used or cleaned with a sponge or cloth. Around 1700 Christoph von Hellwig invented a toothbrush in its current form. With the invention of nylon in 1938, the US company DuPont manufactured the first nylon toothbrushes.
He also revealed that charlatans filled teeth with cheap tin or lead , only covered them with a thin layer of gold, and sold them as expensive gold fillings . Gold leaf to replace hard dental tissue was used in the Arab world as early as the eighth century. The first written references in Europe to gold foil as a filling material for teeth were not found until the middle of the 15th century. In 1484 Giovanni d'Arcoli first used gold foil as a filling material for carious teeth. The gold hammer filling in a molar (molar) is documented in the case of Anna Ursula von Braunschweig-Lüneburg , who was buried in 1601 . At that time, in contrast to the modern age, the gold filling was not cast from liquefied metal, but instead was placed using cold welding . This is based on the property of gold in a highly pure state to form atomic bonds at its interface and thereby harden. The gold foil is tapped (condensed) into the tooth with a hammer (hence the name). The gold hammer filling experienced an upswing in the United States in 1855 by Robert A. Arthur and William Gibson Arlington Bonwill and has been used as a filling process up to modern times, as it is a restoration technique that is gentle on the tooth substance.
diagnostic
programs
Pointed
pliers
Instruments
Drilling
machine
Dentures
The smile revolution
In his book The Smile Revolution in Eighteenth Century Paris , Colin Jones describes that in those days the smile that made teeth visible was frowned upon, especially at court. Small-lipped smiles were required as part of physical control to survive in the world of the royal court of Louis XIV (1638–1715). It was also a social characteristic: no courtier wanted to be seen with his mouth open, let alone portrayed. Tooth gaps and ugly dark teeth were widespread, especially because of the decadent lifestyle and the high-sugar diet. But smiling was also seen as a sign of gullibility, recklessness or bad manners, in the worst case a mark of a madman. In the 18th century, however, the literary works and stage works by Samuel Richardson (1689–1761) and Jean-Jacques Rousseau (1712–1778) caused a change of heart. Richardson's work established the school of sensitive literature . Emotions should be shown through a charming smile, but this was only possible for the social and cultural, wealthy elite who could afford expensive dental treatment. Teeth and dentists became “chic”, which was mainly due to Fauchard's special expertise. He was able, at least in part, to replace the brutal tooth breaker methods customary at the time and devoted himself to tooth preservation and prevention. Nicolas Dubois de Chémant made expensive dentures with porcelain teeth ( see below ).
In autumn 1787, visitors to the exhibition would have loved to sink into the ground when they saw a self-portrait of the important artist Marie Louise Elisabeth Vigée Le Brun (1755–1844) on the walls of the Louvre . The problem was her mouth. He smiled - not just like the Mona Lisa's enigmatic smile , but with a smile that showed her teeth. “Was Vigée Le Brun crazy, a slut or some kind of revolutionary gone mad?” The only thing left for the visitors was to pretend they hadn't noticed anything. However, with the French Revolution (1789–1799), the “Parisian smile” became increasingly widespread in many variations. However, it was soon suppressed by terror and turned into a smile of resignation, up to the desperate smile of the victims on the scaffold . Smiling was no longer an expression of openness, but made people suspicious. People lost their smile and with it the dentists - also through some "reforms" - were pushed to the margins of society and lost their reputation. The “smile revolution” came to an end.
Philipp Pfaff
Fauchard's counterpart in Germany was Philipp Pfaff (1713–1766), who published the first textbook on dentistry in German in 1756: Treatise on the teeth of the human body and their diseases . He described, among other things, the molding of the jaw with sealing wax , whereby the impression , which was first cast with plaster, served as a model for the production of dentures . In 1840, the Americans L. Gilbert and WH Dwinelle accelerated the setting of the plaster by adding salts, thus transforming it into a suitable impression material. As a result, plaster of paris was used for functional plaster casts in toothless patients.
The "direct capping", a covering of the vital (living), opened tooth pulp (tooth nerve) with gold plates, goes back to Pfaff. He also published the first description of an extraoral retrograde root canal filling in the context of tooth replantation . The root canal of the extracted tooth is closed from the tip of the root and then the tooth is replanted (replanted). Pfaff was appointed court dentist by Frederick the Great . The Philipp Pfaff Institute , the joint advanced training academy of the Berlin Dental Association and the Brandenburg State Dental Association , is named after him.
John Hunter
In England, the Scot John Hunter (1728–1793), a surgeon and anatomist who is considered the founder of scientific surgery , wrote in 1771 The Natural History of the Human Teeth (translated from English: John Hunter's natural history of teeth and description of diseases . […] Leipzig 1780) and 1778 A Practical Treatise on the Diseases of the Teeth ("A practical treatise on the diseases of the teeth") with for the first time scientifically detailed descriptions of the anatomy , physiology and pathology of the teeth. Much of English society has been hostile to Scots since the Second Jacobite Rising. In this situation, Hunter had no choice but to turn to the job of the lowest esteem among medical professionals and commonly practiced by quacks and barbers: that of dentist. He wrote the most extensive treatise on dentistry of that time. One of the things Hunter was interested in was the transplantation of teeth. However, he overlooked the fact that in numerous cases infectious diseases, especially syphilis, were transmitted through transplantation . He believed that this was only possible with purulent teeth. Numerous dental practitioners then developed various requirements that a tooth donor had to meet in order to minimize the transmission of diseases. Tooth transplantation was already carried out by the ancient Egyptians, later also by the Etruscans, the Greeks and the Romans. The first written evidence is found in 1594. In 1685, Charles Allen ( York ) made detailed statements on heteroplastic tooth transplantation (from animal to human), including a description of how the animal had to be tied up. It was the first dental booklet to appear in the English-speaking world and containing astonishing insights into anatomy and physiology. In the 1930s, the healing of transplanted teeth was examined histologically by Heinrich Hammer (1891–1972) for the first time . Healing only occurs if the Desmondont (root skin) is completely preserved , otherwise the graft first heals in the bone and is then resorbed . Hunter also conducted research in the field of orthodontics ( see below ) and suggested removing the tooth pulp before filling therapy for carious teeth . He also dealt with the treatment of anomalies in tooth position .
James Lind
Scurvy (English: Scurvy ) was since the 2nd millennium BC. Known as a disease in Egypt. Later Hippocrates and Pliny also wrote about it. In addition to other serious symptoms, bleeding gums and gingival hyperplasia occur. The disturbed collagen synthesis leads, among other things, to a reduced synthesis of the Sharpey fibers of the teeth holding apparatus (periodontium), which mainly consists of collagen , which leads to tooth loss . If there is a persistent lack of ascorbic acid (vitamin C) in the diet, the disease occurs after about four months and, if left untreated, leads to death.
In the Age of Discovery , from roughly the 15th to the 18th centuries, scurvy led to the mass deaths of seafarers ; For example, the ship of Vasco da Gama lost about 100 men to scurvy on a voyage of 160 men. The reason for the frequent occurrence of scurvy at sea was the unbalanced diet, which - due to the lack of preservation options - mainly consisted of salted meat and ship's rusks. In 1734 the theologian and physician Johann Friedrich Bachstrom demanded the use of fresh fruit and vegetables to cure scurvy. That citrus fruits against scurvy help was at least since 1600 known as a doctor of the East India Company had recommended for this purpose, but their use had not initially enforced. It wasn't until the British ship's doctor James Lind was able to show in 1754 that citrus fruits help against scurvy that the disease lost its horror. Lind was the first to investigate its effect in a systematic experiment from 1747. It is one of the first controlled comparative studies in the history of medicine. For his experiment he divided twelve scurvy-sick sailors into six groups. All received the same diet and the first group also received a quart (a liter) of cider daily. Group two took 25 drops of sulfuric acid , group three six spoons of vinegar , group four half a pint (almost a quarter liter) of sea water, group five two oranges and a lemon and the last group a spice paste and barley water . Treatment of group five had to be discontinued when the fruit ran out after six days, but by that point one of the sailors was already fit for duty and the other was almost recovered. In the other test participants, a certain effect of the treatment was only seen in the first group. Scurvy also occurred on land, especially in the winter months , in besieged fortresses , in prisons or among the first North American settlers, where fruit and vegetables were initially scarce. In the 20th century, scurvy occurred en masse during the First and Second World Wars as well as in German concentration camps and in the Soviet gulag .
The name ascorbic acid (previously hexuronic acid ) was derived in 1933 by Albert von Szent-Györgyi Nagyrápolt and Walter Norman Haworth from the Latin name of the disease scorbutus , with the negative prefix a- (weg-, un-) - "anti-scorbutic acid". In 1934, the pharmaceutical company Roche was the first company to start synthetic production of vitamin C to combat this vitamin deficiency disease . As recently as 1936, Roche employees reported that the specialists among the doctors simply rejected vitamin therapy; 80 percent would even laugh at the "vitamin craze". At the time, an internal company letter stated that “the need for vitamins in the first place” had to be created. Vitamin C is only taken regularly "when something hocus-pocus is being made". The National Socialists then very actively promoted the supply of vitamins to the population in Germany. They wanted to "strengthen the national body from within" because they were convinced that Germany had lost the First World War as a result of malnutrition . In 1944 the Wehrmacht ordered 200 tons of vitamin C from Roche, among others.
Other protagonists from the 17th to the 19th century
In France, Italy and Spain in particular, further works were published which dealt with dentistry in whole or in part:
- Jacques Guillemeau (1549–1613), Les Œuvres de chirurgie, 1602
- Wilhelm Fabry von Hilden (1560–1634), city doctor and surgeon in Bern, described the removal of jaw tumors.
- Pierre Dionis (1643–1718), Cours d'operations de chirurgie, 1707; several editions.
- Johann Scultet (1595–1645), L'arcenal de Chirurgie, 1712
- Étienne Bourdet (1722–1789), Recherches et observations sur toutes les parties de l'art du dentiste, 1757
- Antonio Campani (1738–1806), Odontologia ossia trattato sopra i denti opera, 1786
- Félix Pérez Arroyo, (1755–1809) Tratado de las operaciones en la dentadura, 1799
- Louis Laforgue, (? –1816), L'Art du dentiste ou Manuel des opérations, qui se pratiquent sur les dents, Paris 1802
- Jean-Baptiste Gariot (1761–1835), Traité des maladies de la bouche, 1805
- Joseph Fox (1755-1816), first instructions on dental regulations, which were followed in England until about 1850.
- J.-CF Maury (1786–1840), Traité complet de l'art du dentiste d'après l'état actuel des connaissances, 1828
- Jakob Calmann Linderer (1771–1840), teaching of all dental operations based on the best sources and his own forty years of experience. Berlin 1834; Reprint Bremen 1981
- Joseph Linderer (* 1809, Jakobs Sohn), Jakob Calmann Linderer: Handbook of Dentistry, containing anatomy and physiology, materia medica dentaria and surgery, Berlin 1837
- Joseph Linderer: The preservation of one's own teeth in their healthy and diseased condition, Berlin 1842
- Pierre-Joachim Lefoulon, (? –1841), Nouveau traité théorique et pratique de l'art du dentiste, 1841
- Edmond Andrieu (1833–1889), Traité de dentisterie opératoire, 1889
Basic research
Only when anatomy and physiology had made corresponding advances in basic research could dentistry gradually become an independent science in the 19th century. These include primarily the relevant microscopic examinations by Jan Evangelista Purkyně (1787–1869), Anders Adolf Retzius (1796–1860) and Albert von Kölliker (1817–1905).
In 1782, Johann Jakob Heinrich Bücking introduced the first specialized pliers for the various applications. Extraction forceps go back in their current form to the English oral surgeon John Tomes (1815–1895). The Tomes fiber , discovered by him in 1840, is named after him, the cell extension of an odontoblast ( dentine former), which is located in the dentinal tubules . He was elected first President of the British Dental Association because of this and other contributions to dentistry .
Historical forms of treatment
Reconstructive dentistry
There is evidence that dental amalgam was used as a filling material as early as the beginning of the Tang Dynasty ( Chinese 唐朝 , Pinyin táng cháo ) in China (618–907 AD) , as described in the writings of the Chinese doctor Su Kung (蔌 哭嗯) from the year 659. Amalgam returns as a “silver paste” in Ta-Kuan Pent-ts'ao (大观 被 压抑 的 曹操) around 1107. The alloy is also mentioned in 1505 and 1596 (by Li Shi-Zhen李时珍) in the Ming period ( Chinese 明朝 , Pinyin míng cháo ) . In 1505, Liu Wen t'ai (刘 雯 台) describes the exact composition: "100 parts of mercury , 45 parts of silver and 900 parts of tin , to be stirred in an iron pot."
Although special treatises in the local language on dental treatment have been available since the 14th century, "the Ottinger", named after a dentist, has been documented in technical literature since the 15th century. In 1530 the Mittweidaer Zene Artzney Buchlein against all sorts of kranckeyten and frailties of the tzeen was published , a "small healing book for all kinds of diseases and ailments of the teeth", the first book that is entirely devoted to dentistry, written for barbers and surgeons who use the mouth to treat. It covers topics such as oral hygiene , tooth extraction , drilling the teeth and making gold fillings . It contains advice on “how to help the children so that they can easily venture into [them] ir zene”: The little ones should be bathed frequently and then the gums with a finger that has previously been dipped in warm chicken, goose or duck fat has been, "subtle rubbing and trucking". When the teeth break through, one takes “fine, subtle” wool from the neck of a sheep, dips it in warm chamomile oil and then places it on the baby's neck and cheeks. Sometimes people tried to make "difficult" teething easier by hanging a greased bat around the child's neck. However, as in the High Middle Ages, the direct application of fat was probably more common.
One of the first dental monographs is the so-called “useful report” by Walther Hermann Ryff from 1548: a useful report on how to keep the eyes and face, where they are lacking, dark or dark, sheared, healthy, stiffened and confirmed. […] With further instruction on how to keep the mouth fresh, pure, clean, healthy, strong and firm […] .
Those who could not afford gold were usually filled with lead (from the Latin plumbum “lead” the terms plombe and plombieren derive ) or - less permanently - from the resins galbanum or opopanax .
Since the lead was too soft, the search for a durable material continued. The amalgam was rediscovered in Germany and used for the first time in 1528 by the Ulm doctor Johannes Stocker , who in his pharmacopoeia Praxis aurea describes the production of amalgam, which "hardens like stone in a tooth hole". However, amalgam did not see its introduction in the western world until the 1830s. In 1806, Joseph Fox (1755–1816) still used an alloy of bismuth, lead and tin (an alloy studied by the chemist d'Arcet, the " Darcet's metal "). The Parisian dentist Louis Nicolas Regnart (1780–1847) suggested in 1818 that this alloy be introduced into the tooth hole (the cavity to be filled) in small pieces and melted there with a hot plug. By adding a tenth of the mass of mercury, Regnart was able to lower the melting point considerably. Initially, amalgam was made by mixing mercury with a filing made from silver coins. In 1819 Auguste Onésime Taveau introduced the amalgam in France and Thomas Bell in England. As early as 1833, after the forced introduction of amalgam as a filling material by Crawcorn, who had brought it with him from Europe in 1830, the so-called "amalgam war" broke out, which led to a temporary ban on amalgam as a filling material. The time went down in history as Crawcorn days . In 1855, two American dentists, William M. Hunter (1819–1889) and Elisha Townsend (1804–1858), announced a new amalgam formulation that came close to that of modern times. The powder mixture consisted of four parts of silver and five parts of tin; one gram of mercury was processed per gram of this powder. However, any dentist who processed amalgam was expelled from the American Society of Dental Surgeons, leading to the dissolution of this association in 1856. A similar discussion flared up in Germany in the 1920s. During this debate, which has now dragged on for almost two hundred years, no major health hazard could be demonstrated.
The Paris court dentist Antoine Malagou Désirabode described in 1845 in the chapter "De l'obliteration ou plombage des dents" of his book on the art of the dentist a tooth filling that is based on a principle from the construction industry ( fluation ). The fact that fluoride and fluorosilicates (then called "fluate") bind moisture and harden in the process, made them appear suitable as dental fillings when mixed with aluminum oxide. Soon after, there were numerous patents for dental fillings with fluoride additives.
On March 20, 1860, the American dentist Barnabas Wood (1819–1875) received a patent for a low-melting alloy. Wood's metal , named after him, was also used for dental fillings, despite the content of the toxic heavy metals lead and cadmium . The components bismuth , lead, cadmium and tin are ignoble and easily dissolve in the mouth, so that there is a risk of chronic cadmium poisoning . Therefore, the alloy soon disappeared again as a dental filling material.
In connection with amalgam fillings, Greene Vardiman Black drew up Black's rules for cavity preparation, named after him, in 1892, including the principle of extension for prevention ( English: expansion [of the cavity] for prevention). As a result, the tooth should be drilled so far that the filling margins were relocated to an area that is easily accessible for cleaning. He also divided the cavity shapes into five cavity classes , which have retained their global importance to this day. He changed the composition of the filing, which now consisted of 68.5% silver, 25.5% tin, 5% gold and 1% zinc to increase strength. Black also invented the phagodynamometer for measuring chewing pressure, which was presented to the professional world in 1895.
Aesthetic and ritual tooth corrections
The specialty of ethno-dentistry deals with the various procedures of tooth changes. The first dental work was done by the Etruscans and Phoenicians (now Lebanon) in the middle of the first millennium before the turn of the century. The Etruscans (now northern Italy) were able to produce gold spheres 0.1 mm in diameter and connect them to one another without soldering. Their metallurgists had the following recipe: "If you mix the juice of three types of vegetables and charcoal dust with gold particles, tiny gold pearls form as if by magic." The illustration on the right shows human or animal replacement teeth that are attached to a gold band with a metal pin the remaining teeth were attached. They knew that saliva did not attack gold. Women and men were equal. Slaves were also allowed to wear elegant clothes and gold jewelry. Dentistry was in the hands of doctors.
Artificial deformations have been made for thousands of years - always in a ritual or cultural context. Depending on the respective peoples, a distinction is made between different types of deformation: There are pointed, gap, surface or serrated filing of the teeth, horizontal filing up to complete sawing of the tooth crown. In addition, there are furrow, cell and relief filings, the displacement of front teeth from their natural position, the creation and enlargement of diastemas or gaps, the breaking out or levering out of single or multiple teeth with a spear point or stone chipping, the elongation (apparent lengthening) medium Front teeth, the dental jewelry and the artificial coloring of the teeth.
A dental bridge consisting of five human teeth attached to a gold ribbon was discovered in a tomb of the monastery of San Francesco in the Tuscan city of Lucca in Italy . The 17th century dental bridge is similar to the Maryland bridge (adhesive bridge or adhesive bridge) developed at the University of Maryland in the 1970s. The prosthesis found consists of three central incisors and two lateral canines attached to a golden band. Two small gold pins attached the teeth to the band.
Tooth blackening
In Japan, tooth blackening ohaguro ( Japanese お 歯 黒 ) has been fashionable since the middle of the first millennium, as suggested by traces of blackened teeth in bone finds from the Kofun period (300 to 710). The Ohaguro goes back to the Heian period (794–1192). It was first mentioned in writing in the Genji Monogatari ( jap. D , dt. The story of Prince Genji) in the 11th century, although it has been around since 2879 BC. Was practiced. Was conducted ohaguro of men and women of the court nobility and later by the Samurai . During the Edo period (Japanese 江 戸 時代, Edo jidai, 1603 to 1868) it was common for married women to blacken their teeth. It was considered erotic as it increased the contrast with the white skin of the face. It was therefore very common among women in the brothel district . At the same time it was considered a symbol of marital fidelity. In the 18th century men were banned from blackening their teeth, and in 1871 the Meiji government (Japanese 明治 時代 Meiji jidai) finally extended this ban to women by a cabinet decision , as this practice was classified as barbaric under Western influence. In the Nguyễn dynasty ( Hán Nôm : 家 阮 ) in Vietnam (1802 to 1945) the custom lasted into the 20th century. In Southeast Asia it was a symbol of strength and honesty, was considered a symbol of beauty and signaled the willingness to marry women. An elaborately manufactured mixture of iron filings, which were put in tea or rice wine and oxidized, was used to dye the teeth . The resulting black color was applied to the teeth with a soft brush and adhesive powder . Because of the limited shelf life, the procedure had to be repeated every three days. It was also believed that blackening kept teeth healthy and counteracts any iron deficiency during pregnancy. Recent studies of the composition of the dye confirm that there was a certain protection against tooth decay and demineralization of the teeth.
Gemstones
Around the year 900, for ritual or religious reasons, the Mayans decorated their front teeth with various gemstones such as jade , cinnabarite , serpentinite , pyrite or hematite , which were found during excavations in Antigua Guatemala . For this purpose, holes precisely matched to the size of the gem were drilled with a drill and floating abrasives made of quartz powder . More than 50 different patterns were identified. It is believed that each pattern represented a tribal affiliation or had a religious meaning.
In modern times, Mick Jagger decided to have a ruby inserted into an anterior tooth, but had it exchanged for an emerald in order to eventually replace it with a diamond . This started a trend towards tooth jewelery like twinkles (brillies), dazzlers and grills .
Tooth gold plating
Already 1000 BC The Chinese used tooth fillings made of the finest gold leaf, which was stamped into the caries holes. The first prosthetic work was done in 500 BC. Made by the Phoenicians . In Eastern Europe, for example in Tajikistan and the Orient, gold teeth on the front were considered a sign of wealth.
Filed teeth
Teeth breaking out
Tooth
blackening
Jade decorated front teeth
Twinkle
Grills
Gold crowns
Uzbekistan
Urine therapy
Human or animal urine , which is rich in urea and carbamide peroxide , was used in early China for its analgesic properties, healing and teeth whitening. The Huángdì Nèijīng (chin. 黄帝内經) is one of the oldest standard works of Chinese medicine . It is translated as "The Medicine of the Yellow Emperor" ( Huáng Dì , Chinese 黃帝 / 黄帝 ). Two of the 18 volumes are devoted to tooth and gum diseases. In Nei Tching Sou Wen , rinsing with a child's urine is recommended for painful gum disease and bleeding gums. Bernardino de Sahagún (approx. 1500–1590) points out in his writings that the Aztecs put dental care on a level with body care. After rinsing them with cold water and cleaning them with a polishing cloth, they have blackened their teeth with Espiga Negra (a mixture of different plants) or partially rinsed them with urine. Urine was used to clean teeth from the Celtiberians to the ancient Romans to the French high nobility . For example, Marie de Sévigné (1626–1696) wrote in one of her letters to her daughter that she should rinse her mouth with fresh urine every morning and evening, as she had seen many people cured them of toothache and decayed teeth. This application even from the famous Pierre Fauchard ( as recommended). The procedure was to be assigned to folk medicine and not to scientific medicine, although it is still used today as an autologous urine treatment in alternative medicine .
Stomatoscope
The treatment procedures, which became more and more delicate in the 19th century, increasingly required a better view of the treatment area. The Wroclaw surgeon and dentist Julius Bruck (1840–1902) took up the galvano-caustic operation method developed by Albrecht Theodor Middeldorpf (1824–1868) and published his construction in 1865 in the book The Stomatoscope for the x-raying of teeth and their neighboring parts by galvanic incandescent light . Just two years later, based on the same principle, he developed the urethroscope for x-raying the bladder and its neighboring parts . Since then he has been considered a pioneer in endoscopy . He used the "stomatoscope" both for better diagnosis of the oral cavity (Latin stoma ; ancient Greek το στομα, to stoma = mouth, mouth, last opening. See " stomatology ") and by means of diaphanoscopy for caries diagnosis. According to the Dental History Museum in Zschadraß , Joseph Murphy invented the mouth mirror in 1811.
Further therapy methods
Tiberius Cavallo published his book A complete treatise on electricity in 1777 , in which he recommended the use of electricity to treat toothache. For this purpose, he developed a corresponding instrument with which electrical stimuli could be delivered to a tooth in a targeted manner. His ideas have been taken up in modern times and devices for electrical sensitivity testing of teeth were developed, with which the vitality of the teeth can be checked.
Dental trade and transplants
The Englishman Hunter still believed in the 18th century that a freshly extracted tooth only had to be inserted into another patient quickly enough to be able to grow successfully. With printed advertisements he attracted whole groups of poorer 'tooth donors' who had their healthy teeth extracted for a few pence , so that they could be used immediately afterwards by wealthier contemporaries. Hunter's scientific reputation meant that his ' tooth transplants ' were copied not only in Europe but also in the USA. This method, which was associated with a high risk of infection (especially syphilis ) for patients, was only abandoned towards the end of the 18th century .
Human teeth were then captured by corpse bats from tombs and from battlefields and incorporated into dentures by dentists . When George Washington became the first President of the United States in 1789, he was 57 years old and had only one tooth. Washington made do with a cosmetic prosthesis made of hippopotamus teeth, ivory and human teeth that John Greenwood ( see below ) had made. Formerly a carpenter and mechanic of nautical instruments in New York City, this had made a name for himself as a dentist. His practice was a kind of mail order company for denture prostheses. Anyone who sent him a wax impression of his tooth gap received the matching tooth imitation by return of post.
In 1799 Francisco de Goya recorded a scene in the painting A caza de serves ( Spanish: hunting for teeth) in which a well-dressed woman breaks the teeth of a hanged man . With his Caprichos, Goya criticized the conditions in what was then Spain , especially the greed of the property classes. A far greater source of human teeth for prostheses was the Battle of Waterloo (1815), in which tens of thousands of soldiers were killed, including many young men with healthy teeth. The trade in these teeth, with which dentures were made, took on such proportions that they were later called Waterloo teeth ( English: Waterloo teeth ). Waterloo teeth were already collected after the Battle of the Nations near Leipzig from October 16 to 19, 1813. Over 92,000 of them lost their lives where around 600,000 soldiers from several European countries faced each other. After the noise of the battle subsided, the battlefields on the outskirts of Leipzig were haunted by a host of looters who tried to get hold of anything of value. Worst of all were the bats, "who broke open the jaws of the dead and tore out the most beautiful and whitest teeth in order to sell them for use in the episode". Sometimes they tore their teeth from those who were still dying. The flourishing trade in teeth from battlefields is also reflected in the Würzburg dentist and founder of German scientific dentistry, Karl Joseph Ringelmann (1776–1854), in his work "The organism of the mouth, especially the teeth" from the 1820s. He considers the removal of healthy teeth from living people from lower social classes for the rich to be ethically reprehensible, because this is a barbaric process "whereby the art of healing manifests itself as a desecrated servant of the highest degree of human depravity". Victor Hugo (1802–1885) immortalized this immoral practice in his novel " Les Misérables " (The Wretched). Fantine, who had become unemployed, sold her incisors there to help her allegedly ill daughter Cosette with the money.
The teeth of a hippopotamus were also carved onto the jaw as a prosthesis. Waterloo teeth were partially attached to the carved denture base made from teeth of a hippopotamus . Only wealthy circles in the Victorian era could afford both . Another “reservoir” for human teeth was the American Civil War (1861 to 1865). There, too, teeth were extracted from the fallen and sent en masse to London. These teeth were also called Waterloo teeth using the term that has now become established. The end of the bat is likely to have been due to the changed treatment of prisoners of war and fallen soldiers after the signing of the first Geneva Convention on August 22, 1864. At the international conference, twelve European states took a revolutionary step towards more humanity. In the Hague Land Warfare Regulations of 1907, Chapter I. Wounded and Sick , Article 3 ( duty of the victor ): “After every battle, the party claiming the battlefield should take measures to visit the wounded and, like the fallen, against robbery and to protect bad treatment ”, ( Reichsgesetzblatt , No. 25, August 8, 1907, p. 279 ff.). This officially put an end to the practice of scavenging. However, under the National Socialists, it was revived, among other things, in the form of the gold-tooth recycling of the concentration camp victims, whereby prisoners were also forced to have their teeth explanted.
Tooth transplantation in the "fine society"
George Washington prosthesis
Goya: A caza de served
Waterloo teeth
Carving instrument
Hippopotamus prosthesis
History of modern dentures
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In 1789, the Frenchman Nicolas Dubois de Chémant wanted to meet his desire for natural-looking dentures and applied for a patent for the porcelain teeth he had developed . They were called incorruptible ( French: indestructible, "incorruptible"), in contrast to the foul-smelling bone dentures. Chémant took up the idea of the pharmacist Alexis Duchâteau (1714–1792), who in 1774 had experimented with the manufacture of porcelain teeth. The Italian dentist Giuseppangelo Fonzi (1768–1840) acquired this knowledge and achieved fame in 1815 for his successful production of porcelain teeth, which he firmly attached to the denture base with metal pins. The reputation of this incorruptible spread to the Bavarian royal court in Munich , to the Russian Tsar Alexander I and from there to the Spanish Bourbons .
On March 9, 1822, Charles M. Graham of New York was granted a US patent for his invention of an improvement in the construction of artificial teeth. In 1839, invented Charles Goodyear the vulcanization , a method wherein the rubber under the influence of time, temperature and pressure to atmospheric and chemical agents and to mechanical strain is made resistant. This soon resulted in the rubber prostheses according to Thomas W. Evans and Clark S. Putnam (1864), into which porcelain teeth could be built. Around 1840 around 500,000 porcelain teeth were exported from Paris to the USA, which was accompanied by a rapid increase in the number of dentists and dental technicians. According to a survey in the USA in 1940 about 70% of all dentures there were made from rubber. The Court dentist as of from December 11, 1802 Friedrich Karl August (Waldeck-Pyrmont) operating Jakob Calmann relievers (1771-1840), actually Callmann Jacob , can be used as in the tradition of Fauchard, Pfaff, Hunter and Fox standing pioneer of dentistry and scientific dentistry of the first third of the 19th century. The "Linderer" (before 1805/1808 Callmann Jacob) was Göttingen university dentist in 1812, later practiced in Erfurt, Berlin and Königsberg and in 1834 published the book Doctrine of Complete Dental Operations .
In the field of full dentures, the functional impression was described by J. Schrott in 1864 , but it was not introduced into practice until the 1960s. Until then, suction cups were built into upper jaw prostheses to generate suction and thus hold a prosthesis . However, over many years of use, these produced jaw defects and even perforations of the palate , whereupon this aid was abandoned.
The prosthesis plastic polymethyl methacrylate (PMMA) was developed around the same time in Germany, Great Britain and Spain in 1928. In Germany, the chemist Walter Bauer (1893–1968) was involved in this. In 1936, the Kulzer & Co. company introduced the chemoplastic processing method (Paladon method) developed by Bauer. It corresponds to the process that is widespread today to paste the polymer particles into a paste with monomer liquid and to introduce them plastically into hollow molds. The plastic was so developed in the 1950s that it replaced rubber. For patients who complain about plastic intolerance, a partial or full denture made of rubber offers an alternative.
In 1844, Samuel Stockton White (SS White) began making porcelain teeth in the United States . The SS White Dental Manufacturing Company, which is still active today, developed the world's first electric drive for rotating instruments in the dental field in 1870 . The manufacture of porcelain teeth was discontinued in 1937. In 1947, the successor company SS White Burs introduced the first rotary dental hard metal instruments made of tungsten carbide .
The SS White Company published The Dental News Letter , one of the earliest dental magazines. It was included in the prestigious Journal of the American Dental Association (JADA) in 1939, the trade journal of the American Dental Association (ADA), the American dental association. White's classmate and friend Thomas W. Evans , who later became Napoleon III's personal dentist . introduced White's innovative technology in Europe, such as treatment units with the Doriot linkage . SS White became chairman of the ADA. In this capacity, he met Abraham Lincoln during the Civil War (1861-1865) to propose to him the establishment of a dental care for the soldiers of the Union . Due to logistical difficulties, however, nothing came of his proposal in the end. The reason was that every soldier had to have at least six upper and six lower teeth in order to be able to hold and tear open the end of the paper cartridge with his teeth when loading his Chassepot rifle . (The quote comes from a Prussian service instruction: "... the guy should bite until he tastes the powder."). For this very reason, young men had their healthy front teeth extracted in order to avoid military service .
Articulators
The development of the articulator , which, as a chewing simulator, should enable the movements of the lower jaw and thus the reproduction of the chewing pattern, began with an occludator that only allowed the opening and closing of the dentition to be imitated. In 1893 , Julius Parreidt describes in detail various methods common in the 19th century, initially using a door hinge to fix the two jaw models in exactly the same way as the jaws in the mouth relate to one another when biting. After preliminary work by Daniel Evans , William Gibson Arlington Bonwill (1833–1899) from Philadelphia developed the first above-average articulator in 1864, a device for simulating the movements of the temporomandibular joint. For this purpose, plaster models of the dental arches of the upper and lower jaw are mounted in occlusion in the articulator. It was Bonwill who coined the term articulation and replaced the older term occlusion . He also developed numerous workpieces and devices. The Bonwill triangle , an imaginary triangle whose corner points form the lower jaw incisal point and the centers of the two lower jaw condyles , is named after him. The Gysi Simplex articulator developed by the Swiss dentist Alfred Gysi (1865–1957) around 1910 was to prove to be a milestone. Due to the condylar guide surface in the lower part and the joint drum in the upper part, these types are referred to as so-called non-arcon articulators , as the movements take place in reverse to the anatomical-physiological process in the real joint. The Whip-Mix articulator, which is based on the same principle, or the School Articulator Munich (SAM) became better known. Over 100 different articulators have been developed over the past 150 years.
Gnathology
The early history of gnathology begins with the findings of A. Vesalius (1514–1564) and continues through Francis H. Balkwill (1866), William Gibson Arlington Bonwill (1885), Ferdinand von Spee (1890), NG Bennett (1908), George H. Wilson (1917), RL Hanau (1926), Alfred Gysi (1929), George S. Monson (1932), Konrad Thielemann (1938), and later with Ulf Posselt (1952), AE Aull (1965), Albert Gerber (1978), Alexander Motsch (1978), Charles H. Gibbs (1982) to C. Riise (1983).
Later, Arne G. Lauritzen , Peter K. Thomas , Charles E. Stuart and Harry Lundeen (1987) took over the further development with the increasing use of face bows and the use of support pin registrations in toothless patients . In Germany, Axel Bauer and Alexander Gutowski were the first to adopt these concepts; in Switzerland, George Graber , Dean of the Medical Faculty of the University of Basel . To date, there is no teaching of either static or dynamic occlusion, which has developed a concept based on scientific research and observation of human physiology that is not artificially conceived, but rather imitates nature and can thus be integrated into the stomatognathic system without interference.
Impression materials
After Edwin Thomas Truman had developed gutta-percha ( see below ), in 1856 the London dentist Charles T. Stent (1807–1885) added stearin in particular , which improved the plasticity of the material and its stability, and talc as an inert filler to give the material more bulk to give, also resin and red dye and the thermoplastic material named after him was created for the molding of the jaws and teeth. Stent replaced beeswax and plaster of paris, which had been used up until then, as impression materials. After Charles Stent's death, his sons turned distribution of the material over to a dental company called Claudius Ash and Sons . After the two sons of Stents died around 1900, the Ash brothers bought all the rights and kept the name Stent. For the plaster cast, a special, easily breakable plaster of paris was used, which could be broken out of the mouth piece by piece after it had set. The fragments were then glued together and filled with a hard plaster of paris to produce the final model. He also gave his name to the stents , which are used as medical implants, for example in stent angioplasty on the coronary arteries .
The British chemist and pharmacist Edward Curtis Stanford is considered to be the discoverer of alginate, which extracted alginic acid from brown algae in 1880 . In 1940 the salts of alginic acid, commonly known as alginates, were introduced into dentistry as an impression material. Alginates are irreversible hydrocolloids because they set through an irreversible chemical reaction in which Na alginate is converted to Ca alginate. With the reversible hydrocolloids, the first elastic impression materials were introduced in 1925. At the beginning of the 1950s, the elastomeric impression materials were introduced, initially the elastomeric polysulphides (thiocoles) and the condensation-curing silicones , followed in 1965 by the polyethers (Impregum, 3M ESPE ) and in 1975 by the addition-curing silicones (vinyl polysiloxane).
Crown
In May 1869, William N. Morrison described the ring-cap crown ( Morrison crown ) named after him in the Missouri Dental Journal . These metal band crowns, also called band sleeve crowns, were widely used before the establishment of the casting technology. For this purpose, a gold band was adapted to the ground tooth in a ring shape and soldered. The chewing surface (“lid”) was cast separately and then soldered to the tape. In 1876, Cassius M. Richmond from San Francisco developed the ring pin crown ( Richmond crown ) named after him , which could also have a porcelain bowl as a veneer. 1907 William H. Taggert invented a casting machine and a investment material containing a modeled directly in the casting metal by means of lost wax process ( lost wax casting ), and casting method with lost form could result. The cast objects had a previously unknown accuracy of fit. However, the cast crowns produced in this way were not widely used until the 1950s.
Facings
In the mid-1980s, the veneering of metallic crowns with plastic (tooth-colored cladding) experienced an upswing. Until then, the veneers were attached using retentive elements such as retention pins or cast beads. The crucial problem of the metal-plastic composite has now been solved with the help of the silicoater process , which was developed at the Friedrich Schiller University in Jena, the Technical University of Dresden and the Central Office for Corrosion Protection in Dresden. By silicating the metal surface, a reliable bond between the two materials, but also between metal and ceramic, could be achieved.
Fastening material
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Initially intended as a filling material, the Dresden Sylvestre Augustin Rostaing de Rostagni (1794–1866) and his son Charles Augustin Rostaing (* 1831) developed zinc phosphate cement , which they brought onto the market in 1858 and which was ultimately used to fasten crowns, bridges and inlays has been. After Sylvestre Augustin Rostaing took his recipe into his grave, the chemist, inventor and entrepreneur Carl Franz Otto Hoffmann set about recreating the Dentinagene . He brought the fastening material onto the market as Hoffmann's phosphate cement. The Dentinagene mixture was also marketed as Harvard cement by the Berlin Harvard Dental Company from 1892, which was followed by the LD Caulk Company (later merged with Dentsply International ) with Caulk cements in various colors.
Ceramics
After gold crowns, especially in the front, left a lot to be aesthetically pleasing, Cassius M. Richmond produced dental crowns from celluloid in 1870 , which looked similar to natural teeth. Unfortunately, the material turned black or green, smelled bad and therefore soon disappeared from the market.
Only the jacket crown (coat crown) made of all-ceramic in tooth color, for which the dentist Charles Henry Land (Detroit, USA) applied for a patent in 1889 , represented a breakthrough. Ceramic was burned onto a folded platinum cap and shaped into the required shape. Before insertion, the platinum had to be removed from the inside of the crown; then it could be cemented in place.
The American dentist Newell Sill Jenkins (1840–1919) practiced in Dresden between 1866 and 1909 . His circle of patients included not only members of European royal houses, but also celebrities like Richard Wagner . Thanks to Jenkin's persuasion, Wagner did not implement his plans to emigrate to America, whereupon the opera Parsifal was premiered in Bayreuth in the Margravial Opera House . Jenkins developed the porcelain enamel named after him and thereby decisively improved the composition of the porcelain material for inlays , tooth crowns and bridges. The porcelain inlays opened up the possibility of producing tooth-colored anterior fillings for the first time and thus ushered in the era of aesthetic dentistry. For the production and distribution of the "Jenkins Porcelain Enamel" he founded the manufactory Klewe & Co . His personal friend Samuel Langhorne Clemens bought the manufacturing and distribution rights for the American market: the American writer Mark Twain under his maiden name. Despite his great contributions to dentistry, Jenkins was long ignored by dental historians , although he had published and patented 32 scientific articles to improve aesthetic dental care with porcelain fillings. He introduced the rubber dam in Germany and developed a toothpaste that contained disinfectants for the first time (see below).
The breaking strength of the porcelain was not particularly high, so that the research looked for an alternative in which the stability is created by a metal framework (mostly made of a gold-platinum alloy) under the ceramic.
After numerous attempts, M. Weinstein, S. Katz and AB Weinstein were the first to apply for a patent for a ceramic ceramic bond in the USA in 1952, but this often broke off. The coefficient of thermal expansion (CTE) of metal and ceramic differed greatly when they cooled down from the firing temperature of 880 ° C, which led to tension. In 1962 it was possible to adjust the CTE between metal and ceramic, thereby considerably reducing the risk of breakage. At the same time, the company developed Whip Mix Corporation , the phosphate-bonded investment material with which the first high melting gold - platinum - alloys of JF Jelenko Company and J. Aderer Company were cast, which (as a scaffold for keramikverblendete crowns crowns PFM ) are used. The VMK crowns and bridges that have been used worldwide since then were born (composite metal-ceramic) .
The development of all-ceramic systems has been driven forward since the 1970s. Because of their strength, zirconium oxide ceramics have been preferred for metal-free restorations in the highly stressed posterior region since 1994 , especially when it comes to the production of industrially manufactured blanks for CAD / CAM technology.
High performance plastic
From polyaryletherketone (PAEK) developed by DuPont , 1978, polyetheretherketone (PEEK), a high-performance plastic by the company Imperial Chemical Industries (ICI) developed in England. The Victrex company took over the marketing until the material found its way into dentistry for the manufacture of dentures via Juvora in 2012 .
History of the dental technician trade
With the development of materials and techniques at the beginning of the 19th century, the professional group of dental technicians emerged, who at that time were still referred to as dental artists or dentists. Claudius Ash (1792-1854), a silversmith , out of an interest in dentures, carried out an order for a London dentist in 1837 so skillfully that, to his astonishment, he soon spent most of his time on dental assignments. He was thus one of the first professional dental technicians. From this he developed a renowned international dental company Claudius Ash and Sons , which merged with DeTrey in 1924 to form Amalgamated Dental Co. Ltd and is now a division of Plandent, a subsidiary of Henry Schein .
In the USA, the Boston dentist WH Stowe separated the manufacture of dentures from dental treatment in 1883 and in 1887, together with his cousin Frank F. Eddy, created the first dental laboratory in Boston, which operated as Stowe and Eddy . The flourishing business with dentures (in 1930 there were already around 3400 dental laboratories in the USA), which was also offered to patients via newspaper advertisement and sold in direct contact, provoked resistance from dentists. On the threshold of the 20th century, the first dental laboratories emerged in Europe. The Swiss dental technician Arnold Biber opened his laboratory in Pforzheim in October 1886 . The term dental technician was first mentioned in the Reich Insurance Code (RVO) from 1911. Before that, there were the dentist workers and the dental guilds . In 1930, by resolution of the German Chamber of Crafts and Crafts and the Reich Association of German Crafts, "the trade of dental technicians who do not deal with therapeutic treatment ..." was recognized as an independent craft. This decision was made in 1951 with the Ulm Agreement between the Bundesverband der Zahnärzte e. V. (BDZ, later German Dental Association ) and the Federation of purely commercial dental laboratories (BGZL) confirmed. In 1956, the Association of German Dental Technicians Guilds (VDZI) was founded as the successor organization . In the Hamburg Agreement , the VDZI and the BDZ have agreed on complementary cooperation. The dental technicians refrained from incorporating the dental prosthesis into the patient, and the dentists assured their willingness to support and promote the existence of an efficient, skilled dental technician class. This agreement of November 15, 1958 paved the way to the independence of the dental technician trade, because it ensured the fulfillment of the purely handicraft commercial activity. In 1977 the dental technician trade was incorporated into the Reich Insurance Code with the enactment of the Health Insurance Cost Reduction Act , which was followed in 1983 by the introduction of the Federal Standard List of Services for Dental Services (BEL-I) and in 2004 by BEL II, the maximum price list for dental services for those insured by statutory health insurance .
History of Dental Anesthesia
Medieval doctors knew and used, among other things, the pain-relieving effect of opium poppy . It was used by Yuhanna ibn Masawaih to treat toothache. The Islamic scholar At-Tabarī stated that an extract from opium poppy can be deadly and that opium poppy extracts and opium must be considered poisons.
The French surgeon Guy de Chauliac wrote Chirurgia Magna in 1386 , in which he (also) devoted himself to the pathology and therapy of teeth. It is u. a. described the use of opium and mandragora in painful diseases, but also warned of the side effects .
Anesthetics were not widely used until much later. First, laughing gas (N 2 O) was synthesized by Joseph Priestley in 1772 . The chemist Humphry Davy discovered the special medicinal effect in 1799 in self-experiments. Horace Wells (1815–1848), one of the leading dentists in Hartford (Connecticut) , discovered nitrous oxide as a suitable anesthetic for dentistry. Wells had observed its pain-relieving (side) effect at a nitrous oxide demonstration that Gardner Quincy Colton (1814–1898), a chemist who dropped out of medical school, had held on December 10, 1844 in the town. During the demonstration of the humorous effects of the laughing gas, one of the participants in the laughing gas show suffered a deeply bleeding leg wound, but felt no pain from the injury. It was Horace Wells, who ran a joint practice with the "father of periodontology" John Mankey Riggs ( see below ), who then had an upper wisdom tooth extracted painlessly by Riggs in a self-experiment on the following day, December 11, 1844 , while Colton administered the laughing gas with his device. Colton (and his assistants) subsequently extracted an estimated one million teeth under nitrous oxide . In 1868 George Barth and J. Coxeter developed a process for liquefying nitrous oxide so that it could be sold in gas bottles. The aforementioned William Gibson Arlington Bonwill (see above) propagated a method of anesthesia for minor surgical interventions, during childbirth and for dental interventions through forced breathing of the patient ( hyperventilation ). To do this, the patient has to take 80-100 breaths per minute. It was entitled "The air at anaestetic" 1875 (Engl .: The air an anesthetic ) on Franklin Institute presented. Bonwill claimed to be able to do without nitrous oxide based on his 20 years of professional experience.
Ether and chloroform anesthesia followed the nitrous oxide. The American dentist William Thomas Green Morton was able to relieve a patient of his ailment painlessly on October 16, 1846 with an ether anesthetic. As early as March 30, 1842, Crawford Williamson Long had removed a tumor from a patient's neck painlessly, using a towel soaked with ether. But he refrained from publication and thus deprived himself of the recognition of his priority claim. Since then, WTG Morton has been considered the founder of ether anesthesia. When the stumps and roots of broken teeth had to be removed, patients demanded painless treatment. Charles Thomas Jackson , with whom Morton had talked, drew his attention to the intoxicating effects of sulfur ether, which Michael Faraday had already described in a paper in 1818. On September 30, 1846, the cellist Eben Frost came to Morton's practice with a toothache so severe that he agreed to the ether being tested during the extraction of his ulcerated molar. When the patient awoke from his anesthetic, he confirmed to Morton that he had felt no pain when pulling the teeth. Morton tried to disguise which active ingredient he had used to benefit from patenting. During an operation on November 7, 1846, he was forced by the auditorium to reveal his secret. Morton was ruined by the cost of a patent dispute. The successive recognition of the method developed by Morton took place after the successful thigh amputation in a twenty-year-old patient by Henry Jacob Bigelow on November 7, 1846. In 1884, the first oral local anesthesia was carried out using cocaine by William S. Hallsted and Richard J. Hall .
The fact that it belonged to the Japanese tradition to keep treatments secret, was not recognized until 1963 that already on 13 October 1804, the Japanese doctor Hanaoka Seishū the first time a general anesthesia with its anesthetic Tsūsensan has successfully carried out at a breast cancer surgery.
There was definitely resistance to intervening in creation in this way and to put an end to pain, which was accepted as a divine means of education. But many church officials, such as Protheroe Smith , an Anglican obstetrician , Reverend Thomas Chalmers , moderator of the Free Church of Scotland , or Rabbi Abraham de Sola (1825–1886), Canada's first rabbi , supported the advocates of anesthesia.
The use of general anesthesia in dentistry, oral medicine and maxillofacial medicine was made more difficult by the fact that the operating area and the anesthetic route coincide. The inhalation of narcotic gases allowed only short operations, since the mouth was used either for inhalation or for work. If the patient was allowed to inhale through his nose, he exhaled the laughing gas through his mouth, which in turn drove the dentist into a frenzy. So the search for a local anesthetic began.
Local anesthesia
The first coca bushes came to Europe from South America in 1750 . In the winter of 1859/60 Albert Niemann isolated the active components of the coca bush in Friedrich Wöhler's laboratory in Göttingen . He gave the alkaloid the name cocaine . In 1879, Vassili von Anrep (1852–1927) discovered the analgesic effect of cocaine at the Julius Maximilians University of Würzburg . It came into clinical use as a local anesthetic in Germany around 1884 after the ophthalmologist Carl Koller (1857–1944) realized that cocaine was anesthetized when tasted and he then used it to anesthetize the eyes during surgery. He was followed in 1885 by the surgeon William Stewart Halsted (1852-1922), who first used cocaine in dentistry. After the first animal experiments, he used the procedure for local anesthesia of the mandibular nerve as a conduction anesthesia . In addition to surface and conduction anesthesia, infiltration anesthesia developed from this . In 1905, the Leipzig surgeon Heinrich Braun extended the duration and depth of action of the procaine developed by Alfred Einhorn , which assigned the name novocaine to the active ingredient , by adding adrenaline . The Japanese pharmacologist Jokochi Takamine , who had set up his own laboratory in New York , had already succeeded in producing pure adrenaline . He created the word “adrenaline” ( Latin ad 'an' and ren 'kidney'), which he patented and marketed by Parke, Davis & Co., which is now part of Pfizer Inc. The chemist Friedrich Stolz , who came from Heilbronn, succeeded in producing the hormone artificially in 1905 on behalf of Hoechst . This laid the foundations for modern dental therapy. In the same year August Braun developed the idea of trunk anesthesia of the trigeminal nerve . At the same time, the pioneers of local anesthesia in dentistry are Hans Moral (1855–1933) together with Guido Fischer (1877–1959), who dealt with the anatomical and physiological fundamentals in addition to clinical application . In 1920, the dentist and anatomist Harry Safe described in his textbook “Anatomy and technology of central anesthesia in the oral cavity” the exact procedure for performing the various local anesthesia in the oral cavity.
Lidocaine was the first amino - amide -Lokalanästhetikum represented by the Swedish chemist Nils Löfgren (1913-1967) and Bengt Lundqvist was synthesized (1922-1953) in the year 1943rd They sold the patent rights of lidocaine to the Swedish pharmaceutical company Astra AB . In 1957 the development of local anesthetics advanced with the synthesis of mepivacaine , 1958 prilocaine , 1960 bupivacaine . 1974 synthesized novel Muschaweck and Robert Rippel the Articaine (Ultracain). Articain is the most widely used local anesthetic in continental Europe. All substance names are derived from the root word of cocaine.
In 1981 intraligamentary anesthesia was developed as a new method of anesthesia . Small amounts of the local anesthetic are injected at the edge of the tooth. The first attempts to do this were made in France as early as 1920, where reports of anesthesia par injections intraligamenteuses (English: anesthesia through intraligamentary injections) are reported. It was based on the development of the Wilcox-Jewett obtunders for injecting cocaine for local anesthesia of the gums. but did not establish itself as the standard method.
Syringes set
After Robert Boyle and Christopher Wren had already experimented with syringes in the 17th century, the syringe is attributed to the French field surgeon from the time of Louis XIV. Dominique Anel (1679–1730), who used it to clean wounds. Charles-Gabriel Pravaz (1791-1853) developed a syringe for subcutaneous injection in 1850, which is considered the prototype of the hypodermic syringe at all. Georges Guillaume Amatus Lüer (1802–1883), who was born in Braunschweig and whose syringe model was based on the principles of the Englishman Daniel Ferguson , was one of the skilled instrument makers in France . Ferguson's syringe was originally also used for subcutaneous injection to burn a skin lesion using ferric chloride solution . The Irish doctor Francis Rhynd (1801–1861) invented the hollow needle and tried it on a patient in 1844. For the application of an anesthetic, the Maison Lüer patented an all-glass syringe in 1897, which in 1909 at the latest had competition from a construction by the Berlin-based instrument maker Dewitt & Hertz. Its detachable “Record precision syringe” made of glass and metal was characterized by its high degree of tightness and was able to completely empty the injection solution. However, their cannula connection had a different diameter than Lüer syringes and either suitable cannulas or adapters had to be used. The "boiling out" of " record syringes " was supposed to meet the hygiene requirements that were recognized as necessary in the second half of the 19th century until the corresponding disposable items were introduced in the middle of the 20th century .
The New Zealand pharmacist , veterinarian and inventor Colin Murdoch (1929–2008) invented the disposable syringe made of plastic . Murdoch presented his invention to the health department, where it was classified as "too futuristic". In the absence of financial support, the further development of his idea came to a standstill for several years. When he was awarded the patent in 1956, the disposable syringe was a worldwide success and is still in use millions of times a day in the 21st century. The cannula attachment is still based on the Lüer standard , named after the German instrument maker Hermann Wülfing Luer , who worked in Paris . Its patent was taken over by Maxwell W. Becton and Fairleigh S. Dickinson in 1898 and founded the medical technology company Becton Dickinson . The company later developed Murdoch's invention and launched BD Plastipak in 1961 .
In 1917, the American doctor Harvey Samuel Cook (1888–1934) developed the cylindrical ampoule syringe, which was mainly used in dentistry . Here, a cartridge (cylinder ampoule) containing the local anesthetic, a cylindrical glass body, the front end of which is closed with a membrane and can be pierced by a cannula, is inserted into a syringe set. The rear end of the ampoule is sealed off by an axially displaceable piston stopper. The plunger stopper is hooked onto the rod and can thus be withdrawn for the aspiration test. The inside of the cylinder ampoule is siliconized to allow the plunger stopper to slide more easily.
See also
History of Dental X-ray
"Oh, if only there was a means to make people transparent like a jellyfish!", The young country doctor Redlich dreams of in the hope of confirmation of his diagnosis from a local priest. After the wish has hardly been expressed, the female figure of light Elektra appears to the doctor and hands him a can "for the sake of mankind", the magical light of which makes the body completely transparent. With it he can make the diagnosis and heal the pastor of Trichinen . He researches and analyzes the agent, creates it artificially and gives it as a gift to all of humanity. “A new, glorious time has now dawned for us doctors.” The German doctor and writer Ludwig Hopf published Elektra under his pseudonym Philander in 1892 , a physics-diagnostic fairy tale from the twentieth century that actually became reality only three years later. On November 8, 1895, the physicist Wilhelm Conrad Röntgen discovered the very penetrative invisible radiation that he presented to the Physico-Medical Society on January 23, 1896. The hand of the anatomist and physiologist Albert von Kölliker was used as an object of illustration. After the performance, Kölliker suggested naming it as X-rays . Up until then, Röntgen had used the term X-rays ("X" for "unknown"). In Central and Eastern Europe they are called X-rays - with the appropriate language adaptation. In other language areas dominated the designation X-rays such as in the English language as X-Rays , in French as rayons X .
Also in January 1896, the dentist Otto Walkhoff , who was an X-ray patient, had the first X-rays of his teeth taken by his university professor and friend Friedrich Oskar Giesel together with Wilhelm König (1859-1936), with an exposure time of 25 minutes. In some patients, hair loss could be observed after the X-ray. Years of unprotected, careless handling of radiating substances finally took its toll. After a long and agonizing infirmity, Giesel died in 1927 at the age of 75 of cancer caused by extreme radiation damage to his hands. Frank Harrison made simultaneously in England the first X-rays of the teeth on, William James Morton jun., Son of William Thomas Green Morton ( so ) in the US.
Radiation protection
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The use of X-rays in diagnosis in dentistry was made possible by the pioneering work of C. Edmund Kells (1856–1928, see below ), a dentist from New Orleans , who demonstrated it to dentists in Asheville in July 1896 . Kells committed to a long history of suffering by radiation-induced cancer, suicide . He was amputated one finger after the other, later the whole hand, followed by the forearm and then the whole arm. Like many others, he went down in history as a “martyr for science”. Sarah Zobel of the University of Vermont refers in her article The Miracle and the Martyrs (English: "The miracle and the martyrs") to a banquet that was held in the year 1920 in honor of many pioneers of X-raying. There was chicken for dinner: “Shortly after the meal was served, it could be seen that some of the participants were unable to enjoy the meal. After years of working with X-rays, many participants lost their fingers or hands to radiation exposure and were unable to cut the meat themselves. ”The first American to die from radiation exposure was Clarence Madison Dally , assistant to Thomas Alva Edison . Edison began examining X-rays almost immediately after Röntgen's discovery and delegated that task to Dally. However, his death in 1904 caused Edison to give up any further X-ray research.
In 1901, the dentist William Herbert Rollins (1852–1929) demanded that when working with X-rays, protective goggles with lead glass should be worn, the X-ray tube should be enclosed with lead and all areas of the body should be covered with lead aprons . He published over 200 articles on the possible dangers of X-rays, but his suggestions have long been ignored. A year later, Rollins wrote in desperation that his warnings about the dangers of X-rays were being ignored by both industry and his colleagues. At this point, Rollins had already shown that X-rays can kill laboratory animals and cause miscarriages in guinea pigs. Rollin's merits were recognized late. Since then he has gone down in radiology history as the "father of radiation protection". He became a member of the Radiological Society of North America and its first treasurer.
In the year Kells died, the first radiation protection regulations were enacted by the International Congress of Radiology (ICR). Kells founded the International Commission on Radiation Units and Measurements in 1925 . Wilhelm Konrad Röntgen himself was spared this fate through a habit. He carried the unexposed photographic plates around with him at all times in his pockets and found that they would be exposed if he stayed in the same room during the radiation exposure. So he regularly left the room to take x-rays. Between 1920 and 1940, 51 fatal and 62 serious electrical accidents involving the use of X-ray machines as a result of high-voltage accidents were found in the USA. This affected both doctors and patients. They could only be reduced through stricter regulations, especially through better insulation of the connection cables. A radiology memorial in the garden of the St. Georg Hospital in Hamburg-St. Since April 4, 1936, Georg has been remembering 359 victims from 23 countries among the first medical users of X-rays.
In Germany, an X-ray Ordinance ( RGBl. I p. 88) was first issued in 1941 and originally applied to non-medical establishments. The last new version of the X-ray Ordinance was issued on January 8, 1987, followed by a new notice of April 30, 2003 for the implementation of two EU directives on the health protection of persons against the dangers of ionizing radiation in the event of medical exposure.
equipment
Max Gebbert ensured that as early as 1896 production by the company Reiniger, Gebbert & Schall (RGS) concentrated primarily on X-ray tubes and devices. The physicist Joseph Rosenthal , whom Gebbert had hired, was ultimately the one who designed a special X-ray tube for medical diagnostics and had it manufactured by the Emil Gundelach company in Thuringia. The company RGS was later taken over by Siemens ( Sirona ).
At the same time, Albert Koett , who brought the know-how with him from Germany, began producing the X-ray machine known as the Great Flame in the USA . The company Kelley-Koett brought it onto the market together with J. Robert Kelley . In 1919 the physicist Alfred Unartikel and the glass blower Otto Kiesewetter founded the company Unartikel & Kiesewetter for the manufacture of hot cathode X-ray tubes. The Hamburg tube manufacturer CHF Müller and its parent company Philips bring the first rotating anode tube on the market under the name "Rotalix", which was developed by Albert Bouwers (1893–1972). The prototype was used in Chicago in 1937. Because of design problems, but also because of the Second World War, it did not appear on the market until 1947 under the trade name Oralix . In 1933 Siemens developed a rotating anode tube called Pantix . This laid the foundation for the development of modern X-ray tubes. A year later, Siemens launched the X-ray sphere, which had been sold around 30,000 times around the world up until the 1970s. At that time, dentists discovered the X-ray as a marketing tool and advertised with the addition "X-ray" on their practice sign.
Dental film x-ray
The first celluloid-based film was invented by the Anglican clergyman Hannibal Goodwin , for which he applied for a patent in the USA on May 2, 1887. He fought for eleven years with the George Eastman Company (now Kodak ), which ultimately had to pay him five million dollars for the rights in 1914. In 1933, DuPont developed a blue-tinted "Safety film" that replaced the nitrate film with a cellulose acetate film. It was called a safety film because the highly flammable nitrate film caused numerous fires. Photochemistry received a further boost from the two scientists from Agfa Kozlowski and FWH Müller, who were able to increase film sensitivity in 1935 by adding small amounts of gold to the silver bromide emulsions . The use of intensifying screens in the production of dental films has been investigated by Voss and Hickel, but has not caught on because of the loss of image quality.
Antoni Cieszyński (1882–1941), a Polish doctor, dentist and surgeon who is considered the founder of Polish dentistry, developed the half-angle technique in Munich in 1907 , a process for the distortion-free representation of teeth in dental radiology. He was murdered by the SS on July 4, 1941, along with 24 other Polish professors during the Lwów massacre .
The bitewing (ger .: bitewing ) in 1925 Howard Riley Raper (1887-1978), university teacher of dental radiology in Ohio introduced, with an advanced caries diagnosis in interproximal (interdental) is performed. If there is little periodontal bone loss, it can be used as the periodontal status .
Panoramic X-ray
The Japanese Hisatugu Numata developed the first panoramic X-ray machine in 1933/34 . This was followed by the development of the intraoral panoramic X-ray devices , in which the X-ray tube is intra-oral (inside the mouth) and the X-ray film is extra - oral (outside the mouth). At the same time, Horst Beger from Dresden in 1943 and the Swiss dentist Walter Ott in 1946 were busy with it, which resulted in the Panoramix ( Koch & Sterzel ), Status X ( Siemens ) and Oralix ( Philips ) devices .
Yrjö Veli Paatero (1901–1963) from Finland developed the Numata technology together with the engineer Timo Nieminen and initially gave the device he developed the name “Parabolography”, which he changed to “Pantomography” in 1950, before moving in 1958 at the suggestion of Japanese Eiko Sairenji coined the name "Orthopantomography" (OPG). The Finnish company PaloDEx (previously Ruusuvaara Oy ) brought the orthopantomograph onto the market in Europe together with Sirona in 1964 . In the USA it was marketed by SS White under the name Panorex . The X-ray tube and the X-ray film rotate synchronously around the patient's head.
Fluorescent foils were added to the X-ray films as X-ray intensifying foils , whereby 90% of the film blackening was achieved by luminescence and only 10% by direct X-ray exposure and which has led to a considerable reduction in radiation exposure . Thomas A. Edison's collaborators found out in March 1896 that calcium tungstate (CaWO 4 ), glowing blue, is a suitable phosphor that quickly became the standard for intensifying screens . It was not until the 1970s that calcium tungstate was replaced by intensifying screens with luminescent substances ( lanthanum oxybromide , gadolinium oxysulphide ) based on rare earths that were even better for amplifying and more finely detailed .
The intraoral panorama devices were finally abandoned at the end of the 1980s, as the radiation exposure in direct contact with the tongue and the oral mucosa through the intraoral tube was too high.
Digital X-ray
In 1987 Trophy Radiology (France) launched the first digital X-ray machine for dental films under the name “Radiovisiography” (RVG). In 1995 DXIS, the first digital panoramic x-ray machine, developed by Catalin Stoichita , was introduced by Signet SAS (France), whereby analogue machines could also be retrofitted. In 1997, SIDEXIS (Siemens, later Sirona ) followed with the Orthophos Plus. Instead of a film, X-ray imaging plates are used. A scintillator converts incident X-ray photons either into visible light or directly into electrical impulses. The data recorded in the detector are digitally passed on to a computer screen.
"Cone beam computed tomography" (Cone-Beam CT (CBCT)) was developed by the Italian research group Attilio Tacconi, Piero Mozzo, Daniele Godi and Giordano Ronca in 1996 (NewTom 9000) and is available in German-speaking countries as Dental Volume Tomography (DVT) ( also known as digital volume tomography).
Milestones in modern dentistry
Due to the general technological progress and the development of new materials as well as the surgical treatment procedures made possible under local anesthesia and the radiological diagnostic options, dentistry and dental technology experienced a rapid development, which is outlined below.
Prevention
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toothbrush
In China, the first was Toothbrush from pig bristles found that resembles a modern toothbrush, but the Tang dynasty dates from the period (619-907). In 1223, the Japanese Zen master Dōgen Kigen ( Japanese希 玄, 永平) made records in his main work Shōbōgenzō (Japanese: 正法 眼 zeichnungen) that monks in China brush their teeth with brushes made from ponytail hair. Travelers brought the toothbrushes to Europe, where they became popular in the 17th century. Various toothbrush sticks were used ( see above ). The bristles were made from the hair of a pig's neck and attached to handles made of bone or bamboo . The bristles of these natural bristle toothbrushes cause tooth damage because they are cut during manufacture, resulting in sharp ends which in turn damage the tooth enamel . In addition, they are considered unsanitary. Allegedly, William Addis was thrown in jail for a seditious activity and made a toothbrush there. After his release, he began mass producing toothbrushes in England around 1780. The dentist Levi Spear Parmly from New Orleans recommended his patients in 1815 silk thread to clean between the teeth. The first commercially produced unwaxed dental floss was made in 1882, with Johnson & Johnson securing a patent for it in 1898. Mass production of toothbrushes began in France, Germany and Japan in 1840. Wallace Hume Carothers invented nylon in 1934 , which was first used in the manufacture of nylon toothbrushes in 1938 by DuPont under the name "Doctor West's Miracle Toothbrush". Plastic bristles have rounded and therefore gentle tips on the individual bristles due to the melting of the plastic ends. The first electric toothbrush "Broxodent" was developed by Philippe-Guy Woog in Switzerland in 1954 and sold by Squibb from 1956 onwards .
Floss
The invention of the modern dental floss is attributed to the dentist Levi Spear Parmly (1790-1859) . In 1815 he recommended cleaning teeth with untwisted silk thread. The company Codman and Shurtleft began in 1882 with the production of unwaxed dental floss. Johnson and Johnson patented floss in 1898. The physician Charles Cassedy Bass (1875–1975) developed the dental floss made of nylon threads, which is still in use today. A toothbrushing technique ( shaking technique ) is named after him.
toothpaste
In 1850, at the age of 23 , Washington W. Sheffield invented the world's first toothpaste using glycerin . His son, Lucius Tracy Sheffield, observed the use of collapsible metal tubes for paints and varnishes while studying in Paris. From this, in 1876, he developed the idea of filling his father's toothpaste into such tubes. From 1887 Carl Sarg sold his Kalodont toothpaste in closable tubes in Vienna with a large advertising effort . Among the numerous recipes for toothpaste, toothwashes and mouthwashes that Alfred Sedlacek presented in his book in 1907, calodont is listed as dental soap, which contains glycerine, tooth powder and essential oils as well as cosmetic centrifuged soap and was filled in small tin tubes. In 1892, the Dresden entrepreneur Karl August Lingner brought the mouthwash Odol onto the market, a product that for the first time combined the cosmetic and medical effects by adding an antiseptic by adding essential oils . Inventor of the mouthwash, the later of GlaxoSmithKline was sold, was Richard Seifert . In the same year the Dr. Sheffield's Creme Dentifrice is produced and sold. In 1896 the Colgate company entered the toothpaste tube business and built an empire on the product.
Newell Sill Jenkins ( Sun ) developed together with Willoughby D. Miller ( Sun ) and the chemist Harry Ward Foote (1875-1942), a new toothpaste called Kolynos , the first time disinfectants and which was distributed from 13 April 1908th It is still widespread today, especially in South America and Hungary. Colgate-Palmolive acquired the product from American Home Products in 1995 for $ 1 billion. In May 1907, the Dresden pharmacist Ottomar Heinsius von Mayenburg produced a paste made of pumice stone powder, calcium carbonate , soap, glycerine and potassium chlorate , which he also flavored with peppermint and called chlorodont . It was made in the Leowerke . In 1915 Pepsodent was introduced in the USA , first in powder form and later also as toothpaste , which was taken over by Unilever in 1944 and by Church & Dwight in 2003 . It was advertised with the ingredient irium, an advertising name for sodium lauryl sulfate . Pepsin , which led to the name of the product, was also originally added.
From 1940 to 1945 the Berliner Auergesellschaft , founded by Carl Auer von Welsbach ( Osram ), produced a radioactive toothpaste called Doramad , which contained thorium-X and was sold internationally. It was advertised with the statement, “Due to its radioactive radiation, it increases the defenses of tooth and the like. Gums. The cells are charged with new vital energy, the destructive effectiveness of the bacteria is inhibited. ”The advertising message of gleaming white teeth was given a double meaning. Radium had already been added to toothpaste before . As strange as this may sound, from the First World War radioactivity was a symbol of modern achievements and was therefore considered “chic”. Radioactive substances were added to mineral water as well as to powder as cosmetics or condoms . Even radioactive chocolate fortified with radium was on the market. There was apparently no public sensitivity to the dangers of ionizing radiation during the Second World War in the time of National Socialism , but only arose after the atomic bombs on Hiroshima and Nagasaki , which made this toothpaste unmarketable, perhaps also because the works of the Auergesellschaft were completely bombed in 1945 were. Radioactive substances were also temporarily added to Kolynos toothpaste at the end of the 1940s. Later, chlorophyll added.
Fluoridation
Since 1874 “fluoride pastilles” have been used to prevent tooth decay, which go back to Karl Wilhelm Eugen Erhardt (1812–1875). The first oral care products containing fluoride (toothpaste, tooth powder, and mouthwash) were made in 1895. Inspired by the work of Albert Deninger, they were marketed by the chemical company Karl Friedrich Töllner from Bremen under the brand name "Tanagra". In Europe, however, despite a relatively long history (since the beginning of the 19th century) and early, locally limited individual activities, the use of fluoride for caries prophylaxis only found greater interest after the end of the Second World War. The main reasons for this were contradicting analytical data, low echoes in dental circles and the toxic potential of fluorides. Toothpastes containing fluoride only became more widely used after their caries-protective effect had been recognized in the USA . Strongly increased natural fluoride concentrations in drinking water in some areas of the USA were found to be the cause of tooth enamel discoloration in 1931 . This was preceded by research by Frederick Sumner McKay (1874-1959) and Greene Vardiman Black since 1909 in Colorado Springs , where the tooth discoloration was referred to as "Colorado Brown Stain". At the same time, there was a noticeably lower caries incidence in the affected regions. From William John Gies' vision of drinking water hygiene under the supervision of the dental profession , after epidemiological studies, the idea finally developed of enriching tap water with fluoride to prevent tooth decay. Fluoride solutions and gels for topical use in the dental practice have been tested and, finally, toothpastes containing fluoride have also been advertised intensively since the 1950s. According to the latest research, fluorides develop their caries-protective effect mainly when applied locally.
Oral epidemiology
In the 1930s, the DMFT index became an important tool for comparing dental health across populations. The index recorded carious ( Decayed ), missing ( Missing ) and filled ( Filled ) Teeth (Teeth) - each per child per 100 children or per 100 examined teeth - and was supported by the WHO or developed for DMFT index for DMFS index , which also includes the tooth surfaces ( Surface ). The parameters mentioned for the caries status were first used in 1931 by Selwyn D. Collins, chief statistician at the US Public Health Service, and Tagliafero Clark when examining school children and evaluated as the percentage with at least one carious, filled or missing tooth. Shortly thereafter, Amanda L. Stoughton and Verna T. Meaker refined the measure by tabulating the percentage of children in different age groups with 1, 3, 5, 7, or 9 carious, filled, or missing teeth. For the analysis of data from the American Dental Association's first national caries survey (1934), physician Clarence A. Mills summed up the number of carious, filled or extracted teeth per 100 children for the first time and presented the numbers for each US state at the annual meeting of the International Association for Dental Research (IADR) in March 1937 in Baltimore. In December 1937, Henry Klein and Carroll E. Palmer published their study, with which Klein claimed priority for the development of the DMFT index and also claims to have shown for the first time a connection between the fluoride content of drinking water and the frequency of caries. Klein undoubtedly deserves the credit of discussing various disruptive factors in his 1937 work and examining influences such as age, gender, time of tooth eruption, etc. on the DMF index in a subsequent series of studies. After quarreling with Henry Trendley Dean , Klein left the Public Health Service and moved to Paris. With the introduction of the DMFT index, the era of oral epidemiology began , whereupon the WHO, together with the FDI World Dental Federation , set global oral health goals for the first time in 1981 . On the occasion of the FDI General Assembly in Sydney in 2003, these objectives were taken up again by an international working group made up of representatives from the FDI, WHO and IADR and revised for the new millennium by 2020. Since the first German oral health study (DMS I) in 1989, the Institute of German Dentists (IDZ) has been researching the oral health of the population in Germany on behalf of the National Association of Statutory Health Insurance Dentists ( KZBV) and the German Dental Association (BZÄK). The Fifth German Oral Health Study (DMS V) was published in 2016 .
Tooth sealing
Frederick Sumner McKay described the preventive measures used by dentists in the 1940s to fill the chewing surfaces of caries-free teeth with fillings as "excellent dentistry" , which on the one hand falsifies the DMFT / S index, but on the other hand prevents the development of carious lesions in the fissures. The principle of tooth sealing described for the first time in 1955 by Michael G. Buonocore (1918–1981) was less invasive . He conducted controlled clinical studies together with Eriberto Ivan Cueto in the mid-1960s. It is most commonly used in children and adolescents to protect fissures (dimples) on the chewing surfaces, as well as plaque-retaining buccal and palatal fissures, including the dimples at the transition to the Carabelli tuberosity and the caecal foramina on the upper incisors . The fissures are filled with a light-curing varnish that adheres microretentively to the previously etched tooth enamel . In 1976 the procedure was recognized as safe and effective by the American Dental Association (ADA), the association of American dentists, and was subsequently used worldwide in the prevention of tooth decay.
School dental care
In 1743, the Frenchman Robert Bunon made extensive explanations on children's dentistry in his book Essay sur les Maladies des Dents . He pointed out the importance of proper nutrition during pregnancy and childhood in this regard. John Greenwood first promoted reduced-fee dental care to children in his New York practice in the 1780s. He was followed at the beginning of the 19th century by Christophe François Delabarre (1787–1862), who took care of the dental care of children in orphanages in Paris . The first known child prophylaxis program was launched in 1851 by Amédée-Jules-Louis François dit Talma (A.-F. Talma, 1792–1864) in Brussels , the dentist of the Belgian King Leopold I. Palma is also considered the founder of Belgian dentistry . All children between the ages of five and twelve should have had a dental exam and treatment since then. In the second half of the 19th century the first clinics for children's dentistry were founded in Strasbourg , Hanover (by Karl Kühns ), Offenbach am Main and Würzburg . The first legislation on school dental care was passed in 1898 by the Prussian Ministry of Culture. The first screening tests were carried out in schools in Strasbourg in 1900.
In October 1902 the world's first school dental clinic was opened in Strasbourg by Ernst Jessen , who is known as the “father of school dental care”. The creation of the "German Central Committee for Dental Care in Schools" by the central associations of pension and health insurance carriers, representatives of the regional authorities, dentists and dentists in 1909 marked the birth of the German Working Group for Youth Dental Care (DAJ). In 1909 there were already 40 school dental care centers in Germany, caring for a total of 700,000 school children. After the First World War, the number of school dental care facilities increased from 229 in 1919 to over 1000 in 1930. In the absence of a uniform legal regulation, there was a system conflict between different models. Alfred Kantorowicz , who (like Lem'i Belger) was of great importance for the development of dentistry in Turkey from 1933 , also advocated school dental care at the 9th International Dental Congress of the Fédération dentaire international in Vienna in 1936 and also in Turkey In 1948 he pointed out the requirements of oral hygiene and dental care or caries prophylaxis, developed the "Bonn System", Hans Joachim Tholuck the Frankfurt system. There was also the Mannheim system, a referral system to resident dentists.
The first free dental clinic for children established by members of the Rochester, New York Dental Association for Children in Need in 1901, took on the entire financial burden of George Eastman , founder of the Eastman Kodak Company . A corporation was formed in October 1915 that came to be known as the Eastman Dental Dispensary (EDD). The building was inaugurated in 1917. A dental hygienist school was attached. In 1914, Germany was at the forefront of all civilized states in the field of social hygiene. Norway was the first country to introduce state-funded school dental care in 1919. In the Jüterbog-Luckenwalde districts , a car was used as a school dental clinic , which examines and treats the schoolchildren for their teeth. In 1929, a treatment room was set up on a train in the state of Queensland in northeast Australia to treat children in remote locations. During the world wars, after initial Nazi propaganda, dental care for young people came to a standstill (see below: National Socialist school dental care ).
On July 8, 1949, the "German Committee for Youth Dental Care" was founded, with which group prophylaxis ("school dentist") was established across the board. In addition, the specialization in children's dentistry slowly developed .
The oldest school dental clinic in Switzerland was founded in Zurich in 1908. The school medical service , which also employs the school dentist, is responsible for dental checks. The service, like the school system, is regulated by the cantons.
Forensic dentistry
A few cases, particularly since the Middle Ages, have been reported in which identifications were made based on the dentition. In 1881, after the fire in the Vienna Ring Theater , the method of identification based on the position of the teeth was practiced for the first time on the recovered and severely destroyed corpses, thus laying the foundation for the later renowned "Vienna School of Criminology". According to official information, the death toll was 384. Ludwig Eisenberg writes of almost 1,000 deaths. The dentist Oscar Amoëdo y Valdes (1863–1945) from Cuba , however, is referred to as the father of forensic dentistry . The occasion was a tragic fire disaster at a charity event in Paris , the Bazar de la Charité , in 1897 , at which 129 people were killed. Amoëdo was not involved in identifying the burn victims himself, but interviewed the people involved and published the results in the first book on forensic dentistry, L'Art Dentaire de Medicine Legale . But he himself names Albert Hans, the Paraguayan consul, as the originator of forensic dentistry. He called the dentists treating the burn victims together in order to identify the victims. In the 1940s, dentists began to engrave the patient's name on the prosthesis. This made it easier, if necessary, to identify people with prostheses marked in this way. The dentist Paul Revere expanded these identification possibilities and has since been considered a co-founder of forensic dentistry . Werner Hahn (1912–2011), former director of the Clinic for Oral and Maxillofacial Surgery at the Christian-Albrechts-Universität zu Kiel , founded the Working Group for Forensic Odonto-Stomatology in Germany in 1976 as a board member of the DGZMK (AKFOS ) and was its chairman for more than 20 years. From the very beginning he campaigned for further training to become a "specialist dentist for forensic odontology", but without success.
Precious metal-free alloys
At the end of the 19th century, the American Elwood Haynes developed a cobalt -based alloy (starting point for the stellite group ), which he applied for a patent in 1907. It forms the basis of the chrome-cobalt-molybdenum alloys , which are still used in dentistry today and which were introduced as Vitallium in 1932 , for model casting prostheses and for crown and bridge technology. As a rule, the ceramic-on cobalt-chromium alloys differ from the model casting alloys in that tungsten is added . One of the first cobalt-chromium alloys that can be veneered with the low-melting and high-expansion ceramics was developed by the Bremer Goldschlägerei BEGO in 1999.
Attachment of partial dentures
In 1965, the Ney clasp system was introduced for attachment to the teeth. A large group of support members provide attachment is, which were designed in numerous variations. Dolder had improved the principle of the bar connection. Articulated connections followed, such as the Frey or Biaggi joint and removable latch or swivel bridges, which are secured to a fixed bar structure with the help of a latch or a spring. In 1929, Karl Häupl referred to the advantages of anchoring using telescopic crowns with greatly reduced residual dentition. In 1968, KH Körber developed the conical crowns, which eliminated the clearance fit of the telescopic crowns.
Root canal treatment
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The world fame of Philadelphia and its great influence on the development of endodontics over almost two centuries can be traced back to the work of Louis I. Grossman in Philadelphia and his successors at the chair named after him, Leif Tronstad and Syngcuk Kim , although the first attempts have already - as described - go back to Fauchard, Hunter and Pfaff. Eduard Albrecht wrote the first monograph on endodontics in 1858; this was followed by the introduction of arsenic as a means of devitalization by John R. Spooner (1836). The inventor of the extirpation needle (1840) and the associated vital extirpation is considered to be Edward Maynard (1813–1891), who filed it out of watch springs. Maynard was among other things the dentist of the Russian Tsar Nicholas I , the King of Prussia Friedrich Wilhelm IV. And the Swedish King Oskar I. The Swiss Alfred Gysi invented the Triopaste ( Paraformaldehyde , Tricresol and Creolinum anglicum ) in 1889 and suggested using the root canal Hydrogen peroxide (H 2 O 2 ) which goes back to Louis Jacques Thénard (1818) to purify. Sodium hypochlorite (NaOCl) was successfully used by Henry Drysdale Dakin in 1915 as a wound disinfectant during World War I and found its way into endodontics as Dakin's solution . Grossman and Benjamin W. Meiman demonstrated the ability of NaOCl to dissolve tissue in the root canal in the mid-1940s, thus establishing the era of root canal irrigation. In 1922 Otto Walkhoff moved to the University of Würzburg. He dealt with the fine structure and pathology of teeth, including root canal treatment . The Walkhoff paste named after him, an iodoform paste, which is additionally mixed with chlorophenol - camphor - menthol (ChKM), is still used today as a therapeutic, temporary root canal filling. The term “endodontics” ( ancient Greek ἔνδον endon , German 'inside' , ancient Greek ὀδών odon , German 'tooth' ) is attributed to the dentist Harry B. Johnston from Atlanta (Georgia) , who in 1928 opened his own practice Limited to endodontics . In the same year, the French Henri Lentulo developed a variety of treatment techniques that are still used today by dentists around the world. This includes his spiral-shaped root filler, later named after him, for the mechanical filling of root canals and a root canal filling paste.
André Schröder introduced the first representative of the Wurzelfüllpasten on in 1954 ZOE basis as AH26 epoxy - Sealer before. 1959 by the two Swiss was Angelo G. Sargenti (1917-1999) and Samuel L. Richter with N2 medicine and sealer introduced that formaldehyde containing and other questionable ingredients to which swore some dentists, others criticized the fact that massive irritations caused the pulp up to the formation of periapical lesions. This was followed by the leather mix paste by André Schröder in 1962, a combination of an antibiotic ( tetracycline ) and a cortisone derivative ( triamcinolone ). The dissatisfaction with the root canal filling materials can be seen in the variety of pastes which include the polydimethylsiloxane , calcium hydroxide sealers, glass ionomer sealers or gutta-percha-based sealers or filling materials based on polyketone (diaket), methacrylate-based and salicylate-based .
In endodontics, gutta-percha has so far been the least controversial filling material . Gutta-percha sticks, which are used in the technique of lateral condensation , consist of 20–40 percent β-gutta-percha, 30–60 percent zinc oxide , wax or plastic , heavy metal sulfates , dyes and some trace elements . The sealers should also fill the remaining space in the root canal lumen. After 1847 Edwin Thomas Truman (1818-1905) gutta percha was used as a filling material, a secretion of trees of Sapotillafamilie , this came in 1850 mixed with lime , quartz and feldspar as a filling material under the name of the developer Asa Hill as Hill's Stopping on Market. After GA Bowman first filled root canals on an extracted molar with conical gutta -percha pins in 1867 for demonstration purposes, SS White brought ready-made gutta-percha pins onto the market in 1887.
The preparation of the root canal has been revolutionized by the replacement of stainless steel, the preferred material for root canal instruments for about a century, with nitinol instruments , a nickel-titanium alloy that belongs to the shape memory alloys . They were made by Harmeet D. Walia et al. Developed in 1988 and ensured a qualitative boost worldwide, as the preparation of difficult curvatures of the root canal has become safer thanks to the higher break and flexural strength of these instruments. Nitinol itself was developed in 1958 at the Naval Ordnance Laboratory (USA) by William J. Buehler and Frederick Wang.
drill
The hand drill initially developed by Jourdain and already described by Pierre Fauchard was followed in 1790 by the first step drill invented by George Washington's dentist , John Greenwood (1760-1819). His mother's spinning wheel served as a template . In addition, a hand crank drill was developed by Von Lautenschläger in 1803. In 1838, J. Lewis was the first to have one patented. In 1846 Wescott introduced a drill bit attached to a finger with a ring. In 1864, the invention of the followed Erado by the British Dental George Fellows Harrington , of a dental drill to a spring mechanism of a watch movement joined. The spring mechanism was wound up beforehand and then ran noisily for about two minutes. In 1871 James B. Morrison developed a pedal-operated dental drill based on the sewing machine principle . The first electric dental drill was patented by George F. Green in 1875 . Among the inventors is William Gibson Arlington Bonwill with his Bonwill dental engine , a similar but battery-powered development being brought onto the market by SS White in 1875. The era of the Doriot linkage began in 1893 , a belt drive for the transmission of torque from an electric motor to dental handpieces and contra-angles, which was invented by the Paris dentist Constant Doriot and which was standard equipment in a dental practice for almost 70 years. Hydraulically operated drilling machines were also used (English Water-Motor Dental Engine). By 1914, electric dental drills could reach speeds of up to 3,000 revolutions per minute. The Belgian Emile Huet (1874–1944) had designed a motor for dental treatment as early as 1911 that managed a speed of 10,000 / min, but the handpieces of that time were not designed for such speeds.
In 1945 Robert B. Black developed the first device called Air Dent (Air-Flow, Air-Polishing ) for use in cavity preparation and for prophylaxis . It contained a highly abrasive sodium bicarbonate powder. In 1949, John Patrick Walsh designed the air turbine handpiece together with colleagues from the Dominion Physical Laboratory in New Zealand . In 1950 the handpiece was further developed into a contra-angle handpiece . In 1965 the companies Kerr Dental and Siemens (later Sirona , since 2015 Dentsply International ) manufactured the first dental micromotors. Since the micromotor was attached directly to the handpiece or contra-angle handpiece, the problem of power transmission over a longer distance was eliminated. This was followed in 1957 by the development of a high-speed air turbine handpiece by John Borden , called Airotor ( Dentsply ), which considerably accelerated the preparation of teeth and tooth cavities with up to 300,000 revolutions per minute. Turbines were not yet built into the treatment device at the beginning. An air / water mixture ( spray ) cools the tooth surface through one to four nozzles during grinding. An integrated light guide has been providing a better view in the treatment area since 1987.
Periodontics
Periodontology traces its origins back to John Mankey Riggs (1811–1885). The periodontal disease was considered since the launch of its treatment techniques in 1876 Riggs disease called. He was an opponent of the gingival resection , which was practiced at the time, and advocated the removal of tartar including debridement and tooth polishing. He also emphasized the importance of oral hygiene in preventing periodontal disease. The writer Mark Twain , who went to Riggs to treat his periodontal disease, put Riggs' skills on paper in his short essay Happy Memories of the Dental Chair .
In the 19th century periodontopathies had numerous names, such as alveolar pyorrhea , alveolitis infectiosa , caries alveolaris , Geissel medicorum, pyorrhee interalveolodentaire or pyorrheea alveolaris . Her treatment was limited to the removal of tartar, the cupping of the gingiva and the excision of the hyperplastically altered tissue. In Germany, Oskar Weski (1879–1925) is considered a pioneer in periodontal treatment. In 1921 he coined the terms paradentium and paradentosis (which were later replaced by the etymologically correct terms periodontium and periodontitis ).
Charles Cassedy Bass (1875–1975) tried drug treatment for periodontal disease . He still called the disease pyorrhea , for which he made Endameba buccalis ( Entamoeba gingivalis ) responsible. He developed the bass technique (shaking technique) for brushing teeth.
Thomas B. Hartzell refuted the Bass thesis and suggested a thorough removal of the tartar in combination with periodontal surgical measures. In 1922 Paul R. Stillman and John Oppie McCall published the first authoritative textbook in this field, A Textbook of clinical periodontia . He developed the Stillman toothbrushing technique named after him . The Stillmanspalte (English: Stillman's cleft ) of the gums, a gap-like decline, going back to him. Tissue regeneration methods ( Guided Tissue Regeneration (GTR), the principles of which were developed by Lloyd A. Hurley and Frank E. Stinchfield , and Guided Bone Regeneration (GBR)) lead to better results in the treatment of periodontal disease. With these bone augmentation procedures , degraded alveolar bone can be rebuilt. The basics of the GTR come from the orthopedic research of LA Hurley and F. e. Stinchfeld from 1959, on which AH Melcher developed the theoretical basis in periodontology. This was followed by the development of membranes made of polytetrafluoroethylene (PTFE) with the aim of rebuilding lost alveolar bones. For this purpose, the slow bone-forming cells should be shielded from the faster growing connective tissue cells by the membrane. In 1957 Dentsply launched the Cavitron , a device for removing tartar using ultrasound .
Implants
The first implantations to replace teeth are documented in the 7th to 8th centuries among the Mayans by the Italian professor of implantology at the University of Santos (Brazil), Amedeo Bobbio . In a fragment of the lower jaw bone of a young woman there are three implants made from a milled mussel shell. Due to the radiologically proven osseointegration, these mussel implants were inserted during lifetime and not post mortem . Another fragment from the time of the Mayans, which was found and described by the archaeologist RR Andrews, in which a "black stone" should have been implanted as a lower jaw anterior tooth, can no longer be found. Until it was proven by Bobbio in 1970, the mussel implants were considered to be inserted post mortem, in the sense of a funeral ritual.
Other attempts to replace missing teeth are not to be called implants, such as the transplantation or reimplantation of teeth and teeth made of organic or inorganic materials such as ivory or walrus teeth and their attachment to the existing teeth by means of gold threads or gold bands. This also included transplantation of the teeth of the dead, as mentioned in the Middle Ages by Abulcasis and in the early modern period by Pierre Fauchard and Ambroise Paré and many others as well as during the Battle of Waterloo (1815) and other wars.
In 1806 Giuseppangelo Fonzi (1768–1840) invented the artificial ceramic tooth, a discovery that was of great importance for the future development of implantology. He manufactured artificial teeth that were implanted directly into the socket with platinum hooks and that met both aesthetic and functional requirements. A first metal implant made of gold was designed by the Italian J. Maggiolo in 1809 and inserted into a fresh human extraction wound. Maggiolo practiced in Paris and published his findings in his book Le Manuel de l'Art du Dentiste in Nancy.
Around 1840, Chapin Aaron Harris and Horace Henry Hayden , founders of the Baltimore College of Dental Surgery , tried endosseous implants with teeth made of iron and later of lead. Several similar case reports followed by Rogers (1845), Younger (1885), Edmunds (1886), Edwards (1889), and Payne (1898). In 1895 William Gibson reported to Arlington Bonwill about gold and iridium abutments that he implanted in alveoli to replace individual teeth and restore entire dental arches.
Alvin Strock installed the first Vitallium screw implant as a tooth root replacement in the USA in 1937 . Vitallium was the first biocompatible metal, developed a year earlier by Charles Venable , an orthopedic surgeon. The beginning of endosseous implantology is attributed to Manlio Formigini , who recommended a helicoid screw ( Greek : ἑλικοειδής helikoeidēs , as if twisted) made of tantalum . He is known as the father of modern implantology. This was followed by the Raphaël Cherchève screw or the tantalum screws and needle implants by Jacques Scialom and Ernst-Helmut Pruin . The complication-prone subperiosteal framework implants located under the periosteum, which were developed by Müller in 1937 and were widely used in the 1950s and 1960s, formed a side route.
In the 1960s, the blade implant was designed by Leonard I. Linkow ( Linkow Blade ), as was the stabilized blade implant in 1975 by Benedict Heinrich . The development of implantology continued with the discovery of the biocompatibility of the titanium surface by the Swedish orthopedic surgeon Per-Ingvar Brånemark (1929–2014) in 1967, who coined the term osseointegration (functional and structural bond between the bone tissue and the implant surface ) and his Results presented to the scientific public in 1982. In 1974 Werner Lutz Koch (1929–2005) introduced the IMZ implant as a windowed cylinder implant with an intramobile plastic element that was supposed to act as a shock absorber, which was further developed by Axel Kirsch . Like the all-ceramic systems made of aluminum oxide ceramics, such as the Tübingen immediate implant developed in 1976 by Willi Schulte (1929–2008) and Günther Heimke , it often tended to fracture the implant, despite its excellent healing properties. In 1977 Philippe Daniel Ledermann (* 1944) developed the one-piece, self-tapping titanium plasma spray coated TPS screw implant, which was further developed in 1988 into the new Ledermann screw (NLS) made of titanium. It was used for the immediate prosthetic restoration of the edentulous lower jaw with four interforaminal (between the two foramina mentalia ) inserted and splinted by a bar. With the titanium implants , the worldwide spread of dental implants began. Bone regeneration process guided bone regeneration (GBR) can implant restorations to with increased bone loss.
Tooth scheme
The tooth schemes according to Zsigmondy (1816–1880) and Haderup (1845–1913) are of historical importance. In 1928, IBM patented an 80-column punched card format with rectangular holes, which was widely used as the IBM card until the 1970s . The Free University of Berlin had been using a tooth scheme since 1960 that was based on this punch card format and had been developed by the Berlin university professor Joachim Viohl . By limiting it to 80 columns, equal to 80 characters, the tooth scheme was compressed to just two digits. The entry into data processing was thus created. In 1970, the Fédération Dentaire Internationale (FDI) adopted the dental scheme recommended by Viohl as an internationally valid dental scheme at its annual meeting in Bucharest. It has also since been used by the World Health Organization as the WHO Dental Scheme. It is also known as ISO 3950 notation. Other sources name Theilman as the author who is said to have developed it in 1932. In the American tooth scheme ( Universal Numbering System ), which was developed in 1883 by the British George Cunningham (1852-1919), the teeth are numbered from 1 to 32 clockwise, starting with the upper right wisdom tooth and ending with the lower right wisdom tooth. It is still preferred in the USA. In the United Kingdom, the Palmer (1820-1917) tooth scheme is used.
laser
The CO 2 laser was developed in 1964 by the Indian electrical engineer and physicist Chandra Kumar Naranbhai Patel , at the same time the nd: YAG laser (neodymium: yttrium-aluminum-garnet) in the Bell Laboratories by LeGrand Van Uitert and Joseph E. Geusic and the Er : YAG lasers and have been (also) used in dentistry since the early 1970s. In the hard laser area, there are two main systems for use in the oral cavity: the CO 2 laser for use in soft tissue and the Er: YAG laser for use in hard tooth substance and in soft tissue. With the soft laser treatment , biostimulation with low energy densities is aimed for.
Dentine adhesives
Dentin-adhesive fixings are used to fix filling material (composite) or dentures to the tooth. The Swiss chemist Oskar Hagger made his first attempts in 1948 with glycerophosphoric acid dimethylacrylate, which have since led to the 7th generation of dentine adhesives. The thin- bodied dentine adhesion promoters penetrate the surface structures of the tooth and, after chemical hardening, form a micromechanical bond between the dentine and the composite filling or the cementation plastics of the dental prosthesis. In addition, there is microretention on the tooth enamel.
Rubber dam
A pioneering method for rubber dam isolation, described in 1836, can be traced back to Rich, in which the individual tooth to be treated - similar to today's matrices - was isolated by a gold foil lashed tightly around the tooth equator. The name “coffer dam” was used for this and similar tools. Analogous to this method, single tooth isolation made of wax [Swinell, 1850] or plaster of paris [Mills, 1862] came into fashion and soon disappeared again. The rubber dam (English: cofferdam) in the sense of a rubber blanket was introduced into dentistry in 1864 by the New York dentist Sanford Christie Barnum , a tension rubber that isolates the tooth to be treated from the oral cavity. The discovery of the chemical vulcanization of rubber to rubber by Goodyear in 1839 played a decisive role. Originally, it was used to keep the work area dry, as there were no dental suction systems at that time (the American Robert invented a pump for suctioning saliva Arthur 1854). Two years later, the case Dama turn by the in was Dresden American US practicing dentist Newell Sill Jenkins ( as made famous in Germany), which she found in Europe-wide distribution. With the introduction of suction systems in the 20th century, the acceptance of the rubber dam by dentists decreased and its advantages were forgotten. The renaissance of the cofferdam in the 1980s with the endodontics (root canal treatment) and filling treatment using composite restorations in enamel-dentin adhesive technique requiring draining of the tooth to be treated.
CAD / CAM
François Duret is considered to be the founder of dental prostheses manufactured using CAD / CAM . In 1971 he began planning a CAD / CAM system that was originally developed in 1965 at Lockheed (aircraft construction, USA). In 1985 the first tooth crown was milled with great effort using the Duret system . In 1973 Altschulter developed an optical printing process based on holography . In 1980 Werner H. Mörmann and Marco Brandestini worked at the University of Zurich with a chairside system (manufacture at the treatment chair), from which the CEREC system later emerged. The introduction of an intraoral camera (CEREC Omnicam) in 2012 enabled powder-free digital impressions in natural colors. An optical impression of the already prepared tooth to be restored is scanned and a three-dimensional model is calculated. This can be displayed on the monitor and edited digitally. The data is then sent to the fully automated production device. Initially, the focus was on processing titanium, but now the processing of ceramics ( zirconium dioxide ) predominates . The workpieces are manufactured using milling technology or laser sintering processes .
Surgical microscope
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On January 15, 1907, Shirley W. Bowles, DDS, presented a dental microscope at a presentation to the Columbia Dental Society. In September 1921, has Carl Olof Siggesson Nylen during an intervention in the ear, nose and throat area , a surgical microscope used. In 1975 RR Baumann, who worked at the ENT clinic of the Julius Maximilians University in Würzburg , used a modern microscope for the first time in Germany, including as a dentist. In 1982 S. Selden recommended its use, particularly in the field of endodontics and oral surgery, because it enables minimally invasive, more precise treatments.
Space dentistry
In 1973, dentistry took the first step into space when Pete Conrad, as commander of the American space station Skylab, underwent a weightless dental examination by the aviation doctor and astronaut Joseph Peter Kerwin . Earlier that year, the Soviet cosmonaut Yuri Romanenko developed a toothache during his 96-day Salyut 6 flight. The cosmonaut had to endure the pain for two weeks before the crew could return to Earth. Since then, emergency dental equipment has been taken on space flights, which consists of 20 parts and which enables temporary restoration up to and including tooth extraction.
Astronauts use normal toothpaste. Instead of rinsing with water and then spitting into a sink, astronauts spit into a towel because of the weightlessness or they swallow the toothpaste. The toothbrush is then cleaned in the mouth by taking a sip of water in your mouth and waving the toothbrush in it.
Others
Mobile treatment units are increasingly being used for outreach care for people in need of care and people with disabilities . A suction unit , connections for micromotors for attaching contra-angle handpieces and an operating light are housed in a case, so that numerous dental treatments on the hospital or nursing bed are possible. In addition, small delivery vans are being converted so that a mobile, complete treatment room is available.
The cavity preparation is becoming more and more delicate with the aim of preserving as much of your own healthy tooth substance as possible, which means that Black's preparation rules are increasingly being abandoned .
The research deals with regeneration processes of tooth hard substances ( Electrically Accelerated and Enhanced Remineralization (EAER)), which should make the "drill" superfluous in the future.
Modern treatment unit
CAD / CAM system
Implant-supported bridge
Crown frameworks manufactured using the laser sintering process
Milled crown and bridge frameworks
Mobile treatment room
History of Orthodontics
There are also references to orthodontic treatment from the writings of Aulus Cornelius Celsus . He advised the removal of milk teeth to control the eruption of permanent teeth. Marc Aurels ' personal physician , Galenus von Pergamon, took up the idea of regulating teeth and describes how crowding can be reduced by narrowing teeth (by filing).
John Hunter ( Sun ), discovered that the front part of the lower jaw does not grow more from the age of one year, but that the growth of the lower jaw only takes place in the back of the mandible. He performed extractions of the milk teeth as a means of controlling the eruption of the permanent teeth. To eliminate progenous bite conditions, he developed a silver instrument with which the patient can shift the lower teeth distally by biting open (principle of the inclined plane). Étienne Bourdet (1722–1789), the most important dentist of the 18th century after Fauchard, carried out extractions (with the pelican) to create space in crowded areas.
Friedrich C. Kneisel wrote the first work on orthodontic appliances in 1836. This was followed by the introduction of the adjustable clasp band with tooth-fixed screws by Alexis JM Schangé in 1841. Five years later, these were supplemented by Claude Lachaise and Elisha G. Tucker with elastic bands for orthodontic purposes. In 1841 Joachim Lefoulon described orthodontic treatments in his book Nouveau traité théorique et practique de l'art du dentiste .
Classifications
Georg Carabelli (1788–1842) published the first acceptable classification of occlusion types in 1842:
| the regular dentition | mordex normalis |
| the straight teeth | mordex rectus = head bite |
| the open dentition | mordex apertus |
| the protruding dentition | mordex prorsus = prognathy |
| the backward dentition | mordex retrorsus = inversion |
| the zigzag bite | mordex tortuosus = crossbite |
| the old teeth | mordex senilis |
| the Greisenmund | os senile |
Edward Maynard first used elastic bands to regulate teeth in 1843. In 1850, EJ Tucker began making elastic bands for braces. Norman W. Kingsley published a book on modern orthodontics in 1858, and John Nutting Farrar was the first dentist to recommend applying force to teeth over time to straighten teeth.
In 1862 the anatomist Hermann Welcker (1822–1897) chose a different classification of malocclusions:
| Labiodont | The rows of teeth meet like a pair of pliers according to the type of their branches. |
| Psaliodont | The teeth overlap each other like scissors |
| Stegodont | As a result of an elevation of the intermaxillary jaw, the lower incisors are covered by the incorrectly protruding upper ones like a roof. |
| Opisthodont | The lower incisors are 3–10 mm behind the upper ones. |
| Hiatodont | When the rows of teeth are closed, a gap often extends to the first premolar between the upper and lower incisors. |
| (A progenous bite is missing). |
Edward Hartley Angle (1855–1930), a student of Bonwill, is considered the father of orthodontics in the USA. In 1899 he classified the various forms of malocclusion (misaligned teeth). The relative positional relationship of the human upper and lower jaw has since been described worldwide by the Angle classes . One of his students was the Berlin dentist Walter Zielinsky (1883-1918), who developed the circle named after him .
| Class I. | The dental arches in normal mesiodistal relationship (neutral bite). |
| Class II | The lower dental arch distal from the normal in its relation to the upper jaw (distal bite). |
| Class II / l | Cases with protruding upper incisors. |
| Class II / 2 | Cases with inverted incisors. |
| Class III | The lower jaw in its relationship mesial to the normal (mesial bite) |
Braces
Angle first used the technique of fixed braces . Here, brackets for attaching wire arches are integrated ( Edge-Wise technology ). Orthodontics slowly evolved from its niche position, which it held despite the developments brought about by Angle. Today's multi- band technology was initiated by W. Erie Magill in 1868 when he was the first to cement orthodontic bands on teeth. The oldest system of removable braces was the Crozat apparatus by George B. Crozat (1894–1966), who practiced in New Orleans , and his German colleague Albert Wiebrecht. They developed it when fixed band-arch appliances made of precious metals were common in orthodontics and tooth extractions were common for crowded areas. To do this, they replaced the fastening straps of these braces with retaining clips, as they were already known in dental prosthetics. Primarily, this method, introduced in 1919, made oral hygiene easier for the patient and readjustment for the practitioner. It reduced the risk of tooth root resorptions due to overdosed orthodontic forces and is also suitable for patients with periodontally damaged teeth. Viggo Andresen and Karl Häupl investigated the influence of the oral muscles on the development and healing of misaligned teeth in Oslo . From this they developed functional orthodontics and the activator as their basic treatment tool. The Berlin Dental Polyclinic was connected to the "Institute for advanced training courses in the subjects of operative, prosthetic and orthopedic dentistry", which Alfred Körbitz directed. Körbitz introduced the Angle-System to a certain extent in Europe and advocated “biological orthodontics”, in which teeth are moved using the least amount of force. He recognized the raphe median plane (sagittal central plane of the skull) on the skull as an auxiliary line for the symmetry comparison.
Charles Hawley invented the retainer around 1920 , which is used with the aim of stabilizing the teeth in the new target position.
In 1920 Alfred Kantorowicz founded the orthodontic department at the Rheinische Friedrich-Wilhelms-Universität in Bonn from a previously private dental institute . In 1927, Kantorowicz succeeded for the first time in the world in integrating orthodontics into the school dental clinic, thereby increasing the number of treatment cases by opening up the subject to broader groups of the population.
Based on materials and experience in dental prosthetics, active plates were developed by Charles F. Nord as a means of cost-effective “folk orthodontics”. After 1930, Artur Martin Schwarz and co-workers developed many variants and constructed various screw elements that patients can adjust themselves according to instructions. Until around 1980, active plates together with activators were the predominant means of orthodontic treatment in the growth phase in German-speaking countries. In 1955, the subject "Orthodontics" was taken up as an examination subject at German universities. Five years later, the fixed appliances, the so-called multi - band technology , found their way into Europe .
William J. Buehler and Frederick Wang examined the first nickel-titanium arc in 1963, which was named Nitinol , an acronym for Nickel Titanium Naval Ordonance Laboratory . The first discovery of shape memory alloys goes back to the 1920s, but this discovery was initially forgotten. It was not until 1971 that this new material was introduced into orthodontics by Andreasen and Hillemann. This was a work-hardened nickel-titanium alloy, which is martensite at mouth temperature and has a transformation temperature of over 100 ° C.
Assumption of costs
In 1972 the Federal Social Court decided to include orthodontics in the service catalog ( BEMA ) of the statutory health insurance in Germany.
Aligners
The process of correcting misaligned teeth with transparent plastic splints was developed in 1945. At that time, the orthodontist Harold D. Kesling introduced the therapeutic approach of gradually achieving the treatment goal with elastic devices. This aligner therapy is based on the actual condition of the rows of teeth with the help of a special computer graphics process, which is recorded in jaw models. A previously determined treatment goal is displayed in three dimensions and divided into individual treatment phases. For each of these phases, individual plastic splints that resemble crunch splints are produced, each of which is worn for around two weeks. This will gradually push the teeth into the target position.
History of oral and maxillofacial surgery
In addition to the development of dentistry, maxillofacial surgery was more of a shadowy existence than a niche in the field of general surgery. The French surgeon Baron Guillaume Dupuytren (1777-1835) performed the first oral surgery . In 1812 he removed a bone tumor on the lower jaw by means of a partial resection of the lower jaw. In 1843 the Italian surgeon Bartolomeo Signorini (1797–1844) dared to completely extirpate the lower jaw. The first oral surgeon to receive medical and dental training was probably Simon P. Hullihen (1810–1857) who opened a special clinic for "oral surgery" and cleft lip and palate in Wheeling (West Virginia) , USA, in the 1840s , Oral carcinoma, maxillary sinus and jaw surgery. The first clinic for oral surgery , which was affiliated with the Philadelphia College of Dental Surgery in 1840 and became the Pennsylvania College of Dental Surgery in 1856 , was headed by the doctor and dentist James Garretson (1828–1895). He established maxillofacial surgery in America as an independent specialty.
In 1890, Carl Partsch (1855–1932) , who had qualified in surgery , was appointed director of the newly founded Dental Institute in Breslau . He claimed to have “put the knife in the hand of the dentist” and is considered the father of dental surgery. Partsch developed in particular the surgical methods of root resection , in 1892 the cystostomy named after him ( Partsch I ) and in 1910 the cystectomy ( Partsch II ). The incision in these operations also bears his name: Partsch arch cut . The first plastic replacement of the resection site with a bone graft was carried out in 1891 by the Cologne surgeon Bernhard Bardenheuer . He used a pedicled skin-periosteal bone flap from the forehead region. With the discovery of anesthetic procedures, especially local anesthesia, maxillofacial surgery slowly increased. The development of the field of oral and maxillofacial surgery goes back to the special requirements in the care of war injuries in the First and Second World War. It emerged from surgery and dentistry, which was consolidated in the last century. After 1918, the surgeons and dentists dealt with the follow-up treatment of the jaw and facial injuries. The first jaw clinic in Europe was founded in Vienna in 1914 to care for the war wounded by the surgeon Anton Freiherr von Eiselsberg (1860–1939) and staffed by his student Hans Pichler (1877–1949). In 1918 the jaw ward in Düsseldorf was converted into the West German jaw clinic . August Lindemann (1880–1970) became its head . In 1925, the second orthodontic specialist clinic was founded in the Rudolf Virchow Hospital in Berlin , headed by Martin Waßmund (1892–1956). In 1930 the third specialist clinic was inaugurated at the Charité Berlin. Georg Axhausen (1877–1960) was elected as chief physician .
The end of World War II also meant the end of war surgery . After the end of the war, however, the surgeons and dentists were occupied with the permanent care of severe jaw and facial injuries for a long time. The operative war dentists lost their independence in the peacetime. Since they were not double-licensed, they were placed under a specialist in surgery or a double-licensed specialist. A young generation of oral surgeons - under the leadership of Martin Waßmund - advocated independent oral surgery, detached from the "major surgery". The inclusion of the professional title “maxillofacial surgery” met with resistance from the plastic surgeons . They demanded that the work of the double-licensed oral surgeon should be limited to the teeth, the jawbone and the temporomandibular joint. However, Waßmund was able to assert himself, which laid the foundation for the creation of a specialist in oral surgery and a separate professional policy in Germany, Austria and Switzerland.
Development of the dental profession
A non-academic education, competition from lay practitioners and dental doctors, low social prestige, and a limited demand for dental services were the starting conditions for the future of dentists in the middle of the 19th century. Nevertheless, dentists were able to establish themselves as a profession against the existing competition by 1919.
History of the dental assistant professions
The profession of dental assistant is one of the classic assistant professions in the health care system , which are mainly carried out by women . In the middle of the 19th century, the “benevolent daughters” from “upper families” helped with dental treatment.
The dentist C. Edmund Kells (1856–1928) from New Orleans is credited with the first use of a dental assistant. Since 1885 his wife has been doing various auxiliary jobs, such as cleaning and keeping files. A few years later he trained Malvina Cueria (1893–1991) to be the first “Lady assistant”. The presence of a "lady in attendance" also enabled a woman to visit a dental practice without a chaperone , which was otherwise considered improper. Kells deployed both a “chairside dental assistant” ( chairside : 'at the treatment chair ') for treatment assistance, as well as an administrative assistant. Word of the benefits soon spread, and other dentists followed Kell's example and trained dental assistants themselves. The development of surgical suction systems also goes back to Kells.
In the United States, Alfred Civilion Fones (1869–1938) believed that removing plaque and tartar from the surfaces of teeth could prevent tooth loss. In 1906, Fones trained his office assistant and cousin Irene M. Newman to be the world's first female dental hygienist (DH), a professional title ( dental hygienist ) he created. This was just a few years after Willoughby D. Miller discovered the bacterial causes of dental disease. In 1913 he opened the Fones School of Dental Hygiene in Bridgeport, Connecticut . Irene Newman became the first president of the Connecticut Dental Hygienists Association . On the one hand, Fons had the preventive care of school children in focus, on the other hand he wanted to enable less well-off groups who cannot afford a visit to the dentist to provide prophylaxis services more cheaply by dental hygienists. Juliette Southard was hired as a dental assistant by Henry Fowler, a New York dentist in 1911 , and became the first female president of the American Dental Assistant Association (ADAA) in 1924 . There are now 200 dental hygienist schools and 120,000 registered dental hygienists in the United States.
The first American female dental hygienists came to England with the Allied air force during World War II. Even then, good oral hygiene was very important in the USA. Therefore, the pilots were professionally looked after by the accompanying DH as part of their health program. The American Barbara Benson was the first female dental hygienist in Switzerland. It was used in 1961 by Hans-Rudolf Mühlemann in his department at the Dental Institute of the University of Zurich . Only after a five-year struggle of the advocates of this profession was the activity as DH legalized in 1966 in Switzerland. In 1973 the first DH school in Switzerland, the Dental Hygiene School Zurich, started teaching with 20 students. After a two-year training period, the first Swiss female dental hygienists were certified in 1975. Today the training to become a dental hygienist takes three years. DH schools gradually established themselves in Finland, Sweden, Norway, Denmark, England, Holland, Japan, Italy, Portugal and Germany.
In Germany in 1913 people spoke of the “dentist's receptionist”. In 1940, the trainee occupation "office hours assistant at the dentist or dentist" was recognized for the first time. It was only after the Second World War in 1952 that the apprenticeship as a two-year apprenticeship as “dental assistant” and the associated job description was created and officially recognized. With the entry into force of Section 25 of the Vocational Training Act (BBiG) of August 14, 1969 in the FRG, the training to become a “dental assistant” was transferred to the dual system , in which knowledge is imparted at the vocational school and in the dental practice. In the GDR, the job title was from 1977 "Stomatological sister". With the further development of dental work, adequate assistance became more and more necessary. In 1989 the dental assistant training ordinance came into force. As of August 1, 2001, the job title was changed to "Dental Specialist / Dental Specialist". The following professional titles can be acquired through advanced training , depending on the country and dental association area, whereby a distinction is made between treatment and administrative assistance:
- Treatment assistance
- Dental Prophylaxis Assistant (ZMP)
- Dental Assistant (ZMF)
- Dental Hygienist (DH)
- Administrative assistant
- Dental Administrative Assistant (ZMV)
- Assistant Dental Practice Management (AZP)
- Specialist in dental practice management
- Business economist for management in healthcare
History of Animal Dentistry
In the early history of animal dentistry, it was about the treatment and evaluation of the horse's teeth . Horse dentistry was already used by the Chinese in 600 BC. Practiced. In the horse trade , a horse's tooth age estimate was an important factor in determining its worth. The Greek culture improved the age determination and examined the eruption times in the life of a horse. Simon of Athens described in the 5th century BC The technique of determining the age of horses and their breakthrough. Flavius Vegetius Renatus wrote a separate treatise on animal and especially equine medicine in his work Digesta Artis Mulomedicinae , in which he writes of the "Thuringians", the Saxon-Thuringian heavy warmbloods, as a horse breed particularly suitable for military service. In Roman times, early veterinary dental work for dogs consisted of surgical procedures to remove the lyssa , part of the tongue. In dogs and cats there is a lengthwise connective tissue strand in the base of the tongue, which is referred to as "rabid" (Lyssa) . This was previously associated with rabies disease. The method of age estimation goes back to Pessina von Czechorod , who taught at the Vienna Military Veterinary School at the end of the 18th century . With the development of reliable criteria, it was now possible to check the age of the previous owner. Age was only irrelevant when it came to gifts: “You don't look in the mouth of a given horse” is still a popular saying today. " Rosstäuscher " then tried to make horses look younger again , among other things by branding customers . As customers ( Latin Infundibulae ) one calls cup-like Schmelzeinstülpungen to the incisors . They are 12 mm deep in the upper jaw in the erupting incisor and 6 mm deep in the lower jaw and wear about 2 mm / year.
Aristotle described periodontal disease in horses in his book The History of Animals (333 BC). In the absence of anesthetic methods and knowledge of physiology and pathology , unnecessary, unsuitable or even barbaric treatments were often carried out. Progress in animal dentistry was very slow and only flourished after the introduction of suitable anesthetic procedures .
Carlo Ruini (1530–1598) was the author of one of the most important veterinary works of the 16th century, the Anatomia del Cavallo ( Italian : "Anatomy of the horse"), which was first published in 1598 - three months after his death - which also deals with anatomy who dedicated horse teeth. It is considered a milestone in veterinary anatomy and in particular equine medicine , which was strongly influenced by the works of Andreas Vesalius and was only exceeded in the second half of the 18th century.
During the Renaissance - among many others - Leonardo da Vinci and Carlo Ruini (1530–1598) contributed to equine dentistry, Ruini in his work Anatomia del Cavallo (Anatomy of the Horse). They included surgical descriptions of how to circumcise a horse's lip for better placement of the bridle or techniques for tooth extraction. The book "Equine Medicine" was published by Jordanus Ruffus .
In 1762 the first veterinary school was founded in Lyon , France (from 1764 École royale vétérinaire de Lyon ) by Claude Bourgelat , which also initiated the development of modern animal dentistry. The first publication on veterinary dentistry appeared in 1889. Further books followed in 1905 and 1938. These books were devoted to equine dentistry and small animal dentistry. In the 1930s, Joseph Bodingbauer proved to be a pioneer in small animal dentistry in Vienna . During this time, the focus of veterinary science shifted from horses to dogs, cats, and other small animals. 1929 published a series of detailed work by Edward Mellanby that dealt with the effects of dietary changes on tooth development and diseases of the canines (Mellanby Ms. May was a well-known dentist and took advantage of the made by her husband around 1923 discovery that vitamin D against Rickets is effective. She used Vigantol in human dentistry).
In 1971 the Department of Dentistry was set up at the Clinic for Small Pets at the University of Bern by a government council resolution. It was the world's first such department at a university. It was founded primarily thanks to the foresight of Ulrich Freudiger , then director of the small animal clinic , and Hugo Triadan (1930–1987) from the clinic for dental conservation in human medicine. In 1972 Triadan developed an animal tooth scheme that has been used worldwide since then. In doing so, he was based on the FDI human tooth scheme , which was developed in 1960 by the Berlin university professor Joachim Viohl .
In the USA, the formation of the American Veterinary Dental Society in 1976 gave animal dentistry a boost, first in the small animal sector, then in the equine sector and later in the field of rodents and pets, which led to the establishment of specialist societies worldwide.
After the European Veterinary Dental Society (EVDS) was founded in 1992, the German Society for Animal Dentistry (DGT – DVG) was established in 2004 . The specialist title “for dentistry of small animals” was introduced in 2008 against considerable resistance from the professional representatives in the veterinary associations so far only in Schleswig-Holstein and Bavaria. In the United States, veterinary dentistry is one of the 20 veterinary specialties recognized by the American Veterinary Medical Association . In addition, dental technician training to become an animal dental technician has been taking place since 2001. In the same year the British Association of Equine Dental Technicians , the "British Society of Equine Dental Technicians " was founded in Great Britain.
Animal dentistry makes use of modified general dentistry procedures.
Customers on front teeth of a horse
Dental treatment in horses
Dental examination in horses
Removal of tartar from dogs
Tooth extraction in the dog
Tooth cleaning of the dolphin
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Historical collection and museums on the history of dentistry
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The history of the historical collection on dentistry and the research institute for the history of dentistry in the German Society for Dentistry, Oral and Maxillofacial Medicine are very closely linked to the Jewish dentist Curt Proskauer (1887–1972), on whose initiative the Reich Institute was founded in 1927 for the history of dentistry and its extensive library and private collection was given to the Reich Association of Dentists in Germany. V. left. This was sponsored by the then chairman Fritz Linnert (1884-1949) and the second managing director Fritz H. Witt (1887-1969). The library was rescued over the chaos of war and then by the German Dental Association of until her move to Berlin and the dissolution of German Dentists-library managed. At the time of the move in 2000, it contained around 40,000 writings, including many valuable historical ones. It has been stored in containers in Berlin since the move and has been waiting for historical processing ever since. It is believed that files were deliberately destroyed, perhaps by authors who played a role in the establishment of the new self-government at that time and afterwards. Among other things, there are volumes of dental communications in archives from which articles were torn out with a razor.
70 years after the end of the war, the Medical Association for Vienna announced on April 16, 2015 that it wanted to come to terms with its Nazi past. The project was assigned to the Institute for Legal and Constitutional History at the University of Vienna .
There are currently four museums in German-speaking countries that specialize in the history of dentistry and are open to the public, including the Linz Museum for the History of Dentistry and Dental Technology in Upper Austria. The Dental Museum in the University Dental Clinic Vienna . The collection was founded by Georg Carabelli , Edler von Lunkaszprie, who in 1821 was the first to give university lectures on “Dentistry”. The dental historical Gustav Korkhaus collection is exhibited at the Center for Dentistry, Oral and Maxillofacial Medicine of the Rheinische Friedrich-Wilhelms-Universität Bonn . The Dental Museum in Zschadrass consists of over a hundred small and large private collections, numerous well-known dental company archives, the Thiedmar Oehlert collection, the former Bodirsky private museum and the Winkelmann museum.
In addition, several dental clinics have teaching and research collections for internal training purposes. The historical dental collections in Germany today are scattered in universities, museums, companies or professional organizations. A large part of the collections was lost because the valuable items were repeatedly neglected. A preservation process that began around 1986 made it difficult to secure pieces.
criticism
The Swiss historian Schär criticizes the fact that the comparatively sparse dental historical literature comes almost without exception from the pen of dentists. It is mainly about historically oriented dental dissertations as well as anniversary publications. The narrative of "achievement historiography" dominates. It tells a story of the “search for means to relieve toothache”. Social and cultural-historical studies that focus on the historical and societal roots of dental work, the cultural nature of their knowledge and the non-medical effects of dentistry are largely lacking. In dentistry, caries has represented much more than just a bacteriological process in the mouth since the discipline became scientific at the end of the 19th century. The "tooth decay" was considered a symptom of a general "culture decay". Behind this interpretation was a civilization-critical and culturally pessimistic view of social change , according to which this alienates modern people from nature and leads to a "softening" of the way of life.
literature
- Walter Artelt : German dentistry and the beginnings of anesthesia and local anesthesia. In: Dental communications. Volume 54, 1964, pp. 566-569, 671-677, 758-762 and 853-856.
- Max Baldinger: Superstition and Folk Medicine in Dentistry. (Medical dissertation, Basel) In: Switzerland. Folklore Archive. Volume 35, 1936, Issues 1-2, pp. 23-52 and 65-104; also in: Folk Medicine: Problems and Research History. Edited by Elfriede Grabner, Darmstadt 1967 (= Paths of Research. Volume 63), pp. 116–199.
- Elisabeth Bennion: Old Dental Instruments. German edition by Marielene Putscher and Ulrich Lohse. Cologne 1988.
- André Besombes: Dentistry from the Middle Ages to the eighteenth century. In: Illustrated History of Medicine . German arrangement by Richard Toellner a . a., special edition Salzburg 1986, Volume IV, pp. 1986-2015.
- Georg Carabelli von Lunkaszprie: Systematic manual of dentistry . Braunmüller, 1831.
- Publications of the working group "History of Dentistry" in the German Society for Dentistry, Oral and Maxillofacial Medicine . Retrieved November 5, 2014.
- Fritz Driak: Share of the Viennese school in dentistry of the XVIII. and XIX. Century. In: Wiener Klinische Wochenschrift. Volume 49, 1936, pp. 951-964.
- H.-H. Eulner: The early academic days of dentistry in Germany. In: Medical History Journal. Volume 1, 1966, pp. 3-15.
- Werner E. Gerabek , Gundolf Keil : Cultural History of Dentistry, I – III: A tough fight between dentists for respect and recognition. In: Dental communications. Volume 79, 1989, pp. 1872-1876, 2064-2069 and 2914-2197.
- Werner E. Gerabek: Dentistry. In: Werner E. Gerabek u. a. (Ed.): Encyclopedia of medical history. Pp. 1518-1523.
- (Hans) Christian Greve: Tabular overview of the history of dentistry. [Edited by the Institute for the History of Medicine and Natural Sciences in Berlin]. In: German dentistry, oral and maxillofacial medicine. Volume 4, 1937, pp. 801-817.
- Christian Greve: From the dental trade to dentistry. Munich 1952.
- Dominik Groß , Werner E. Gerabek : Dentist , tooth breaker , tooth extraction , tooth caries and tooth worm . In: Werner E. Gerabek, Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 1515-1524.
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Walter Hoffmann-Axthelm : The history of dentistry. The quintessence, Berlin 1973.
- 2nd, revised edition: Walter Hoffmann-Axthelm: The history of dentistry . Quintessenz, Berlin 1985, ISBN 978-3-87652-160-2 .
- Walter Hoffmann-Axthelm, The History of Oral and Maxillofacial Surgery , Quintessenz, Berlin 1995, ISBN 978-3-87652-077-3 .
- Jakob Calmann Linderer: Doctrine of all dental operations [...]. Berlin 1834
- Ulrich Lohse: Instruments, dental. Encyclopedia of Medical History. 2005, pp. 675-680.
- Arthur Ward Lufkin: A history of dentistry. 2nd edition Philadelphia 1948.
- Placido Micheloni: Il mondo dei denti e la sua storia. I-II, Rome 1976/77.
- Ullrich Rainer Otte: Jakob Calmann Linderer (1771-1840). A pioneer in scientific dentistry. Medical dissertation, Würzburg 2002.
- Julius Parreidt: History of the Central Association of German Dentists 1859–1909 . Springer, 2013, ISBN 978-3-662-41001-1 , pp. 6th ff . ( books.google.com ). .
- Alfred Renk: Materials science, dental. In: Werner E. Gerabek u. a. (Ed.): Encyclopedia of medical history. P. 1472 f.
- Alfred Renk: Tooth fillings. In: Werner E. Gerabek u. a. (Ed.): Encyclopedia of medical history. P. 1517.
- Malvin E. Ring (Ed.): Dentistry - An illustrated history. St. Louis and New York 1985; Reprints ibid 1992 and ö.
- Jutta Schönfeld: Dentistry in the "Kitâb Zâd al-musâfir" [10. Century] of Ibn al-Jazzar al-'Gazzâr . In: Sudhoff's archive. Volume 58, 1974, pp. 380-403.
- Konrad Schubring : On the tooth anatomy and physiology of late antiquity and the Middle Ages. In: Medizinhistorisches Journal 1, 1966, pp. 144-148.
- Otto Spies : Contributions to the history of Arab dentistry. In: Sudhoff's archive. Volume 46, 1962, pp. 153-177.
- Hedwig Strömgren: Some ancient and medieval cures for toothache. In: Janus. Volume 31, 1927, pp. 359-367; and: Further considerations on the article “Some ancient and medieval cures for toothache”. In: Janus. Volume 33, 1929, pp. 14-17.
- Hedwig L. Strömgren (= Hedvig Lidforss Strömgren): Dentistry in the eighteenth century. A piece of cultural history. Copenhagen 1935.
- Hedwig L. Strömgren: Dentistry in the nineteenth century. Copenhagen 1945.
- Wolfgang Strübig, History of Dentistry: An Introduction for Students and Dentists, January 1989, Dt. Doctors-Verlag, Cologne, ISBN 978-3-7691-1099-9
- Karl Sudhoff : History of Dentistry. Leipzig 1921; 2nd edition, ibid. 1926; Reprint Hildesheim 1964.
- Gisela Tascher: In the service of the people's body. Synchronization of the dental profession after 1933. In: Zahnärztliche Mitteilungen. Volume 20, 2017 (in: zm online. From October 16, 2017).
- Ralf Vollmuth : "Of ulcers, stinking and putrefaction of the squabble". Considerations on the history of periodontal prophylaxis from the late Middle Ages to around 1900. In: Würzburger medical historical reports. Volume 16, 1997, pp. 261-271.
See also
Web links
- History of Dentistry Timeline , American Dental Association . Retrieved November 9, 2014.
- Histoire de l'art dentaire (French), Société française d'histoire de l'art dentaire. Retrieved August 11, 2015.
- Frank Möller, History of Orthodontics (PDF) Weimar, 1999–2001. Retrieved August 13, 2015.
- Timeline - History of dental hygienists , American Dental Hygienists Association (ADHA). Retrieved March 15, 2016.
- List of famous dentists , Ranker; List of famous dentists. Retrieved July 21, 2016.
- Dominik Groß: The history of the dental profession , dental communications , 12 episodes, issue 21/2015 – issue 15/2016, Deutscher Ärzteverlag Cologne. Retrieved January 21, 2017.
Individual evidence
- ↑ See for example Karl Sudhoff: History of Dentistry. 2nd Edition. Leipzig 1929.
- ↑ See for example Johann Jakob Joseph Serre: Practical representation of all operations in the art of dentistry. Berlin 1804.
- ↑ F. David, V. D'Iatchenko, JG Enloe, M. Girard, M. Hardy, V. Lhomme, A. Roblin-Jouve, AM Tillier, C. Tolmie: New Neandertal remains from the Grotte du Bison at Arcy- sur-Cure, France. In: Journal of human evolution. Volume 57, Number 6, December 2009, pp. 805-809, ISSN 1095-8606 . doi: 10.1016 / j.jhevol.2009.03.006 . PMID 19683787 . Full text online (English).
- Jump up ↑ Louise T. Humphrey, Isabelle De Groote, Jacob Morales, Nick Barton, Simon Collcutt, Christopher Bronk Ramsey, Abdeljalil Bouzouggar: Earliest evidence for caries and exploitation of starchy plant foods in Pleistocene hunter-gatherers from Morocco. In: Proceedings of the National Academy of Sciences. 111, 2014, pp. 954-959, doi: 10.1073 / pnas.1318176111 .
- ↑ Gregorio Oxilia, Marco Peresani et al .: Earliest evidence of dental caries manipulation in the Late Upper Palaeolithic. In: Scientific Reports. 5, 2015, p. 12150, doi: 10.1038 / srep12150 .
- ↑ A. Coppa, L. Bondioli et al. a .: Palaeontology: early Neolithic tradition of dentistry. In: Nature. Volume 440, Number 7085, April 2006, pp. 755-756, ISSN 1476-4687 . doi: 10.1038 / 440755a . PMID 16598247 . Retrieved September 20, 2014.
- ↑ Dig uncovers ancient roots of dentistry. In: The Associated Press (2008) in NBC News. Retrieved September 20, 2014.
- ↑ Federico Bernardini, Claudio Tuniz, et al .: Beeswax as Dental Filling on a Neolithic Human Tooth. In: PloS one. Volume 7, number 9, 2012, p. E44904, ISSN 1932-6203 . doi: 10.1371 / journal.pone.0044904 . PMID 23028670 . PMC 3446997 (free full text). Retrieved September 20, 2014.
- ↑ Pia Bennike, Lise Fredebo: Dental treatment Age in the Stone. In: Bulletin of the History of Dentistry. Volume 34/35, 1986, pp. 81-87.
- ↑ Pia Bennike: Ancient Trepanation and Differential Diagnosis: A Re-Evaluation of Skeletal Remains from Denmark. In: Robert Arnott, Stanley Finger, Chris Smith: Trepanation. History, Discovery, Theory. Swets & Zeitlinger, Lisse 2005, pp. 95–115, here: p. 104 ( limited preview on Google Books ).
- ^ John Robb: The Early Mediterranean Village. Agency, Material Culture, and Social Change in Neolithic Italy. Cambridge University Press, Cambridge 2007, p. 38.
- ↑ Susann Lindemann: Ritual deformations among primitive peoples. (PDF) Dissertation, University of Greifswald 2007, p. 2. Accessed on November 13, 2014.
- ↑ Richard P. Suddick, Norman O. Harris: Historical perspectives of oral biology: a series. In: Critical Reviews in Oral Biology and Medicine. Volume 1, Number 2, 1990, pp. 135-151, here: p. 142 ISSN 1045-4411 . PMID 2129621 . on-line. (PDF) Retrieved September 20, 2014.
- ^ Hermann Prinz: Dental Chronology - A Record of the More Important Historic Events in the Evolution of Dentistry. Lea & Febiger, Philadelphia 1945, p. 7.
- ↑ Astrid Hubmann: The tooth worm. The story of a folk medicine belief. (PDF) Dissertation, 2008, p. 17. Accessed on November 18, 2014.
- ↑ It is said to be under the signature tablet 55547 in the British Museum in London (Arthur Bulleid: The Microbe Hunters. In: Proceedings of the Royal Society of Medicine. Section of Odontology. 47, 1953, pp. 37-40, here: p . 39).
- ↑ P. Pachaly: The Chronicle of Medicine . H. Schott (Ed.). Chronik-Verlag, Dortmund 1993, ISBN 3-611-00273-9 . In: Pharmacy in Our Time. 23, 1994, pp. 33-33, doi: 10.1002 / pauz.19940230111 .
- ↑ Astrid Hubmann: The tooth worm. The story of a folk medicine belief. (PDF) Dissertation, 2008, p. 14. Accessed December 1, 2014.
- ↑ Hedwig Strömgren: Further considerations on the article "Some ancient and medieval cures for toothache" . In: Janus 33, 1929, pp. 14-17.
- ↑ Pliny the Elder: Naturalis historia . 28.49, 31.46, 31.21 + 26, 36.42.
- ↑ Hedvig Lidforss-Strömgren: About Cajuzs Plinius Secundus and his relationship to dentistry. In: Nova Acta Leopoldina , New Series, 27 (Leipzig) 1963, pp. 141–144.
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