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 Table of Contents  
REVIEW ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 4  |  Page : 229-234

Milestones of dental history


Department of conservative dentistry and Endodontics, Manubhai Patel Dental College and Hospital, Vadodara, Gujarat, India

Date of Web Publication11-Oct-2017

Correspondence Address:
Rajesh Mahant
3/233, Guj. H. Board (Old), Gorwa, Vadodara - 390 003, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjhr.cjhr_37_17

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  Abstract 

Since ages, human beings suffer from the dental problems. With the journey as time elapsed the person treating the teeth changed (i.e., from barbers and monks to present dentists), equipment changed (i.e., from bow drills to airotor and laser handpieces), materials changed (i.e., from ground mastic alum/honey to tooth colored composite and ceramics). There has been drastic change in treatment planning from extraction to the conservation of teeth and from manual restoration to computerized restorations computer-aided design/computer-aided manufacturing. Thus, this review is an attempt to have an insight into major milestones of the dental timeline.

Keywords: Amalgam, dental handpiece and burs, dental history


How to cite this article:
Mahant R, Agrawal S V, Kapoor S, Agrawal I. Milestones of dental history. CHRISMED J Health Res 2017;4:229-34

How to cite this URL:
Mahant R, Agrawal S V, Kapoor S, Agrawal I. Milestones of dental history. CHRISMED J Health Res [serial online] 2017 [cited 2017 Oct 17];4:229-34. Available from: http://www.cjhr.org/text.asp?2017/4/4/229/216472


  Introduction Top


A profession that is ignorant of its past experiences has lost a valuable asset because “it has missed its best guide to the future.”

Dentistry has a long and fascinating history. From the earliest of times, humans have been plagued by dental disease. Many of the remarkable techniques in modern dentistry can be traced to the very earliest of times in every culture. Dental disease can include cavities or caries and gum disease or periodontal disease. It can lead to systemic, somatic disease.

Dental history timeline

  • 7000 BC-evidence of ancient dentistry has recently been found in a Neolithic graveyard in ancient Pakistan. Teeth dating from around 7000 to 5500 BC show evidence of holes from dental drills were found in people of the Indus Valley Civilization
  • 5000 BC-A Sumerian text of this date describes “tooth worms” as the cause of dental decay. The legend of the worm is also found in the writings of Homer, and as late as the 1300's AD the surgeon Guy de Chauliac still promoted the belief that worms cause tooth decay [Figure 1]
  • 1700-1550 BC-An Egyptian text, the Ebers Papyrus, refers to diseases of the teeth and various toothache remedies.
Figure 1: Tooth worms

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Hesi-Re was the earliest Egyptian dentist who practiced in 3000 BC, was called “Chief of the Toothers” and often called the first “dentist.” An inscription on his tomb includes the title “the greatest of those who deal with teeth, and of physicians.”[1]

Egyptian pharaohs suffered from periodontal (gum) disease but teeth were not bad as wear from a rougher, nonprocessed diet removed small cavities before they had a chance to get established.

Hippocrat, the father of medicine, wrote a book “on affection” in 0BC–370BC. He observed that if tooth is decayed and loose it must be extracted. If neither decayed nor loose and still painful it is necessary to desiccate it by cauterizing.

Historical perspectives on erroneous theories

In early 1900s, focal infection theory, i.e., teeth with infected necrotic pulps and endodontically treated teeth might leak bacteria or their toxins into the body, causing arthritis and diseases of the kidney, heart, nervous, gastrointestinal, endocrine and other systems, resulted in a frightening era of tooth extraction both for the treatment of systemic diseases and as a prophylactic measure against future illness. Fortunately, subsequent microbiological and epidemiological studies disproved the claims that extraction of teeth could restore the systemically ill person to good health. The extraction tide was stemmed.[2]

Middle ages and the renaissance: Beginnings of the dental profession

In 500–1000, medicine, surgery, and dentistry, are generally practiced by monks. In 1130–1163 barbers assume the monks' surgical duties: Bloodletting, lancing abscesses, extracting teeth, etc. In 1210, a guild of barbers is established in France.

According to Rhazes (Arabian author) (841–926 AD), carious teeth were filled with ground mastic, alum and honey. In 1460–1525 AD, removal of carious matter from teeth before filling with gold leaf was given by Giovanni Da Vigo in his article “Practica copiosa in arte chirurgica.” Remove them with trephines, files or any other convenient instruments and fill the cavity with gold. During 1517–1590 AD, Ambroise Pare prepared artificial tooth from bone and ivory. In 1589 AD, RIVIERE mentioned the use of oil of clove in dental operations.

1746

Claude Mouton describes a gold crown and post to be retained in the root canal. He also recommends white enameling for gold crowns for a more esthetic appearance.

1844

Samuel S. White, a Philadelphia Jeweler, used porcelain to fill large cavities and established his S.S. White dental manufacturing company.

1723

Pierre Fauchard, a French Surgeon Publishes The Surgeon Dentist, A Treatise on Teeth (Le Chirurgien Dentiste). Fauchard is credited as being the Father of Modern Dentistry because his book was the first to describe a comprehensive system for the practice of dentistry.

1801

R.C Skinner published his book “a treatise on human tooth.” It is a 16-page pamphlet and deals with dental disease and their prevention.

1890

Greene Vardiman Black wrote the book “A description anatomy of human tooth.” He standardized the rules for cavity preparation, hand instrument formula, and manufacturing process of silver amalgam.[3] He developed the principle of “extension for prevention” and remembered as “Father of Operative Dentistry.”[4],[5],[6],[7],[8]


  Etiology Top


Romans thought the worm just appeared or drilled its way into a tooth. If the tooth pain was severe, it meant that the worm was moving around. If the aching stopped, then the worm was resting. People smeared their aching teeth with honey and waited all night with tweezers in hand, ready to pull out the tooth worm. In 1683, Antony Van Leeuwenhoek identified oral bacteria using a microscope. In 1890, Willoughby Miller an American dentist in Germany, notes the microbial basis of dental decay.[9]


  Device Top


Handpiece and bur

There is evidence that the Maya and other ancient cultures used primitive “bow drills” and other devices to prepare round ornamental cavities in teeth.

In 1728, Pierre Fauchard, “Le Chirurgien Dentiste”- first detailed description of dental practice represented the use of bow drill to prepare teeth with cutters [Figure 2].
Figure 2: Pierre Fauchard's bow drill

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By the nineteenth century, hand drills with steel bur heads were used by twirling the long handles with the fingers. Later, a “bur thimble,” was used. S.S. White, however, shows an 1867 manually twisted drill in its catalog of the same era.

In 1871, Morrison introduced his foot treadle dental engine [Figure 3] which was followed by handpieces with hand-made steel drills.[10] This represented the first significant increase in rotational speed over the hand-operated long-handled drills. In 1874, most significant development was the introduction of electric motor with 1000 rpm.
Figure 3: Morrison's foot drill

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In 1891, the S.S. White company introduced the first machine-made steel burs, known as revelation burs.[11] In 1942, diamond cutting instruments with 5000 rpm were introduced. In 1947 Carbide Burs with 12,000 rpm replaced the steel burs. Recently, smart burs are introduced which are harder than infected dentin but softer than affected and healthier dentin. Hence, they tend to remove a just infected portion of tooth preventing the inadvertent removal.

Many of the handpieces are noteworthy, such as norlen's “dentalair,” conceived in 1948, walsh's air turbine handpiece (1952). In 1950, speed of 60,000 rpm and above had been attained by new equipment employing speed-multiplying internal belt drives. In 1955, Page-Chayes handpiece was the first belt-driven angle handpiece to operate successfully at speed over 100,000 rpm. It was in 1957, John borden introduced his sensational airotor handpiece, operated by air and allowing for rotational speeds up to 20,000 rpm.[12] 42. It is from this design that all current air operated high-speed handpieces have evolved.

Air abrasion

Air abrasion dentistry has evolved over a period as a new concept of drill-less technique to excavate caries for the preservation of a maximal sound tooth structure. The use of air abrasion technology initiated by Dr. Robert Black in the 1940s was successfully introduced in 1951 with the Airdent air abrasion unit (S.S. White). During air abrasion, a fine stream of particles is aimed at the decayed portion of the tooth by compressed air or gas that runs through the dental handpiece. These particles are made of silica, aluminum oxide, or a baking soda mixture.[13]

Lasers

Proposed in 1990 by Hibst and Keller, who introduced the possibility of using an Er:YAG laser as an alternative to conventional instruments such as the turbine and micro-motor. FDA approves the erbium YAG laser to treat tooth decay. Thanks to the affinity of the Er: YAG laser wavelength (2940 nm) to water (absorption peak = 3000 nm) and hydroxyapatite (absorption peak = 2800 nm), laser technology allows for efficient ablation of hard dental tissues without the risk of micro- and macro-fractures. The dentin surface treated by laser appears clean, without a smear layer and with the tubules open and clear.[14]

X-ray

On Friday, November 8, 1895, Professor Wilhelm Conrad Roentgen, a professor of physics at the University of Wurzburg in Germany, serendipitously discovered a “new kind of ray – X-ray.” The first X-rays were called “roentgenograms.”[15] Friedrich Otto Walkhoff (1860–1934). Within 14 days of the announcement of Roentgen's rays, the first dental images were made by Friedrich Otto Walkhoff and Wilhelm Konig using an ordinary photographic glass plate wrapped in a rubber dam as an image receptor.

After about nine decades, radiovisiography marked the starting point of intraoral digital radiographic techniques in dentistry invented by Dr. Frances Mouyens and manufactured by Trophy Radiologie (Vincennes, France) in 1984.

The 1st generation computed tomography (CT) was invented in 1967 by Sir Godfrey N. Hounsfield, who won Nobel Prize in 1979. It gave the three-dimensional image of the tooth. The first cone beam CT (CBCT) scanner was built by Robles RA in 1982 for angiography purpose [3] CBCT is more advanced for its resolutions.


  Direct Restorative Materials Top


In the history of operative dentistry, direct restorative materials have principally included: lead, mastic, gold, tin, amalgam, fuisble metal of darcet, gutta-percha, silicate cement, direct filling methyl methacrylate resin, composite resin, and glass ionomer cement (GIC).


  Medieval and Early Modern Period Top


The use of gold leaf to fill cavity was the most significant development during this period. Early Greeks produced gold leaf of approximately 1/100,000 inch thickness.

Gold is one of oldest materials used for at least 2500 years. Guerini provides indirect evidence of the possibility that the Arabs used gold foil for filling teeth in a later 8th century. In 1746–1755, Claude Mouton makes a gold crown and post and recommends enameling the gold crown white to promote more pleasing esthetic dentistry. In 1855, Robert Arthur originates the cohesive gold foil method allowing dentists to insert gold into a cavity with minimal pressure. A powdered gold encapsulated in fibrous gold foil was introduced in 1962.

In the succeeding years, direct gold changed very little, except for the introduction of mat gold and gold pellets, both of which enhanced the speed of compaction.


  History of Amalgam Top


A medical text in China mentions the use of “silver paste,” a type of amalgam in 700. August taveau, of Paris, mixed shavings from French five-franc pieces with Mercury in 1826.[16] The Crawcour brothers introduced amalgam into the United States in 1833. Unfortunately, they used the material unscrupulously and gave it a bad name, so major rift known as amalgam war occurred. The American Society of Dental Surgeons was established and a couple of years later they banned the use of silver amalgam (1840).

First amalgam war

In 1843, American Society of Dental Surgeons condemned the use of all filling materials other than gold as toxic, thereby igniting “First Amalgam War.”[17],[18] Dr. Towsend of Philadelphia (1855) proposed the combination of 4 parts of Ag and 5 parts of Sn. However, it was unbalanced having poor edge strength and was used until about 1863. This “battle” pitted many highly-respected dentists against each other.[19] G.V. Black introduced a balanced amalgam formula to the profession in 1895.[20],[21] This formulation and its derivatives remained essentially unchanged until at least the 1960s and were responsible for the salvation of countless millions of teeth. In late 1870, an organized movement supporting the use of amalgam to become known as “new departure” begins.

Second amalgam war

In mid-1920s German dentist Professor A. Stock started the so-called “Second Amalgam War.” Absorption of mercury from dental Amalgam, led to various health problems, stating that nearly all dentists had excess mercury in their urine. Mercury released from amalgam responsible for human diseases affecting cardiovascular and nervous system recovery from multiple sclerosis, Alzheimer's diseases when removing amalgam fillings. However, research in the United States and other countries demonstrated clearly that there is no cause-effect relationship between dental amalgam restoration and other health problems.

Third amalgam war

The current controversy, sometimes termed as “Third Amalgam War” began in 1980 primarily through the seminars and writings of Dr. Huggins, a practicing dentist in Colorado.

Gutta-percha was discovered in India in 1842. In 1847, Hill Developed “Hill's-stopping” a restorative temporary material, a mixture of bleached gutta-percha and carbonate of lime and quartz.[22]

Various cements have been used under the restorative material:

  • 1858 - zinc oxide eugenol cement
  • 1860 - zinc oxychloride cement
  • 1879 - zinc phosphate cement
  • 1920 - calcium hydroxide cement (Hermann).



  History of Tooth Colored Restorative Materials Top


In 1908, silicate cement was introduced in the United States, although earlier, cruder forms were used in Europe in the late 1800s.[23] Silicate cement had the advantage of high fluoride release but was highly soluble in oral fluids.

To replace silicate, methacrylate resins were introduced in 1947.[24] These resins have tooth color like appearance, insolubility in oral fluids, ease of manipulation and low cost. In 1955, Dr. Michael Baunocore opened the way of bonding of resins by applying phosphoric acid to enamel.[25],[26] As a result, Dr. Ray L. Bowen of American Dental Association research unit in 1962 developed a new type of composite material. He innovated Bis-GMA, a dimethacrylate resin and organic silane coupling agent to form a bond between filler particle and resin matrix.

In the late 1960s and early 1970s, pit and fissure sealants advocated for prevention of caries in children accompanied by early skepticism and later with better material gain acceptance.[27],[28] Such practice has become widespread and has been responsible for the adoption of very conservative restorative procedure.

Microfilled resin introduced in 1977 was highly polishable and stain resistant.[29] First composite was cured by chemical activation polymerizing process by mixing two pastes. Its drawbacks were; trapping of oxygen in pores, inhibit polymerization, and weaken the structure. To overcome these problems resins were developed which use photosensitive initiator system and light source for activation. In 1973, ultraviolet lights were used.[29] Soon it replaced by more cooler visible light in 1978.

Microfilled, hybrid, and microhybrid resins are used extensively in cosmetic procedures, ranging from small Class III restorations to diastema closures, large Class IV restorations, and direct anterior veneers. In addition, composite resins have come into widespread use for the restoration of all classes of cavities in posterior teeth.


  Historical Development of Glass Ionomer Cement Top


GIC was invented in 1968 and first described by Wilson and Kent in 1971 which has high fluoride and low solubility.[30],[31] Glass ionomers used the aluminosilicate powder from silicates and the polyacrylic acid liquid of polycarboxylates. Its earliest commercial product was also known as aluminosilicate polyacrylic acid.

In 1980s, to increase physical properties of GIC, it was modified by adding metal filler particles and termed as metal modified GIC which are of two types: miracle mix (Simmons 1983) and cermet (Lean and Gasser 1985) particle reinforced.

In early 1990s, GIC was further modified by replacing filler particle and making the setting reaction more composite like and termed as resin-modified glass ionomer.

Polyacid-modified resin composite or compomers is most recent evolution of GIC. It has 2 components: polymer-based composite and glass ionomer except water. It is excluded to prevent premature setting of material and to ensure that setting occurs through polymerization reaction.


  Indirect Restorative Materials Top


Indirect restorations have generally been fabricated from impressions taken of prepared teeth.

The earliest impression was probably beeswax. A reference to the use of wax for dental impressions was made in 1684 by a German surgeon.[32] Wax was a poor impression material by todays' standards, but it functioned adequately in its day by being capable of removal over undercuts. Still, for the present time Von Horn (1910) recommended wax pattern investment at a temperature equal to mouth temperature using high silica content investment.

Gutta-percha, obtained from certain trees in Malaysia, may have been introduced as impression material in 1848, but it was not very satisfactory for the purpose.

Reversible hydrocolloid was introduced to the dental profession in 1925, 85 by Alphonse Poller, an Austrian.[33] The product was patented as “Nogacoll.” In 1931, the material was also sold under the name of “denticole.” The fundamental ingredient of hydrocolloid is agar-agar, a colloid obtained from seaweed.

During the World War II era, or just before, irreversible hydrocollois was developed and they were introduced to the dental profession in 1943.[34] Agar-agar had become scarce since most of it came from Japan. Like their reversible counterparts irreversible hydrocolloids, known as alginates, were developed from seaweed and were salts of alginic acid, such as sodium alginate.

One of the greatest achievements in restorative dentistry occurred with the introduction of “Lost Wax Technique,” by William Taggart, in 1907, method of making gold castings.[35],[36] Dentists were able to cast complete gold crowns with precision. Further refinements were soon made to his technique, including the introduction of the centrifugal casting machine by Jamieson in that same year of 1907.

French dentist Agiulhon da Saran (1844) reported to form investment mold from the impression of the cavity and pour gold to make inlay.

Ceramic

In 16 century, Jacques Guillemeau (1550–1613 AD) prepared a paste by fusing waxes gums, ground mastic, and powdered pearl and white corelle. It was used as filling material. It is a forerunner of esthetic fused porcelain. Gueseppangelo Fonzi (1806) prepared 1st baked porcelain single tooth with attached platinum hooks. He also made 26 shades of porcelain by using metal oxides. Porcelain inlays were described at least as early as 1857. In the period from 1900 to 1910, there was a particularly large number of articles published on porcelain inlays, whereas after 1915 the number was vastly reduced.

1902

Dr. C. H. Land develop fused porcelain jacket crown design to replace all or major part of the enamel of the tooth.

1908-Basic principle of porcelain inlay given by John Q Byram.

In recent years, inlays and onlays nade of high strength plastic materials and porcelain have been introduced. In 1985, the first ceramic inlay made by a chairside computer-aided design/computer-aided manufacturing device was cemented into a patient's tooth.[37] In 2000, the CEREC 3® was introduced. This latest system provides a means by which a sophisticated ceramic inlay or onlay can be fabricated, with a hand-held scanner reading the details of the preparation and software subsequently being used to drive the mechanism to precision mill (grind) a restoration without the use of an impression and without the need for a second dental appointment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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Abstract
Introduction
Etiology
Device
Direct Restorati...
Medieval and Ear...
History of Amalgam
History of Tooth...
Historical Devel...
Indirect Restora...
References
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