- Email: [email protected]
Ptyalin-Blood Broth: A New Medium for the Cultivation of Mouth Organisms*
Roberts— Ptyalin-Blood Broth w o u ld a id us all in e v a lu a tin g suggested m ethods o f tre a tin g root canals i f w e cou ld h a v e the op portu n ity o f k n o w in g , fr o m the study o f c a r e fu lly g ath ered data, ju st w h at happens in at least fo r ty cases o f root canals filled a c c o rd in g to the m ethods un der d is cussion. P erson ally, I w o u ld a p p reciate f o l lo w -u p details on D r. M offitt’ s m ethod to enable m e to determ in e f o r m yself ju st h ow closely he is ca r ry in g us to w a r d the “ safe and san e” p ro ce d u re s w e all cov et. D r . M o ffitt (c lo s in g ): T h e best an sw er I co u ld g iv e to the discussers w o u ld be to sh o w the rem a in d er o f the pictures. F igu re 13 sh ow s a root p ro p e r ly filled. It c ou ld b e used i f necessary as a perm anent abutm ent an d w o u ld la st; so w h y not re m ov e the pulp o f such a tooth rather than h ave a d a m a g in g attachm ent on a vita l o n e ? D r. M e rritt speaks o f the necessity o f using the ru bb er d am in root ca n a l treatm ent. W e n e v e r use it. D entists extract teeth all o v e r the coun try, and there is ra re ly any trouble in the unprotected sockets o f those teeth. I d o not see w h y, then, w h en you are g o in g to treat canals, and since w e often find roots b e lo w the lev el o f the gum s on w h ich you cann ot put' a ru bb er dam , that it w o u ld be w r o n g to treat such roots becau se you cann ot use the dam . W h a t D r. M e rr itt has said about pulp rem ov al is true in all cases w h en y ou do not k n o w the latest m ethods o f trea tin g pulps p rop erly. W e take them out, w h en necessary f o r abutments, and have no
1493
trouble, and thus protect the a d jo in in g tooth fr o m recession o f the gum s and fr o m d en tures that h a v e clasps, by the use o f inside attachm ents.18 In an terior teeth, especially, it is necessary to k n ow h o w to rem ov e the pulp and keep the tooth in place. W e k n ow that w e can keep d ev ita liz e d teeth in the m outh f o r fo r t y o r fifty years. It is the ones not h a n d led p ro p e rly that a fte rw a rd s g iv e trou ble. In an terior teeth especially, b rid ges should be an a tom ica lly correct and sh ow no clasps or other attachments. T h e se are m uch m ore sa tisfy in g to the patient, even to men. I f y ou fe e l that you can n ot trea t them that w ay, there is som e fla w in y ou r w o r k ; just as in w o r k in g w ith ou t a ru bb er d a m : if you can n ot d o it su ccessfully, you should not use the m ethod. I ag ree w ith w h at D r. K itch in has said about D r. H aden. H e is v e r y con serv ative. I m erely qu oted fr o m him to illustrate the point. D r. M e rr itt has spoken about autogen ous v a ccin es n ot b ein g v e r y efficacious. W e h ave been using au to g enou s vaccin es fo r about fifteen years and w e h a v e fou n d in m ost cases that they are v e r y ben eficial to the patient. T h e y n ev er d o any harm . M a n y tim es they strengthen the patient system ically, and the op era tor fe e ls that he is p rotectin g the p atien t w h ile w o rk in g on infected teeth and that there is no d a n g er that a system ic in fection w ill d e v elop . 18.
F ootn ote 10, p. 1043.
PTYALIN-BLOOD BROTH: A NEW MEDIUM FOR THE CULTIVATION OF M OUTH ORGANISMS* By GEORGE FENN ROBERTS, M.D., Buffalo, New York N presenting this formula fo r a nutri tive medium, I have only filled the want (if w e except Loeffler’s blood serum) of something in which oral or ganisms w ill grow freely.
I
*R ea d b e fo re the Section on H istology, P a th o lo g y , P h y siolog y , B a c te r io lo g y and C hem istry (R e se a rc h ) at the Sixty-N in th A n nual Session o f the A m e rica n D en tal A s s o ciation , D etroit, M ich ig a n , Oct. 26, 1927.
Jour. A. D. A., August, IQ28
M y idea was to make (approxi mately) a fluid that would represent the saliva as found, in an ordinary mouth, as many organisms which can be found in mouth smears refuse to grow on the commonly used mediums. T h e first step was taken by using a 0.5 per cent boiled starch solution, hu man saliva being employed as a source of
1494
T he Journal of the American D ental Association
ptyalin, but it was difficult at all times to obtain a suitable saliva, so I asked Messrs. G . W . Carnrick o f N ew Y ork to prepare for me an active dessicated powder of the three different salivary glands. In looking around for a better sub stance than starch, I was led by a brewer friend o f mine to try flaked corn, manufactured by the Buffalo Cereal Co. T his corn is used along with malt in the making of near beer, etc. T his proved to be a great improve ment as you w ill see from the quoted analysis that it contains vegetable pro teins as w ell as starchy matter. T h e material required for the new medium is given in T able 1. The analysis of flaked maize is given in T able 2.
a glass pestle and mortar to mix them. Place in an incubator and shake from time to time. N ext morning, test with iodin. T here should be no violet color ation. T hen add the defibrinated blood and about 5.0 c.c. o f toluene. Place in the incubator again for forty-eight hours. Boil this mixture for about twenty min utes and strain through cheese cloth and absorbent cotton, pouring enough dis tilled water over the strainer to keep 1 liter. Measure out 10.00 c.c. and drop in lime water to make the pH 7.5. T hen add enough lime water to bring the whole amount to this reaction using brom-thymol blue as the indicator. Ster ilize. T h e mixture should be perfectly clear and of a light straw color. T
able
2 .— A
n a l y s is
of
M
e d iu m
1. Average composition from practi W a te r ............................................................. 10.160 cal points for practical brewers pub Soluble protein ........................................... 0.152 Insolu ble protein ........................................ 10.370 lished by the National Brewers Academy, 0.570 F at ................................................................... N ew Y ork. F iber ............................................................... 0.610 T
able
I.— M
t iv a t io n
of
a t e r ia l
R e q u ir e d
M
O r g a n is m s
outh
for t h e in
Cu l
P t y a l in -
B lood B roth Flaked C orn
(m a iz e )....
c. c. 10.00
S ource B u ffalo C ereal C o.
D istilled w a te r ...................1,000.00 D essicated p arotid g la n d . 1.00 M essrs. G. D essicated su bm axillary W . C arng lan d .................................................... 1.00 rick, D essicated su blingual 15 L aigh t g lan d .............................................. 0.50 St., E nglish d rop chalk N e w Y o rk (C a C o 3) ................................. 10.00 City D efibrin ated sheep’ s b lo o d .100.00
T h e directions for making are as fo l lows : Soak the flaked corn in the distilled water overnight. In the morning, boil until the corn is w ell cooked, then pass through a tomato sieve, allow it to cool and add the glands and the chalk, using
A sh ................................................................... 0.460 C arboh yd rates (sta rch ) ......................... 77.830 E qu iva len t in m altose ( c a lc u la t e d ). . 86.500 C o ld -w a te r soluble substances.............. 27.520 R eaction o f solution to litm us, neutral. R eaction o f solution to phenol phthalein, colorless. R eaction o f solution to m eth yl-orange, neutral. R eaction of solution to F eh lin g’ s solution, stron g reduction. R eaction o f solution to alcohol, heavy precipitate. R eaction o f solution to iodin, dark blue.
TECHNIC
T h e cereal is soaked overnight, as it makes a better mixture and does away with long boiling. Passing through the sieve also breaks up all the flakes. Eng lish drop chalk ( C a C 0 3) was found to act better than the precipitatus carbon ate as the former is amorphous and the latter crystalline. I f this chalk is not
Lew is— Systemic Conditions as Factors in M alocclusion added, the mixture becomes unduly acid and the ptyalin ceases to work. T h e toluene is only used to prevent putrefaction and is lost in sterilization. T h e neutralization is made with lime water as it has been found that sodium salts such as the chlorid are not bene ficial to the growth of many organisms. T h e finished fluid is sterilized by the fractional method in an A rnold ster ilizer. T h e solidification of this medium by the addition of agar-agar is not a success as regards aural organisms, as many that grow w ell in the fluid refuse to grow on the solid medium. T his appears to be purely physical, as, when nutrient agar is placed in the incubator, it slowly dries up, the surface, o f course, first, and the
1495
lack o f moisture there is probably the cause o f the nongrowth. I f agar is used, it should be washed three times with dis tilled water before being placed in the ptyalin-blood broth. So far, I have not tried out the addi tion o f pieces o f fresh sterile tissue such as the brain nor used fresh blood to enrich it. A m ong the organisms that grow espe cially w ell are the streptococci, for the growth o f which I have found it the best broth to use. I have tested this medium out for the last tw o years, and the more I use it, the better I find it in our root-canal clinical w ork in the Dental Department o f the University of Buffalo. 281 E m slie St.
SYSTEMIC CONDITIONS AS CAUSATIVE FACTORS IN MALOCCLUSION* By SAMUEL J. LEWIS, D.D.S., Detroit, Mich.
H A T is the truth about systemic conditions as causative factors in malocclusion of the teeth? T h e views most widely held today go back to our textbooks on orthodontics. W e find that such diseases as scarlet fever, whooping cough, measles and chickenpox are believed to cause malocclusion because they are known to have a dele terious effect on the epithelial structures. W e find syphilis mentioned as a possi ble cause since it produces a certain type o f hypoplasia of the enamel, which, in
W
* R ea d b e fo re the Section on O rth odon tia and P e rio d o n tia at the S ixty-N in th A nn ual Session o f the A m e rica n D en tal A ssociation , D etroit, M ich ., Oct., 27, 1927.
Jour. A. D. A., August, IQ28
turn, destroys the force of the inclined planes. W e find rickets causing a spe cific type o f malocclusion described as a general narrowing o f the maxilla and a widening of the mandible in the region of the rami and the body, the lower por tion o f the mandible being turned out ward and the teeth inward, the result of the muscular forces exerted on them. W e find that tuberculosis gives a result almost directly opposite to that of rick ets, in that the eruption o f the deciduous and permanent teeth is early instead of la te; also that the deciduous roots are not absorbed, and thus the permanent teeth are forced to erupt by the side of the deciduous teeth.
1493
trouble, and thus protect the a d jo in in g tooth fr o m recession o f the gum s and fr o m d en tures that h a v e clasps, by the use o f inside attachm ents.18 In an terior teeth, especially, it is necessary to k n ow h o w to rem ov e the pulp and keep the tooth in place. W e k n ow that w e can keep d ev ita liz e d teeth in the m outh f o r fo r t y o r fifty years. It is the ones not h a n d led p ro p e rly that a fte rw a rd s g iv e trou ble. In an terior teeth especially, b rid ges should be an a tom ica lly correct and sh ow no clasps or other attachments. T h e se are m uch m ore sa tisfy in g to the patient, even to men. I f y ou fe e l that you can n ot trea t them that w ay, there is som e fla w in y ou r w o r k ; just as in w o r k in g w ith ou t a ru bb er d a m : if you can n ot d o it su ccessfully, you should not use the m ethod. I ag ree w ith w h at D r. K itch in has said about D r. H aden. H e is v e r y con serv ative. I m erely qu oted fr o m him to illustrate the point. D r. M e rr itt has spoken about autogen ous v a ccin es n ot b ein g v e r y efficacious. W e h ave been using au to g enou s vaccin es fo r about fifteen years and w e h a v e fou n d in m ost cases that they are v e r y ben eficial to the patient. T h e y n ev er d o any harm . M a n y tim es they strengthen the patient system ically, and the op era tor fe e ls that he is p rotectin g the p atien t w h ile w o rk in g on infected teeth and that there is no d a n g er that a system ic in fection w ill d e v elop . 18.
F ootn ote 10, p. 1043.
PTYALIN-BLOOD BROTH: A NEW MEDIUM FOR THE CULTIVATION OF M OUTH ORGANISMS* By GEORGE FENN ROBERTS, M.D., Buffalo, New York N presenting this formula fo r a nutri tive medium, I have only filled the want (if w e except Loeffler’s blood serum) of something in which oral or ganisms w ill grow freely.
I
*R ea d b e fo re the Section on H istology, P a th o lo g y , P h y siolog y , B a c te r io lo g y and C hem istry (R e se a rc h ) at the Sixty-N in th A n nual Session o f the A m e rica n D en tal A s s o ciation , D etroit, M ich ig a n , Oct. 26, 1927.
Jour. A. D. A., August, IQ28
M y idea was to make (approxi mately) a fluid that would represent the saliva as found, in an ordinary mouth, as many organisms which can be found in mouth smears refuse to grow on the commonly used mediums. T h e first step was taken by using a 0.5 per cent boiled starch solution, hu man saliva being employed as a source of
1494
T he Journal of the American D ental Association
ptyalin, but it was difficult at all times to obtain a suitable saliva, so I asked Messrs. G . W . Carnrick o f N ew Y ork to prepare for me an active dessicated powder of the three different salivary glands. In looking around for a better sub stance than starch, I was led by a brewer friend o f mine to try flaked corn, manufactured by the Buffalo Cereal Co. T his corn is used along with malt in the making of near beer, etc. T his proved to be a great improve ment as you w ill see from the quoted analysis that it contains vegetable pro teins as w ell as starchy matter. T h e material required for the new medium is given in T able 1. The analysis of flaked maize is given in T able 2.
a glass pestle and mortar to mix them. Place in an incubator and shake from time to time. N ext morning, test with iodin. T here should be no violet color ation. T hen add the defibrinated blood and about 5.0 c.c. o f toluene. Place in the incubator again for forty-eight hours. Boil this mixture for about twenty min utes and strain through cheese cloth and absorbent cotton, pouring enough dis tilled water over the strainer to keep 1 liter. Measure out 10.00 c.c. and drop in lime water to make the pH 7.5. T hen add enough lime water to bring the whole amount to this reaction using brom-thymol blue as the indicator. Ster ilize. T h e mixture should be perfectly clear and of a light straw color. T
able
2 .— A
n a l y s is
of
M
e d iu m
1. Average composition from practi W a te r ............................................................. 10.160 cal points for practical brewers pub Soluble protein ........................................... 0.152 Insolu ble protein ........................................ 10.370 lished by the National Brewers Academy, 0.570 F at ................................................................... N ew Y ork. F iber ............................................................... 0.610 T
able
I.— M
t iv a t io n
of
a t e r ia l
R e q u ir e d
M
O r g a n is m s
outh
for t h e in
Cu l
P t y a l in -
B lood B roth Flaked C orn
(m a iz e )....
c. c. 10.00
S ource B u ffalo C ereal C o.
D istilled w a te r ...................1,000.00 D essicated p arotid g la n d . 1.00 M essrs. G. D essicated su bm axillary W . C arng lan d .................................................... 1.00 rick, D essicated su blingual 15 L aigh t g lan d .............................................. 0.50 St., E nglish d rop chalk N e w Y o rk (C a C o 3) ................................. 10.00 City D efibrin ated sheep’ s b lo o d .100.00
T h e directions for making are as fo l lows : Soak the flaked corn in the distilled water overnight. In the morning, boil until the corn is w ell cooked, then pass through a tomato sieve, allow it to cool and add the glands and the chalk, using
A sh ................................................................... 0.460 C arboh yd rates (sta rch ) ......................... 77.830 E qu iva len t in m altose ( c a lc u la t e d ). . 86.500 C o ld -w a te r soluble substances.............. 27.520 R eaction o f solution to litm us, neutral. R eaction o f solution to phenol phthalein, colorless. R eaction o f solution to m eth yl-orange, neutral. R eaction of solution to F eh lin g’ s solution, stron g reduction. R eaction o f solution to alcohol, heavy precipitate. R eaction o f solution to iodin, dark blue.
TECHNIC
T h e cereal is soaked overnight, as it makes a better mixture and does away with long boiling. Passing through the sieve also breaks up all the flakes. Eng lish drop chalk ( C a C 0 3) was found to act better than the precipitatus carbon ate as the former is amorphous and the latter crystalline. I f this chalk is not
Lew is— Systemic Conditions as Factors in M alocclusion added, the mixture becomes unduly acid and the ptyalin ceases to work. T h e toluene is only used to prevent putrefaction and is lost in sterilization. T h e neutralization is made with lime water as it has been found that sodium salts such as the chlorid are not bene ficial to the growth of many organisms. T h e finished fluid is sterilized by the fractional method in an A rnold ster ilizer. T h e solidification of this medium by the addition of agar-agar is not a success as regards aural organisms, as many that grow w ell in the fluid refuse to grow on the solid medium. T his appears to be purely physical, as, when nutrient agar is placed in the incubator, it slowly dries up, the surface, o f course, first, and the
1495
lack o f moisture there is probably the cause o f the nongrowth. I f agar is used, it should be washed three times with dis tilled water before being placed in the ptyalin-blood broth. So far, I have not tried out the addi tion o f pieces o f fresh sterile tissue such as the brain nor used fresh blood to enrich it. A m ong the organisms that grow espe cially w ell are the streptococci, for the growth o f which I have found it the best broth to use. I have tested this medium out for the last tw o years, and the more I use it, the better I find it in our root-canal clinical w ork in the Dental Department o f the University of Buffalo. 281 E m slie St.
SYSTEMIC CONDITIONS AS CAUSATIVE FACTORS IN MALOCCLUSION* By SAMUEL J. LEWIS, D.D.S., Detroit, Mich.
H A T is the truth about systemic conditions as causative factors in malocclusion of the teeth? T h e views most widely held today go back to our textbooks on orthodontics. W e find that such diseases as scarlet fever, whooping cough, measles and chickenpox are believed to cause malocclusion because they are known to have a dele terious effect on the epithelial structures. W e find syphilis mentioned as a possi ble cause since it produces a certain type o f hypoplasia of the enamel, which, in
W
* R ea d b e fo re the Section on O rth odon tia and P e rio d o n tia at the S ixty-N in th A nn ual Session o f the A m e rica n D en tal A ssociation , D etroit, M ich ., Oct., 27, 1927.
Jour. A. D. A., August, IQ28
turn, destroys the force of the inclined planes. W e find rickets causing a spe cific type o f malocclusion described as a general narrowing o f the maxilla and a widening of the mandible in the region of the rami and the body, the lower por tion o f the mandible being turned out ward and the teeth inward, the result of the muscular forces exerted on them. W e find that tuberculosis gives a result almost directly opposite to that of rick ets, in that the eruption o f the deciduous and permanent teeth is early instead of la te; also that the deciduous roots are not absorbed, and thus the permanent teeth are forced to erupt by the side of the deciduous teeth.