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Re: Beyond roentgenographic cephalometry—What?
LETTERS TO THE EDITOR
Re: Beyond roentgenographic cephalometyy-What? To the Editor: Thank you for sharing Dr. Melvin Moss’s guest editorial (AM. J. ORTHOD. 84:77-79, July, 1983) with us. It certainly gives us a better insight into Dr. Moss’s thoughts and interests than his recent scientific papers reveal. Moreover, it serves several very useful editorial functions: It is a challenge to orthodontists to keep pace with the science of space and time. It is a subtle polemic against the dogma and mysticism which haunt our profession. It demonstrates a healthy impatience with the status quo seldom seen in a scientist so richly honored in his own time. It provides a peek into the future of mathematics and computer science as potential clinical tools in the diagnosis of crania-facial disorders. Given the already monumental contributions of Dr. Moss, it is reassuring to learn that he is unwilling to rest until orthodontists abandon their smug complacency and take advantage of mathematical concepts and technology available to us in the Age of Information. Certainly, the ethical revolution in which the health care industry is embroiled will demand nothing less. However, as a protagonist he does his cause little good by casting implicit aspersions on our ancestry. Or why else did he choose to entitle his editorial “Beyond Roentgenographic Cephalometry-What?” Is not radiographic the preferred term? Is not contemporary radiography as far beyond Roentgen as Bookstein is beyond Broadbent? Why does he make such a distinction between morphometrics and cephalometrics? Is not morphometrics a more generic term than cephalometrics? Does not morphometrics mean the measurement of form, while cephalometrics means the measurement of the form of the skull? Why does Dr. Moss insist on his own private meaning for generic terms? Does he not, by so doing, fall into the very mystical trap from which he is trying to save us? Who looks up into the northern heavens at Polaris and sees the allometric center of the universe? However, what skilled mariner could not, with classic navigational tools, find his way across the trackless ocean with bearings on Polaris none-the-less? Because sightings on Polaris are less than perfect, would Dr. Moss have us put a curse on the ancient mariner? As navigational science has continually improved ever since the first man ventured beyond the sight of land, can we not expect also that both the science of morphometrics and the specialty of cephalometrics will 182
become more effective and efficient in the measurement of the time and space of human change? Provoke we must! Challenge we must! Search we must! Communicate we must! Serve we must! Patronize we must not! Flaunt we must not! Denigrate we must not! Ingratiate we must not! Obscure we must not! I agree with Dr. Moss that orthodontists are more consumers of science than generators of science. I agree with Dr. Moss that there is a vast undiscovered ocean of truth out there which will either carry us to new horizons or engulf us. The choice is ours. However, I also agree with Sir Peter Medawar, Nobel laureate in immunology, who is reputed to have declared: “It is no use looking to scientific papers, for they do not merely conceal but actively misrepresent the reasoning which goes into the work they describe.” In that context as well as in a fundamental etymological sense, I disagree with Dr. Moss that the understanding and the application of “new truth” is beyond the capacity of conventional language or the mind of the common clinician. The task lies with the dreamer of dreams and the conceiver of ideas to convey them undistorted to the consumer and not merely to the privileged few. Science, to be useful to mankind, must be marketed as well as produced. I contend that no man is an island; nor is any man the allometric center of anything. If each of us is part of the main, then let us talk to each other rather than up, down, or around the point. To that end, might I suggest the article in Discover Magazine of May, 1983, “Putting a New Face on Surgery” by Glenn Garlik, to find an engineering, mathematical, and computer science application in current clinical use which makes use of the propositional truths of MosslBookstein. I am sure that Dr. Moss recalls Jim Avery’s work on the nasal capsule which made use of a primitive tectnique based on the same concepts. The concepts are not new. Only new technology makes them more accurate and more available for clinical use. By all means, we need to be provoked into rational thought and action. We do not need to be patronized or intimidated or to have our forebears denigrated in the process. Beyond radiographic cephalometry? Better measurements, clearer communications, and morequestions.
Thomas J. Zwemer, D.D.S., M.S.D. School of Dentistry Medical College of Georgia Augusta, GA 30912
Re: Beyond roentgenographic cephalometyy-What? To the Editor: Thank you for sharing Dr. Melvin Moss’s guest editorial (AM. J. ORTHOD. 84:77-79, July, 1983) with us. It certainly gives us a better insight into Dr. Moss’s thoughts and interests than his recent scientific papers reveal. Moreover, it serves several very useful editorial functions: It is a challenge to orthodontists to keep pace with the science of space and time. It is a subtle polemic against the dogma and mysticism which haunt our profession. It demonstrates a healthy impatience with the status quo seldom seen in a scientist so richly honored in his own time. It provides a peek into the future of mathematics and computer science as potential clinical tools in the diagnosis of crania-facial disorders. Given the already monumental contributions of Dr. Moss, it is reassuring to learn that he is unwilling to rest until orthodontists abandon their smug complacency and take advantage of mathematical concepts and technology available to us in the Age of Information. Certainly, the ethical revolution in which the health care industry is embroiled will demand nothing less. However, as a protagonist he does his cause little good by casting implicit aspersions on our ancestry. Or why else did he choose to entitle his editorial “Beyond Roentgenographic Cephalometry-What?” Is not radiographic the preferred term? Is not contemporary radiography as far beyond Roentgen as Bookstein is beyond Broadbent? Why does he make such a distinction between morphometrics and cephalometrics? Is not morphometrics a more generic term than cephalometrics? Does not morphometrics mean the measurement of form, while cephalometrics means the measurement of the form of the skull? Why does Dr. Moss insist on his own private meaning for generic terms? Does he not, by so doing, fall into the very mystical trap from which he is trying to save us? Who looks up into the northern heavens at Polaris and sees the allometric center of the universe? However, what skilled mariner could not, with classic navigational tools, find his way across the trackless ocean with bearings on Polaris none-the-less? Because sightings on Polaris are less than perfect, would Dr. Moss have us put a curse on the ancient mariner? As navigational science has continually improved ever since the first man ventured beyond the sight of land, can we not expect also that both the science of morphometrics and the specialty of cephalometrics will 182
become more effective and efficient in the measurement of the time and space of human change? Provoke we must! Challenge we must! Search we must! Communicate we must! Serve we must! Patronize we must not! Flaunt we must not! Denigrate we must not! Ingratiate we must not! Obscure we must not! I agree with Dr. Moss that orthodontists are more consumers of science than generators of science. I agree with Dr. Moss that there is a vast undiscovered ocean of truth out there which will either carry us to new horizons or engulf us. The choice is ours. However, I also agree with Sir Peter Medawar, Nobel laureate in immunology, who is reputed to have declared: “It is no use looking to scientific papers, for they do not merely conceal but actively misrepresent the reasoning which goes into the work they describe.” In that context as well as in a fundamental etymological sense, I disagree with Dr. Moss that the understanding and the application of “new truth” is beyond the capacity of conventional language or the mind of the common clinician. The task lies with the dreamer of dreams and the conceiver of ideas to convey them undistorted to the consumer and not merely to the privileged few. Science, to be useful to mankind, must be marketed as well as produced. I contend that no man is an island; nor is any man the allometric center of anything. If each of us is part of the main, then let us talk to each other rather than up, down, or around the point. To that end, might I suggest the article in Discover Magazine of May, 1983, “Putting a New Face on Surgery” by Glenn Garlik, to find an engineering, mathematical, and computer science application in current clinical use which makes use of the propositional truths of MosslBookstein. I am sure that Dr. Moss recalls Jim Avery’s work on the nasal capsule which made use of a primitive tectnique based on the same concepts. The concepts are not new. Only new technology makes them more accurate and more available for clinical use. By all means, we need to be provoked into rational thought and action. We do not need to be patronized or intimidated or to have our forebears denigrated in the process. Beyond radiographic cephalometry? Better measurements, clearer communications, and morequestions.
Thomas J. Zwemer, D.D.S., M.S.D. School of Dentistry Medical College of Georgia Augusta, GA 30912