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Report of the Committee on Nomenclature of the American Dental Association
Report of Committee on Nomenclature was palliative and symptomatic until about six and one-half weeks after the patient had the tooth extracted, when she returned with a generalized bilateral and symmetrical erup tion on the body, extremities ^and head. A t this same time, there were headaches, generalized weakness and spells of sweating. T h e rash was dusky red and copper colored, and papular in character. M any of the lesions were covered with a dry, dirty gray and somewhat adherent scale. There was very little tendency to coalescence, although the papules were of various sizes. Further examination revealed mucous patches on the vulva. Both the W assermann and Kahn tests at this time were strongly positive. T he diag nosis of primary and secondary syphilis was made in the dermatology department with the primary lesion occurring on the gingiva. Under antisyphilitic treatment, the evident
2233
manifestations disappeared and the general condition of the patient continued to improve.
Th e importance of making an early diagnosis of syphilis is so great that mere mention of the fact is certainly insuffi cient recognition. Modern understand ing and comprehension of this disease has definitely brought to light the tre mendous importance of making the diag nosis of syphilis in the first stage of the disease, because it is in this period that Spirochaeta pallida is most abundant in the site of inoculation and can be dem onstrated in the dark-field even when the serologic tests are negative, and be cause treatment instituted in this stage is the patient’s golden opportunity for a cure.
REPORT OF THE COMMITTEE ON NOMENCLATURE OF THE AMERICAN DENTAL ASSOCIATION
I
N our report in 1932, we recommended that the Committee be enlarged to in clude a representative from each of the specialties of dental practice, namely, exodontia, oral surgery, periodontia, or thodontia and prosthetic dentistry. This recommendation was made because we believe that we would receive better co operation from these sources, and that the recommendations of the committee would be more representative of the general thought on the subject of nomen clature than is at present the case. In deed, we attribute the lack of support of the work of the committee from some sources to the fact that some of the spe cialties are not represented on the com mittee. As no action was taken on this recom mendation last year, we again offer the recommendation, and urge action on it at this time. If the action is favorable,
we request that such members be ap pointed for the coming year. W e are pleased to report that, under the auspices of the International Dental Federation, there has been organized an international association for the study of paradentosis (abbreviated A . R. P. A .) , with a number of European and Ameri can countries represented, for the pur pose of research into the subject of socalled pyorrhea alveolaris, and its first effort has been directed toward simplifi cation of the terminology. As a result of this effort, adoption of the term “ para dentosis” to take the place of the term pyorrhea alveolaris has been recom mended. They have also tentatively proposed terms to designate the various forms and degrees of paradentosis, on which we shall report later. Y our committee is in accord with the spirit and objectives of the A. R. P. A.
2234
The Journal of the American Dental Association
and recommends that the term it has adopted be adopted in this country. This term has been in use for some two years in Europe and, we believe, has con tributed much to a better understanding of this common disease, in which so much confusion as to terminology has existed in the past. In this connection, we also recommend the adoption of the term “ paradentium,” also in use and adopted by the A. R. P. A., to mean the investing tissues of the teeth. A t present, the term “ peridentium” is being used in this country to mean the investing tissues of the teeth, but this use is very confusing, for the reason that “ peridentium” has long been in use in den tistry to mean the peridental membrane. W e would again define the terms “ gingival line” and “ cervical line,” as there seems to be an impression that these terms are interchangeable. W e would offer a further recommen dation with regard to the use of “ cuspid,” “ bicuspid,” “ canine” and “ premolar.” W hile these terms are used interchange ably and are well understood in dental literature, we recommend that the terms “ canine” and “ premolar” be used prefer ably in theses or contributions which in volve the other biologic sciences. W e suggest this modification for the reason that these terms (canine and premolar) are well established in, for instance, an thropology; while the terms “ cuspid” and “ biscupid” are not understood in the sense in which we use them. W e would again call attention to our recommendation made several years ago as to the use of the term “ pathosis” as meaning a disease condition, in preference to the misuse of the term “ pathology” in this sense. DENTAL NOTATION
In recent years, there have been in use several methods of noting the teeth sym
bolically, or by numbers, for the sake of brevity. W e recommend what we be lieve is a simple and easily understood system of notation, suggested by Dr. Haderup of Denmark and now quite generally used in Europe. By this method, the teeth are desig nated by the numbers one to eight begin ning with the central incisors, with the symbol plus ( + ) to indicate the upper teeth and the symbol minus ( — ) to in dicate the lower teeth. For the right side of the mouth, the symbol appears to the right of the number; for the left side, it appears on the left side of the number indicating the tooth. Thus, 1-f- desig nates the upper right central incisor; -|-1 the upper left central incisor; 1— the lower right central incisor, and —1 the lower left central incisor. For the deciduous teeth a cipher pre cedes the number of the tooth. As an aid in recognizing the side of the mouth intended, we suggest the fol lowing simple rule: Th e side of the num ber of the tooth on which the symbol appears indicates the side of the mouth, thus: 1+ , the right side, and + 1, the left side of the mouth. W e believe this system an improve ment in notation in that it is simple and does not require extra type characters in printing. A t the suggestion of one of our lead ing anatomists, your committee has been studying the terminology of the anatomy of the teeth as devised by G. V. Black, with a view to designating some of the occlusal surface markings more distinctly and possibly more differentially. O ur reverence for this grand old man of dentistry and our high regard for the immense value of his contribution to ana tomic nomenclature make us extremely diffident in attempting to improve on his work, but we believe that the expe
Report of Committee on Nomenclature rience of anatomists in teaching has shown that confusion in some of the terms that he devised can be eliminated by some sug gested revisions. W e therefore offer the follow ing: For the cusps of the first lower molar tooth we recommend mesiobuccal, centrobuccal, distobuccal, mesiolingual and distolingual. For the developmental grooves of the first lower molar, we rec ommend mesiobuccal, mesiobuccoclusal, distobuccoclusal, distobuccal; distolingual, linguoclusal, mesiolingual; central, mesial and distal (lateral continuations of the central) grooves. For the surface markings of the upper bicuspid or premolar tooth, we recom mend: cusp ridge, buccal and lingual in place of buccal triangular ridge and lin gual triangular ridge, respectively; mesial and distal plane of buccal cusp in place of mesiobuccal and distobuccal inclined plane of buccal cusp; mesial and distal plane of lingual cusp in place of mesiolin gual and distolingual inclined plane of lingual cusp; mesial and distal arms of buccal cusp in place of mesiobuccoclusal marginal ridge and distobuccal marginal ridge; mesial and distal arms of lingual cusp. For the developmental grooves of the upper first molar, we recommend central, mesiobuccal, distobuccal, mesiolingual and distolingual, buccoclusal, linguoclu sal ; for the developmental grooves of the lower second molar, buccoclusal, linguo clusal, mesiobuccal, mesiolingual, disto buccal, distolingual; central, mesial and distal (lateral continuations of central groove). For the benefit of those who failed to note them when presented, we repeat the definitions of the terms “ articulation” and “ occlusion” as recommended by the com mittee to be used in the dental sense.
2235
Articulation. The arrangement of ar tificial teeth to conform to the require ments of the edentulous space or spaces which they are to occupy, and to serve adequately the purposes of the natural organs which they are intended to replace. N ote: Articulation refers to the actual placing of artificial teeth, one by one, into the required position; but articulation is not to be used to describe the occlusal re lations of artificial teeth after they have been so arranged. Occlusion. The contact of the teeth of both jaws, when closed (together) or during those excursive movements of the mandible which are essential to the func tion of mastication. Pathosis. A disease condition. A mor bid dissolution of tissues. Paradentosis (or parodontosis) (G r. para, about, near; L. dens, tooth and osis, condition of disease). A disease condition of the tissues about the teeth. Paradentium (or parodontium). The investing tissues about or near the tooth as a group, namely, the pericementum, the gingiva and the alveolar process. Peridentium (or periodontium). The membranous tissue immediately sur rounding the cementum of the tooth and between the cementum and the alveolar process; synonyms: pericementum, peri dental membrane. Cervical line. The line of the anatomic neck of the tooth, to be distinguished from gingival line. Gingival line. The line of contact of the gingiva to the tooth; to be distin guished from cervical line. Cuspid; bicuspid. T o be used inter changeably with canine and premolar; use of the former to be confined to a strictly dental audience; the latter to be used in addressing an audience including representatives of other biologic sciences.
2236
The Journal of the American Dental Association
T h e committee would also recommend that a compilation o f the terms that we have suggested in previous years be pub lished in T h e J o u r n a l or in pamphlet form or both, for the reason that the pro fession generally does not appear to be fa
miliar with the terms offered. Respectfully submitted, W illia m
B. D u n n i n g
J u l i o E n d e lm a n L . P ie r c e A n t h o n y ,
Chairman
IMAGES OF RADON IMPLANTS ON ORAL ROENTGENOGRAMS By HAROLD A R T H U R SOLOMON, D.D.S., Buffalo, N .Y.
S
E V E R A L people at the 1932 A .D .A meeting reported that they had been puzzled on finding images of radon implants or “ seeds” on oral roentgeno grams. As radium therapy is being widely adopted in the treatment of ma lignancy, it is important that everyone engaged in oral roentgenography be able to recognize roentgenographic evidence of such bodies. In order that those unfamiliar with radium may recognize implanted “ seeds,” the accompanying intra-oral film is pre sented, from the files of the New York State Institute for the Study of M alig nant Diseases, at Buffalo. This film shows the images of three interstitial radon implants or “ seeds” in an epithe lioma involving the inner cheek and su perimposed upon the image of the dental structures. These implants are of solid gold and are approximately 4 mm. in length, hav
ing a diameter of 1 mm. and a wall thick ness of 0.3 mm. They contain radium emanation which is a gas from which the alpha, beta and gamma rays are given
Intra-oral film showing three radon “ seeds” in cheek.
off. The gold acts as a filter to remove the alpha and beta rays, which would cause a severe necrosis of the adjacent tissue. Such implants are not removed; but are allowed to remain, either to slough out or to become encapsulated with fibrous connective tissue.
2233
manifestations disappeared and the general condition of the patient continued to improve.
Th e importance of making an early diagnosis of syphilis is so great that mere mention of the fact is certainly insuffi cient recognition. Modern understand ing and comprehension of this disease has definitely brought to light the tre mendous importance of making the diag nosis of syphilis in the first stage of the disease, because it is in this period that Spirochaeta pallida is most abundant in the site of inoculation and can be dem onstrated in the dark-field even when the serologic tests are negative, and be cause treatment instituted in this stage is the patient’s golden opportunity for a cure.
REPORT OF THE COMMITTEE ON NOMENCLATURE OF THE AMERICAN DENTAL ASSOCIATION
I
N our report in 1932, we recommended that the Committee be enlarged to in clude a representative from each of the specialties of dental practice, namely, exodontia, oral surgery, periodontia, or thodontia and prosthetic dentistry. This recommendation was made because we believe that we would receive better co operation from these sources, and that the recommendations of the committee would be more representative of the general thought on the subject of nomen clature than is at present the case. In deed, we attribute the lack of support of the work of the committee from some sources to the fact that some of the spe cialties are not represented on the com mittee. As no action was taken on this recom mendation last year, we again offer the recommendation, and urge action on it at this time. If the action is favorable,
we request that such members be ap pointed for the coming year. W e are pleased to report that, under the auspices of the International Dental Federation, there has been organized an international association for the study of paradentosis (abbreviated A . R. P. A .) , with a number of European and Ameri can countries represented, for the pur pose of research into the subject of socalled pyorrhea alveolaris, and its first effort has been directed toward simplifi cation of the terminology. As a result of this effort, adoption of the term “ para dentosis” to take the place of the term pyorrhea alveolaris has been recom mended. They have also tentatively proposed terms to designate the various forms and degrees of paradentosis, on which we shall report later. Y our committee is in accord with the spirit and objectives of the A. R. P. A.
2234
The Journal of the American Dental Association
and recommends that the term it has adopted be adopted in this country. This term has been in use for some two years in Europe and, we believe, has con tributed much to a better understanding of this common disease, in which so much confusion as to terminology has existed in the past. In this connection, we also recommend the adoption of the term “ paradentium,” also in use and adopted by the A. R. P. A., to mean the investing tissues of the teeth. A t present, the term “ peridentium” is being used in this country to mean the investing tissues of the teeth, but this use is very confusing, for the reason that “ peridentium” has long been in use in den tistry to mean the peridental membrane. W e would again define the terms “ gingival line” and “ cervical line,” as there seems to be an impression that these terms are interchangeable. W e would offer a further recommen dation with regard to the use of “ cuspid,” “ bicuspid,” “ canine” and “ premolar.” W hile these terms are used interchange ably and are well understood in dental literature, we recommend that the terms “ canine” and “ premolar” be used prefer ably in theses or contributions which in volve the other biologic sciences. W e suggest this modification for the reason that these terms (canine and premolar) are well established in, for instance, an thropology; while the terms “ cuspid” and “ biscupid” are not understood in the sense in which we use them. W e would again call attention to our recommendation made several years ago as to the use of the term “ pathosis” as meaning a disease condition, in preference to the misuse of the term “ pathology” in this sense. DENTAL NOTATION
In recent years, there have been in use several methods of noting the teeth sym
bolically, or by numbers, for the sake of brevity. W e recommend what we be lieve is a simple and easily understood system of notation, suggested by Dr. Haderup of Denmark and now quite generally used in Europe. By this method, the teeth are desig nated by the numbers one to eight begin ning with the central incisors, with the symbol plus ( + ) to indicate the upper teeth and the symbol minus ( — ) to in dicate the lower teeth. For the right side of the mouth, the symbol appears to the right of the number; for the left side, it appears on the left side of the number indicating the tooth. Thus, 1-f- desig nates the upper right central incisor; -|-1 the upper left central incisor; 1— the lower right central incisor, and —1 the lower left central incisor. For the deciduous teeth a cipher pre cedes the number of the tooth. As an aid in recognizing the side of the mouth intended, we suggest the fol lowing simple rule: Th e side of the num ber of the tooth on which the symbol appears indicates the side of the mouth, thus: 1+ , the right side, and + 1, the left side of the mouth. W e believe this system an improve ment in notation in that it is simple and does not require extra type characters in printing. A t the suggestion of one of our lead ing anatomists, your committee has been studying the terminology of the anatomy of the teeth as devised by G. V. Black, with a view to designating some of the occlusal surface markings more distinctly and possibly more differentially. O ur reverence for this grand old man of dentistry and our high regard for the immense value of his contribution to ana tomic nomenclature make us extremely diffident in attempting to improve on his work, but we believe that the expe
Report of Committee on Nomenclature rience of anatomists in teaching has shown that confusion in some of the terms that he devised can be eliminated by some sug gested revisions. W e therefore offer the follow ing: For the cusps of the first lower molar tooth we recommend mesiobuccal, centrobuccal, distobuccal, mesiolingual and distolingual. For the developmental grooves of the first lower molar, we rec ommend mesiobuccal, mesiobuccoclusal, distobuccoclusal, distobuccal; distolingual, linguoclusal, mesiolingual; central, mesial and distal (lateral continuations of the central) grooves. For the surface markings of the upper bicuspid or premolar tooth, we recom mend: cusp ridge, buccal and lingual in place of buccal triangular ridge and lin gual triangular ridge, respectively; mesial and distal plane of buccal cusp in place of mesiobuccal and distobuccal inclined plane of buccal cusp; mesial and distal plane of lingual cusp in place of mesiolin gual and distolingual inclined plane of lingual cusp; mesial and distal arms of buccal cusp in place of mesiobuccoclusal marginal ridge and distobuccal marginal ridge; mesial and distal arms of lingual cusp. For the developmental grooves of the upper first molar, we recommend central, mesiobuccal, distobuccal, mesiolingual and distolingual, buccoclusal, linguoclu sal ; for the developmental grooves of the lower second molar, buccoclusal, linguo clusal, mesiobuccal, mesiolingual, disto buccal, distolingual; central, mesial and distal (lateral continuations of central groove). For the benefit of those who failed to note them when presented, we repeat the definitions of the terms “ articulation” and “ occlusion” as recommended by the com mittee to be used in the dental sense.
2235
Articulation. The arrangement of ar tificial teeth to conform to the require ments of the edentulous space or spaces which they are to occupy, and to serve adequately the purposes of the natural organs which they are intended to replace. N ote: Articulation refers to the actual placing of artificial teeth, one by one, into the required position; but articulation is not to be used to describe the occlusal re lations of artificial teeth after they have been so arranged. Occlusion. The contact of the teeth of both jaws, when closed (together) or during those excursive movements of the mandible which are essential to the func tion of mastication. Pathosis. A disease condition. A mor bid dissolution of tissues. Paradentosis (or parodontosis) (G r. para, about, near; L. dens, tooth and osis, condition of disease). A disease condition of the tissues about the teeth. Paradentium (or parodontium). The investing tissues about or near the tooth as a group, namely, the pericementum, the gingiva and the alveolar process. Peridentium (or periodontium). The membranous tissue immediately sur rounding the cementum of the tooth and between the cementum and the alveolar process; synonyms: pericementum, peri dental membrane. Cervical line. The line of the anatomic neck of the tooth, to be distinguished from gingival line. Gingival line. The line of contact of the gingiva to the tooth; to be distin guished from cervical line. Cuspid; bicuspid. T o be used inter changeably with canine and premolar; use of the former to be confined to a strictly dental audience; the latter to be used in addressing an audience including representatives of other biologic sciences.
2236
The Journal of the American Dental Association
T h e committee would also recommend that a compilation o f the terms that we have suggested in previous years be pub lished in T h e J o u r n a l or in pamphlet form or both, for the reason that the pro fession generally does not appear to be fa
miliar with the terms offered. Respectfully submitted, W illia m
B. D u n n i n g
J u l i o E n d e lm a n L . P ie r c e A n t h o n y ,
Chairman
IMAGES OF RADON IMPLANTS ON ORAL ROENTGENOGRAMS By HAROLD A R T H U R SOLOMON, D.D.S., Buffalo, N .Y.
S
E V E R A L people at the 1932 A .D .A meeting reported that they had been puzzled on finding images of radon implants or “ seeds” on oral roentgeno grams. As radium therapy is being widely adopted in the treatment of ma lignancy, it is important that everyone engaged in oral roentgenography be able to recognize roentgenographic evidence of such bodies. In order that those unfamiliar with radium may recognize implanted “ seeds,” the accompanying intra-oral film is pre sented, from the files of the New York State Institute for the Study of M alig nant Diseases, at Buffalo. This film shows the images of three interstitial radon implants or “ seeds” in an epithe lioma involving the inner cheek and su perimposed upon the image of the dental structures. These implants are of solid gold and are approximately 4 mm. in length, hav
ing a diameter of 1 mm. and a wall thick ness of 0.3 mm. They contain radium emanation which is a gas from which the alpha, beta and gamma rays are given
Intra-oral film showing three radon “ seeds” in cheek.
off. The gold acts as a filter to remove the alpha and beta rays, which would cause a severe necrosis of the adjacent tissue. Such implants are not removed; but are allowed to remain, either to slough out or to become encapsulated with fibrous connective tissue.