Nazi Dental Gold: from Dead Bodies to Swiss Banks

On the 23rd of September 1940 SS Reichsfürher Heinrich Himmler, gave the SS doctors orders to collect the gold teeth from the mouths of those killed in death camps. Here we ask: who were the SS dentists who are directly implicated in that collection, what were the figures behind the process and how did the Nazis conduct this retrieval of gold? Here we give the answers for the first time...

Drs. Smith Brothers: dental surgeons of Calcutta

During the British raj, India attracted dental practitioners from all over the world who set up practices in the Presidency towns of Calcutta, Bombay, Madras and Bangalore. Lured by the abundant opportunity to make good money, these mercenary but courageous dentists counted Viceroys, Indian royalty and political leaders amongst their clients. Some, like the famous American Smith Brothers of Calcutta, were sought after even by the rulers of neighboring countries. Dr. Mark Smith's hazardous visit to the Amir of Afghanistan made worldwide headlines more than 100 years ago for the fabulous fee he was paid for the dental treatment. This paper briefly describes the exploits and experiences of the Smith brothers while in India.

Longing for modern composite materials in the late 1800s

Restoring teeth in the late 1800s required ingenuity and creativity, as the materials available were a far cry from is presently used. Likewise, restorative preparation designs had not yet been promulgated by GV Black. Concerns about both restorations that contracted due to the nature of the filling material and retention of sound tooth structure in favor of cutting away dentin and enamel in order to place "metal caps" were held by many dentists. While some dental professionals had a vision for the ideal restorative materials, they made do with what they had in an attempt to provide quality dentistry.

Extension for prevention: margin placement

This article will review the concept of extension for prevention popularized by G.V. Black around the early 1900s. Concepts of extension and prevention have changed over the years with a more informed knowledge of the caries process, improved materials, cutting instruments, and techniques. The reasons for placement of the outline form relative to the tooth morphology, gingival tissue, relationship to adjacent teeth, and the choice of material will be described for all of the materials used in restorative dentistry. Research will be cited to support the scientific basis for outline form placement.

[Cavity preparation and restorative therapy in articles, published by the Fogorvosi Szemle in the last hundred years]

The aim of this review is to overview the development achieved in restorative therapy based on the publications in Fogorvosi Szemle during the past hundred years. The top quality of the restorative therapy was, and still has been the inlay, but nowadays the esthetic inlay -- fixed with adhesive material -- has priority over the gold inlay. The quality of amalgam fillings has been recently improved by using high-copper containing amalgam alloys. The development on the field of adhesive material and methods made it possible to give up the routine use of any conventional base material. The place of gingival wall of the cavity moved from subgingival position into supragingival position. The macro retention has been replaced by micro retention, and nowadays the cavity preparation prefers minimal-invasive techniques.

The evolution of the CEREC system

BACKGROUND AND OVERVIEW

Early in 1980, the author anticipated the attraction of restoring posterior teeth with tooth-colored material. He conducted studies and developed the clinical concept of bonded ceramic inlays, at the same time raising the issue of the fast fabrication of the ceramic restorations. The author developed plans for in-office computer-aided design/computer-aided manufacturing (CAD/CAM) fabrication of ceramic restorations specifically to enable the dentist to complete one or multiple ceramic restorations chairside, in a single appointment. The initial concept comprised a small mobile CAD/CAM unit integrating a computer, keyboard, trackball, foot pedal and optoelectronic mouth camera as input devices, a monitor and a machining compartment. CEREC 3 (Sirona Dental Systems GmbH, Bensheim, Germany) divided the system into an acquisition/design unit and a separate machining unit. Three-dimensional software makes the handling illustrative and easy both in the office and in the laboratory.

CONCLUSIONS

It appears that the CEREC CAD/CAM concept is becoming a significant part of dentistry.

CLINICAL IMPLICATIONS

Sound knowledge of adhesive bonding and diligent planning are essential for the successful integration of CAD/CAM into clinical dental offices.

A 100-year journey from GV Black to minimal surgical intervention

Over the past 140 years, dentistry has matured from the original tenets of GV Black by moving from "extension for prevention" to a minimal intervention approach. This is part of an evolution that stresses a medical, rather than a surgical model for caries management. This transition has been facilitated by the introduction and advancement of adhesive dentistry, which encourages preservation of tooth structure. Even with these changes, some of the original writings of Black are still relevant today: "The day is surely coming...when we will be engaged in practicing preventive, rather than reparative, dentistry."

Characterization of dental fillings found in skulls from individuals buried in San Jeronimos Church, New Spain: historical and archaeological evidences

Repair of teeth during the XIX century was often a very costly and painful procedure. During this period, restoration of teeth was a procedure limited only to those who could afford such care. In this study we analyzed teeth from a skull sample found in San Jeronimo's Church. The characterization of molar fillings was made with techniques such as X-ray fluorescence, X-ray diffraction and electron microscopy. The purpose of this investigation was to establish technical procedures for analysis, and to discuss the results within the context of the socioeconomic status of these individuals and the written descriptions of the dental practice during the XIX century.

A comparative analysis of periapical health based on historic and current data

AIM

To compare periapical health using samples from prehistoric and historic periods until the present day, and to emphasize the major risk indicators for apical periodontitis (AP).

METHODOLOGY

A comparative survey to assess periapical health was performed on five samples (525 individuals) drawn from different periods of history within the time frame 2000 BC to 2000 AD. Twenty-one binary risk indicators for AP were retained for a logistic regression model. The probability of a diseased tooth was defined from a two-level response variable based on the periapical index (PAI). An individual regression model was computed with partial least squares (PLS) regression model, based on the individual mean values of the nine retained risk indicators.

RESULTS

Condensing osteitis, tooth wear, caries, root fillings and the presence of inadequate root fillings were associated with the PAI levels. The maxillary molars and recent time periods (contemporaneous and seventeenth century) were also risk indicators for the pathological condition. The PLS regression for individuals demonstrated correlations between risk factors. This multidimensional analysis indicated that the mean PAI was correlated mainly with caries and condensing osteitis. Condensing osteitis was more frequent in the mandibular than in the maxillary bone (P=0.001), and correlated with tooth wear in ancient periods.

CONCLUSIONS

This comparative analysis demonstrated a significantly higher prevalence of AP in the contemporary period. The most important risk indicators for that period were the presence of inadequate root fillings, carious lesions and condensing osteitis.

Advances in the history of composite resins

The use of composite resins as direct restoration material in posterior teeth has demonstrated a great increase, due to esthetic requirements and the controversy regarding the mercury content in silver amalgams. In this article, we have reviewed the composition modifications which have occurred in materials based on resins since their introduction over a half a century ago which have enabled great improvements in their physical and mechanical properties. Likewise, we have highlighted current lines of research, centered on finding the ideal material for replacing silver amalgam as a direct filling material.

From vulcanite to vinyl, a history of resins in restorative dentistry

This article provides historical background on the development of resin-based dental restorative materials. With an understanding of the evolution of these materials, clinicians can better appreciate both the complexity of and similarities among the wide variety of resins and polymerization techniques available today. Common problems associated with the use of resin-based materials are explained, and more advanced resin-based systems currently under development are briefly reviewed.

Greene V. Black and "extension for prevention"

This study is an attempt to intervene in the contemporary debate on the interpretation of Greene V. Black's well known principle of "extension for prevention." It is possible to discern two, divergent strains within Black's thought: he contends that his principle should have universal application, at the same time as he seeks to limit its application. The conflict between these two positions may be resolved by arguing that Black's comments are directed at different audiences: Black does not actually believe that extension for prevention should be universally applied, but reserves the judgment not to extend to only the most experienced operators. The remainder, the majority of operators, should behave as if it were a universal principle.

Dental caries in the second millennium

This historical review of dental caries diagnosis and management is based on information obtained from reports published between 1839 and 1965 and forty textbooks on caries diagnosis and management published since the nineteenth century. The history of understanding of any disease or condition in humans has passed through two distinct eras. The first, which lasted until the twentieth century and may still be ongoing today, is the "observational" era. The second, which has developed and revolutionized our understanding of the causes and treatments of all diseases, is the "scientific" era. During the observational era, treatments of oral or dental problems were based on neither biological nor scientific principles. Rather, experimentation without validation was, and to a lesser extent during the last fifty years is still, common. In terms of disease management, dental practice is still in the gray years of the "restorative era" and in the midst of the "preventive era" where the emphasis would soon shift towards early detection of biological markers of diseases and prevention of their initiation and progression. This review has found that most contemporary questions on caries diagnosis and management have been debated since the middle of the nineteenth century. There is a need for a comprehensive research program to provide scientifically based information to assist dental practitioners in caries detection, diagnosis, and management.

Eighteenth and nineteenth century dental restoration, treatment and consequences in a British nobleman

This paper examines unusual eighteenth and nineteenth century dental treatment and its consequences, in a nobleman excavated from beneath St. Nicholas' Church, Sevenoaks, Kent, UK in the early 1990s. This rare archaeological case exhibits erosion of dental enamel on the labial surface of all the anterior dentition. A programme of historical research suggests that this might be attributed to the application of an acid-based dental tincture or the use of an abrasive substance to whiten the teeth. Palliative treatment for the consequence of this application was prescribed by Dr Robert Blake of Dublin. Further, it bears witness to three dental restorations, two of gold and one tin. The two gold (foil) fillings are an occlusal in the upper-right second molar and a cervical on the labial surface of the upper left canine. The tin filling is an occlusal in the upper left second molar. Excavation of the carious tissue appears to have been undertaken using a spoon shaped implement.

Discoveries of importance in restorative dentistry over the past 40 years

The advancements in restorative dentistry over the past several decades have been impressive. It is now possible to prevent dental caries on a predictable basis. If prevention is not carried out in early life and teeth are lost, it is now possible to restore mutilated or missing teeth with high efficiency and effectiveness. The future for restorative dentistry is extremely bright and has never been better in its history.

Amalgam at the new millennium

Dental amalgam has served as an excellent and versatile restorative material for many years, despite periods of controversy. The authors review its history, summarize the evidence in regard to its performance and offer predictions for the future of this material. For the present, amalgam should remain the material of choice for economical direct restoration of posterior teeth. When esthetic concerns are paramount, tooth-colored materials, placed meticulously, can provide an acceptable alternative.

Centenary year of scientific papers in the British Dental Journal

This final part of the centenary series covers Kramer and McLean's paper, 'The response of the human pulp to self-polymerising acrylic restorations', which was one of the first papers to give such a detailed account and assessment of such changes. It is reviewed by Dr Graham Mount, who first met John McLean in 1973 and has worked closely with him since then.

Dentistry: a look backward and a peek into the future

From the time of Pierre Fauchard in the early 1700s, dentistry has undergone many changes. The introduction over the past two centuries of new materials and techniques has allowed dentists to perform wonders in tooth restoration and retention. Emphasis on better esthetics, more functional prostheses and greater pain control has led to the introduction of materials and techniques undreamed of only a short time ago. The future promises to reveal even more exciting advances.

Back to the Little Bighorn

Fillings found in the skull of a 7th Cavalry trooper killed 118 years ago in the Battle of Little Bighorn show sophisticated, well-executed dentistry. Some fillings are examples of early preventive dentistry, using a variety of materials and techniques typical of 19th-century cavity preparation. Dental care most likely was delivered by a private dentist or performed in part at a dental school in the East or Midwest, in a large city or at West Point. The logical, deductive process suggests an identification: Cpl. George Lell. Without additional corroborative documentation, however, this is speculation. Whoever he was, the cavalryman was older and shorter and had better oral care and health than most of the comrades who died with him in 1876. He used tobacco, most likely by chewing it. His remains provide a glimpse into the reality of life and death, dental care and hygiene of the mid-19th century.

Prosthetics, periodontal therapy and conservative dentistry in the eighteenth century: archeological findings from Grand Sacconex, Geneva, Switzerland

There are only few archaeological findings on therapeutic measures dating to the early times of scientific dentistry. The remains of two burials from the mid-eighteenth century permit the assessment of the spectrum of dental treatments of that time. Bridges, ivory dentures, gold ligatures for splinting as well as various metal fillings demonstrate the state-of-the-art of contemporary practical dentistry. A presentation of the findings should be of interest not only for the history of dentistry but can also supplement the written records of that time.

Dental restorations and artificial teeth in a Georgian population

In the recent exhumation of a predominantly Georgian population at Christ Church, Spitalfields, 12 skulls showed evidence of dental restorations or artificial teeth. These have been described in some detail and the findings discussed in the light of current knowledge about practical dentistry in England up to the year 1852.

A grave matter--dental findings of people buried in the 19th and 20th centuries

The exhumed remains of 181 people, buried during the period 1848-1984 were examined. Because of the carelessness of exhumations, only 125 yielded sufficient information to compare the condition of skulls and jaws with the period in the grave, while 63 yielded information about the teeth. No correlation could be shown between the condition of the skulls and jaws and the period interred, but it was found that the better preserved remains belonged to younger people. Dental findings included the presence of healthy and decayed teeth, gold foil restorations, gold and porcelain inlays, amalgam and silicate fillings, and vulcanite and acrylic dentures. Amalgam restorations were present in people buried from 1875 (114 years ago) and vulcanite dentures from 1882 (107 years ago). The characteristics of the earliest amalgam restorations showed that they could have been placed before 1850. Findings of this study indicate that: (a) one cannot on the appearance of exhumed remains estimate the burial period, (b) dental features were well preserved and can be used for dental identification if antimortem data are available, (c) advanced dentistry could have been practised in South Africa during the last century, and (d) recovery of human skeletal remains from old cemeteries should be undertaken with care to preserve as much information as possible. A plea is made for closer co-operation between developers of old graveyard sites and scientists in order to preserve as much information as possible.