healing of the traumatised dental pulp

FEBRUARY, 1959 51 W. J. TUCKFIELD, D.D.SC., Editor Emeritus ROBERT HARRIS, M.D.s., Editor Volume 4 :: Number 1 Dentid Journal Published by the Australian Dental Association 135 Macquarie Street, Sydney, N.S.W. HEALING OF THE TRAUMATISED DENTAL PULP The problem of maintaining a healthy pulp in a carious tooth has been before us from time immemorial. That it has been recognised is also a fact of long standing, for Archigenes, the Syrian physician and surgeon who practised in Rome at the end of the 1st Century and the beginning of the 2nd held that odontalgia in certain cases arose from a disease of the interior of the tooth. He also discovered an excellent method for curing such cases-when the tooth was discoloured and caused pain, he drilled down into the centre of the tooth. Various remedies for easing the pain were suggested, such as hot mouth washes of strong vinegar in which gall-nuts and halicaccabum had been boiled, and where reflex pain produced otalgia then a mixture of pepper and oil of almonds was dropped into the ear on the affected side. Subsequent to these ancient times, many of the practices of the Romans, Greeks and Arabians fell into desuetude and their teachings were lost to the peoples of the Dark Ages. However, l’faff, Flagg and Paiichard did much to restore the skills, standing and acceptance of dental practice of their days, and thwe is evidence that they and their contemporaries developed methods for capping the exposed pulp with gold foil or some other metal prior to the insertion of the filling and Fauchard in pai.ticnlar tleveloped a method of pulp therapy which included destruction by caiitcJrisation and replacement of the necrotic contents of the canal, after suitable tiw tnient with various twential oils, by gold filling. Tht. (*oiisei*\ ativr trentrnrnt of the tranmatised piilp has pilssed tlirongh fairly \vt.11 dt~finetl eixs. Firstly there was an era of empiricism wherein little was attempted by vai~ioiis nuthorities to evaliiate the methods and results on any comparative basis. Trtwtriitwt m;iinly consistetl of the application of some form of canstic 014 the actiial (%1iteiay followetl by some filling material of choice. The fact that the piilp not only diet1 in these c~irciimstanc~rs but. as in the case of arsenic application, decomposed, I\ as iiot re;ilised foia some time. Rnt once this was observed, some' serious nttempts wrrt~ lnitde to niotlify the procediires. At about this time the idea spread that a tliscl;istltl or t1;IItliIgt.d piill) could not fully reciiperatp because it was encased in a h:~i*d iiic.oml)i.rssi~)le striictnre. This contention of course is often held to-day.

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Page 1: HEALING OF THE TRAUMATISED DENTAL PULP

FEBRUARY, 1959

5 1

W. J. TUCKFIELD, D.D.SC., Editor Emeritus ROBERT HARRIS, M.D.s., Editor

Volume 4 :: Number 1

Dentid Journal Published by the Australian Dental Association

135 Macquarie Street, Sydney, N.S.W.

HEALING OF THE TRAUMATISED DENTAL PULP

The problem of maintaining a healthy pulp in a carious tooth has been before us from time immemorial. That it has been recognised is also a fact of long standing, for Archigenes, the Syrian physician and surgeon who practised in Rome a t the end of the 1st Century and the beginning of the 2nd held that odontalgia in certain cases arose from a disease of the interior of t he tooth. He also discovered an excellent method for curing such cases-when the tooth was discoloured and caused pain, he drilled down into the centre of the tooth. Various remedies for easing the pain were suggested, such as hot mouth washes of strong vinegar in which gall-nuts and halicaccabum had been boiled, and where reflex pain produced otalgia then a mixture of pepper and oil of almonds was dropped into the ear on the affected side.

Subsequent to these ancient times, many of the practices of the Romans, Greeks and Arabians fell into desuetude and their teachings were lost to the peoples of the Dark Ages. However, l’faff, Flagg and Paiichard did much to restore the skills, standing and acceptance of dental practice of their days, and thwe is evidence tha t they and their contemporaries developed methods for capping the exposed pulp with gold foil or some other metal prior to the insertion of the filling and Fauchard in pai.ticnlar tleveloped a method of pulp therapy which included destruction by caiitcJrisation and replacement of the necrotic contents of the canal, after suitable tiw tnient with various twential oils, by gold filling.

Tht. (*oiisei*\ ativr trentrnrnt of the tranmatised piilp has pilssed tlirongh fairly \vt.11 dt~finetl eixs. Firstly there was an era of empiricism wherein little was attempted by vai~ioiis nuthorities to evaliiate the methods and results on any comparative basis. Trtwtriitwt m;iinly consistetl of the application of some form of canstic 0 1 4 the actiial (%1iteiay followetl by some filling material of choice. The fact that the piilp not only diet1 in these c~irciimstanc~rs but. as in the case of arsenic application, decomposed, I\ a s iiot re;ilised foia some time. Rnt once this was observed, some' serious nttempts wrrt~ lnitde to niotlify the procediires. A t about this time the idea spread that a tliscl;istltl or t1;IItliIgt.d piill) could not fully reciiperatp because it was encased in a h : ~ i * d iiic.oml)i.rssi~)le striictnre. This contention of course is often held to-day.