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Return to Oral Pathology History Page Bouquot Research
A Review of the Beginning of Modern Oral Pathology, Reporting the First Mention of Benign Odontogenic Tumors and Cysts. Published in Oral Surgery Oral Medicine Oral Pathology in 1994; 78:343-350.
Jerry E. Bouquot, D.D.S., M.S.D., Professor and Chairman, Department of Oral Pathology, West Virginia University School of Dentistry; Professor and Section Head, Department of Pathology, WVU School of Medicine, Morgantown, West Virginia; Elizabeth C. Lense, D.D.S., Assistant Professor, Department of Oral Pathology, West Virginia University School of Dentistry
Too frequently literature reviews of oral pathologic entities lack a truly historical perspective, presuming that the mid- to late-twentieth century reports are the first valid reports available. The mid-nineteenth century dental journals, however, are replete with clinical, surgical, and microscopic descriptions of oral tumors and cysts. Most of these have never been referenced during the present century. The purpose of the present paper is to report the earliest dental journal references for a variety of benign oral tumors and cysts. These references are derived from a canvas of all dental journals published from the first journal (American Journal of Dental Science) in 1839 to the appearance of Dental Cosmos and the organization of the American Dental Association in 1860.
Oral Pathology as a specialty of dentistry is traditionally presumed to have its origin in the 1930s and 1940s,[1] perhaps commencing with Bunting's Textbook of Oral Pathology,[2] Thoma's Oral Pathology,[3] or the first issues of the Archives of Clinical Oral Pathology,[4] and Oral Surgery, Oral Medicine, Oral Pathology.[5] The American Academy of Oral Pathology and the American Board of Oral Pathology were formed during this time period, preceded slightly by the first organizations devoted exclusively to Oral Pathology, the New York Institute of Clinical Oral Pathology and the American Dental Association's Registry of Dental and Oral Pathology.[6,7] An even earlier landmark was Bloodgood's 1915 "everything-you-need-to-know" review of oral lesions in the second volume of the Journal of the American Dental Association.[8]
The first professorship of "Dental Pathology", however, originated much earlier, with the 1840 establishment of the Baltimore School of Dental Medicine.[9] The first text dedicated to Oral Pathology as we know it today was published shortly thereafter by Bond,[10] and, of course, Fouchard,[11], Jordain,[12] Hunter,[13] Bell[14] and others had reported even earlier on a variety of tooth anomalies. In reality, it appears that the mid-nineteenth century was the time of the true birth of both Oral Pathology (Table 1). The age that saw an unprecedented, world-wide "mental stir" [30] in consequence also saw the emergence of "modern" or organized dentistry. This first "Golden Age" [31] of dentistry, 1835-1860, began with dentistry "not a whit more respectable than the barber-surgeons of old times",[30] and concluded with its establishment as an organized, science-based health profession with techniques and therapeutic successes not unlike those of the twentieth century. The face of dentistry was absolutely changed to something unrecognizable from that which came before.[32]
A fascination for pathologic processes was an integral part of modern dentistry at its inception, as was a strong and apparently new belief that information should be openly and widely shared.[33] Approximately half of all "scientific" articles in the first volume of the earliest published dental journal were related to pathologic conditions of the mouth and jaws,[34] and the first truly comprehensive text for the dental profession in the United States, Bell's 1829 classic,[14] dealt extensively with pathologic processes, including first reports of numerous oral diseases. Lester Cahn believed that Sir Jonathan Hutchinson was the earliest Oral Pathologist,[1] but the chairman of Baltimore's Department of Special Pathology, Thomas Bond, more correctly holds that distinction. Bond's insight was so remarkable that he was able to hypothesize etiologies and pathophysiologies which are still valid today.
Koecker, although a less influential dental surgeon, was the first professional to actually be designated a "dental pathologist" in print.[19] He published a general text on dentistry, Principles of Dental Surgery, as early as 1822.[25] Interest in pathology continued to grow as dentistry became a strong and independent health profession, and by 1860 many of today's well-established oral lesions had been reported in the various dental journals then publishing (Table 2). These accounts frequently anteceded the usually quoted "first reports" by several generations. Oral pyogenic granulomas, for example, were
not well understood until Kerr's[36] 1951 analysis, yet Simon P. Hullihen, the "father of oral surgery", described one succinctly in an 22 year-old pregnant woman as early as 1844 (Figure 1).[37] Hullihen documented a recurrence of his
patient's gingival "aneurysm" with her second pregnancy. During the same year Westcott[38] described pregnancy gingivitis under the diagnosis of "uterine irritation"; Harris[15] had described it earlier as "hemorrhoidal discharge in dysmenorrhea"..
Oral pathology papers frequently begin with historical reviews of the lesion or disease under discussion, usually mentioning the first cases identified. It seemed appropriate, therefore, to document the first actual dental journal reports of such entities. The attempt to do so is considerably facilitated by the fact that American dentistry, through its free exchange of innovative technology and scientific inquiry, its journals, national organizations, and its schools of dentistry, dominated the profession
throughout the nineteenth century. Consequently, virtually all of the earliest journals were published in English and almost always in the United States (Table 2). While individuals from other countries published occasional textbooks of exceptional quality and insight, other countries lacked the cooperative spirit needed to assure a rapid expansion of professional knowledge. This first Golden Age of dentistry was a truly remarkable and uniquely American phenomenon, as declared in 1851: "dental surgery, as at present practiced, is almost an American creation, for although operations upon the teeth have been practiced since the days of the Pharaohs, and probably before, yet the rude and simple character of the early manipulations hardly give them a claim to be regarded among the effects of scientific art, and until comparatively lately, but very little improvement seems to have been made in this department of surgery."[33]
It is presumed that, because of this American dominance, references in early American dental journals are among the first reasonably accurate references to oral pathologic entities. It is hoped, however, that the present paper will stimulate additional investigation into early references of such lesions, especially in textbooks, which were much less widely circulated than journals and are much more difficult to obtain today.
METHODS
A listing of nineteenth century dental journals [40] was supplemented by a four-year systematic perusal of journals in the libraries of West Virginia University, the University of Minnesota, the Mayo Clinic, and the National Library of Medicine. Table 2 lists all dental journals published, in any language, between 1839 and 1860. Almost all English-language articles published in all volumes of each journal in Table 2 were reviewed for references to oral pathologic entities. While most diagnoses were obvious, even though the lexicon was different from that in use today, educated guesses were occasionally made for several lesions since some early investigators neglected to provide detailed histologic descriptions. All lesions reported from 1839-1860 were recorded, whether first reports or not, and additional references are available upon request.
The first dental journal reports of oral pathologic entities dealt with odontogenic anomalies (Figure 2). Dentists were beginning to share clinical information on a wide scale and the odd case noted in clinical practice was specifically sought by editors. One of the most well-accepted anomalies was "exostosis", an enlargement at the apex of the root or "bone" of an extracted "fang".[41] Such lesions were thought to be a major cause of tooth-ache pain and inflammation of the "dental nerve" (pulp), a natural assumption considering that they were only found upon extraction of painful, cariously destroyed teeth.[21,42-44] By 1851, Vandenburgh [45] hypothesized that pulpal inflammation caused this lesion and it was, therefore, not a true exostosis.
Harris[15] and Lee[46] believed that multiple cases in one individual were the result of "constitutional causes" rather than inflammation. Today we refer to this as hypercementosis and know it to represent excessive cementoblastic activity secondary to hypereruption of a tooth. We still accept one "constitutional" cause, Paget's disease of bone, for multiple hypercementoses.[47] A few exostoses were much too large to conform to a hypercementosis diagnosis and were obviously benign cementoblastomas. Several were reported to have completely obliterated the ipsilateral maxillary sinus.[48,49] The very first dental journal reference to an odontogenic neoplasm was a 7 cm. cementoblastoma of a maxillary molar, reported in the inaugural volume of the American Journal of Dental Science (AJDS), the official publication of the first national dental association and the only dental journal accepted by the early American Medical Association as a legitimate medical journal.[50,51]
This same entity became the first odontogenic lesion reported with microscopic confirmation (Figure 3), almost a century before Norberg[53] published the paper most usually quoted as the first report of this lesion. Table 3 provides first reports of other odontogenic neoplasms. The first journal report of a complex odontoma was in a 25 year old female and was most unusual in that it erupted with the underlying tooth.[42] Without such eruption, of course, this lesion would not have been noted in a age without radiographs. The complex odontoma with the most definitive microscopic confirmation, however, was not reported until Forget's[49] superb paper translated in the first volume of Dental Cosmos (Figure 4). The first unequivocal cases of compound odontoma, one with at least 25 distinct teeth and another with a gross specimen drawing confirming the diagnosis, were reported in 1854 and 1858, respectively.[61,64] While these are the first journal reports of odontomas, it was probably Pierre Fouchard[11] who provided the first accurate description of these lesions. Oudet[66], in 1809, suggested that they were of dental origin, but the term "odontome" was not applied until 1868.[67] They were undoubtedly the oldest recorded odontogenic neoplasms, having been reported in a 500,000 year old fossilized horse.[68]
An earlier journal report of an intraosseous neoplasm might possibly have dealt with a complex odontoma, discovered only because of its large size.[58] But the surgical description is more appropriate to a central ossifying/cementifying fibroma. The first unequivocal case of the latter entity was one of considerable size, contained numerous microscopic foci of dark globular cementum, and was not published until 1865 (Figure 5).[64] The odontogenic (nonossifying) fibroma is an entity which, until recently, was frequently confused with simple fibrous hyperplasia of the parafollicular connective tissues,[69] but Adams[60] reported a "circumscribed fibrous tumor" around the crown of an impacted mandibular molar which seems large enough to justify it as the first report of a true odontogenic fibroma. Also, Furgusson[62] reported a similar case which was gelatinous rather than fibrous, hence was likely an odontogenic myxoma.
Other odontogenic neoplasms were difficult or impossible to identify without detailed microscopic description. It is probable that none were actually reported, or were reported with so little descriptive detail as to defy proper diagnosis. Thoma[3] listed only four types of odontogenic neoplasms as late as 1947. Ameloblastomas, which had been reported in Europe by 1827 and inspired hundreds of publications after the first Golden Age,[70,71] were not reported between 1839 and 1860. Ironically, an 1871 histologic drawing may be the first depicted ameloblastoma, but it is on one of the most recently delineated types, the unicystic ameloblastoma.[72]
While not true odontogenic neoplasms, ovarian teratomas or dermoid cysts were well known to frequently contain teeth, almost always within "sockets" of bone.[73] Brodie (see reference 73) had already reported a case of "a jaw with full grown teeth" by 1848.
Cysts of the jaws were noted only when they produced cortical expansion or some other visible alteration of surface tissues. The single exception was also the first cyst reported in a dental journal: the periapical cyst (Table 3). These cysts, called simply "sacs", were a routine experience for busy dental surgeons extracting and examining carious teeth. By the 1830s dentists were almost as familiar with periapical pathoses as we are today, although many believed that the periapical lesion produced tooth death, rather than vice versa.[17] Noncystic periapical lesions were described as inflammations, granulations,, abscesses, and suppurations, and it was well known that facial or alveolar fistulae could result from them (Figure 6).
Dentigerous cysts were described as early as 1778 in France,[67] but were not well delineated until 1842, and were not illustrated in a journal until 1859 (Figure 7).[49,54] These cases were reported approximately a century after Scultet[74] first described jawbone cysts as "liquid tumors". The concept of a benign, epithelial-lined cystic space with internal pressures capable of producing bony expansion was formed during those early years.[75]
Several cystic lesions were aggressive enough to be classified today as odontogenic keratocysts or unicystic Ameloblastomas. The first large cyst was Dornbluth's[57] 1844 description of a multilocular dentigerous cyst or "encysted tumor" which had entirely filled the antrum and distorted the orbital floor. This case has all the earmarks of an odontogenic keratocyst, but a microscopic description is lacking. The aggressive nature of such lesions is emphasized by contemporary diagnoses used, such as "cystic sarcoma" and "cystic carcinoma".[72] It is probable that the multilocular cyst found by Salama and Hilmy[76] in the mandibular ramus of a 2,800 B.C. Egyptian mummy was a keratocyst. It was not associated with an impacted tooth and had greatly expanded the overlying cortices, causing pathologic fracture. This skull also contained a dentigerous cyst around the crown of an impacted maxillary cuspid (Gorlin's syndrome, perhaps?).
The eruption cyst help special significance for early dental surgeons.[59] The anatomy of the trigeminal nerve had recently been described by the Englishman Charles Bell[77] and a direct connection between teeth and the brain was proven for the first time -- a connection first proposed by Aetius soon after Galen's treatise on teeth.[78] Since many children suffered from viral or other encephalitis and meningitis attacks at a period of life similar to the eruption of teeth, it was assumed that tooth eruption, and particularly its "severe" forms (with eruption cysts), was the cause of "brain fever".[79] The universal acceptance of this concept is perhaps best illustrated in Charles Dicken's[80] Bleak House, wherein a sickly child is assumed to be dying from "a difficult teething". The logical treatment for convulsions and stuporous fevers became, quite naturally, the surgical incision of gingival tissues overlying eruption cysts and erupting teeth. This treatment appeared to be successful, of course, because brain fevers typically lasted 7-14 days, presuming death did not intervene. Such treatment came to be known as "scarification" and was used also on Epstein's pearls or gingival cysts of newborns.[56]
Several nonodontogenic cysts were reported during the Golden Age (Table 4). The first was an epidermoid (inclusion) cyst of the oral floor.[87] At the time it was thought that yellow and yellow/white discolorations could only be produced by pus or fat, hence this particular lesion with its soft cheesy center was called a "painless abscess". By 1858 microscopic analysis had determined that such a cyst possessed the "elements of cancer", although not really cancerous, from the fact of its possessing a distinct capsule.[95] Bond[10] considered these "wens" to be common on the facial skin but rare in the mouth.
A semitransparent lymphoepithelial cyst was reported from the lingual tonsil as a "hydatid cyst" in 1857,[93] and a probable cervical lymphoepithelial (branchial cleft) cyst was reported by Bond[10] as a "great sac" near the angle of the mandible in a young woman. A true salivary retention cyst of the palate was mentioned in Parmentier's[93] translated treatise on palatal tumors, and a parotid cyst was described as a "cyst in the duct of Steno" in 1856.[91]
Early dental surgeons frequently reported nonmalignant soft tissue and bony masses, but inadequate descriptions make exact identification difficult, if not impossible. The first obvious oral "tumor" reported in a dental journal was a parulis or "gum boil",[43,96] a lesion described by Hullihen[43] in 1840 along with a "fungus of the nerve" (pulp polyp) (Table 5). The parulis was considered an inflammatory response to suppuration or "pus" from an abscessed tooth and it was known that a similar phenomenon could be noted on the facial skin if a dental fistula extended so far.[15,16,43,103] The appropriate treatment was to remove or endodontically treat the offending tooth,[103] although the intraoral use of leeches was also considered useful.[10] Root canal therapy at the time consisted of complete extirpation of the pulp canals with hooked or barbed silver pins, and then complete filling of canals and pulp chambers with gold foil.[15,104]
Pulp polyps were described as painless but impossible to treat without extraction.[14,43] Apparently they were noted frequently in patients with poor oral hygiene or ANUG, as there was "no disease of the mouth, which makes the breath so intolerable".[43] Bilateral examples were reported, as were examples of polyps which hemorrhaged abundantly with each menses ("vicarious menstruation").[43] Gunnel[97] presented a thoughtful description and treatment protocol for pericoronitis in 1844. This was apparently a common as well as a serious, and occasionally fatal, condition before the advent of antibiotics. While we now have difficulty envisioning pericoronitis as a mortal affliction, it should be emphasized that early dental surgeons believed that as many as 10% of all childhood deaths could be ascribed to problems with the dentition.[38]
Thackston[48] described antral polyps extending into the oral cavity via antral-oral fistulae in an extensive dissertation on maxillary sinus diseases. He was also the first to describe a maxillary sinus carcinoma and a lesion which was likely an inverted papilloma ("fungating ulcer") but could have been a polyp with secondary inflammatory ulceration.[48] Early American dental surgeons were usually physicians and published extensively on sinus diseases and therapies. Hemimaxillectomies were first performed by them during this time period.[10,48,81,105]
Pyogenic granulomas were supposedly first defined in the skin in 1897,[107] but oral "pregnancy tumors" were clearly described an as early as the 1840s, one presumably arising from the "metastasis of the menstrual secretion from the uterus to the mouth".[37,106] The first pyogenic granuloma outside pregnancy was probably reported by Chapin Harris[107] in 1846 from the maxillary antrum. But it should be remembered that almost all fungating, hemorrhagic masses were at that time considered to be malignancies and benign lesion are difficult to separate out. Tomes[59] mentioned a similar but larger and more bluish lesion, probably a peripheral giant cell granuloma from an extraction site, in his extensive and popular lecture series on dental physiology, dentistry's earliest attempt at continuing education in print. The need for such education is emphasized by a contemporary article reporting a case of peripheral giant cell granuloma associated with a retained root ("embedded fang") in an elderly female.[109] She came to surgery with her will made out because so many clinicians had indicated that it would likely be a fatal lesion.
Salivary lesions were seldom reported, even as mistaken diagnoses. The first example of a simple swelling from acute bacterial parotitis was presented to the Virginia Society of Surgeon Dentists in 1844.[99] The first mucocele reported was one from the maxillary sinus.[81] That a sinus mucocele should be reported long before a labial example (published in 1857 [93]) is another reminder of the strong interest shown in maxillary sinus pathology by early dental surgeons. The first reported ranula was also considered to be a salivary infection, but it had the "unusual" history of intermittent enlargement and diminution.[100] It is obvious from the tone of Walton's[110] 1858 case that ranulas were being routinely encountered in practice. He disagreed with Bond's[10] conclusion that marsupialization was ineffective as a primary treatment, but recommended surgical removal when it failed.
Harris[81] described a "fibrous tumour" of the maxillary sinus in 1842, and long before that Paulus Aegineta[111] (circa 800 A.D.) made a clear distinction between a fibrous gingival epulis and a parulis. But the first cases of oral irritation fibromas were not reported in the dental literature until 1845 and 1846, under the diagnosis of "fibrous epulis".[64,89] A probable peripheral ossifying fibroma, from an extraction site, was described a year earlier,[101] and Arnott[112] later described two lesions in such microscopic detail that there can be no doubt of their ossifying fibroma diagnosis. Peripheral ossifying or odontogenic fibromas were not separated out from other fibromas until the mid-twentieth century and are much, much less common than irritation fibromas.[113] Perhaps that very uniqueness was responsible for its early reporting. It is interesting that fibromas were considered benign, in contradistinction to virtually every other oral or paraoral mass.
A generalized fibrous hyperplasia of gingiva was reported as "fungus excrescence" in 1856.[92] It was treated by conservative surgical removal and discussed by Saurel[101] shortly thereafter in the first review of oral fibrous growths.
In 1915 Bloodgood,[8] a Johns Hopkins surgeon, pleaded with the dental profession to take an interest in benign oral lesions because physicians had long demonstrated a lack of interest. His argument was augmented by the fact that he personally saw many more oral cancers than benign masses. His concern seems justified by the earliest dental literature, which expended many, many more pages on cancers than on benign lesions. This interest was surprising in light of recent epidemiologic investigations reporting that not only do many (3.4%) adults have benign oral masses (excluding tori) but that such entities are 30 times more common than oral cancers.[114,115]
Chapin Harris[15] reported the first benign nonodontogenic oral neoplasm, a hemangioma, in 1842 during a continuing education seminar given at the second annual meeting of the American Society of Dental Surgeons. his "bluish excrescence" was within alveolar bone, with blood flowing "in torrents" at surgery. Such a lesion might also have been an aneurysmal bone cyst or arteriovenous malformation but was described in an elderly patient and was neither cystic or pulsating. The first soft tissue hemangioma, reported in 1847, extended throughout the cheek, contained several phleboliths, and was treated by ligation of the common carotid artery.[116] Parmentier[93] referenced a 1795 French report of a "sanguinous" tumor of the palate. The first lymphangioma, called chronic "clustered vesicles", was reported in 1850,[85a] although not pictured microscopically until Arnott's[117] report of a fatal congenital case in 1872. All vascular lesions were treated by surgical removal, local injection of caustics or "actual" cautery. Some vascular malformations or neoplasms were even reported to have undergone "spontaneous cure" after local trauma from the teeth.[118]
An osteoma was reported on the lateral wall of the maxillary sinus in 1842 and, Harris[81] referred to a similar case from Beaupreau in France in 1767, but to the best of our knowledge no oral osteomas were reported during the Golden Age. An orbital ridge osteoma was the first to be reported with a histologic description.[119] One of the curiosities of the Age was that palatal tori, common and obvious lesions, were only reported once in dental journals.[93]
Lipoma, called wither "fatty tumor" or "yellow epulis" appears to have been a well-understood benign neoplasm, with the first detailed dental journal report published in 1849.[83] It was seldom reported thereafter, however. Another seemingly well-established but seldom reported entity, the squamous papilloma. was first reported by Tomes[59] in the mouth (gingiva) in 1848. It's only other mention was a lesions from the maxillary sinus,[90] perhaps confirming early in our literature the fact that the unusual lesions or lesion locations are likely to be reported before their more common counterparts. A one-inch long cutaneous horn was reported, with a detailed histologic description, on the lower lip of a 70-year old man in 1855, but not in a dental journal.[120] The first dental journal report was a three-inch long horn from the temple of an 84 year old woman.[84]
Few salivary neoplasms were reported during the Golden Age. The earliest acceptable case was a rather obvious pleomorphic adenoma or "fibro-cartilaginous tumor" of the parotid gland in 1852,[88] although Bond[10] had earlier reported a long-standing salivary tumor, the size of the patient's head, which was probably a pleomorphic adenoma but lacked histologic description.
Microscopic drawings of a parotid "enchondroma" were first printed in 1857 in the earliest published series on salivary tumor (Figure 8). A probable Warthin's tumor was also described in 1852, as an "enlarged lymphatic gland" of 15 year's duration in an elderly male.[86]
Intraosseous lesions with cortical expansion were frequently mentioned in the 1839-1860 dental literature, but usually from the perspective of surgical technique. This was a time, after all, when the removal of all or a large portion of the maxilla or mandible was completely new and typically performed without anesthesia. Numerous cases of osseous malignancy were reported, but the first acceptable benign (developmental) lesions was fibrous dysplasia reported in a 14-year old girl in 1853.[89] The microscopic description of this "fibrous tumor of the jaw" included immature calcified trabeculae. An earlier (1845) case in the mandible of a young woman was the first benign fibro-osseous lesions reported in a dental journal, but its description was not detailed enough to delineate between fibrous dysplasia and central ossifying fibroma[89} The only other obvious intraosseous benign neoplasms reported during this time period were an enchondroma (chondroma) of the anterior maxilla, and a central giant cell granuloma reported by a French surgeon as having cells called "myeloplaxes" with up to 30 nuclei.[90,102] All lesions were removed by radical local excision.
It is hoped that the present paper will prove to be a stimulant to more extensive and more in-depth historical reviews of oral athologic lesions. At the very least it offers early references which can be used in introductions to clinicopathologic investigations, references heretofore difficult to identify because they were in print several decades before Index Medicus began publication.[121] As a further aid, a databank of lesion-specific references has been created for the years 1839-1860. This material is available upon request and will be extended into later years as time permits. Additional references from outside the dental journals of the first Golden Age are welcome and will be incorporated into the databank upon receipt.
1. Cahn LR. Contributions to the development of oral pathology. Oral Surg Oral Med Oral Path 1959; 12:3-13.
2. Bunting RW. A text-book of oral pathology, for students and practitioners of dentistry. Philadelphia: Lea & Febiger, 1929.
3. Thoma KH. Oral pathology. St. Louis: C.V. Mosby Co., 1941.
4. Cahn LR (editor). Arch Clin Oral Path 1937; 1:1-245.
5. Thoma KH (editor). Oral Surg Oral Med Oral Pathol 1948; 1:1-1162.
6. Hillenbrand H.. Twenty-five years in retrospect. Oral Surg Oral Med Oral Path 1959; 12:62-65.
7. Bernier JL. The birth and growth of oral pathology. Oral Surg Oral Med Oral Path 1972; 34:224-230.
8. Bloodgood JC. What every dentist should know about surgical lesions of, and in the region of, the upper and lower jaw; with especial reference to the early recognition of the precancerous lesions. J Natl Dent Assoc (later the J Amer Dent Assoc) 1915; 2:3-19.
9. Lintolt WH. To the editor of the London Lancet: progress of dental science in America. Am J Dent Sc 1842; 2:300-301.
10. Bond TE Jr. A practical treatise on dental medicine. Philadelphia: Lindsay & Blakiston, 1848.
11. Fouchard P. Le Chirurgien Dentiste, on Traite des Dents. Paris; Pierre Jean Mariette, 1746.
12. Jordain E. Traite des Maladies Chirurgicales de la Bouche. Paris; 1778.
13. Hunter J. The natural history of the human teeth: explaining their structures, use, formation, growth, and diseases. London: J Johnson, 1771.
14. Bell T. The anatomy, physiology and diseases of the teeth. London; 1829.
15. Harris CA. A physiological and pathological inquiry concerning the physical characteristics of the human teeth and hums, the salivary calculus, the lips and tongue, and the fluids of the mouth. Am J Dent Sc 1841; 2:39-120.
16. Baker E. Account of a remarkable tooth, with drawings. Am J Dent Sc 1839;
1:14-15.
17. Brown AM. Review of Burdell and Burdell's Observations on the structure, physiology, anatomy and diseases of the teeth. Am J Dent Sc 1839; 1:19-24.
18. Brown S. An extraordinary instance of the force of hereditary principle; in which is seen an example of the tendency of everything in nature to produce its like. Am J Dent Sc 1839; 1:15-16.
19. Brown S. Premature dentition. Am J Dent Sc 1839; 1:12.
20. Harris CA. Editorial comment to: Koecker L. An essay on artificial teeth, obturators, and palates, with the principles for their construction. Am J Dent Sc 1840; 1:180-184.
21. Hullihen SP. Observations on tooth-ache. Am J Dent Sc 1840; 1:105-111.
22. Taylor J. Opening address delivered before the Mississippi Valley Association of Dental Surgeons. Am J Dent Sc 1844; 5:91-104.
23. Anonymous. Is the Negro subject to hair-lip? Am J Dent Sc 1845; 5:314.
24. Harris CA. Dental medicine. Am J Dent Sc 1849; 10:139.
25. Dickey SJ. Osseous union of the teeth. Dent News Letter 1850; 3:60-61.
26. Birkett. Carcinomatous tumor attached to the uvula and posterior pillar of the fauces; removal; recovery. Am J Dent Sc (new series) 1852; 2:124-127.
27. Harris CA. New York Medical College announcement. Am J Dent Sc (new series) 1852; 3:155.
28. Richardson J. Gangrenous degeneration of the cheek and gums, with necrosis and exfoliation of the alveolar processes and maxillary bone. Dent Regist West 1856; 10:16-26.
29. Warren JM. Tumors of the parotid region. Am J Dent Sc 1857; 7:587-595.
30. Piggot AS. Valedictory address to the graduating class of the Baltimore College of Dental Surgery. Am J Dent Sc 1858; 8(new series):149-163.
31. Foster JH. Address delivered before the Society of the Alumni of the Baltimore College of Dental Surgery, at their first annual meeting. Am J Dent Sc 1849; 9:265-300.
32. Pease WA. Is there a degeneration in the teeth? If so, to what is it attributable. Am J Dent Sc 1855; 5(new series):605-614.
33. Anonymous. Dental exhibitions. Dent Regist West 1854; 7:95-101.
34. Harris CA (ed). Amer J Dent Sc 1839/40; 1:1-292.
35. Quoted in Harris CA. Filling teeth when the lining membrane is exposed. Am
J Dent Sc 1851; 2 (new series):72-91.
36. Kerr DA. Granuloma pyogenicum. Oral Surg Oral Med Oral Path 1951; 4:158-176.
37. Hullihen SP. Case of aneurism by anastomosis of the superior maxillae. Am J Dent Sc 1844; 4:160-162.
38. Westcott A. Dissertation on the claims of the medical science upon the practitioner of dental surgey. Am J Dent Sc 1844; 5:3-31.
39. Harris CA. Historical review of the progress of dental surgery in the United States, with reflections upon the causes that have accelerated it, and the means necessary for its further advancement. Am J Dent Sc (new series) 1851; 2:92-101.
40. Johnson EA, O'Rourke JT, Partridge BS, et al. The status of dental journalism in the United States. Baltimore, MD: Waverly Press, Inc., 1932:1-44.
41. Flagg JF. Dental exostosis. Dent News Letter 1859; 12:241-249.
42. Harris CA. Miscellaneous notes. Am J Dent Sc 1847/48; 8:106-112.
43. Hullihen SP. Abscess of the jaws, and its treatment. Am J Dent Sc 1847/48; 8:106-112.
44. Satter JA. Papers on dental pathology. Am J Dent Sc 1857; 7(new series): 14-31.
45. Vandenburgh D. Observations on exostoesis. Dent Regist West 1851; 4:194-198.
46. Lee J. Extraction of teeth. Am J Dent Sc 1847; 8:23-29.
47. Regezi JA, Sciubba JJ. Oral pathology, clinicopathologic correlations. Philadelphia: W.B. Saunders, 1989: pp. 427-430.
48. Thackston WWH, A dissertation on the diseases of the maxillary sinuses. Am J Dent Sc 1842; 2:279-291.
49. Forget A. Dental anomalies and their influence upon the production of diseases of the maxillary bones. Dent Cosmos 1860; 1:229-236, 283-289, 398-404, 451-457.
50. Rodriguez BA. Case of exostosis of the upper jaw. Am J Dent Sc 1839; 1:88-89.
51. Davis NS. Report of the Committee on Medical Literature. Tran Am Med Assoc 1853; 6:99-135.
52. Salter J. Cancellated or vascular exostosis on the fang of a bicuspid tooth. Trans Pathol Soc London 1855; 6:168-169.
53. Norberg O. Zur Kenntnis der dysontogenetischen Geschwalste3 der Kieferknochen. Vjschr Zahnheilk 1930; 46:321-355.
54. Jenks. Singular phenomenon. Am J Dent Sc 1841; 2:________.
55. Harris CA. Book review of Ashburn J. On dentition and some coincident disorders (published 1834). Am J Dent Sc 1842; 2:294-297.
56. Grey WH. Lancing the hums in stridulous convulsions. Am J Dent Sc 1843; 3:228.
57. Dornbluth. Cyst in the orbital cavity. Am J Dent Sc 1844; 4:296-297.
58. Shepherd SM. Alveolar exostosis. Am J Dent Sc 1844; 4:45-46.
59. Hawkins JW. Cases of fibrous tumors of the upper jaw-epulis. Am J Dent Sc 1844; 7:77-84.
60. Tomes J. A course of lectures on dental physiology and surgey (lectures I-XV). Am J Dent Sc 1846-1848; 7:1-68, 121-134; 8:33-54, 120-147,313-350.
61. Talma AF. Memoirs on a few fundamental points of dental medicine, considered in its application to hygiene and therapeutics. Am J Dent Sc 1854; 4 (new series):294-302.
62. Fergussen. Resection of portions of the lower jaw on account of tumor. Am J Dent Sc (new series) 1860; 10:112-117.
63. Shillitoe B. Fibrous tumor from near the angle of the lower jaw. Trans Pathol Soc London 1865; 16:223-224.
64. Andrews EH. Extraordinary successive development of teeth. Am J Dent Sc 1858; 8(new series):16.
65. Qoted in Sprawson E. Odontomes. Brit Dent J 1937; 62:177-201.
66. Broca P. Gaz Leb de Med et de Chir (Paris) 1868; 5:19,70,113.
67. Owen R. A history of British fossil mammals and birds. London; 1846:388-389.
68. Waldron CA. Odontogenic tumors and selected jaw cysts. In : Gnepp DR. Pathology of the head and neck. NY: Churchill-Livingstone, 1988:403-458.
69. Cusack JW. Report of the amputation of portions of the lower jaw. Dublin Hosp Rec 1827; 4:1-3.
70. Baden E. Terminology of the ameloblastoma: history and current usage. J Oral Surg 1965; 23:40-49.
71. Wagstaffe WW. Case of cystic sarcoma of lower jaw. Trans Pathol Soc London 1871; 22:249-253.
72. Cone CO. Report on practical dentistry. Am J Dent Sc 1848; 9:3-82.
73. Scultet I. L"Arcenal de Chirurgie. Lyon: Antoine Cellier, 1671.
74. 1857/58? cystic expansion theory.
75. Salama N, Hilmy A. An ancient Egyptian skull and a mandible showing cysts.
Brit Dent J 1951; 90:17-18.
76. Bell C. The nervous system of the human body. London, 1830.
77. Allen J. Address delivered before the Mississippi Valley Association of Dental Surgeons. Am J Dent Sc 1844; 5:105-112.
78. Canton A. On teaching. From a treatise on the teeth. Am J Dent Sc (new series) 1851; 1:131-138.
79. Dickens C. Bleak House.
80. Harris CA. Dissertation on the diseases of the maxillary sinus. Am J Dent Sc 1842; 3:20-132, 153-189.
81. Roux M. On exostoses: their character. Am J Dent Sc 1848; 9:133-134.
82. Liston. Gum boils--fungous growth of the gums-epulis. Dent Regist West
1848/49; 2:191-195.
83. Blasbury. Horny growth from the head in the human subject. Am J Dent Sc 1849; 9:388.
84. 1850, lymphangioma
85. Canton. Removal of a tumor embedded in the parotid gland. Am J Dent Sc (new series) 1852; 2:312.
86. 1852, epid cyst
87. PA, 1852
88. Hodgson. Fibrous tumor of the inferior maxilla. Am J Dent Sc 1845; 5:319.
89. Giraldes JA. Diseases of the maxillary sinus. Am J Dent Sc 1856; 6(new series):482-497.
90. Rudolfi M. The treatment of salivary fistula. Dent News Letter 1856; 9:125-126.
91. Goddard WH, Gross. Case of hypertrophy of the gums. Dent Regist West 1856; 9:276-282.
92. Parmentier. Essay on tumors in the palatine region. Am J Dent Sc 1857; 7(new series):324-339,456-465,545-561.
93. Culter. Glossal papillary tumor. Dent News Letter 1858; 11305-306.
94. Guersant. Clinical remarks upon congenital cysts. Dent Cosmos 1860; 1:498-499.
95. Ericksen, Harley. Movable tumor of the cheek. Dent News Letter 1858; 11:305.
96. Hayden HH. Of conjoined suppuration of the gums and alveolus. Am J Dent Sc 1941; 2:214-297.
97. Gunnel JS. A remedy for the painful affection produced from cutting the lower dens sapientia or wisdom tooth, etc. Am J Dent Sc 1844; 4:43-44.
98. Shpherd SM. Alveolar exostosis. Am J Dent Sc 1844; 4:46-47.
99. Lethbridge S. Transactions of the Virginia Society of Surgeon Dentists. Am J Dent Sc 1844; 5:120-123.
100. Boykin EM. A case of acute inflammation of the sublingual glands. Dent Regist West 1848/49; 2:97-100.
101. Saurel L. Memoirs upon the tumors of the gums, known under the name epulis. Am J Dent Sc 1858; 8(new series):33-43,212-231.
102. Magitot E. Memoir on tumours of the dental periosteum. Dent Review 1860; 271-277, 465-474.
103. Brown AW. Remarkable case of alveolar abscess and ulceration of the fang. Am J Dent Sc 1839; 1:58.
104. Arthur R. Treatment of dental caries, complicated with affections of the pulp and periodontal membrane. Am J Dent Sc (new series) 1851; 1:229-240.
105. Gross SD. Observations on excision of the superior maxillary bone: illustrated by seven cases. Am J Dent Sc (new series) 1852; 3:131-151.
106. Dayton AC. Letter to editor. Am J Dent Sc 1849; 10:42-43.
107. Harris CA. Case of fungus tumor occupying the left maxillary sinus, successfully treated by the extraction of the first and second superior molares of the affected side. Am J Dent Sc 1846; 6:318-320.
108. Poncet et Dor A. De la Botryomycose humaine. Rev der Chir (Paris) 1897; 18:996-997.
109. PGCG=fatal
110. Walton. Ranula, removal by dissection, after the failure of incision and the Seton. Dent News Letter 1858; 11:306.
111. Hockley A. An historical review of dental surgery from the earliest period to the commencement of the present century. Dent News Letter 1858/1859; 12:120-126, 282-289 (translated from Kurt Sprengel's Geschichte der
Medicin).
112. Bhaskar SN, Jacoway JR. Peripheral fibroma and peripheral fibroma with calcification: report of 376 cases. JADA 1966; 73:1312-1320.
113. Bouquot JE. Common oral lesions found during a mass screening examination. JADA 1986; 112:50-57.
114. Bouquot JE, Gundlach KKH. Oral exophytic lesions in 23,616 white Americans over 35 years of age. Oral Surg 1986; 62:284-291.
115. Post. Venous erectile tumor of the cheek. Dent Intel 1847; 3:137-138.
116. Arnott H. Macro-glossia, or congenital enlargement of the tongue. Trans Pathol Soc London 1872; 23:109-111.
117. Anonymous. Aneurism of the coronary artery, of the lower lip. Am J Dent Sc 1846; 6:331.
118. Canton E. Orbital exostosis. Am J Dent Sc (new series) 1851; 2:146-147.
119. Gray H. Horny tumor from the lower lip. Trans Pathol Soc London 1869; 20:186-187.
120. Arnott H. Soft enchondroma of the parotid gland. Trans Pathol Soc London 1869; 20:186-187.
121. Billings JS, Fletcher R (eds). Index Medicus, a monthly classified record of the current medical literature of the world, vol 1; 1879.
Table 1: Historical events which established Oral Pathology and Oral Medicine as integral parts of organized dentistry.
____________________________________________________________________________
YEAR HISTORICAL EVENT
1828 FIRST TEXTBOOK DEVOTED TO DISEASES OF THE MOUTH [10]
1839 FIRST JOURNAL REPORT OF ORAL PATHOLOGIC ENTITY (DILACERATION)[11]
1839 FIRST EMPHASIS ON SYSTEMIC EFFECTS ON ORAL TISSUES [12]
1839 FIRST ARTICLE WITH A LITERATURE REVIEW [13]
1839 FIRST REPORT OF HEREDITARY EFFECT ON ORAL TISSUES [13,14]
1840 FIRST USE OF TERM "DENTAL PATHOLOGIST" (FOR L. KOECKER) [15]
1840 FIRST REPORT OF SPECIFIC SYSTEMIC EFFECT (MENSTRUATION) ON ORAL
LESION (PULP POLYP) [16]
1840 FIRST PROFESSORSHIP OF DENTAL PATHOLOGY (BALTIMORE) [17]
1842 FIRST CONTINUING EDUCATION COURSE IN ORAL PATHOLOGY [18]
1843 FIRST TEXT DEVOTED TO HEAD AND NECK TUMORS [19]
1845 FIRST REPORT OF RACIAL PREDILECTION FOR AN ORAL DISEASE [18]
1848 FIRST TEXT OF DENTAL/ORAL MEDICINE [20]
1849 FIRST USE OF TERM "ORAL MEDICINE" [21]
1850 FIRST LITERATURE REVIEW IN ORAL PATHOLOGY [21]
1850 FIRST TEXTBOOK OF ORAL MEDICINE [20]
1852 FIRST MICROSCOPIC DESCRIPTION OF A LESION IN DENTAL JOURNAL [22]
1852 FIRST DENTAL PATHOLOGY LECTURESHIP IN A U.S. MEDICAL SCHOOL [23]
Table 2: The earliest published dental journals, worldwide, 1839-1860. All are American titles, unless otherwise specified.
___________________________________________________________________________
YEAR(S) OF
PUBLICATION JOURNAL TITLE
1839-1915 American Journal of Dental Science
1843-1848 Stockton's Dental Intelligencer
1843-1939 British Journal of Dental Science (London; intermittently publ
1845-1846 The Forceps (London)
1845 The Dental Mirror
1846-1856 New York Dental Recorder
1847-1923 Dental Register of the West
1847-1859 Dental News Letter (became Dental Cosmos in 1859)
1851 Dental Times
1853 Dental Expositor
1853-1860+ Der Zahnarzt (Berlin)
1855 The Forceps (New York)
1855 The Dental Monitor
1856-1859 Dental Obturator
1856-1907 Transactions of the Odontogolical Society of London
1857-1859 Dental Reporter
1857-1859 Quarterly Journal of Dental Science (London)
1857-1860+ L'Art Dentaire (Paris) *
1858 Cincinnati Dental Lamp
1858-1864 New York Dental Journal
1858-1936 American Dental Review (intermittently published)
1858-1859 The Dental Enterprise
1858-1859 The Dental Register
1859-1860+ The Dental Review (London) *
1859-1936 Dental Cosmos **
1860-? Zeitschrift fur Zahn-Heilkunde (Hamburg) *
1860-? Revue Odontotechnique (Paris) *
1860-? Southern Dental Examiner *
* last year of publication is unknown by authors
** incorporated into Journal of American Dental Association in 1936
Table 3: First reports of odontogenic neoplams and cysts in dental journals, 1839-1860. ________________________________________________________________________________
DIAGNOSIS YEAR ORIGINAL DIAGNOSTIC TERM * REF.
BENIGN CEMENTOBLASTOMA 1839 EXOSTOSIS; CANCELLATED EXOSTOSIS 35
PERIAPICAL CYST 1839 SAC 36
DENTIGEROUS CYST 1842 DISTENDED CAPSULE; OSSEOUS CYST; 44
SEROUS CYST
GINGIVAL CYST OF NEWBORN 1843 45
ODONTOGENIC KERATOCYST 1844 CYST; CYSTIC CARCINOMA 46
CENTRAL OSS./CEM. FIBROMA 1846 FIB. TUMOR W/ CALCIUM DEPOSITS 20
ERUPTION CYST 1847 EPULIS 11
?COMPOUND ODONTOMA 1848 14
?COMPLEX ODONTOMA 1857 WARTY TOOTH 47
* some orignal terms are taken from other contemporary articles
Table 4: First reports of nonneoplastic, usually inflammatory benign oral masses as reported in dental journals, 1839-1860; listed by year of publication.
_________________________________________________________________________________
DIAGNOSIS YEAR ORIGNIAL DIAGNOSTIC TERM * REF.
PULP POLYP 1840 FUNGUS OF THE NERVE; FUNGUS GROWTH 15
PARULIS 1840 GUM BOIL; LIQUID TUMOR; ABSCESS; FISTULA 38
PERIODONTAL ABSCESS 1841 CONJOINED SUPPURATION; PYORRHEA
PYOGENIC GRANULOMA 1844 ANEURYSM; FUNGOUS GRANULATIONS (EPULIS) 11
PERICORONITIS 1844 PAINFUL AFFECTION 21
PERIPH. OSSIFYING FIBROMA 1844 OSSEOUS EPULIS; BONY EPULIS 55
ACUTE PAROTITIS 1844
IRRITATION FIBROMA 1846 FIBROUS EPULIS; FIBROID; FIBROUS POLYP 20
RANULA 1848 ACUTE INFLAMMATION OF GLAND 56
PERIPH. GIANT CELL GRAN. 1848 FUNGUS FLESH; EPULIS 12
GUMMA 1852 INDURATED KNOT (OF SYPHILIS) 52
MUCOCELE 1857 SALIVARY RETENTION CYST; SEROUS CYST 53
EPULIS FISSURATUM 1858 MAMILLATED EPULIS; SIMPLE EPULIS 55
* some orignal terms are taken from other contemporaneous articles
Table 5: First reports of nonodontogenic benign neoplastic and developmental or masses and cysts, as reported in dental journals, 1839-1860; listed by year of publication.
_______________________________________________________________________________
DIAGNOSIS YEAR ORIGNIAL DIAGNOSTIC TERM * REF.
HEMANGIOMA 1842 BLUISH EXCRESCENCE 18
OSTEOMA 1842 CYST; EXOSTOSIS 18
BONY EXOSTOSIS 1848 62
LIPOMA 1849 FATTY TUMOR; EPULIS 63
CUTANEOUS HORN 1849 HORNY GROWTH
WARTHIN'S TUMOR 1852 ENLARGED LYMPHATIC GLAND 64
LYMPHANGIOMA 1852 CLUSTERED VESICLES 52
EPIDERMOID CYST 1852 PAINLESS ABSCESS 52
PLEOMORPHIC ADENOMA 1852 FIBRO-CARTILAGENOUS TUMOR 59
ENCHONDROMA 1856 65
ARTEROVENOUS MALFORMATION 1856 65
PAPILLOMA 1856 65
LYMPHOEPITHELIAL CYST 1857 HYDATID CYST 53
TORUS PALATINUS 1857 MEDIO-PALATINE EXOSTOSIS 53
GINGIVAL FIBROMATOSIS 1858 FUNGUS EXCRESSENCE 55
* some orignal terms are taken from other contemporaneous articles
Figure 1: A pyogenic granuloma (pregnancy tumor) in an 18-year old pregnant woman recurred with successive pregnancies and was hemorrhagic enough to be called an "aneurysm" by the reporting surgeon.[31]
Figure 2: This case of dilaceration, shown from three different angles, is the first picture of an oral anomaly reported in a dental journal.[34] Such cases were thought to result from the fusion of the remnants of fractured roots, as with bone healing, and were initially called "osseous union".
Figure 3: Gross appearance of a benign cementoblastoma of a maxillary bicuspid. The "considerable incrustation of hypertrophied tooth-bone" was detroying the normal tooth.[35]
Figure 4: Gross and microscopic appearance of a complex odontoma in situ in the mandible. Dentinal tubules, as depicted here, were a recently discovered phenomenon.[40]
Figure 5: A multitude of periapical pathoses, including fistula formation, was depicted in this 1840 composite drawing. Note the external caries of the teeth, exemplifing the new acceptance of an external etiology for tooth decay.[49]
Figure 6: Dentigerous cyst in situ in the posterior mandible.[40] The distinction between cysts and neoplasms, especially malignant neoplasms, was unclear, hence hemimandibulectomy was the treatment of choice for large "cystic carcinomas".