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MEDICAL INTELLIGENCER.

JOHN G. COFFIN, EDITOR.

DEVOTED TO THE CAUSE OF PHYSICAL EDUCATION, AND TO THE MEANS OF PRE

VENTING AND OF CURING DISEASES.

VOL, 5.

TUESDAY, SEPTEMBER 4, 1827.

NO. 16.

ON THE TRANSPLANTATION OF alive to the dissemination of useTEETH.

ful knowledge, determined me to Observations on the Transplantation write this paper, and at the same

of Teeth, which tend to show the time to endeavor to prove the imimpossibility of the Success of this possibility of transplanting teeth Operation : supported by a ner from one mouth into another, with Theory. By James GARDETTE, the success expected and promisDentist.

ed by the operator, namely, that I HAD, a considerable time since, the tooth transplanted will remain determined to write on the sub- firm, and be as useful as the tooth ject of the transplantation of teeth which had originally grown in the from the mouth of one living per- jaw. son into that of another; but my I shall preface this paper by ingreat occupations, and the diffi- forming my readers that I arrived dence I always had in writing En- in Philadelphia in June, 1784, and glish for publication, have pre. began to practise my profession ; vented me from attempting it ; and that Mr. Lemayeur, with the and it is probable I should never reputation of an eminent dentist, have done it, had I not been en- had transplanted one hundred and couraged by my friend, Dr.Mease, seventy teeth in this city, in the who, after a conversation on the course of the winter of the years subject, lent me the first volume 1785 and 1786, as he told me of the Memoirs of the Medical himself, at Baltimore, in the fall Society of London, in which seve- of the last mentioned year; and ral cases of disease succeeding that, of all these transplanted the transplantation of teeth are teeth, not one succeeded! Some published, by J. C. Lettsom, M. became firm, and lasted, more or D., &c.; one of which happened less so, for one or two years, in in August, 1785. I read the arti- the sockets in which they had cles with great attention, and been inserted; but these cases found I was acquainted with the were very rare. In the course first case, which had been related of my practice, after that time, to me by the gentleman, J. Y., I had occasion to extract at least now a citizen of Philadelphia, in fifty of these transplanted teeth; whom it had occurred a few years most of them without an instrubefore.

ment, with my fingers only, and The reading of these articles, to replace them by artificial teeth. and the observations of my friend, Many accidents occurred to the Dr. Mease, who is very much transplanted teeth, while they

were growing firm, and some ne I was also informed, that a Mr. ver got firmly fixed in the sockets T., of Virginia, had a front upper at all. I shall now relate some incisor transplanted about the year cases of this nature, which hap- 1790, by the same dentist, the pened to teeth transplanted by exact time not being rememberMr. Lemayeur, which, I dare say, ed, which occasioned much inflamwill be recollected by some per- mation in the gums and eyes. Afsons now living in this city, and ter some time, the ophthalmia beperhaps by relations of the per- came severe, and other symptoms sons who were operated on at the justified the opinion that the lues time.

venerea had been introduced into Mrs. A. W., a lady of great the system by the transplanted respectability, had several, I be- tooth, which, no doubt, was taken lieve three front incisors of the up- from an unsound subject. I was per jaw transplanted'; after suf- informed at the time, that Mr. T. fering for a considerable time, the had lost his sight, and that after transplanted teeth not becoming lingering for some considerable firm, she was obliged to have them time, he died. extracted, and artificial teeth re Mr. W. H., of Philadelphia, placed in their room.

had three upper front incisors Miss W., a young lady at a transplanted in London, in the year boarding school, had the four up. 1784, or 1785, under the superinper front incisors attempted to be tendence of the distinguished surtransplanted, but they never be- geon, John Hunter ; the operacame firm; the gums were so in- tion was performed with all the flamed and ulcerated, that the care and skill possible, and the disease was communicated to the teeth became firm in a short time, lip, so as to form a complete ad- without any accident of imporhesion with it ; they were sepa- tance. I saw the gentleman in rated by scarification, but the ad- this city about five years after the hesion of the guin and lip could transplantation of the teeth, which not be prevented, till the trans- at that time were somewhat loose. planted teeth were extracted ; He consulted me as to the cause which being done, the lip and of the looseness of the transplantgums perfectly cicatrized in a ed teeth. Onexamining his mouth, short time ; the space was then I found that the teeth of the unfilled with artificial teeth. der jaw directly opposite the

I was informed that about the transplanted ones, struck against same time, a young lady of New them on their internal surface, York, Miss S., had a large front and I judged that the continued incisor transplanted in the upper shock occasioned by the under jaw, which produced a disease, teeth, was the real cause of their judged by the physicians who at- looseness ; but that the original tended her, to be the lus venerea. cause of the under teeth touching This young lady was so affected the upper, was the inflammation by the disease that, notwithstand- of the gums of the transplanted ing all the medical aid given her, teeth, which caused their dropher health declined, and after ping down, and thus to meet the considerable suffering of mind and under incisors opposite to them. body, she died.

In order to remedy this inconve

nience, I proposed to shorten the the gum, on the left side of the under teeth, which I did with a transplanted tooth ; but this was file; I then advised the gentle- not much regarded at the time, man to make use of an astringent being very trifling. The daily atwash to brace the gums of the tention paid the teeth, by washing transplanted teeth, which were and brushing them, prevented the inflamed, and somewhat spongy ; lady from taking notice of its promy prescription was followed, and gress for some years. the teeth became firm in the Having determined to leave course of two weeks.

I did not London and come to Philadelphia, see the gentleman's mouth after after the peace of 1783, she bad, this for a considerable time, as he a few days before her departure, lived out of the city. But having her mouth examined by her denhad occasion to see him some tist, who readily found that fistula years after the time I attended was the result of the continual him, I perceived he was without issuing of a small quantity of pus the transplanted teeth, which he from the socket of the transplanthad never replaced.

ed tooth. It was then judged by of all the transplanted teeth him, that the tooth could not rethat I ever saw, or heard of, none main long in its place; he advised have lasted so long as those trans- the lady to have a tooth prepared, planted in the mouth of Mr. W. that could be easily fixed in the H.; for they remained very firm place of the transplanted tooth by for about five or six years, and a dentișt, should there be one in lasted about as long in a loose Philadelphia, which, it appears, state, which increased till the was much doubted at the time in teeth either dropped out, or the London. After her arrival in this gentleman extracted them him- city, Mrs. P. consulted Dr. W. self with his own fingers ; for I Shippen, who, after examining am persuaded they were not ex- her mouth, determined that the tracted by a dentist.

transplanted tooth should be exNone of the teeth transplanted tracted. The doctor sent for and by Mr. Lemayeur, in Philadel- asked me if this was not my opi. phia, remained firm two years, nion ; after examining and probing and in two or three cases which I the part of the socket which could have seen of teeth transplanted be reached with a probe, I found by other dentists, they did not re- that the left side of the root of main firm one year.

the tooth, as also the socket, were Mrs. J. P. bad a large incisor completely decayed to the extreof the upper jaw transplanted in mity of the root, which was perLondon, also under the care of fecily adherent to the socket on the celebrated John Hunter, in the right side, the tooth being still the year 1780, or thereabout, the time, which was mentioned to me, not being remembered,

* It was a porcelain tooth, made by

Dubois Dechman, a French dentist in the tooth became firmly fixed in London, who first invented the manner of a short time ; but about a year making artificial teeth out of porcelain, after its transplantation, a small and which has been so much improved

since by several dentists, and particularly discharge of matter was perceiv- by Fonzi, an Italian dentist and chemist ed issuing from the under edge of at Paris.

very firmly fixed, notwithstanding proved the absolute vecessity of the existing caries.

its removal. I told Dr. Shippen that the It is possible that the dentist tooth ought to be extracted, in who transplanted the tooth, findorder to cure or dry up the fistu- ing the root of it too big, filed off la. But there was some difficul. some of its thickness, -as I have ty in extracting the tooth without heard of this being done somebreaking that part of the alveola, times, to let it go easily into the which was completely ossified socket; the periosteum having with the right side of the root ; been removed, the root could not and which I thought I could avoid adhere to the alveola on that side; by means of an instrument which and that may have occasioned the I would cause to be made by our formation, and of course the émis. old and only cutler, Mr. Schively, sion of the purulent discharge and which I described to the doc- spoken of. tor as follows, namely: The blade In order to establish my theory, in the form of a narrow straight I shall cite some cases which have scalpel, thin, and very sharp occurred to me in the course of pointed. After having informed my practice ; which will prove the doctor of my intended method that a diseased tooth taken from of performing the operation, he its socket, the cavity of it plugapproved of it.

At the time fixed ged, and the tooth replaced in the by the lady, I operated in the pre- same socket, will become in the sence of Dr. Shippen and a gen- course of ten or fifteen days, as tleman, a friend of the family, firmly and solidly fixed as it was Mr. John Millin, in the following before the extraction, and last for manner. I separated the adhe- a great number of years, and rent plate of the socket from the sometimes during life. This is root of the tooth with my sharp certainly a tooth transplanted to pointed instrument with all possi- all intents and purposes, but in ble care, in the space of about the same socket from which it two minutes ; I then removed the was extracted. If therefore antooth with a straight forceps, with other tooth could have been found, the greatest ease imaginable. The the root of which was exactly of exfoliation of the part of the sock- the same length, size and form, it et, which required it, and the ci- might have been placed in the catrizing of the gums, required socket of the tooth just spoken of; nearly a month, when I replaced and it would certainly have bea natural tooth, mounted on a gold come as firm, and have lasted as plate, after the mode which I had long as the tooth which had growa invented about that time; this in this socket. tooth resembled so perfectly the I have frequently, partially ex: large incisor which remained, that tracted and returned to their no person could perceive the dif- sockets, small and large molares, ference.

which had been very painful ; afThe transplanted tooth being ter having cut the gum on the side examined after extraction, it was opposite to that on which I intendfound that one half the root had ed the tooth to fall in partially been destroyed by caries, longitu- extracting it. The purpose of dinally to its extremity, which this operation is to separate or

,

[graphic]

as to prevent the tooth from giving pain she consented to have it done, and in future; the tooth is then put I proceeded in the following manback into its socket ; permitted to ner. I extracted the tooth with become firm, and the cavity is a straight forceps, cleared the then to be plugged: this I always cavity of its carious parts, filled it did with full success.

with gold, washed it in warm waIt has sometimes happened that ter, and inserted it in its alveola ; a dentist has extracted a sound all this was done in the space of tooth for a bad one, either by his five minutes. I then requested neglect in ascertaining the tooth Miss B. to bite a piece of flat to be extracted, or by misinfor- cork, which I prepared for the mation from the patient. If such purpose, several times in the tooth is replaced in its socket im- course of the day, and to wash her mediately after extraction, it will mouth frequently with a slight certainly become as firm and as astringent liquid which I prescribuseful as ever.

ed ; if I recollect right, the tooth All that has been said will was perfectly firm the twelfth prove, I hope, that a tooth taken day. This tooth rendered service out of its socket and put back in to the lady for nearly eighteen its place, will become firm and years, as I extracted it I believe useful ; therefore, if a tooth taken seven or eight years since, having from another subject, the root of become more carious and therewhich is of the same shape, length fore troublesome, and size, is placed in the socket It is to be observed, that it is of the tooth extracted, it will only the incisores and canine teeth certainly become as solidly fixed which are attempted to be transas the original one. But the den, planted, as they have but one root. tist who transplants it, must judge It is therefore the same species that the roots of both teeth are of teeth which I have extracted, , precisely alike in size and shape, plugged, and replaced in their before he sees either ; this being sockets ; I have performed the impossible, the operation, there- same operation frequently in the fore, cannot succeed.

course of the last twenty five In the year 1801, I was re- years of my praetice, with the quested to call on Miss B., a young same success as in the case last lady of great respectability, who mentioned. had suffered extremely from pain I will, however, detail the parin a front tooth. I found it was ticulars of one case, in which the the canine tooth of the left side of tooth extracted and replaced was the upper jaw which caused the a small molaris of the under jaw. violent pain. I was requested to This operation was performed in extract the tooth affected; but I the mouth of a lady of this city, observed to her that the loss of Miss ******, and I expected this tooth would be very great, complete success; but on examinand that it might be preserved by ing the tooth after extraction, I replacing it in its socket after ex- found that the extreme end of the traction, and that it would become root being bent, it broke in the as firm and as useful as ever. Af- extraction, and the piece so bent, ter explaining the manner in which about an eighth of an inch, re

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