VOL. 5.

ON THE TRANSPLANTATION OF
TEETH.

Observations on the Transplantation
of Teeth, which tend to show the
impossibility of the Success of this
Operation supported by a new
Theory. By JAMES GARDETTE,
Dentist.

I HAD, a considerable time since, determined to write on the subject of the transplantation of teeth from the mouth of one living person into that of another; but my great occupations, and the diffidence I always had in writing English for publication, have prevented me from attempting it; and it is probable I should never have done it, had I not been encouraged by my friend, Dr.Mease, who, after a conversation on the subject, lent me the first volume of the Memoirs of the Medical Society of London, in which several cases of disease succeeding the transplantation of teeth are published, by J. C. Lettsom, M. D., &c.; one of which happened in August, 1785. I read the articles with great attention, and found I was acquainted with the first case, which had been related to me by the gentleman, J. Y., now a citizen of Philadelphia, in whom it had occurred a few years before.

The reading of these articles, and the observations of my friend, Dr. Mease, who is very much

NO. 16.

alive to the dissemination of useful knowledge, determined me to write this paper, and at the same time to endeavor to prove the impossibility of transplanting teeth from one mouth into another, with the success expected and promised by the operator, namely, that the tooth transplanted will remain firm, and be as useful as the tooth which had originally grown in the jaw.

I shall preface this paper by informing my readers that I arrived in Philadelphia in June, 1784, and began to practise my profession; and that Mr. Lemayeur, with the reputation of an eminent dentist, had transplanted one hundred and seventy teeth in this city, in the course of the winter of the years 1785 and 1786, as he told me himself, at Baltimore, in the fall of the last mentioned year; and that, of all these transplanted teeth, not one succeeded! Some became firm, and lasted, more or less so, for one or two years, in the sockets in which they had been inserted; but these cases were very rare. In the course of my practice, after that time, I had occasion to extract at least fifty of these transplanted teeth; most of them without an instrument, with my fingers only, and to replace them by artificial teeth. Many accidents occurred to the transplanted teeth, while they

were growing firm, and some never got firmly fixed in the sockets at all. I shall now relate some cases of this nature, which happened to teeth transplanted by Mr. Lemayeur, which, I dare say, will be recollected by some persons now living in this city, and perhaps by relations of the persons who were operated on at the time.

Mrs. A. W., a lady of great respectability, had several, I believe three front incisors of the upper jaw transplanted; after suffering for a considerable time, the transplanted teeth not becoming firm, she was obliged to have them extracted, and artificial teeth replaced in their room.

Miss W., a young lady at a boarding school, had the four upper front incisors attempted to be transplanted, but they never became firm; the gums were so inflamed and ulcerated, that the disease was communicated to the lip, so as to form a complete adhesion with it; they were separated by scarification, but the adhesion of the gum and lip could not be prevented, till the transplanted teeth were extracted; which being done, the lip and gums perfectly cicatrized in a short time; the space was then filled with artificial teeth.

I was informed that about the same time, a young lady of New York, Miss S., had a large front incisor transplanted in the upper jaw, which produced a disease, judged by the physicians who attended her, to be the lues venerea. This young lady was so affected by the disease that, notwithstanding all the medical aid given her, her health declined, and after considerable suffering of mind and body, she died.

I was also informed, that a Mr. T., of Virginia, had a front upper incisor transplanted about the year 1790, by the same dentist, the exact time not being remembered, which occasioned much inflammation in the gums and eyes. After some time, the ophthalmia became severe, and other symptoms justified the opinion that the lues venerea had been introduced into the system by the transplanted tooth, which, no doubt, was taken from an unsound subject. I was informed at the time, that Mr. T. had lost his sight, and that after lingering for some considerable time, he died.

Mr. W. H., of Philadelphia, had three upper front incisors transplanted in London, in the year 1784, or 1785, under the superintendence of the distinguished surgeon, John Hunter; the operation was performed with all the care and skill possible, and the teeth became firm in a short time, without any accident of importance. I saw the gentleman in this city about five years after the transplantation of the teeth, which at that time were somewhat loose. He consulted me as to the cause of the looseness of the transplanted teeth. On examining his mouth, I found that the teeth of the under jaw directly opposite the transplanted ones, struck against them on their internal surface, and I judged that the continued shock occasioned by the under teeth, was the real cause of their looseness; but that the original cause of the under teeth touching the upper, was the inflammation of the gums of the transplanted teeth, which caused their dropping down, and thus to meet the under incisors opposite to them. In order to remedy this inconve

nience, I proposed to shorten the under teeth, which I did with a file; I then advised the gentleman to make use of an astringent wash to brace the gums of the transplanted teeth, which were inflamed, and somewhat spongy; my prescription was followed, and the teeth became firm in the course of two weeks. I did not see the gentleman's mouth after this for a considerable time, as he lived out of the city. But having had occasion to see him some years after the time I attended him, I perceived he was without the transplanted teeth, which he had never replaced.

Of all the transplanted teeth that I ever saw, or heard of, none have lasted so long as those transplanted in the mouth of Mr. W. H.; for they remained very firm for about five or six years, and lasted about as long in a loose state, which increased till the teeth either dropped out, or the gentleman extracted them himself with his own fingers; for I am persuaded they were not extracted by a dentist.

None of the teeth transplanted by Mr. Lemayeur, in Philadelphia, remained firm two years, and in two or three cases which I have seen of teeth transplanted by other dentists, they did not remain firm one year.

Mrs. J. P. had a large incisor of the upper jaw transplanted in London, also under the care of the celebrated John Hunter, in the year 1780, or thereabout,the time, which was mentioned to me, not being remembered,the tooth became firmly fixed in a short time; but about a year after its transplantation, a small discharge of matter was perceived issuing from the under edge of

the gum, on the left side of the transplanted tooth; but this was not much regarded at the time, being very trifling. The daily attention paid the teeth, by washing and brushing them, prevented the lady from taking notice of its progress for some years.

Having determined to leave London and come to Philadelphia, after the peace of 1783, she had, a few days before her departure, her mouth examined by her dentist, who readily found that fistula was the result of the continual issuing of a small quantity of pus from the socket of the transplanted tooth. It was then judged by him, that the tooth could not remain long in its place; he advised the lady to have a tooth prepared, that could be easily fixed in the place of the transplanted tooth by a dentist, should there be one in Philadelphia, which, it appears, was much doubted at the time in London. After her arrival in this city, Mrs. P. consulted Dr. W. Shippen, who, after examining her mouth, determined that the transplanted tooth should be extracted. The doctor sent for and asked me if this was not my opinion; after examining and probing the part of the socket which could be reached with a probe, I found that the left side of the root of the tooth, as also the socket, were completely decayed to the extremity of the root, which was perfectly adherent to the socket on the right side, the tooth being still

It was a porcelain tooth, made by Dubois Dechman, a French dentist in London, who first invented the manner of making artificial teeth out of porcelain, and which has been so much improved

since by several dentists, and particularly by Fonzi, an Italian dentist and chemist at Paris.