Dental Fillings, Crowns, and Bridges

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Dental fillings, crowns, and bridges

Cavities (areas of decay) in teeth have been filled since earliest times with a variety of materials, including stone chips, turpentine resin (an organic plant substance), gum, and metals. Giovanni d'Arcoli recommended gold-leaf (gold beaten into very thin sheets) fillings in 1484. The renowned French physician Ambroise Paré (1510-1590) used lead or cork to fill teeth. In France of the 1700s, Pierre Fauchard (1678-1761; often referred to as "the father of modern dentistry") favored tin foil or lead cylinders. Philip Pfaff (1715-1767), dentist to Frederick the Great of Prussia (1712-1786), used gold foil to cap teeth.

Gold leaf as a filling became popular in the United States in the early nineteenth century. Marcus Bull of Hartford, Connecticut, began producing beaten gold for dental use in 1812. In 1853 sponge gold was introduced in the United States and England to replace gold leaf. This was followed by the cohesive, or adhesive, gold introduced by American dentist Robert A. Arthur in 1855.

Amalgam Experimentation

The invention of the power-driven dental drill led to increased demand for fillings and for inexpensive filling material. Auguste Taveau of France developed the first dental amalgam (blend) in 1826. The amalgam was a solution of silver in mercury. When the French Crawcour brothers emigrated to the United States in 1833, they introduced Taveau's amalgam. Because of the amalgam's poor quality, many dentists refused to use it. Numerous experiments were carried out from the 1860s through the 1890s to develop improved amalgam filling materials. Chicago, Illinois, dentist G. V. Black (1836-1915) finally standardized both cavity preparation and amalgam manufacture in 1895.

Dental Cement

After truly effective dental cement was developed, baked porcelain (a hard, white ceramic) inlays came into use for filling large cavities. These were first described by B. Wood in 1862. In 1897 an Iowa dentist, B. F. Philbrook, described his method of casting metallic fillings. Philbrook used a wax impression that perfectly matched the shape of the cavity. Dr. William H. Taggart of Chicago described a similar method for casting gold inlays in 1907. This technique made possible the modern era of accurate filling and inlay fitting.

Crowns and Bridges

Crowns are used to replace and cover missing portions of teeth. Bridges are mountings for artificial teeth attached at either end to natural teeth. Both of these devices were made of gold and used by the Etruscans (people living in the ancient country of Etruria, an area of western Italy) 2,500 years ago. Crowns and bridges fell out of use during the Middle Ages and were only gradually rediscovered.

The gold shell crown was described by Pierre Mouton of France in 1746. It was not until 1873 that the gold shell crown was patented. The Logan crown, patented in 1885, used porcelain fused to a platinum post. It replaced the unsatisfactory wooden posts previously used. In 1907 the detached-post crown was introduced, which was more easily adjustable.

Bridge work developed as crowns did. Dentists would add extra facing to a crown to hold a replacement for an adjacent missing tooth. The major advance came with the detachable facings patented by Dr. Walter Mason of New Jersey in 1890 and the improved interchangeable facings introduced by the American dentist Thomas Steele in 1904. The common problem of broken facings was now easy to fix and permanent bridge installation became both possible and successful.

[See also Adhesives and adhesive tape ]