ORTHODONTICS: AN HISTORICAL REVIEW OF ITS 
ORIGIN AND EVOLUTION ORTHODONTICS 
AN HISTORICAL REVIEW OF ITS 
ORIGIN AND EVOLUTION 
INCLUDING AN 
EXTENSIVE BIBLIOGRAPHY OF ORTHODONTIC LITERATURE 
UP TO THE TIME OF SPECIALIZATION 
BY 
BERNHARD WOLF WEINBERGER, D.D.S. 
lU 
NEW YORK CITY 
LIBRARIAN FIRST DISTRICT DENTAL SOCIETY OF THE STATE OF NEW 
YORK AND ADVISORY LIBRARIAN (DENTAL DEPARTMENT), NEW 
YORK ACADEMY OF MEDICINE. MEMBER FEDERATION 
DENTAIRE INTERNATIONALE AND VARIOUS 
DENTAL AND ORTHODONTIC SOCIETIES- 
ILLUSTRATED 
VOLUME II 
ST. LOUIS 
THE C. V^MOSBX^OMPANY 
I926 Copyright, 1926, by The C. V. Mosby Company 
(AU rights reserved) 
Printed in U. S. A. 
Press of 
The C. V. Mosby Company, 
St. Louis, Mo. CONTENTS VOLUME II 
PART V 
FIFTH PERIOD (1870-1900) 
ORTHODONTIA, TO ITS CULMINATION AS A SPECIALTY 
CHAPTER XXIII 
Norman W. Kingsley to John Nutting Farrar __________ 487 
CHAPTER XXIV 
Simeon H. Guilford to Jules Parreidt _____________ 545 
CHAPTER XXV 
Eugene S. Talbot to W. G. A. Bonwill _____________ 625 
CHAPTER XXVI 
The Influence of Edward H. Angle ______________ 674 
CHAPTER XXVII 
Victor Hugo Jackson to Henry N. Dodge ____________ 720 
CHAPTER XXVIII 
Calvin S. Case to Clark L. Goddard _____________ 769 
CHAPTER XXIX 
W. S. Davenport to George C. Ainsworth ____________ 814 
CHAPTER XXX 
John Nutting Farrar __________________ 863 
Summary ______________________ 895 
CLOSING REMARKS 
Closing Remarks ____________________ 907 
BIBLIOGRAPHY 
Bibliography _____________________ 909 
Index of Proper Names _________________ 984 
Index of Subjects ___________________ 997 PART V 
FIFTH PERIOD (1870-1900) 
ORTHODONTIA, TO ITS CULMINATION AS A SPECIALTY 
" There are two distinct classes of men: first, those who work at enlarging 
the boundries of knowledge, and secondly, those who apply that knowledge to useful 
ends. ' '-JR. W. von Bunsen. 
In the foregoing periods, we have attempted to describe how ortho- 
dontia first received its inception, and how through slow stages of de- 
velopment this growth took a form of both progressive and retrogressive 
advancement. This period centers around the era just prior to the time 
orthodontia became a specialty and is one of the most interesting and 
enlightening of all. 
The great practical achievements of the then so-called orthodontia are 
to be found almost entirely within these thirty years. They arc so mani- 
fold that it would not be feasible even to sketch in general outline, the 
development of the main fundamentals, nor attempt to mention the names 
that stand out most prominently. 
In tracing the sources of orthodontia it should be noted that there were 
distinct centers of almost independent development, and though in the 
fourth period we find that our own countrymen took an active part in 
this development, not until this period do we find America taking a 
leading part which it still maintains. CHAPTER XXIII 
NORMAN AV. KINGSLEY TO JOHN N. FARRAR 
Norman William Kingsley (1829-1913), the foremost of the early mod- 
ern pioneers in our branch of dental science, described by one of our 
historians as "the father of orthodontia, author, artist, sculptor, and 
inventor," began to publish occasional papers on regulating and palatal 
deformities as early as 1858. These practicable contributions became 
more numerous in the prime of his professional career, and through his 
individual influence, he succeeded to some extent in simplifying ortho- 
dontia. 
"Treatment of Irregularities," published in Dental Cosmos, 1872, 
page 63: 
"This treatment consisted entirely of wedges which were inserted 
between all the teeth, and worn from the first. These wedges were of 
elastic rubber, and used of such thickness only as would exert a gentle 
pressure. The retaining-plate answered a twofold purpose: it kept the 
teeth from the possible contingency of any one of them moving toward 
the center of the mouth; and secondly,-that which was of equal impor- 
tance-points of the retaining plate were allowed to pass between all 
the teeth, which kept each wedge from slipping up into and irritating 
the gum. 
"I have heretofore claimed something for esthetic art in the practice 
of dentistry; for the above I claim nothing but a recognition of pure 
mechanical principles in dental practice. The wedge is one of the recog- 
nized mechanical powers. Its application here is identical with its use 
by the architect for a keystone in building his arch. Drive in the key- 
stone and the arch is necessarily enlarged, and will continue to be en- 
larged so long as a wider keystone is admissible, and there is a support 
which will prevent the whole arch from tumbling in ruin to the center. 
"In a course of lectures delivered on this subject, I took the ground 
that everything relating to the means to be used in regulating teeth was 
purely mechanical, and the history of inventions has shown what mar- 
velous works are accomplished by the most simple of mechanical con- 
trivances. The foregoing case illustrates that the simplest of all me- 
chanical powers wrought all that could have been done by jackscrews, 
levers, inclined planes, straps, bands, and pulleys, combined." 
Under Irregularities, page 130 in Johnston's Dental Miscellany, 1874, 
Kingsley describes the following method of treating the "V-shaped 
maxilla. " 
487 488 
ORTHODONTICS HISTORICAL REVIEW 
"The treatment consisted of a plate of vulcanite adapted to the roof 
of the mouth. A hook of gold was inserted in the plate against each 
molar, and a little T-shaped catch was made of gold to pass between the 
centrals. Before introducing the plate, a rubber ring cut from tubing 
was secured to one of the hooks at the back of the plate, passed through 
a loop made in the stem of the T, and caught upon the hook on the op- 
posite side. The plate was then adjusted to the roof of the mouth, and 
the T brought forward; its stem, being quite thin, was passed between 
the centrals, and the crossbar caught on their labial surfaces. This was 
Fig-. 212.-Norman William Kingsley (1829-1913). 
the only treatment the case received, and in seven weeks the result was 
secured. 
"The above case illustrates how great a work can be accomplished 
by a very simple means, and yet this kind of an appliance might not be 
of any benefit in any other case except one exactly like the above. This 
case would very naturally be termed one of a 'Y-shaped maxilla'; but 
it was not a V-shaped maxilla. 
"It was a V-shaped, or triangular, dental arch-an arch in which the 
sides from the base to the center were not curved as they should be, but 
nearly on a straight line. I believe therefore, that the apices of the 
roots were in the maxilla upon their normal line; the crowns of the in- 
cisors thrown beyond the line, and the side teeth drawn within it. Had NORMAN W. KINGSLEY 
489 
it been otherwise I do not believe that force alone, on the center, like 
pressure made on the keystone of an arch, would have produced the 
desired budging at the sides. 
"As to its cause, I have no knowledge sufficient to prove its heredi- 
tary character. I do not believe it to have been the result of 'thumb- 
sucking' nor 'fruitless sucking' of any kind. It was not associated with 
'enlarged tonsils,' nor did the patient habitually keep the mouth open 
for breathing, and thus (as it has been claimed) have the sides of the 
arch unduly pressed upon." 
On page 172 of the same publication in treating another "V-shaped 
maxilla" Kingsley states: "All of the teeth anterior to the molars are 
so related to each other that pressure on one point would cause the arch 
to collapse. Even if a plate had bridged the palate and come in contact 
with the teeth at the sides, so as to prevent a collapse, no force upon the 
center as they now stand would have carried those teeth outward. A 
fixture operating like the T would not have affected the bicuspids and 
molars, but would have drawn the middle incisors toward the center in 
the same twisted condition, and would have moved the laterals and ca- 
nines irregularly apart. 
"The widening of the arch, therefore, which is of primary importance, 
must be effected by other means. 
"The correction of the deformity necessitated three separate stages and 
three distinct operations, as follows: first, the widening of the arch; 
second, the twisting of the central incisors, and third, the reduction of 
the V to a proper curve. 
"The widening was produced by a jackscrew; that most effective of 
all known agencies wherever it is applicable. 
"Its mode of adjustment is very fairly shown. A plate of vulcanite 
was made as there represented, so thin and elastic along the center that 
it would straighten under moderate force, and so stiff where it came in 
contact with the teeth that it would not yield. The attachment of the 
jackscrew is made after the vulcanite plate is finished, and is readily 
accomplished by carefully cutting a little mortise in the plate on one 
side and allowing the point of the screw to rest in a pit on the opposite 
side. This case was retained by a simple plate of vulcanite with a small 
gold wire embedded in it and passing to the outside of the six front 
teeth, through a small gap between the cusps of the canine and bicuspid 
on each side. If the articulation of the teeth of both jaws had been 
such, on occlusion, as to shut this gap, then this kind of retaining plate 
could not have been used." (Fig. 213.) 
Tn February, 1875, in Johnston's Dental Miscellany, Kingsley illus- 
trates his use of the headcap to shorten the teeth by retracting them 
within the jaw after they had elongated through "natural or develop- 490 
ORTHODONTICS HISTORICAL REVIEW 
mental causes." Perhaps the first effort to accomplish this movement 
of the teeth was that made by Kingsley in 1866, reported in the same 
year at the May meeting of the New York Dental Society and published 
in the Dental, Cosmos. 
Cases of Irregularity.-1 'In the child the incisors were protruding, and 
the whole upper jaw gave the appearance of being excessively large. 
The teeth of the lower jaw were normal. 
"The teeth behind the canines were all in contact and articulated well 
with those of the lower jaw, but the incisors were spread and straggled, 
and the crowns had the appearance of being of extraordinary length. 
"As interference need be no longer postponed, I made a frame of 
gold, covering the cutting edges of the incisors, and lapping on to the 
canines, and a plate of vulcanite adapted to the roof of the mouth, such 
Fig-. 213.-Kingsley (1874) 
as described in former articles, and cut away in front to provide for the 
retrocession of those teeth. Ligatures cut from rubber tubing were 
attached to the posterior part of the vulcanite plate, one on each side, 
and drawn forward and caught on projecting spurs of the gold frame. 
This apparatus, which can be easily understood from the description, was 
worn for a short time, when two discoveries were made. First, the arch 
in front was by this means contracted, until the teeth came in contact, 
but was not sufficiently reduced. With the teeth all now in close con- 
tact, there was no hope of further reduction without the removal of a 
tooth, and the first bicuspid on each side was consequently extracted. 
Secondly, the backward movement showed an apparent elongation of 
the incisors. I do not think it was an actual elongation, but an appear- 
ance arising from crowns of an already extraordinary length becoming 
more perceptible as they came into a vertical line. 
"It became evident that any further pressure in the same direction NORMAN W. KINGSLEY 
491 
would eventually carry the teeth down so as to touch the gum of the 
lower jaw, thus completely hiding the lower incisors and producing a 
deformity but little preferable to the first. 
"Tn this emergency I conceived the attempt to shorten the crowns of 
the upper teeth by driving them up into the jaw. 
"I continued the apparatus as before described within the mouth, and 
added to the gold frame a stud or post about half an inch in length, 
soldered to it opposite the canines, and coming out of each corner of 
the mouth. This apparatus, when in position, is shown in Fig. 214. The 
arms extending upward, passing outside the cheeks, were made of strips 
of brass, and were connected by elastic ligatures with a skullcap as 
shown in Fig. 215. 
Fig. 214.-Kingsley (1875) 
"This skullcap was made of leather, and the whole apparatus was 
very easily applied as follows: 
"The vulcanite plate was inserted in the mouth, and the rubber liga- 
tures brought forward and caught as before described, the skullcap 
placed on the head, and strong elastic straps were caught over buttons 
or hooks on the cap, and like buttons or hooks on the cheek arms. The 
action will be understood by observing Fig. 215. The outside pressure 
was forcing the teeth up into the jaw, while the pressure inside was 
carrying them in a direct line backward. 
"The success in this case involved absorption of the walls of the 
socket, and is not to be confounded with some cases which I have seen 
since reported, where a tooth had become elongated by accident, as, for 
instance, the presence of a rubber ring around the neck of the tooth, and 
pressure was resorted to, to restore it." 492 
ORTHODONTICS-HISTORICAL REVIEW 
On page 212 of the above-mentioned publication of the same year, we 
find the report of a case Kingsley presented before the New York Odon- 
tological Society. In this case he discovered that it was necessary, in 
order to reestablish normal occlusion, to bring about a new articulation. 
"In all cases which I have heretofore observed of a well-shaped lower 
arch associated with a V-shaped upper one the articulation was not good, 
the lower bicuspids and molars articulated outside the cusps of their 
superior antagonists. I was puzzled over this anomalous state until my 
plaster models were made, and with a better opportunity of studying the 
articulation, I discovered that the lower teeth were articulating one 
tooth behind their normal place in the upper jaw, that is, the first bi- 
Fig'. 215.-Skullcap as devised by Kingsley (1875) 
cuspid of the lower jaw was shutting between the bicuspids of the upper 
jaw, while in all cases the normal occlusion requires that the lower 
bicuspids should shut in advance of their correspondents above. In my 
plaster models I was able to see the perfection of articulation in this 
state of malocclusion, and also to see that the movement to shut the 
lower jaw farther forward showed the upper jaw too narrow to receive 
it. It was thus that I obtained a clear insight into the cause of the 
deformity. 
"The remedy evidently lay in the widening of the upper jaw until the 
lower would be received in its forward and natural place; and resolved 
itself, therefore, into three elements, viz.; first, widening the upper arch so 
that the lower teeth could not articulate as they had been accustomed 
to; secondly, compelling a new articulation in an advanced position; NORMAN W. KINGSLEY 
493 
and, thirdly, flattening the pointed and projecting appearance of the 
incisors." 
Under "Regulating Teeth" in the January number of Johnston's Dental 
Miscellany, 1877, Kingsley described different applications of the jack- 
screw. 
"Fig. 216 shows the employment of two screws upon the upper jaw. 
The plate was of vulcanite, and the screws have no other nut than the 
plate itself. The plate was vulcanized around the screws, thus making 
Fig. 217. 
Fig;s. 216 and 217.-Kingsley's application of the jackscrew (1877) 
Fig. 216. 
Fig. 218.-Combination of vulcanite and 
gold arch. 
Fig. 219.-Kingsley's application of 
the inclined plane (1877). 
the thread very perfect. This plate was used to drive out a very stub- 
born canine, and also to twist a central incisor. 
1 'Fig. 217 is an illustration of the same principle applied to both sides 
of the lower jaw, and was used in a case where the inferior dental arch 
was narrowed and the canines pushed outside the line. Elastic straps 
were attached to the extremities of the plate, as seen in the engraving, 
and drawn forward over the canines, which came into line as soon as the 
arch was widened. The spreading of the lower jaw is ordinarily much 
more difficult than the upper, and such appliances as Fig. 217 possess 
peculiar advantages in utilizing the extraordinary power of the screw, 494 
ORTHODONTICS HISTORICAL REVIEW 
when the presence of the tongue would make a screw bearing directly on 
the teeth inadmissible. 
"The following engravings will illustrate some of the appliances of 
elasticity. 
"Fig. 218 shows a combination of vulcanite and gold wire for bring- 
ing into line certain irregular teeth upon the lower jaw. 
"It was a former practice in a case like this to use the wire band 
independent of the plate, the ends being tied with silk or twine liga- 
tures to the molar or bicuspid teeth; but experience showed that the 
ligatures were apt to irritate the gums, besides giving much trouble 
whenever the fixture was removed for cleaning by the difficultv of re- 
tying. Consequently, the wire was carried over the teeth, selecting such 
a gap when the jaws were closed as was most favorable, and the ends 
of the wire anchored in vulcanite. Tn this way perfect facility in re- 
moving and replacing' was obtained. 
"Another advantage derived from fixing the wire in a vulcanite frame 
is the steadiness with which the wire is kept in relation to the teeth. 
"In drawing teeth toward a wire, rubber elastics exert a constant ten- 
dency to force the wire into some position where the elastics will not 
remain on the teeth, particularly the incisors and canines." 
"Treatment of Irregularities with Inclined Planes and Levers," in April, 
1877, issue of J ohnston's Dental Miscellany, page 121 : 
"Fig. 219 shows another application of an inclined plane somewhat 
out of the ordinary course. 
"It was adapted to the inside of the superior dental arch, and the 
inclined surface marked A projected below and caught the inferior in- 
cisors. 
"The object was, not to protrude the lower teeth, but to change or 
jump the bite in the case of an excessively retreating lower jaw. 
"In the engraving the appliance is shown bottom up, to exhibit more 
clearly the attachment of some elastic ligatures which were caught on a 
hook in the roof of the plate, and were drawn out through corresponding 
openings, and connected with a gold bar worn across the front of the 
superior incisors to reduce their prominence. 
"The fixture was worn constantly, and in a few months produced the 
desired result. The objection urged against the use of an incline, because 
the time required had a tendency to alter the articulation of the teeth, 
was in this case an argument in its favor, and an advantage, because 
a new articulation was desired, and the incline, as adapted, offered no 
opposition to the antagonism of the teeth. 
"The principle of the inclined plane is always operating in the mouth, 
and may often be taken advantage of beneficially, while at other times 
it will tax our ingenuity to the utmost to overcome its powerful influ- NORMAN W. KINGSLEY 
495 
ence. In the case of the superior incisors shutting within the lower, 
after they have been brought forward so as to barely catch over the 
lower ones, then the principle of the inclined plane becomes available in 
completing the operation. 
"The points of the lower teeth, catching within the upper ones, strike 
their natural inclined surfaces, and nature may be relied upon for the 
rest. 
"In moving the bicuspid teeth of the upper jaw, cither outward or 
backward, all that is accomplished by fixtures may be entirely overcome 
by the articulation of the lower teeth forming an inclined plane, and 
thus acting upon the upper ones to return them to their former places. 
"Levers do not come into such universal application as do some other 
powers; the principal objection being, that the limited space of the 
mouth does not permit their unrestricted movement. 
"Levers may be used to advantage in revolving teeth in their sockets; 
and for this purpose a band around the tooth is necessary, which will 
not slip, and the lever will be attached to the band. Force may bo 
brought against the long arm of the lever by ligatures connected with 
convenient teeth. Such an appliance will pretty surely accomplish the 
result, but it can generally be obtained with a less cumbrous fixture. 
"Levers may often be advantageously used on the outside of the arch, 
to press gently against some offending tooth, and thus drive it into its 
desired position. 
"One figure illustrates a method of reducing one or more teeth to a 
regular line by means of a wire or bow going around the outside and 
acting partly as a lever and partly by the force of elasticity. The en- 
graving sufficiently explains the action. The plate is of vulcanite and 
an elastic loop acts to contract the circle by drawing the ends of the 
wire together. 
"There was a wide gap between the lateral incisor and the canine 
tooth, and the opening extended through the alveolar arch and into the 
nasal passage. 
"It was desired to bring the maxilla into contact, and a fixture like 
the last would only act upon the teeth, tending to give them a wrong 
inclination." "This fixture was made to embrace the gum as well as the 
teeth with the wire running through the length of the vulcanite to give 
both stability, and the terminal hooks were drawn toward each other 
when in situ, with a silver wire wound around and twisted with a pair 
of pliers. In the process of twisting, the gap was seen to perceptibly 
close, and ultimately came together and united." 
In December, 1879, he brought together the scattered knowledge of 
what is now our science, culminating his efforts in what was the first 
American treatise scientifically and comprehensively treated. His "Trea- 496 
ORTHODONTICS HISTORICAL REVIEW 
tise on Oral Deformities as a Branch of Mechanical Surgery" was a stand- 
ard textbook for many years and will always be considered a valuable 
contribution to orthodontia. It comprised, not only the results of his 
own labor, but summarized the efforts of those who preceded him, thereby 
stimulating to a greater degree the treatment of malocclusion of the 
teeth. The volume embraced seven chapters on irregularities of the 
teeth, their etiology, diagnosis, and treatment, besides a consideration 
of cleft-palates and fractures of the mandible and their treatment. 
Although Westcott and others had previously used the headcap foi' 
occipital anchorage, Kingsley, twenty years later, reintroduced this 
method, and for over forty years it proved the only successful method 
of handling extreme cases of malocclusion. The greatest credit is due 
him for being the first to successfully "jump the bite," as he proposed 
Fig. 220.-Method as used by Kingsley (1879) 
and executed the bodily movement of the mandible from a posterior 
position forward into normal occlusion with the maxillae. 
He also made use of the headcap to shorten teeth by retracting them 
within the jaw after they had elongated through ''natural or develop- 
mental causes." 
Kingsley greatly extended the usefulness of vulcanite, employing it 
in many ways and making it the basis of the greater part of his ap- 
pliances. He also made use of the jackscrew, arch, elastic bands, and 
ligatures. 
It will be impossible to review his articles as extensively as they should 
be, for time and space will not permit. His book is to be had and 
should be read carefully. It will not be possible to take up all his papers, 
only the most important being mentioned. 
As the subject of etiology of irregularities has been brought together 
in his book, it will perhaps be best to review it there. 
Irregularities of the Teeth (pages 1 to 25). "Irregularities, either in 
the form of the arch or the position of the teeth, are very uncommon in NORMAN W. KINGSLEY 
497 
the deciduous set. We have seldom seen an irregular arch in a child 
prior to the eruption of the permanent teeth, unless associated with and 
correlated to some other deformity. In a few instances there has been 
observed a slight malposition of one or more of the incisors, sometimes 
of congenital origin, and sometimes the result of mischievous habits; as, 
for example, the two centrals may be pulled forward by the prolonged 
use of an artificial nipple, sucking the thumb, or other similar habit. 
"Congenital deformities rarely amount to more than a trifling dis- 
placement of one or two of the incisors; but, considering the temporary 
character of the deciduous teeth, and more especially the incisors, no 
irregularity in their position that we have seen can be regarded as of 
special importance, or as justifying any interference for its correction. 
They are to be classed as mere freaks of nature not associated with nor 
indicating any other peculiarity in the child. Nor do they prognosticate 
an irregularity in the development of the second set. This important 
fact cannot be too prominently borne in mind. The deciduous dental 
arch is always well formed, and the positions of the teeth are regular 
(mere freaks of nature excepted). But from this perfectly symmetrical 
dental arch there develop with the growth of the permanent set some 
of the most astounding abnormalities. 
"Symmetry and harmony do not imply uniformity; and the dental 
arch may be developed up to the highest type of perfection, and yet 
there exists as great a variety of form as there would be in the faces of 
the aggregated beauties of the world. Races, nations, and families are 
thus represented without deformity. 
"In classifying the causes of irregularities, they will be placed under 
one of two heads-developmental or accidental; the developmental oper- 
ating prior to the eruption of the crowns, and the accidental at the 
time of eruption or subsequently. 
"The premature extraction theory rests upon the supposition that 
the jawbone contracts upon the removal of the deciduous teeth. The 
fact seems to have been entirely ignored that the teeth and alveolar 
processes are a superstructure of the jawbone, growing up on it, ful- 
filling their destiny, and passing away, without disturbing the founda- 
tion much more than an oak disturbs the planet upon which it has been 
sustained. 
"Whatever may be the inducement to remove any or all of the de- 
ciduous teeth prior to their period of shedding, the canines should be 
retained until there is ample evidence of the early emergence of their 
permanent successors, unless the health or comfort of the child would 
be sacrificed in so doing. 
"The question naturally arises, 'Is the presence of the deciduous teeth 
the cause or the effect of the irregularity?' If their presence be the 498 
ORTHODONTICS IIISTORK'AL REVIEW 
cause of irregularities, then it is manifest that in this generation of mal- 
posed teeth it is our duty to anticipate the trouble, and at an early day 
remove them before even it is possible for them to give a wrong direc- 
tion to their successors. 
"Many of the forms of irregularity are directly traceable to inheri- 
tance, and arc transmitted peculiarities. Probably in a large proportion 
of cases where the irregularity in a dental arch is confined to one or 
two teeth, the primary cause, so far as that individual is concerned, is 
a hereditary family peculiarity. The teeth of every person possess more 
or less individuality, and most of those peculiarities which stamp their 
individuality are inherited. The form and color of teeth, when not dis- 
turbed by abnormal influences, are derived from the same source. When- 
ever we find any departure from what we are apt to regard as the typal 
form of each tooth, or any disproportion of size in their relations to 
each other, we shall be likely to find them peculiarities of descent. 
"There is one form of irregularity which is sometimes due to heredi- 
tary predisposition and sometimes to causes acting after eruption. An 
undue prominence of the upper incisors may be either congenital or 
acquired. The acquired origin is almost always a habit of thumb-sucking 
or its equivalent. It is not difficult, as a general thing, to make the 
distinction even without questioning the patient. Tn a protrusion of 
congenital origin the jaw is generally pinched in the bicuspid region, 
and the protrusion culminates in a pointed or V-shaped position of the 
central incisors. When such prominence has a mechanical or accidental 
origin, the whole front of the arch will be found rounded out, and the 
teeth pulled forward; and there will be likely to be more or less space 
between each of the teeth anterior to the bicuspids. 
"A perfect dental development is the result of well-balanced physical 
and nervous systems, without hereditary taint. 
"The causes of irregularities wo classify as developmental and acci- 
dental; the developmental operating prior to the eruption of the teeth, 
and the accidental subsequently. 
" Abnormalities of. development having their origin in the same individ- 
ual are due to a disturbance of the trigeminal nerve during the period in 
which the crowns of the permanent teeth are forming and arranging them- 
selves in the jaw prior to eruption; or, when arising from causes ante- 
dating the life of the individual, are traceable to an inherited tendency, 
which tendency had its origin in a like disturbance in one of the pro- 
genitors, and was subsequently transmitted; or are the result of mixing 
different and distinctly marked types of jaws and teeth by the pro- 
genitors. 
"This proposition may be stated in another form as follows: The 
cause of irregularities of the teeth other than accidental lies in a want NORMAN W. KINGSLEY 
499 
of development of the jaws commensurate with the size of the teeth ; 
and this want of relation is sometimes due to a retarded growth of the 
jaw while the development and eruption of the teeth is not retarded, 
and sometimes due to the inheritance of large teeth out of all proportion 
to the size of the inherited jaw. 
"In our view we do not call a feeble mind, a sluggish brain, or a dull 
intellect a nerve-lesion or a brain-disturbance; for it is abundantly proved 
that when this condition is associated with an average physique, the de- 
velopment of the dental organs is tardy, but in regular order. 
"No force operating on the brain can interrupt or alter the type or 
inherited model of the dental arch, after the first decade of life. All 
cerebral disturbances occurring during that period, showing mental aber- 
ration, we should class under the head of idiocy-imbecility. After that 
period, such manifestations come more properly under the head of lunacy 
--insanity-which might degenerate into imbecility or idiocy. Conse- 
quently, neither lunacy nor insanity, in the ordinary acceptation of the 
terms, can have any direct bearing upon the development of the dental 
organs; but such a condition would bo most potent of evil if transmitted 
to offspring. 
"I do not hesitate to place it upon record that the next generation 
will see more of abnormality in dental development, and an increase of 
nervous and cerebral diseases, and that the two are correlated and spring 
from the same cause. It is too late to stop it in those who have passed 
infancy, but it is not too late to modify and partially remedy the evil 
in those now being born, and those who may be begotten hereafter. 
"An erroneous teaching has maintained that the full number of teeth 
must be retained in the mouth, regardless of their organization, the 
progress of decay, the limited capacity of the arch, or the external 
features. 
"Two arguments are advanced to support such a judgment: First, 
that a certain number of teeth arc developed by nature, and therefore 
every one must be preserved. A second argument in favor of retention 
of all the natural teeth is, that the alveolar arch and the associated 
maxilla will become contracted, narrowed, pinched, as the result of such 
loss, consequently the articulation of the tooth broken up and the effi- 
ciency of the masticating organs impaired. 
"The articulation of masticating organs is of much more importance 
than their number, and a limited number of grinding teeth fitting closely 
on occlusion will be of far greater benefit to the individual than a mouth- 
ful of teeth with the articulation disturbed. 
"It is often better to extract a malposed tooth than disturb a whole 
arch to bring it into line. 500 
ORTHODONTICS HISTORICAL REVIEW 
"In hereditary cases of extensive character, which have been de- 
layed until at or near maturity, we can never feel certain but that the 
original tendency to malposition, so long unbroken, will reassert itself 
at any time that we abandon retaining fixtures." 
Before the New York Odontological Society, February 18, 1879, Kings- 
ley introduced a new and novel method of regulating teeth. This method 
is described in the Dented Cosmos, page 323, of that year. 
"A new vulcanite plate, adapted as a retaining plate to the widened 
arch, was introduced, and this became the anchorage of another rubber 
strap, to which was attached, for greater convenience, a little gold cross- 
bar for the incisors, with a little stem and an eyelet, passing between 
the teeth, as shown in Fig. 220. The stem was long enough to rest its end 
upon the vulcanite, and thus keep off pressure from the gums. To keep 
the crossbar from slipping up into the gum, a little hook came down over 
the cutting edge of each central, and thus completed the appliance for 
regulating, save that as the centrals became flattened the crossbar was 
lengthened to bear on the laterals, and at a later period and for a short 
time only included the canines. The horseshoe-shaped opening seen in the 
plate, Fig. 220 was made as a ready means of attaching the rubber liga- 
ture, but in consequence of the lengthening of the stem of the brace the lig- 
ature was afterwards fastened farther back, as seen in the engraving. In 
just five weeks from the day when the operation was commenced, the 
process was completed. 
"I desire to call your attention especially to the simplicity of this 
whole apparatus. 
"One of two vulcanite plates so devoid of intricacy that anyone could 
make and adjust them; and although the crossbar and stem may seem a 
little more complicated, they are really not essential to success. By pull- 
ing the rubber forward and tying it to a bit of broken match, the same 
flattening of the centrals would result." 
In the thirty-fourth volume of the Dented Cosmos, 1892, pages 16, 100, 
357, 442, we find undoubtedly the most important series and contributions 
that Kingsley gave to orthodontia. Although entitled "Adenoid Growths, 
Mouth-Breathing and Thumb-Sucking in Their Relation to Deformities of 
the Jaws and Irregular Teeth," he describes for the first time, "jumping 
the bite," unquestionably one of the greatest adjuncts we have in our 
treatment of orthodontic cases. The case described is one of the open- 
bite types. 
"The opening of the jaws in front was due slightly to the projection of 
the incisors, but principally to an excessive and abnormal development 
of the alveolar process in the molar and bicuspid region, and the remedy 
must be in its reduction; or, in other words, the teeth and processes must 
be driven higher up. NORMAN W. KINGSLEY 
501 
"The pitch and projection of the upper incisors would have been here- 
tofore attributed to thumb-sucking or its equivalent, but that practice 
had never been acquired; the child had never been a thumb-sucker. Still 
we find a typical thumb-sucking case where there had been no thumb- 
sucking,-a perfectly developed and symmetrical lower jaw and a 
strangely abnormal upper one, coincident with adenoid growths of the 
pharynx and long-continued mouth-breathing. 
"It will be observed that the upper jaw is also normal in width and 
outline, and the back teeth of the upper jaw occlude or articulate prop- 
erly with the low'er ones; the opening of the mouth has not, therefore, 
caused a pressure of the muscles of the cheeks upon those teeth and 
narrowed the jaw. 
"As a proper correction of this deformity required the incisors to be 
carried backward somewhat, and as there appeared to be no spaces in 
the arch which would permit of its contraction, the first or sixth-year 
molar on each side was extracted." 
Up to this time Kingsley believed it was necessary to extract teeth to 
correct irregularities of the teeth, but after completing the case recorded 
he in his own words proves the fallacy of this procedure. "I am con- 
vinced by a study of the case since the correction was completed, that 
the extraction of those permanent teeth was unnecessary. I find now, 
to my surprise, that although there then appeared no room to carry the 
incisors back without extracting two teeth, there are now ample spaces 
among the teeth on each side to permit of another tooth. 
"The first attempt at correction was made with a skeleton skullcap, as 
seen in Fig. 221, a padded cap over the chin (shown in Fig. 222) and a 
frame over the incisors, with arms projecting outside the cheeks, as 
shown in Fig. 223. The skullcap was made of leather; the chincap of 
sheet copper (stiffened around the edge with nonelastic steel wire ac- 
curately fitted to a plaster cast of the chin) padded, and covered with 
leather. When these appliances were in use, an elastic strap cut from 
rubber tubing passed from the hook near the angle of the chincap to 
the hook marked A on the skullcap (Fig. 221) and another similar strap 
passed from the button at the end of the incisor frame to the hook marked 
B in Fig. 221. The expectations from such an arrangement are obvious. 
The strain upon the incisors would carry them directly backward, and 
the hope was entertained that the pressure of the lower jaw upon the 
upper at the points of contact would diminish the undue prominence. 
"It is worth while here to query whether pressure, being equal upon 
the lower as well as the upper molars, might not, if it had ever accom- 
plished anything, have done so at the expense of one jaw as much as the 
other. However that might have been, the fact was that although worn 
constantly night and day, except at meals, for about three weeks, the 502 
ORTHODONTICS HISTORICAL REVIEW 
chin became so sore under the pressure that we feared an abscess, and it 
was abandoned. It is doubtful if it served any purpose in closing the 
gap in front. 
Fig. 221.-Skeleton skullcap. (Kingsley, 
1892.) 
Fig. 222.-Padded chincap. 
Fig. 223.-Exterior frame with attachment for anterior teeth. (Kingsley, 1892.) 
"The frame upon the incisors did accomplish in that time all that was 
desired of it. The incisors, without being lengthened, were altered in 
their pitch and the cutting edges moved back. 
"The reason that this apparatus did not lengthen the incisors in their 
backward movement was because the strain put upon the crowns was NORMAN W. KINGSLEY 
503 
not at a right angle with a line lengthwise through the center of the 
tooth. The strain was at such an angle that the teeth were held in their 
sockets by a partially upward pressure while the absorption of the proc- 
ess behind them was going on. The distance backward which the cutting 
edges were carried was ascertained to be 11 per cent. 
"The second apparatus, which fully accomplished the work, T ought 
to have thought of in the beginning, as it is only an application of the 
principle involved in my interdental splints for the last twenty-five 
years. Ft is shown in Fig. 224. A frame covering the bicuspids and 
molars of the upper jaw, with arms coming out of the corners of the 
mouth and extending along the cheeks to a point exactly opposite the 
center of pressure required within the mouth; a small wire passed in 
front of the incisors to keep them from springing forward, and two elas- 
Fig. 224.-Second type using- the principle of the interdental splint. (Kingsley, 1892.) 
tic straps connected this frame with the skullcap exactly as seen in Fig. 
221. Both these elastics were required partly to prevent any tendency 
of the recently moved incisors from carrying the whole apparatus for- 
ward, but particularly to keep the proper balance of the skullcap, the 
strain of either elastic alone having a tendency to pull it out of place. 
"The apparatus is made of one continuous piece of Stubbs' steel forged 
to follow the buccal faces of the teeth, then pass through the gap made 
by the extraction of the molars, and cross (without touching it) the vault 
of the palate to the other side. The bearings upon the teeth were made 
of silver plate swaged with accuracy to fit the molars, to keep the frame 
from slipping about, but resting only on the cusps of the bicuspids, thus 
giving freedom for lateral movement of the bicuspids. 
"It was essential that the extremities of these arms should be adjusted 
with great nicety, so that the force exerted through them upon the offend- 
ing teeth should be evenly distributed. If the bearing were forward of 504 
ORTHODONTICS HISTORICAL REVIEW 
the center, the apparatus would be loose at the back, and vice versa. 
This apparatus was applied about the first of March, 1891, and worn 
almost uninterruptedly without inconvenience until June following, at 
which time the upper and lower incisors were in contact, the upper ones 
lapping normally. 
"A study of the models shows that the articulation of the molars at 
the present time is precisely the same as before regulation commenced, 
and the great change in the front of the mouth is attributable principally 
to the driving upward of teeth in the molar region, the upward and for- 
ward movement of the lower jaw, and partly by the incisors being car- 
ried back without elongating. 
Fig. 225.-Kingsley (1892) 
"The plan which I formed to correct this deformity was the result 
partly of my own judgment, and partly to humor the strong desire of 
the mother that it should he done, if possible, without extracting any 
teeth. With that view I decided to attempt to accomplish it by widening 
the jaw, retreating somewhat the upper incisors, and complete it by 
'jumping the bite.' 
"The apparatus for that purpose is shown in Fig. 225 and consists of 
a vulcanite plate and jackscrew for widening the arch, and, acting simul- 
taneously with it, a T-bearing on the face of the central incisors and 
connected by a rubber strap to a hook in the central part of the plate, 
as seen in Fig. 225. 
"The jackscrew was tightened daily for a couple of weeks, and the 
jaw widened about half the diameter of a bicuspid, but the incisors had 
not moved perceptibly, nor had the widening made an enlargement of 
the circle sufficient to permit the incisors to be carried back. NORMAN W. KINGSLEY 
505 
"A plate was made of silver covering the roof of the mouth and the 
teeth. This was made of silver in preference to vulcanite because I 
wanted as little thickness as possible over the molars and bicuspids, and 
that thickness to be uniform, so that the interference with the lower 
teeth in mastication caused by widening the upper jaw might have a 
tendency to widen the lower one to the same extent. This plate was 
retained in position by narrow clasps around the molars, and, when 
Fig. 226. 
Figs. 226 and 227.-Kingsley (1892) 
Fig. 227. 
fitted, a bite was taken upon it in wax to show the position of the lower 
incisors. 
"The plate was then extended horizontally like a flange or apron in 
front of the lower incisors, on a level with and resting upon the cutting 
edges of the upper incisors. This apron did not interfere with the lower 
incisors in masticating, as they closed behind it. 
"A stout band of gold was made to fit the face of the upper incisors, 
with a hook at each end, and hooks over the cutting edges to keep it in 
position. The strain upon the teeth was made with rubber elastics reach- 506 
ORT 11 ODONtIOS HISTORIC AL REVIEW 
ing from the extremities of the bar backward, and caught on hooks near 
the posterior border of the silver plate. This apparatus is shown in 
Figs. 226 and 227. It needs no argument or description to show that 
while in use the incisors must be moved backward by the strain of the 
elastics, and that it was impossible for them to become elongated so long 
as the plate was kept in close contact with the molars and bicuspids and 
this contact was secured by the clasps and by mastication upon it. This 
is exactly what it did accomplish. It was worn uninterruptedly except 
for cleansing, and was readily removable (almost too readily) by the 
patient. The only attention required at the office was to cut off the 
horizontal flange from time to time as the incisors were retreated. 
Fig. 228.-Kingsley (1892). 
"An appliance as shown in Fig. 228 was adjusted. It was a vulcanite 
plate with piano wires, one from each side, meeting and lapping in front, 
and in their relaxed position standing off for an eighth of an inch from 
the face of the teeth, but were sprung in and tied to the incisors with 
waxed ligatures. This vulcanite plate was made pretty stout, compara- 
tively nonelastic, and impinged upon the lingual walls of the bicuspids 
and molars, for the purpose of assisting nature, which was widening the 
arch by occlusion with the upper one, and, as from time to time it 
loosened by those teeth yielding, the plate was warmed and readjusted. 
A small ring from rubber tubing was also stretched over the three teeth, 
to assist in closing the gap. 
"The most singular result of the rearrangement of the lower incisors, 
and one for which at present I do not attempt to account, is that these 
teeth have gone down into their sockets not less than a quarter the length 
of their crowns; they are no longer higher than the natural plane of the 
lower arch. NORMAN W. KINGSLEY 
507 
"I say that these teeth appear to have been driven into their sockets, 
but no apparatus worn on either the upper or lower jaw could have had 
such a tendency; on the contrary, the strain upon them in moving for- 
ward would have been more likely to have elongated them than to have 
shortened them. If we cannot accept the idea that they sunk in their 
sockets, we arc forced to the only other alternative, that all the other 
Fig'. 229. 
Fig'. 230. 
Fig. 231. 
Figs. 229, 230 and 231.--Type of appliance to "jump the bite'' (1892). 
teeth, cuspids, bicuspids, and molars, simultaneously and uniformly rose 
from their sockets, for certainly now the plane is not abnormal." 
Another appliance similar to Fig. 227 was devised to correct another 
case and is shown in Fig. 229. Figs. 230 and 231 are the means used to 
jump the bite. 
"The appliance for the mouth, Fig. 231, was a copy of the silver plate 
already worn, also made of silver, with the addition of arms attached to 508 
ORTHODONTICS HISTORICAL REVIEW 
it projecting from the corners of the mouth and extending along the 
face a couple of inches toward the ears. A skeleton skullcap was also 
made, and connected with the arms by an elastic strap, as seen in Fig. 
232. This, as will be seen, was thus acting only upon the upper jaw, and 
was not originally intended to reduce that undue prominence; neverthe- 
less it did prove of great value in that direction. 
"The primary object of this skullcap and its connections with the 
plate in the mouth was to afford an attachment for an elastic band going 
under the chin, which should press with only sufficient force to overcome 
the natural inclination of the lower jaw to drop." 
In concluding this series of articles Kingsley says: "A moment's re- 
flection will recall the knowledge to any dentist that the lower jaw can 
be moved forward or backward on the same plane, more than the diam- 
Fig\ 232.-Kingsley skeleton skullcap (1892). 
eter of a tooth, and this difficulty confronts everyone in making full sets 
of artificial teeth." 
Fifty years after his first article appeared, in a journal we find what 
was undoubtedly the last Kingsley gave to orthodontia. In a letter to 
the Alumni Society of the Angle School of Orthodontia, published in the 
American Orthodontist, 1908, page 125, he states: 
"Gentlemen, Students in the Science of Orthodontia and Fellow-workers 
in the Art: 
"I greet you as colleagues in one of the most interesting and impor- 
tant specialties of medicine. 
"If half a century of continued efforts to improve the art entitles one 
to be called a patriarch, I certainly am a patriarch. 
"Some one has said that I am the 'Father of Orthodontia.' I make 
no claim to that honorable distinction, but for the purpose of this let- NORMAN W. KINGSLEY 
509 
ter I accept the designation and will endeavor to act the part of the 
counsellor to his disciples. 
"This is not a formal address, it is rather a 'heart to heart' talk of a 
father to his sons, who are at the threshold of their careers, for what- 
ever age you may be individually, you are still beginners. 
"You are the Alpha, I am the Omega. 
"What I may say is not likely to be new to you; at most I can only 
refresh your minds upon things you have already learned-much may 
appear commonplace and obvious and will command your respect only 
Fig. 233.-The occlusion of the teeth prior to "jumping the bite." 
Fig'. 234.-The final occlusion of the teeth. 
because commonplaces when hoary with age are frequently counted as 
wisdom. 
"Fifty years ago there were no orthodontists. There was no ortho- 
dontia. We were not practicing a science, we were just straightening 
crooked teeth and making them even in the arch. We had no settled 
system and therefore it was not entitled to the distinction of a science. 
It may be that the term had been coined before that time, but if so, it 
was not in common use and indeed now it is not to be found in some of 
the most modern dictionaries. 
"We were empirics-experimenting, inventing and trying out our 
plans. All science begins in empiricism and orthodontia as a science 
was founded in empiricism. I think your Dr. Angle has been one of the 510 
ORT 110 DON TI ('S HISTORIC AL REV IE W 
greatest empirics of his dag-mind you, not a charlatan, but an experi^ 
menter, and out of his empirics he has forged a system of related facts, 
and thus his empiricism has contributed to create a science. 
" There could have been no greater empiric for thirty years or more 
than I, myself, for during all that time T was constantly regulating 
teeth and without any previous experience of others or any knowledge 
except that gained by experience. I was devising new ways to meet 
every emergency. 
"You young gentlemen have a great advantage. Your brains are not 
taxed by conceiving new experiments and trying plans that end in fail- 
ure. You have a formulated science and proved system to guide you in 
almost any conceivable emergency. I congratulate you-you start your 
careers without the handicap of ignorance, and wonderful possibilities 
lie before you. 
"I want to impress upon you a few things as a father out of a father's 
experience. Start fair-begin right-don't take a second step until you 
are perfectly sure that your first is correct. Study your case from mod- 
els as well as the oral cavity, but be sure that you have perfect models. 
Be sure of a good impression--no matter what material you use. Do 
not be guilty of the solecism of showing an imperfect cast and apologiz- 
ing for it by saying that the impression was taken in a hurry. Be hon- 
est and own up that it was the best you could do. 
"Of all things, this step must not be hurried. Better none at all than 
a hurried, defective one. If your time will not permit, then postpone 
the setting. Don't begin this most wonderful branch of technical scien- 
tific art with a false start. Det exactness be your dominating motive-■ 
exact in every step and each succeeding one will be attained easier and 
the end a triumphant success. Except in the very simplest cases, make 
and keep good models of your cases properly occluded and articulated. 
It is better that you connect your casts at the heel either by a hinge or 
guide-pins and thus preserve the occlusion from being bruised by handling. 
"Preserve with care for study and future reference the first casting 
from your impressions and be particular about the appearance of these 
models. Appearances go a long way to support assumptions. I think 
in times past my colleagues have been more impressed by the symmetry 
of my models than by all my talk. Talk is cheap-anybody can talk, 
but it is not everybody who shows neat, carefully prepared, artistic 
models. 
"Fine models, without any talk, carry more conviction than all the 
oratory with a display of unsightly plaster casts. Many times I have 
seen an exhibit of dirty casts, apparently rescued from the ash-heap, 
which challenged attention only by their number and shabbiness-casts 
exhibited to illustrate some phase of orthodontia, devoid of articulation, NORMAN W. KINGSLEY 
511 
'(Aly as held in the hands. Casts that so far as accuracy went, might havo 
been mismatched and almost reversible. A lot of teetering, wabbling 
models with the cusps rubbed off to such an extent that one could prove 
almost anything by them. Such models prejudice the standing of ortho- 
dontia more than they advance it, while on the other hand, beautiful 
models not only command the respect of your colleagues, but are an 
ethical form of advertising to your patients both justifiable and com- 
mendable. 
"It is not so difficult to straighten crooked teeth. The requirements 
for bringing into proper relations and alignment have been in a great 
measure anticipated and appliances have been developed until a sys- 
tem of general application is at your command. Tn the present advanced 
state of mechanical apparatus, it is not a difficult matter to get the den- 
tal system into a position acceptable to your patients and yourself, but 
to hold it there until it becomes permanently settled is a much more 
serious problem. It is the one important consideration in all your prog- 
nosis. The success of orthodontia as a science and an art now lies in 
the retainer. The perversity and contrariness of inanimate things is 
proverbial and nowhere more strikingly exhibited than in the effort of 
Nature, when forcibly diverted, to return to its former condition. Again, 
what we call Nature, seems frequently more disposed to go awry than 
right, and here Nature is seconded by the impatience of the subject, who, 
having gone through a period of prolonged strain, encouraged by the 
progress and by the expectation of benefit and satisfied with the accom- 
plishment, feels any continuance is a hardship. Too often has the victim 
been left in a worse state than before the beginning; gains have not 
been fixed, the work must be renewed and between the see-sawing of 
advance and retreat a nervous system is shattered which will take a life- 
time to recover. 
"The ideal, universal retainer has not yet been devised. I warn you, 
therefore, with all the solemnity of a patriarchal experience, do not dis- 
charge the case or abandon retainers until there is reasonable expecta- 
tion of permanence. You may rightfully ask of that experience, 'How 
long will that be?' Your patient will pester you with the same query. 
Out of the same observation and experience, 1 can only answer--I am 
agnostic, 1 don't know. Tn each and every individual case, I don't know. 
It took a long time to go wrong, it will have to be held a long time to 
overcome the tendency to retreat and particularly if the malposition 
seems to come from an inherited tendency, not a settled inherited de- 
formity, but a predisposition which can be obliterated by correction and 
its transmission aborted. Settled transmitted deformities become per- 
manent types. 512 
ORTHODONTICS HISTORICAL REVIEW 
"I want you to realize that in adopting this specialty you must be 
something more than a mere mechanic. One who, like the plumber, has 
been taught his trade and can do only those things that he has learned 
and do them in no other way. You must become an artisan and apply 
brains to your mechanics, but more than that, if you meet all the possi- 
bilities of benefit to your clients, you will encroach upon the domain of 
the artist, which involves the highest order of mechanical achievement. 
This is an extravagant Utopian claim or expectation. The altruist can 
reach no higher ideal than you in fulfilling the requirements of your 
vocation. You not only make your patient physically better, but you 
contribute to his self-respect and to his beauty. 'Within limits, you can 
transform a face from inharmony of feature to symmetry, from ugliness 
to comeliness, and from a repulsive expression to a winning one. 
"A few years ago a gentleman whom T regard to be the most distin- 
guished representative of intellect and culture that America has ever 
produced, a veritable giant in attainments, said to me: 'I want to thank 
you for what you have done for my son. You have transformed him 
with an ugly face and made a right handsome boy of him.' 
"In the effort to become artists in orthodontia as well as artisans, do 
not let sneers or ridicule affect you. Forty years ago I was lecturing 
to a class upon these general lines when I encountered in print, from the 
pen of a dental editor, who was likewise a college professor-referring 
to my lectures, he wrote: 'Whose art is some plaster casts and his lec- 
tures maudlin sentiment.' Was it maudlin sentiment? Forty years have 
passed, but I may be permitted to say that the name even of that pro- 
fessor is forgotten while the 'maudlin sentiment' has become a part of 
the advanced teaching of orthodontia. 
"Bear in mind that you are engaged in a profession, not in a trade. 
The education, culture and customs of civilization all accord superi- 
ority to the learned professions and require that they be conducted with 
dignity and in a manner to avoid reproach. There is an unwritten code 
of ethics among honorable men which you will not violate, but while 
your vocation is beneficent and humanitarian in a large sense, it is also 
a business and must be so conducted as to bring a remuneration equal to 
a similar education and ability in other occupations in your environment. 
You are entitled to fees that will maintain your social standing with the 
better class of your neighbors. You must get these fees by your recog- 
nized skill. You must obtain patients on your merits and not under any 
circumstances by offering or paying commissions to any one whatsoever. 
Commissions offered to a professional brother mean bribery, detested 
by all honorable men. Commissions exacted are equivalent to the de- 
mand of the road agent of the plains-'stand and deliver.' Commissions 
paid by you mean cowardice. You yield to a 'blackmailer' under threat NORMAN W. KINGSLEY 
513 
of injury. You yield to the demand from your professional brotherhood 
under the implied threat of a loss of bread and butter. It is nobler to 
go hungry than buy bread at the sacrifice of professional dignity and 
honor. 
"In all my fifty years of experience I never offered or paid a commis- 
sion to any man and I was constantly receiving patients recommended 
to me by dentists. If your fellow-practitioner cannot treat the case prop- 
erly and feels that he cannot afford to let it go without remuneration, 
find some other way of recompensing him than by vulgar coin. Send 
him some patient that his ability can master and thus establish reci- 
procity. I believe in reciprocity. Let him have all the fee without re- 
bate that the patient is willing to pay. Let it be a matter entirely 
between themselves. This does not refer to business arrangements that 
you legitimately make with an associate or an assistant upon a division 
of the fees, for in the latter case he becomes, in the eye of the law, a 
partner; the arrangement is a legal co-partnership and will stand the 
test of the courts. 
"You are filling a most important place in the world's work. You 
are making people more comfortable and incidentally improving the 
race. In the very best sense you are a humanitarian and an altruist. It 
is right that on all proper occasions you magnify your vocation, but 
don't get bumptious or conceited. Your calling is exceedingly limited 
in its influence on mankind as contrasted with men of large affairs. The 
captain of industry is master and director of enterprises that benefit 
the masses and contribute to the progress of civilization. Yours is lim- 
ited to the individual, therefore put forth your claims to recognition with 
becoming modesty and thus command respect for yourself and for your 
science. 
Lives of great men all remind us, 
We can make our lives sublime, 
And departing leave behind us, 
Footprints on the sands of time. 
"Warren Point, New Jersey, December 3, 1908." 
Albert H. Fuller (1841-1912), in the Missouri Dental Journal, 1872, 
published a new method of making a coil wire band, describing his 
method in the following way: "In 'regulating cases,' having at times 
found it extremely difficult to perfectly fit a band to a tooth which I 
desired to twist, it occurred to me that the difficulty could be overcome 
in the manner which I will describe and which I have since found of 
great advantage, saving time and patience, and giving a more accurate 
adaptation than could be obtained by any other method with which I 
am acquainted. 514 
ORTHODONTICS HISTORICAL REVIEW 
"I take an impression of the tooth, from which I got a plaster model; 
around this 1 wind a fine platinum wire, one coil above the other, until 
a band of sufficient width is formed. Over this, and while yet on the 
plaster model, flow gold solder, and you will have a perfect fitting band. 
Attach your catches at whatever points on the hand you wish to apply 
your force by soldering on a small piece of plate, or in any manner the 
case may suggest to your mind as the best. 
"Clasps can be perfectly fitted to teeth in this manner, using heavier 
wire and twenty carat gold for solder, cutting the band so as to clasp 
the tooth in the proper manner." 
Thomas C. Stellwagen (1841-1918), before the Odontographic Society 
of Pennsylvania, in discussing a paper reported in the Dental Cosmos, 
page 605, 1872, saying: "Study the patient's features both full face 
and profile, noting any defects that may lie apparent. Many limes pro- 
tracted suffering, and even serious injury, may be avoided by remem- 
bering that it is unnecessary to expand the alveolar arch simply to got 
the whole of the teeth in position, where it is large enough to harmonize 
with the face and does not impair the voice or mastication. 
"While it is questionable or even bad practice to preserve useless 
teeth, always remember that it is rare that any of the six anterior teeth 
can be removed without serious deformity resulting from the loss. The 
first or second bicuspids from their liability to disease, their secondary 
importance in speech, expression, or mastication, and, finally the spaces 
left after their extraction, being so easily filled and so frequently suffi- 
cient for the purposes of the orthodontist, are all sufficient arguments 
for the sacrifice of these organs in preference to others. 
"The occlusion of the teeth, the manner in which they tend to inter- 
fere with the movement of each other, also the proposed occlusion to be 
gained after the treatment has been completed, should be taken into 
account. 
"The occlusion of the teeth has more to do with their moving than 
any power that could be produced either with a plate or ligatures." 
Wm. A. Breen, in the. same journal, said he "had a case similar to the 
one under consideration. He used whalebone in place of wood, as sug- 
gested by Prof. McQuillen, and then used an inclined plane upon the 
laterals until they were forced between the cuspids and centrals; then 
removed the plate, and allowed them to fall into the arch of their own 
accord, which they did very satisfactorily." 
Robert Baume (1848-1907), in Vierteljahrsschrift, fur Zahnheilkunde, 
1872-73, and translated in the Monthly Review of Dental Surgery, Vol. 2, 
has a series of articles on the "Eruption of the Teeth." He takes ex- 
ception to the theories of Wedl and Tomes but adds little that is really 
new. NORMAN W. KINGSLEY 
515 
J. T. Browne-Mason (-1916), on the "Irregularities of the Teeth," 
published in the Transactions of the Oclontological Society of Great Brit- 
ain, page 161, 1872, treated the subject in the following manner. He 
divided the subject into heads: "First, the treatment of cases not re- 
quiring mechanical appliances; secondly, cases that need such aid. 
"The first-named cases are frequently the result of the crowding of 
the teeth by pressure forwards of the back teeth. 
"With regard to the treatment of irregularities caused by insufficiency 
of room. To get the offending teeth into the dental arch, it is clear that 
we can only make room for them by the withdrawal of others. 
Fig. 235.-Robert Baume (1848-1907). 
"The bicuspids, unless their space has been lost by the early removal 
of the milk molars, find their way into their normal places without much 
trouble, for their predecessors leave them abundance of room. Should 
they, however, be pushed out of place, I should not hesitate to remove 
the bicuspid, for its room would, under the circumstances, be an advan- 
tage. 
"The canines are very frequently thrust out of the dental arch by want 
of room. 
"My mode of procedure is to leave the six front teeth intact, and 
sacrifice a bicuspid, or first molar, on each side. Which of the two is to 
be the tooth sacrificed must depend on circumstances. 
"Now, with regard to the treatment by mechanical aid. I find the 
cases in which the lower jaw requires such assistance so rare that I 
cannot give any examples of it, for T have almost invariably found that 516 
ORTHODONTICS HISTORICAL REVIEW 
when there is sufficient room in the lower jaw the teeth will arrange 
themselves. 
"You will find that most of the irregularities of the lower jaw will 
be reduced by Nature, provided, as before said, there is room in the jaw. 
"Our model being taken, the tooth or teeth must be turned and cor- 
rected on it, and then a plate fitted accurately round the inside of the 
incisors, coming quite to the inner edge of these teeth, capping the tem- 
porary molars, and extending back over the masticating surface of the 
permanent first molars, to prevent these teeth rising in the jaws whilst 
the plate is worn, which would interfere with the bite when the plate is 
left off. The caps must go well under the gum of the temporary molars, 
so as to firmly grip the necks of these teeth, otherwise the plate will 
not be perfectly steady, but apt to slip: there should be a piece of plate 
to thicken the caps over the grinding surfaces, and this thickening should 
be considerable over the first temporary molar, and less over the second 
temporary molar, ceasing with that tooth. If this extra thickness is not 
placed on the caps, you will find, when the plate is in the mouth and 
the mouth closed, there will be no bite except on the last teeth on each 
side, and the patient would then have difficulty in masticating whilst 
the plate is worn. I like to have the bearing hard on the first milk molar, 
and if found too hard on that tooth a sharp sculptor will soon remove 
the points borne on, for after our plate is in its place, as will presently 
be seen, it should not have to be removed for some time. A bar must 
also be carried from first molar to first molar, fitting close to the outside 
of the central teeth, to keep them steady when turned. When the plate 
is ready, I seize the tooth or teeth with a pair of forceps, like a pair of 
broad, flat pliers, the biting surface of the jaws of the instrument being- 
covered with lint or chamois-leather, to prevent injury to the enamel 
of the teeth. Then, with a steady twist I revolve the offending tooth 
or teeth in their sockets, and immediately place on the plate, and the 
work is done. I have never seen any unpleasant effects from the tor- 
sion in this way, the pulp not being injured by the process. 
"Case No. II. I fit a plate as already described, only without tam- 
pering with the cast in any way, a screw being brought to bear on the 
teeth that require correction at about the point where the distolateral 
and lingual surfaces of the tooth form their junction, whilst a rigid bar 
is carried round from the first molar to determine the degree of prom- 
inence, in order that the teeth may not, by the pressure of the screw, be 
thrust too far out, but, by the restraining action of the bar, be revolved 
on their own axes when the desired prominence is gained. The screw 
should be turned every morning and evening if practicable, until as much 
pressure is produced as the patient can bear; if necessary, the advancing 
tooth must be followed by building up plate behind it, a fresh screw be- NORMAN W. KINGSLEY 
517 
ing inserted as required. By this means, in nine visits, extending over 
seven days, a complete correction was made of the offending teeth in 
the case before you. After the teeth are in position, I take a fresh cast, 
and adjust my plate and bar to retain the teeth in their places; the ap- 
paratus is then worn by the patient for four to six months, to ensure the 
teeth retaining their new positions, the hold of the caps having been 
slackened to allow the patient to remove the plate for the purpose of 
cleansing it and the teeth. (See Fig. 236.) 
"I prefer the use of the screw to compressed wood, for the latter I 
found occasionally slip out of position, besides being much slower in 
operation; and I have a great preference for speedily finishing such 
cases, as it must necessarily be less trying to the patient, whilst the 
permanence of the work is not affected by it. I also think the screw 
more desirable for bringing teeth forward than the inclined plane placed 
Fig. 23 G. 
Fig. 23 7. 
Figs. 23 6 and 237.-Browne-Mason (1872) 
on the lower teeth ; for, by the latter plan, the patient has constant worry, 
and more especially during meals. From the molar teeth having no 
bearing, all mastication during the period of the moving the teeth being 
perforce most imperfect, and the discomfort, to say the least, at those 
times of the teeth under treatment, tender as they are, striking on the 
inclined plane, is, I think, much more trying than the pressure of the 
screw, which only causes discomfort and pain at the time it is moved. 
Actual torsion should be performed as early as practicable before the 
root of the tooth has completed its growth. (See Fig. 2'37.) 
"Plate of either gold or dental alloy is more manageable than vul- 
canite, as it is easier to follow up advantages gained by building up 
plate than by taking a fresh cast, and by making almost a new frame 
when the changes of the mouth require it." 
Peter Headridge (1873-1921)-For "Improvements in Dentistry for 
Expanding the Upper and Lower Maxillary." 518 
ORTHODONTICS HISTORICAL REVIEW 
"The modus operandi whereby dental malformations arc now treated 
is by a base or plate of vulcanite, gold, or other materials made to fit 
the palate and teeth in one piece. The teeth arc moved by means of 
pressure interiorly against the surface by means of wedges of wood 
fitted between the base and teeth. These wedges cause irritation of the 
surrounding membrane. Screws and other appliances arc also resorted 
to, having the same result. By this method dental malformations are 
not so successfully treated, the teeth oftentimes falling into their original 
positon, likewise having a tendency to press the root of the teeth inwards, 
resulting in a pressure against the nasal cavities; these malformations 
often cause obstruction in the nasal cavities, which affects the pronun- 
ciation of speech which is not relieved by the foregoing appliances. 
"My improvements consist of the following, that is to say, the upper 
and lower maxillary is expanded by a sectional base or plate. This sec- 
tional base or plate can be made of vulcanite, gold or other materials; 
these sections A are united by a spring or springs B. The upper maxil- 
lary is expanded by means of a sectional base or plate covering the pal- 
ate and back teeth; this sectional base or plate meets on the median line 
of the maxillary; situated interiorly are two shoulders on the base near 
the grinding surface of the teeth on each side to receive and hold a 
spring that fits close to the base; when put in the mouth the spring ex- 
erts pressure against the sides, causing the upper maxillary to open the 
center, at the same time opening the nasal cavities. If the pressure of 
the spring is wanted to be exerted at the front or back of the mouth, the 
sections are fastened by means of a small immovable cord as required. In 
some cases where a strong pressure is required on the nasal cavities a 
spiral spring made from steel, gold, or platinum or flexible rubber may 
be extended across the top of the palate of the base. In the lower max- 
illary the base or plate is divided into three or more sections covering 
the lower teeth; these may have a groove to receive the spring and 
sockets at the back part of the sectional base to hold the spring which 
can be regulated to exert pressure against all three sections, or only one 
as the case may require. These springs I prefer making of steel wire, 
but springs of several metals or India rubber introduced between the 
sections of a coiled spiral spring may be bridged across. 
"The value of this invention lies in forming the base or plate in sec- 
tions, and using springs B to expand them, which is new and never be- 
fore used for dental irregularities. 
"Also my appliance claims for itself much more comfort to the wearer 
inasmuch as it causes no pain or irritation, or takes up any unnecessary 
room in the mouth like the present method of treating dental malfor- 
mations. NORMAN W. KINGSLEY 
519 
Isaiah Forbes (1810-1885). "Irregularity." "Writing upon the sub- 
ject of the causes that produce irregularity, if one coincides with the 
generally expressed opinions of the day, would be a waste of time, and 
the result an unprofitable paper, for the subject seems to be completely 
exhausted. But when the subject is to be considered in a different light 
from that in which our early education has taught us, a new field is open 
for our consideration, reflection and investigation. I will therefore con- 
fine myself to that branch of the subject which we are educated to 
regard as the principal cause of irregularity of the dental arch, viz.: 
the premature extraction of the deciduous teeth-and while expressing 
my well-known convictions on this subject, I cannot but feel that my 
position is an unenviable one. There is nothing so difficult to change as 
Fig. 238.-Isaiah Forbes (1810-1885). 
the impressions and prejudices of our early education. The more I have 
studied and reflected on this branch of the subject, the more have I be- 
come satisfied that the doctrine, as taught in our dental textbooks, can- 
not be correct. Several years have passed since I first expressed my 
convictions on this subject in our local societies, and the most forcible 
argument that was then advanced in opposition was: 'Is that the way 
you do in your practice?' 
"We know that the first permanent or sixth year molars stand farther 
apart at the age of twenty than they did when first erupted, and they 
stand as perpendicular in the jaw. We know that the labial surface of 
the crowns of the six front teeth stand almost perpendicular in the adult 
as the deciduous teeth in the child; therefore the 'elongatory process of 
enlargement' above, and the retention of the deciduous wedges in the 520 
ORTHODONTICS- -HISTORICAL REVIEW 
springy arch, would not, could not possibly increase the span of the 
arch 'half as much again,' so as to enlarge the space necessary to permit 
the teeth to attain a perfectly regular position. We know the six front 
permanent teeth are certainly quite as large again as their deciduous 
predecessors. We know the bicuspids are no larger than the deciduous 
molars. We know that in the incipient stages of development the per- 
manent teeth lay, as it were, folded upon each other or lapping one an- 
other. We know that if the arch of the jaw did not enlarge, that the 
permanent teeth must erupt, and continue in an irregular position. We 
know that the base of the arch of a child's jaw is not as broad as the 
man's. We know that the child's tongue holds the same relation, as 
regards size, to the child's jaw as the man's tongue does to the man's 
jaw. We know that the man's tongue is much broader than the child's, 
therefore, the base of the arch of the man's jaw must be broader than 
the child's. We know that the arch of an adult jaw extends to the 
distal surface of the canines; from thence backward the jaw is nearly a 
straight line. We know that arterial branches, totally distinct and in- 
dependent of each other, supply the jaws, the alveolus and the teeth. 
We know that the extraction of a temporary tooth, or the absorption 
of the temporary alveolus docs not diminish the size of the haversian 
canals through which the blood vessels How that supply the permanent 
teeth and alveolus. We know that the haversian canals, which are 
channeled out of the compact substance, convey the blood vessels for 
its nutrition. Therefore I cannot conceive how it is possible that the 
removal of one or more of 'the wedges that compose the springy arch' 
would cause a 'springing together of the parts at the sites of the re- 
moved wedges.' On the contrary I can conceive how an undue reten- 
tion of the deciduous teeth, and a firm alveolus on the labial surface of 
the jaw, might cause a 'pathological pandora's box.' " 
L. Fleschmall, in Wiener Med. W ochenschrift (Dental Cosmos, 1873, 
page 261), under "Irregularity of Teething, Diagnostic of Rhachitis," 
calls attention to how seldom this subject is alluded to and claims 
rhachitis can be hereditary or acquired. It is with the latter class that 
the author has to do, and it is the most frequent form, affecting nearly 
one-third of all children. Rhachitis is due to a peculiar disturbance of 
nutrition in a growing body, a "dystrophy," amenable with more or 
less success to treatment at the beginning. Children nourished arti- 
ficially are, for obvious reasons, more liable to if than those brought up 
at the breast, and the latter, when affected are generally so after wean- 
ing; that is, after the tenth or twelfth month. 
"The teeth come first in the order of the bones affected, and the dis- 
turbances, therefore, in the ossification of the teeth can serve as a valu- 
able sign of a very important disease. The formation of the embryo of NORMAN W. KINGSLEY 
521 
a tooth commences in the second month of fetal life, and in the middle 
of the third month is completed for all the teeth. The milk-teeth are 
formed in the fifth month, and are so far advanced at birth that the 
crowns of the incisors and first molars arc completely developed; those 
of the canine and posterior molars one-third formed. As the acquired 
rhachitis, according to experience, rarely comes on before the end of the 
sixth month, and most frequently in the latter part of the first year, 
reaching its highest point between the second and third years, it follows 
that, if we place the appearance of the first teeth at the seventh month. 
Fig'. 239.-Joseph Richardson (1824-1889). 
the rhachitic process will not have had any influence upon these. The 
only exceptions to this arc when a hereditary rhachitis makes rapid 
progress immediately after birth, or when the infant is weaned very 
early, and is brought up with improper food; in such cases it happens 
sometimes that one waits in vain for the appearance of the first teeth 
and sees a year or more elapse. In the majority of cases rhachitis shows 
itself first after the breaking through of the first molars." 
Joseph Richardson (1824-1889), before the Odontological Society of 
Pennsylvania {Denial Cosmos, 1873, page 350), in a paper "Treatment 
of a Case of Irregularity," explained the following method of handling 
these cases, first extracting the first bicuspid and then a narrow band ORTHODONTICS HISTORICAL REVIEW 
522 
of vulcanized rubber (Fig. 240) was constructed embracing the six an- 
terior teeth. "Pressure was made upon the misplaced teeth by means of 
wooden pegs inserted in holes drilled through the band, at such points 
as were indicated by the direction which it was desired the teeth should 
take. In the present case the pegs rested against the posterior mesial 
angles of the lateral incisors in such a way as to force them, when the 
band was applied, outward and backward, while those inserted into the 
opposite or labial portion of the band carried the cuspidati backward 
and inward. These pegs projected but slightly at first, and were length- 
ened from time to time, as the teeth moved, their removal and replace- 
ment being but the work of a few minutes. Before applying the band, 
all connecting partitions of rubber were divided, and the band cut away 
sufficiently at necessary points to enable the teeth to move in the desired 
direction. In most cases this band may be removed and replaced by 
the patient for the purpose of cleansing the teeth. 
Fig-. 240.-Vulcanized rubber plate with wooden pegs. (Richardson, 1873.) 
4'The mechanical action of this simple fixture is readily apparent. The 
band, when applied, being forced apart by the intervention of the pegs, 
acts, by virtue of its elasticity, as a clamp, or compressor, forcing the 
teeth in a direction opposite the insertion of the wooden pins. 
"I found the case now complicated with a marked elongation of the 
lateral incisors. 
"Without any published precedent, so far as I am aware, I entered 
upon the novel undertaking of shortening (relatively) the elongated 
teeth in question, by pressure applied on a line with their long axes. To 
this end, a plate affording fixed points of resistance was constructed, 
having clasps attached and pinned to the centrals with wooden pegs rest- 
ing against their anterior, and the plate against their posterior surfaces. 
To this plate firm elastic cords were attached, stretching across the open- 
ings for the lateral incisors. When this plate was pressed firmly to its 
place upon the teeth, and held securely by the means already adverted 
to, the contractile force of the cords, acting forcibly and persistently 
upon the cutting edges of these teeth produced the requisite shortening. 
During this time pressure was also being made upon the cuspids, which, 
in addition to forcing them further backward and inward, assisted in 
fixing the plate in aid of the shortening process. NORMAN W. KINGSLEY 
523 
Finally, a plate was made, resting accurately against the posterior 
faces of the central and lateral incisors, and cut away somewhat pos- 
teriorly to the cuspids, to enable the latter to drop down until they shall 
become symmetrical in length with the adjoining teeth." 
D. F. Drake, before the American Dental Convention, 1873, read an 
essay on ''Orthodontia,'' saying that "he thought that orthodontia meant 
something more than the mere application of appliances to the teeth to 
throw them into their proper position. The conditions to be desired are: 
(1) Youth or proper age; (2) health of the parts; (3) absence of syph- 
ilitic taint, hereditary or otherwise; (4) absence of scrofula or struma; 
(5) absence of all scorbutic tendencies; (6) absolute cleanliness; (7) 
confidence of patient. All these things being conditions favorable, suc- 
cess is certain. Remember that the simplest method is always prefer- 
able. With the appliances nicely adjusted and carefully watched, the 
carrying of the teeth to their proper position is an easy matter. This 
must be done neither too fast nor too slow, for either will jeopardize 
the operation. There is little danger of moving too fast if it is done 
steadily. A steady, firm pressure will provoke much loss inflammation 
than an unsteady oscillating movement. Move the teeth as fast as it is 
possible without injuring the pulp. It is quite common for children to 
inherit large teeth from one parent and small maxillae from the other. 
In such a case an enlargement of the maxillae must be obtained, but not 
until the majority of the second teeth have made their appearance. This 
contraction of the maxillae is almost invariably associated with irregu- 
larities of the teeth." 
Charles Sissmore Tomes (1846- ), in the Dental Cosmos, 1873, page 
292, in an address before the Philadelphia Dental College on "The Bear- 
ing of the Development of the Jaws on Irregularities," stated: "Teeth 
when they are erupted do not come down and take their places in a hone 
already prepared for them; on the contrary, that which is there to start 
with is absorbed, and the bone in which they are ultimately implanted 
is built up around them, no matter what position they may assume sub- 
sequently to their eruption. And the inference to be drawn from these 
facts is tolerably obvious; namely, that premature extraction or the 
temporary extraction of the temporary teeth is perfectly unable to be 
the cause of contraction of the jaw. For, unless the bony bar which 
lies below our imaginary line be distorted, it matters very little indeed 
what happens above it, so long as the permanent teeth meet with no 
obstruction during their exit from their cysts. 
"Now the case is very instructive, for it shows very plainly that con- 
traction of the jaw is by no means a necessary sequence of early removal 
of deciduous teeth, but that on the contrary, every single one may be ORTHODONTICS HISTORICAL REVIEW 
524 
removed, and yet, the jaw become of full size and the teeth be arranged 
with perfect regularity. 
"Along the outside of the dental arch the muscular structures of the 
lips and cheeks are perpetually exercising pressure perfectly symmetri- 
cally, and on the inside the tongue is with ecpial persistency doing the 
same thing. Now if we imagine a plastic material placed between the 
tongue and the lips, it cannot fail to be molded into the form of a regu- 
lar dental arch, and this is precisely what happens with the mobile, 
freshly erupted teeth; and should it chance that an individual tooth be- 
Fig. 241.-Charles Sissmore Tomes (184 6- ) 
comes deflected by some obstruction, so that it stands outside or inside 
its neighbors, it will obviously come in for more than its due share of 
pressure, and so soon as the obstruction is removed, will be pushed into 
place. And as the muscular action of the tongue is more powerful than 
that of the lips, a tooth which stands inside the arch is reduced to its 
proper position more quickly than one which lies outside. There is, I 
believe, no such thing as a natural tendency towards the assumption of 
the regular form in a dental arch; the physical forces at work, namely, 
the lips and tongue, are amply sufficient to account for all the phenomena 
observed; and explanations based upon such a tendency fall, like refer- NORMAN W. KINGSLEY 
525 
enccs to 'vital force' as an explanation of physiologic phenomena, into 
the category of mere forms of words calculated to cloak our real ig- 
norance. 
"Certain cases known as V-shaped contracted jaws likewise illustrate 
the power of the pressure of the lips and check to modify the position of 
the teeth, for it will generally be found that this malformation is asso- 
ciated with greatly enlarged tonsils, which necessitate breathing being 
carried on with the mouth open. Now, as everyone can easily verify 
upon himself, the effect of the mouth being held open is to increase the 
tension of the soft parts about its angles, and the result of the increased 
pressure is to bring about a bending inwards at the corresponding point; 
i.e., the bicuspid region. At the same time, the median portion of the 
arch escapes the controlling pressure, which would have been exercised 
by closed lips, and the effect of this is traceable in the excessive promi- 
nence of the median pair of incisors, and also in their oblique positions, 
which makes them correspond with the form assumed by the inner sur- 
face of the lips when the mouth is open. 
"The association of this form of contracted jaw with congenital idiocy, 
as well as some other considerations, lead me to infer that the contraction 
of the face of the jaw is due to causes in operation from a very early 
period; but the agency of the lips and tongue is that which determines 
the position of the teeth themselves." 
In the British Journal of Dental Science, May, 1873, page 200, in de- 
scribing "A Case of V-shaped Contracted Maxilla, in Which There Was a 
Wide Separation Between the Upper and Lower Front Teeth," Dr. Tomes 
said: "Mouths in which the back teeth alone antagonize, and the upper 
and lower front teeth fall short of meeting one another, are not very un- 
common. 
"The upper jaw presented the ordinary form of a V-shaped maxilla, 
the central incisors meeting one another at an angle, their mesial edges 
being greatly everted and overlapping one another, and the palate being 
excessively deep and narrow. When the mouth was closed to the utmost 
extent possible, a gap of %(; of an inch intervened between the edges of 
the upper and lower central incisors, of between the right laterals and 
the canines, and of %6 between the left laterals, while the left canines 
occupied a position (relatively one to another) too irregular to admit of 
exact measurement. Behind the canines the upper and lower teeth came 
in contact with one another, but their disposition was very irregular. 
Thus the second upper bicuspid (the first having been previously re- 
moved) bit inside the corresponding lower tooth; whilst of all the teeth 
in the upper jaw the second molars were the only ones which preserved 
their normal relations by biting outside the corresponding lowei' teeth. 
It was therefore necessary to move outwards the central and lateral in- 526 
ORTHODONTICS HISTORICAL REVIEW 
cisors, the canines, and the second bicuspids on both sides. The first 
stage in the treatment was to expand the arch of the upper teeth. 
"The first upper molars, being excessively carious, and often painful, 
were extracted, and a vulcanite plate was then inserted, which forced 
the bicuspids outwards by means of wooden wedges, whilst at the same 
time it disengaged them from the cusps of the lower teeth by means of 
gold caps fitted over the second molars so as to prop the mouth open. 
It should be added that the removal of the first molars did not enable 
the front teeth to be approximated any more closely than before. 
"As soon as the bicuspids had passed out, so as to bite outside the 
lower teeth, this plate was abandoned in favor of one with a stout gold 
wire passing outside the incisors, canines, and bicuspids, and being at- 
Fig. 242.-Circular air-cushion (Tomes, 1873). 
tached to the vulcanite plate in the spaces left by the extraction of the 
first molars. 
"To this band, which had been rendered elastic by hammering, the 
central and lateral incisors and canines of both sides were firmly at- 
tached by silk ligatures, the band being pressed inwards towards the 
teeth by the finger of an assistant, while each ligature was being tied. 
"The effect of this was to draw the teeth outwards rapidly, and to 
make the front of the arch rounded in the place of having the angular 
form characteristic of the V-shaped jaw, so that the upper teeth as- 
sumed a perfectly regular position amongst themselves. 
"As soon as the upper teeth had been drawn outwards so that the arch 
was wide enough to allow of their passing outside the lower teeth, pres- 
sure was brought to bear in order to close the front part of the mouth 
by means of a simple arrangement of elastic bands. NORMAN W. KINGSLEY 
527 
"A circular air-cushion was adapted to the chin and connected by 
strong pieces of elastic with a cloth band passing over the top of the 
head; the whole was kept in place by two pairs of ribands which were 
tied at the back of the head (Fig. 242). At first some little trouble was 
experienced, owing to the skin of the chin becoming tender under the 
heavy pressure; but this was combated by the use of spirit lotions, and 
by putting slightly oiled lint between the air pad and the skin. This 
apparatus was worn constantly at night, and also during a considerable 
part of the day, the teeth being kept from falling back into their former 
positions by a light retaining plate. At the time when this apparatus 
was first adjusted the only teeth which came into contact were the upper 
and lower second molars and second bicuspids. 
"For a few weeks no very marked effect was produced save slight 
pain in the region of the temporomaxillary articulation; but after that 
the gap between the upper and lower incisors diminished each week by 
an amount that could be measured, and the expiration of six months 
from the first commencement of treatment (the elastic bandage having 
been worn for about four months), not only had the gap entirely closed, 
but the upper central incisors had been made to overlap the lower to 
the extent of %6 of an inch, while, as may be seen in the accompanying 
figure, the laterals and the canines also overlap and antagonize." 
Alfred Alex. DeLessert, in the same journal June, 1873, page 245, in 
speaking of "The Results of Fruitless Thumb-Sucking," concluded his 
article by saying: 
"But though fruitless sucking has undoubtedly its many attendant 
evils, this most natural habit must surely have its attendant benefits if 
not carried to the excesses I have alluded to; and I think there is little 
doubt but that the pressure exerted by the tongue, thumb, finger, or 
hand, materially assists in the development and expansion of the jaws; 
for it is an undoubted fact that most of the V-shaped palates and mouths 
with crowded teeth so often placed under a dentist's care for regulation 
are found in patients suffering from enlarged tonsils, and whose respira- 
tion through the nares is almost an impossibility, so that an open mouth 
is necessary, and thus the dental arch is allowed to contract without any 
opposing force." 
William Barkley, in speaking of "Pegs vs. Screivs in Cases of Torsion," 
page 307 of the British Journal of Dental Science, 1873, takes exception to 
Browne-Mason's claim "that torsion was practiced only by Sheffeld and 
his pupils." 
"As regards the discussion as to the advantage offered by pegs over 
screws, and vice versa, my own experience is decidedly in favor of pegs. 
I have more than once seen the enamel strained by the undue pressure 
of screws, and if we furnish our patients with such powerful means as a 528 
ORTHODONTICS HISTORICAL REVIEW 
screwdriver to perform their own dental regulations such a result is not 
to be wondered at. And I must quite disagree with the gentleman who 
stated pressure by pegs is not continuous; if such is ever the case it is 
only because they are applied in a manner ill calculated to effect the 
object in view. The first step towards success is to obtain a perfectly firm 
fit of the plate, without bands or clasps for if such are used when pres- 
sure is applied, they can hardly fail to act injuriously on the teeth they 
embrace. My plan, which I do not offer as being particularly novel, is 
to strike the plate entirely over the molars, first covering the same with 
sheet lead sufficiently thick to admit of platina gauze being soldered on 
the plate, on which gutta-percha is imbedded; the plate is then placed in 
boiling water, and the patient directed to bite it steadily into place; it 
will be found to fit so firm as to require some force to remove it, and in 
this condition it should be allowed to remain for a short time; in fact 
until the patient has become accustomed to it, the cells for the pegs are 
of course already soldered to the plank. In a day or two the pegs may 
be added, but left or % of an inch too long, the plate not then touch- 
ing the entire palate by a distance equal io the excess of the pegs." 
S. Jonathan Hutchinson (1828-1913) describes "A Simple Method of 
Correcting Irregularities," in the above journal, page 401. "In order to 
test the value of such a method as is now to be described, the require- 
ments necessary to treat a case of irregularity may be mentioned to seo 
how far this may fulfill them. 
"1. As to its efficiency in moving irregular teeth. 
"2. Whether it is comfortable to wear. 
"3'. Is it easily made and easily adjusted? 
"Lastly. As to the length of time it is kept in place, and how fre- 
quently the patient must see the dentist. 
"A plate to fit the palate extending as far back as the first molar may 
bo made of vulcanite or gold, the former preferably with a plain round 
gold wire, pin size, extending outside the arch of the teeth, not quite 
touching them, and on a level with their necks, each end embedded in the 
vulcanite, going either behind the last molar or even between the molars, 
or bicuspid and molar, or through any space caused by extraction. 
"'Should any of the upper teeth fall within the lower arch of course 
the back teeth will require capping, and to the caps the wire may be 
fixed. The plate will now fit in the mouth quite firmly, and the means of 
moving the misplaced teeth can bo adjusted without making the plate 
much more uncomfortable than an ordinary artificial denture is at first. 
"It is only necessary to use a small elastic ring, either an ordinary 
regulating ring as supplied by the depots, or what I find answer better, 
keeping the contractile force longer, slices of India rubber tubing, such 
as is used for the ether spray. NORMAN W. KfSGSLEY 
529 
"The ring is first put around the neck of the irregular tooth then the 
plate is put in; the ring is now stretched forward above the gold wire, 
brought down over it and back again over the tooth. This can only be 
done when the teeth are fully erupted and well developed, for should they 
be very short and inclined outwards it is better to put a small stud in the 
plate behind the tooth to be moved to hook the ring over, though then 
only two strands of elastic are at work, whereas, in the first case, four 
strands are dragging vigorously, but steadily, at the tooth; sometimes, 
also, it is requisite to tie floss silk or gilling twine to the ring and then 
round the neck of the tooth to prevent its slipping off. Another way of 
fixing the ring in the palate is to drill two small holes side by side, coun- 
tersink between them on the side next to the palate, and tie the ring to 
the silk, cutting two grooves for the elastic to lie in so as to be out of the 
way of the opposing teeth and less irritating to the tongue. 
"The gold wire being made springy and standing off from the teeth is 
dragged against them by the elastic, but when their movement has com- 
menced the wire regains its normal curve, thus lending additional out- 
ward force, and does not uncomfortably protrude the lip, but is farthest 
away from the side teeth. 
"In conclusion, how far does this method fulfill the conditions re- 
quired ? 
"It is certainly efficient, because the contraction of an elastic ring is 
a constant force very different from a piece of compressed wood, whereof 
the full expansibility is gained in at the most two hours. 
"It is more comfortable to wear than a plate which is displaced by the 
motive power, for in this the position of the wire and plate is constant, 
the elastic working on the tooth from two fixed points." 
James Oakley Coles (1845-1906), in 1868, began to write occasionally on 
deformities of the mouth. In that year in the British Journal of Dental 
Science, July number, we find an article of his under the title of "The 
Mechanical Treatment of Oral Deformities." 
In the Monthly Review of Dental Surgery, 1873, under "The Trans- 
mission of Hereditary Peculiarities," Coles discusses the possibilities of 
transmitting dental peculiarities from one generation to another, but ar- 
rives at no definite conclusion, merely reporting six cases. 
In the same journal, page 301, under "A Simple Method of Regulating 
Teeth," the same author describes the following plan to remedy the ir- 
regularity of the teeth: 
"After measuring the distance across, from the most prominent part of 
the labial surface of the canine to the center of the labial surface of the 
central incisor, cut off a stick of compressed hickory (in the round form) 
of the measurement obtained, split the stick in two, or cut it down till 
you have a half-round stem of wood, the one surface being quite flat; 530 
ORTHODONTICS-HISTORICAL REVIEW 
trim up the ends so that they do not present any sharp edges to the lip, 
this can be applied to the mouth or model, the two ends resting by the 
flat surface upon the canine and central teeth, care must be taken that 
free space exists between the surface of the wood and the lateral that 
is to be drawn forward, if the flattened surface is in contact, room may 
be given by filling a concavity in the wood immediately over the tooth; 
the wood being fitted in a satisfactory manner, a piece of gilling thread 
(American hemp, small size) is passed double between the central and 
lateral, and then passing behind the lateral tooth close to the neck, the 
double thread is brought out again between the lateral and canine; we 
have then on the labial side, the loop projecting next the central, and 
the two ends of the double thread projecting next the canine, while 
on the lingual surface we have the double thread closely embracing the 
neck of the lateral. If we now tie the two ends of the thread (next the 
canine) together so that they embrace the end of the hickory, the other 
end being embraced by the loop, we exert considerable pressure upon the 
lateral tooth; (1) by merely trying; (2) by the contraction of the thread 
as it becomes moistened by the saliva; and (3) by the expansion of the 
compressed hickory, tightening the thread still further. This appliance 
needs renewal twice a week, but intelligent patients can do it for them- 
selves or their friends can do it for them. 
"It is obvious that the same principle can be applied to the treatment 
of a great variety of irregularities, modified of course, according to the 
requirements of each case. At the same time I remark that its advantages 
over treatment by plate are considerable; (1) it is not liable to displace- 
ment; (2) the teeth can be kept clean without removing the thread and 
wood; (3) the progress made is easily seen and recognized both by 
patient and operator; (4) the pressure is continuous and not under the 
control of the patient; (5) it is not unsightly in appearance, and lastly; 
(6) it is inexpensive, so that in hospital practice many more patients 
can be treated than by the old method." 
Coles expressed the opinion, which was held by others at that time, that 
the best types of English jaws made an equilateral triangle. He applied 
Greek names to the different classes into which he divided various types 
of dental arches, basing his classification on the forms of the arch. In- 
termaxillary prognathism he attributed to a force originating in the 
sphenoid bone and acting on the intermaxillary bones. Under "De- 
formities of the Upper Jaw: an Attempted Classification of Them," page 
103, Transactions of the Odontological Society, 1879-80, he classified the 
deformities of the maxilla into seven groups. 1. Dolichoid jaw (long). 
2. Brachoid jaw (short) contracted maxillae. 3. Macroid jaw (large 
and massive). 4. Microid (small). 5. Intermaxillary prognathism. 6. 
Intermaxillary upognathism. 7. Lamboid jaw. NORMAN W. KINGSLEY 
531 
"The question lias been invested with an unnecessary amount of ob- 
scurity from the variety of terms that have been in use to express very 
often the same class of deformity: thus at the present time there would 
be no difficulty in finding in the works dealing with this and allied sub- 
jects such names as:-(a) V-shaped maxillae, (b) contracted arch, (c) 
saddle-shaped palate, (d) high roof, (e) vaulted palate, (f) narrow or 
contracted palate, (g) highly-arched palate, (h) keel-shaped palate, (i) 
Gothic palate, (j) upsilon palate. 
"1. These terms are used in many cases without any accompanying ex- 
planation of the meaning attached to them by the author, and since in 
most instances they have no definite signification in themselves, confusion 
and misconception have very often arisen in the minds of those who have 
had to study and investigate the class of cases under discussion. 
"2. If the importance of the subject be such as to have induced so 
many authors to have adopted so varying a nomenclature, it seems self- 
evident that a more precise and scientific classification is necessary. 
"3. It would be but little to the purpose were anyone to propose a 
simply arbitrary set of terms to supersede those now in use. They would 
be open to the objections urged against existing names, and would, if 
merely arbitrary, still lack that degree of scientific accuracy that is es- 
sential to the successful prosecution of a purely morphologic investigation. 
"The chief obstacle at the attainment of the necessary end may be said 
to have been due to the absence of any exact standard of an absolutely 
perfect form of jaw. 
"To say that a well-developed dental arch will correspond in outline 
with one or other of the conic sections is only to remove the difficulty 
one step further off, and render a complex subject still more difficult 
of description. 
"4. My investigations as to the correlation between the palate and 
cranium, commencing some ten years ago, compelled me to take some 
record of the dental arch in such a manner that it could be easily 
recorded and tabulated. The ordinary terms, such as paraboloid, el- 
liptical, horse-shoe shaped, and others were quite useless for my purpose, 
on account of the almost infinite variety of form that each term might 
be made to include. 
"In order to render the subject complete, I propose now to give first 
the name (with its derivation) and definition of each class, and then pass 
on to a concise description of a typical case. 
1. DOLICHOID JAW (AoAtyos, LONG) 
"Definition.-A term applied to an upper jaw in which, with an aver- 
age or less than average length from base to apex of triangle, the inter- 
bicuspid line will be found resting at its extremities upon the sides of the 532 
ORTHODONTICS HISTORICAL REVIEW 
triangle, thereby showing the degre| of parallelism (tending even to 
bicuspid contraction) of the two sides of the dental arch. 
2. BRACHOID JAW (Bpayvs, SHORT) 
"Definition.-A term applied to an upper jaw in which, with a less Ilian 
average length from base to apex of triangle, the interbicuspid line falls 
upon or within the sides of the triangle, or quite outside of the side of 
the triangle. 
3. MACROID JAW (Maypos, LARGE) 
"Definition.-A term applied to an upper jaw in which the measure- 
ments of the arch, though relatively to each other normal, are yet abso- 
lutely greater than the average standard, the palate, moreover, being 
the seat of well-marked deformity. 
4. MICROID JAW (Mtypos, SMALL) 
"Definition.-A term applied to an upper jaw in which all the measure- 
ments are below the average standard. 
5. INTERMAXILLARY PROGNATHISM (IIpo, BEFORE; Fvd(9os, THE CHEEK OR 
jaw) 
"Definition.-A term applied to an upper jaw, in which the dental tri- 
angle having been taken, the distance from the interbicuspid line to the 
apex of the triangle is greater than the normal standard, and also 
greater than the distance from the interbicuspid line to the base of the 
triangle, to which it should normally be nearly equal. 
6. INTERMAXILLARY UPOGNATHIS (Ytto, DEFICIENT, LESS THAN; 
Tvados, THE CHEEK OR JAW) 
"Definition.-A term applied to an upper jaw in which, the dental tri- 
angle having been taken, the interbicuspid line will- fall far in advance 
of the normal distance from the base of the triangle, the four incisor 
teeth being crowded together, and the canines, by reason of the small- 
ness of the anterior section of the arch, kept out of their normal position. 
7. LAMBDOID JAW (A, LAMBDA) 
"Definition.-A term applied to an upper jaw in which the outline of 
the dental arch and the sections of the palate resemble the form of the 
Greek letter lambda and present a wedge-like appearance. 
"After a series of measurements and experiments that I need not now 
describe, 1 arrived at the conclusion that the triangle was the best geo- 
metrical figure for the object that I had in view, as it gave in the sim- 
plest and most diagrammatic form two at least of the measurements 
that were required, namely, the length and breadth of the dental arch. NORMAN W. KINGSLEY 
533 
11 Desiring to form a triangle that should be applicable to the largest 
number of cases, whether edentulous or not, and capable of use with 
approximate accuracy to all races alike, I decide to form the base of the 
triangle by an imaginary line drawn from the center of the distal sur- 
face of the second molar on each side, as near to the level of the alveolus 
as the third molar (if present) would admit of. By choosing the second 
in preference to the third molar, I disposed of the liability to error aris- 
ing from abnormalities of the wisdom tooth, and at the same time was 
enabled to take my measurement at any period after the thirteenth year 
of the patient's existence. 
"One other object was gained by the choice of this position, and that 
was that the absence of the molars on one side of the mouth did not of 
necessity render measurements impossible, as the center of the distal sur- 
face corresponds very nearly with the center of the alveolar ridge which 
in this region is generally well marked. 
"The base being thus obtained, the remainder of the triangle was pro- 
duced by lines drawn from the point of contact of the mesial surfaces of 
the two central incisor teeth to the extremities of the base line already 
referred to. This incisive point, as T shall hereafter call it, still keeps 
the angles of Ihe triangle upon the central line of the alveolar ridge, so 
that in this respect again we measure from a point of least variation. 
"We have Ibus formed a triangle, giving at the molars the breadth of 
the jaw, and by a line drawn from the apex of the triangle to the center 
of the base line the length of the jaw, exclusive, of course, of the space 
occupied by the third molars. 
"This interbicuspid measurement has always been deemed a very im- 
portant one, and most writers on the deformities of the palate have 
referred to it. 
"Contrary to the practice of some observers, T was induced to choose 
the second bicuspid 'as the best point of observation, as it corresponds 
with the position occupied by the second molar of the primary dentition, 
and is altogether the tooth subject to the least variation of position if 
the changes incident to the growth of the jaw be normal in character. 
Whilst on the other hand, given an abnormally developed jaw, we may 
be tolerably certain that the second bicuspids will to some extent be 
affected. The interbicuspid measurement was, therefore, taken at the 
line of junction of the neck of the tooth with the margin of the alveolus 
on either side of the jaw, this position being chosen so as to avoid the 
inaccuracies likely to occur in the event of a largely developed bicuspid 
crown. 
"At a distance from the base corresponding with the distance of the 
second bicuspids from the distal surface of the second molar, this inter- 
bicuspid line was allowed to traverse the triangle. These lines and dis- ORTHODONTICS HISTORIC 'AL REVIEW 
534 
tances were obtained with an ordinary pair of compasses, and measured 
off by means of a millimeter rule. Beyond this, the height of the palate 
was taken, together with the total length (in the skull) and also its trans- 
verse and anteroposterior curves. 
"Thus, the deformity of the palate, arising from premature ossifica- 
tion of the intermaxillary or palatomaxillary sutures, would of necessity 
invalidate the tracings and measurements of the palate, whilst abnor- 
mally large crowns to the teeth, or extreme irregularity in the crowns, 
would quite as obviously render comparatively valueless the data on 
which the triangle was constructed. Still, if these sources of error 
would be fully recognized and carefully allowed for, an approximately 
accurate diagram may be obtained. 
"My observations were in the first instance directed solely with the 
object of ascertaining certain normal measurements, and the first set of 
these dimensions were taken by means of strips of lead, accurately molded 
to the contour of the palate in different positions, the result being imme- 
diately outlined on cardboard; the measurements were then taken off 
by means of compasses and a millimeter rule. It will be desirable here 
to give three dimensions of the palate; viz., the width, taken from the 
inner margin of the alveolar process opposite to the second bicuspids; 
the height taken from the center of the line representing the above 
width to the center of the palatal arch; and the length, taken horizontally 
from between the central incisor sockets to a vertical line let fall from 
the posterior nasal spine. 
"The skulls examined fall into two series: first, thirty-four adult skulls 
of European origin; and secondly, thirty-two adult skulls of mixed races. 
In the first series the average length was 49 millimeters (maximum 58 m., 
minimum 40 m.) ; the average width was 35 m. (maximum 42 m., mini- 
mum 31 m.) ; the average height was 9 m. (maximum 15 m., minimum 
5.5 m.). Tn the second series the average length was 54 m. (maximum 
65 m., minimum 43 m.) ; the average width 35 m. (maximum 40 m., mini- 
mum 29 m.); the average height was 12 m. (maximum 18 m., minimum 
6 m.). 
"Beyond the dimensions just enumerated, I obtained with the com- 
passes the dental triangle to which I have already directed attention. 
The first set of observations having special reference to the palate, and 
the second to the alveolar and dental arches. 
"Two main facts are deducible from the data obtained in the second 
instance: first, that the best type of well-developed English jaw will 
give an equilateral triangle as the result of measurements taken in the 
way I have described; secondly, that the interbicuspid line will fall 
upon the triangle some five-tenths in the perpendicular from the base NORMAN W. KINGSLEY 
535 
line, and that the extremities of the interbicuspid line will pass well 
beyond the boundary of the triangle on either side. 
"In regard to the prognathous and upognathous jaws, we are in a 
somewhat more satisfactory position, and although I would not presume 
to speak with authority, yet I trust I may be able to put forward a case 
with such a show of reason as shall at least command further and patient 
investigation. 
"My first assertion is this, that the deformity known as intermaxil- 
lary prognathism is the result of a force operating on the intermaxillary 
bone, such force originating in the body of the sphenoid, and being 
transmitted by the intervening nasal septum. (I may at once say that 
when speaking of force I mean a direction of growth in a given line of 
such energy as to overcome the resistance offered to it by surrounding 
structures.) 
"The foregoing assertion is based upon the interpretation of the fol- 
lowing observed facts: First, the true case of intermaxillary prognath- 
ism will have a long thin nose. Secondly, this long thin nose is not ob- 
servable during the first dentition, nor is the prognathism, excepting to 
a very slight degree indeed. Hence we may conclude that the long thin 
nose and prognathous jaw are capable of intensification by growth and 
development during early life. Thirdly, it has been shown that the meas- 
urement from the interbicuspid line to the incisive angle is greater in 
the prognathous than in the normal jaw; hence it follows that the change 
from the normal arch occurs at a point anterior to the second bicuspids, 
whilst the second bicuspids are known to correspond with the position 
of the second molars of the milk dentition. Thus it is shown that the 
prognathism is not of the whole jaw carried forward on a horizontal 
plane, but is really intermaxillary or alveolosubnasal in its character. 
Fourthly, it is simple, logical sequence of the process that produces inter- 
maxillary prognathism, carried a step further during embryonic life, 
that produces double hare-lip and fissured alveolus." 
Coles, "The Origin and Treatment of Certain Irregularities of the 
Teeth." 
The author referred to his classification of deformities of the upper 
jaw, to be found in the recently published third edition of his work on 
that subject, and then stated that at birth all jaws, in which there were 
no lesions, were normal in form, and there was no evidence of what the 
ultimate outline of the dental arch will be. He then entered upon a 
consideration of the influence of the antrum in regard to certain irregu- 
larities of the teeth, and was of opinion that an irregular growth of the 
external wall of the antrum was the cause of hypognathism, and associ- 
ated with struma. Mr. Coles alluded to the relation between the facial 
angle and the antrum, as mentioned by Professor Humphrey; also to 536 
ORTHODONTICS 111 ST() H H ' AL R EV IE W 
the relationship between the sphenoid, premaxillary bones, and antrum, 
in reference to dental and maxillary irregularity of form and arrange- 
ment. The author then briefly considered certain points in the method 
of treatment, and recommended the expansion of the whole maxillary 
arch, and not of the teeth only. 
Without going at length into the question of treatment, he submitted 
the following points: (1) That if expansion is tried, it should be expan- 
sion of the jaw with the teeth in situ in the first instance, and regulation 
of the teeth individually as a subsequent operation, rather than expan- 
sion of the dental arch by pressure applied to the teeth and their alve- 
oli. And (2) the desirability of extracting the teeth that are out of 
position, and then restoring the contour of the arch by expansion; this 
applied, of course, only to the more severe cases. He brought this point 
forward because there seemed to be some danger that in the pride of 
professional skill, patients might be subjected to greater pain and risk 
in the endeavor to save teeth than would have been the case were they 
extracted. 
Walter Harris Coffin (1853-1916), before the International Medical Con- 
gress in London, 1881, presented a paper describing what he termed "A 
Generalized Treatment of Irregularities." "The Expansion Method" that 
had been used in practice by his father, Dr. Coffin and Dr. Peter Head- 
ridge, since 1869. This method attracted general attention before Coffin 
read his paper, for we find it described and illustrated in an article by 
Alfred Coleman, in the Transactions of the Odontological Society of Great 
Britain, 1877, page 111, in which he states it had been in use for years. 
It consisted of a vulcanite plate, capping the teeth, unless held in by 
clasps, wire or ligatures, divided in the median line of the palate into 
two halves, which were held together by a piece of pianoforte wire bent 
in W shape. (Fig. 243.) This acted as a spring and by opening the 
plate gradually enlarged the dental arch. The advantages of such an 
arrangement are "steadiness and uniformity of action, together with 
the avoidance of numerous visits so necessary in such cases." Coffin 
said, "A large class, uncomplicated by crowding, in which aberrant teeth 
arc easily replaced, admit of direct and immediate correction by suit- 
able means (a simplification of which will be alluded to). 
"Of the remainder, the majority are cases of every variety, in which 
the teeth-not really too large or too numerous for the jaw they might 
symmetrically occupy-are, by some chance of their eruption, irregu- 
larly disposed, interlocked, and crowded. Of these it may be affirmed, 
quite generally, that rectification necessitates the movement of many 
teeth or all, and an altered shape or outline of the dental arch; for any 
attempted direct adjustment of individual teeth will be accompanied by 
such a disturbance, more or less extensive. These present the greatest NORMAN W. KINGSLEY 
537 
difficulty in regulating by the usual way especially with a rigid plate; 
but in the most intricate or the simplest of them, the permissive control 
of the general tendency of movement during regulation reduces their 
successful treatment to comparative ease and certainty. This mechan- 
ical anticipation of favorable conditions may be illustrated by assum- 
ing an incisor to be moved in a crowded arch by any means applied by 
a plate rigidly embracing the bicuspids and canines, when a certain force 
in a certain time may complete the operalion; but were the plate either 
abolished, or its symmetrical halves partly independent and free to move 
relatively in the plane of the arch, less time and force would suffice; and, 
furthermore, if its halves tend lint slightly to separate by an elastic 
spring reaction, many cases will require very much less time and force 
to be exerted on the tooth. The action thus stated in its simplest form 
is obvious from a priori considerations, but was observed, it is believed, 
for the first time by a singular accident. 
"Soon after the introduction of vulcanite my father was employing a 
plate of that material to move an incisor by the swelling of wood. Sue- 
Fig. 243.-Pianoforte wire bent in W-shape for Coffin's plate (1877). 
cessive increments of force were resisted until not only was it suddenly 
in position, but other front teeth were found slightly separated where 
previously in overlapping contact, the wood (being nearly on the median 
line), by lateral expansion, having split the plate down the center. In 
this instance, as will often be the case, previous 'expansion of the arch' 
by the means usually applied was certainly not indicated, and therefore 
not resorted to, although just the slight amount of spreading required 
was prevented by the rigid construction of the plate. A conviction of 
this led to a particular method of treating various irregularities, which, 
as anticipating changes common to them-usually expansive,-has been 
called, somewhat indefinitely, an 'expansion treatment'; and whose adop- 
tion has been abundantly justified by experience. 
"The troublesome and delicate operation of 'expanding the arch,' as 
usually performed, if attempted by the ordinary 'jackscrew' direct, must 
be accomplished before other regulating action can generally be com- 
menced, and may then prove to be either excessive or unnecessary. The 
screw is applicable, with care, to severe contraction (though inferior to 
other means) ; but undivided plates, however thin and elastic, or hinged 538 
ORTHODONTICS HISTORICAL REVIEW 
plates, however actuated, have not the freedom of movement and ad- 
justability desirable; and the screw is entirely unsuitable for a split 
plate. 
"The little device my father calls an 'expansion plate,' whether used 
for direct expansion or not, is intrinsically of extreme simplicity, while 
of complex regulating action, comprising a means easily embodied in 
any plate of conveniently permitting or assisting (instead of hindering 
or preventing) during regulation, the inevitable changes of the arch 
naturally accompanying it, and supplementing ordinary expedients with 
an expansive characteristic. Its distinguishing function depends on the 
principle of permitting a relative motion, or maintaining a particular 
controllable reaction, between two semi-independent parts, usually its 
symmetrical halves. 
"If required, any force, however small, is sufficient, if exerted con- 
tinuously over a certain distance, with not too rapidly diminishing in- 
tensity. Mere repulsion, however, between two points on a split plate, 
is an unstable system, and uncontrollable. Allowing a certain freedom 
of motion, means must be provided for restraining it, and maintaining 
by a yielding guidance any desired degree of parallelism. 
"Difficulties attended the first realization of these conditions; but it 
is found that a wire spring of certain form, if a constructive part of the 
plate, will itself meet all requirements. 
"Modifications of the arrangements found most convenient and satis- 
factory arc exhibited,-after actual use, and in different stages of con- 
struction. 
"The perfection of the model must be insisted upon, as an entire plate 
may fit well and securely, and yet both its halves be so loose when di- 
vided as to be useless; while, on the other hand, the halves of a split 
plate may be easily fitted, which before division could not possibly be 
inserted. The best impressions have been obtained with the preparations 
of gutta-percha or ballata gum, no other material affording with ease 
the absolute fit essential for a split plate. Their physical property (when 
in good condition and at the right temperature) of being elastic and 
recoverable to rapid changes, reproducing, if inserted slowly and removed 
quickly, the most intricate undercuts just sufficiently-and affording by 
the slight contraction in cooling just enough shrinkage-for a thin hard 
rubber copy to fit tightly. A delicate and elastic vulcanite plate from a 
good gutta-percha impression-if the model be vulcanized upon direct, 
and not touched to accentuate undercuts or correct imperfections-will 
generally spring over the teeth with so absolute a fit that its removal may 
even be embarrassing; but until divided its insertion is not usually 
attempted. NORMAN W. KINGSLEY 
539 
"Trials of the metals and their alloys proved the superiority for 
springs of apparently so undesirable a material as steel. 
"The almost insuperable difficulty of satisfactorily tempering bent soft 
steel without deformation of shape was obviated by the use of piano- 
forte wire, as possessing every uniform texture, temper permitting it 
to be fashioned and used without heating, and a surface hardness and 
burnish which greatly tend to its preservation. To coat this wire with 
other substances was found unnecessary and undesirable. The behavior 
of steel to the fluids of the mouth is such that, if hard and bright at 
Fig. 244.-Method used to expand upper 
arch by Coffin. 
Fig. 245.-Lower appliance. 
first, and continuously immersed in average saliva, it generally assumes 
a black polished surface, the smooth, fairly adherent tarnish being ap- 
parently insoluble. A diameter of between three- and four-hundredths 
of an inch (about 0.035 inch) is most suitable, as of this a convenient 
length of from one to two and one-half inches exerts an appropriate 
tension in average cases. The force, varying inversely as the length, may 
be thus determined within those limits, beyond which a different size 
is required. Figs. 244 and 245 will give a clear idea of this appliance. 
11 Great credit is due, for working out certain details of the expansion 
plates, to Peter Headridge, of Manchester, for many years assistant to 
my father. This gentleman even obtained a patent for some constructive 540 
ORTHODONTICS HISTORICAL REVIEW 
particulars, which, however, he very advisedly abandoned. The curious 
are referred to specification 1101, 1869. 
"Tn final justification, the advocates of a method they find to simplify, 
and trust may extend, the treatment of irregularities appeal to their 
record of results, which-of whatever real importance or value-would 
have been difficult or impossible to otherwise attain; and have ventured 
at such length to detail their procedure, for confirmation or criticism 
by others. 
"The paper was illustrated by more than five hundred odd, regulating 
plates, which had been actually used, about four hundred being 'expan- 
sion plates,' upper and lower, symmetrically and unsymmetrically di- 
vided, of which nearly two hundred were 'simple expanders,' some two 
hundred embodying other regulating devices with 'expansion'; the re- 
mainder showing the application of pianoforte wire in ordinary plates 
for general regulating purposes. 
"There were also specimens, with demonstrations, showing at different 
stages details of their mode of construction. 
"The models exhibited in the Museum of the Congress, at Burlington 
House, of forty typical cases (recording by three or more casts to each 
the condition before, during and after treatment) were classified as 
illustrating- 
"1. Expansion auxiliary to ordinary regulating. 
(a) Tn simple crowding. 
(b) For rotation and alignment. 
"2. General expansion. 
(a) For operative treatment of caries. 
(b) For misarticulation. 
(c) Versus extraction of misplaced teeth. 
(d) For prominent incisors. 
(e) For contracted, narrow, or misshaped arch. 
"3'. Applications of steel wire to every kind of ordinary regulating. 
(a) Alone, without plate or accessories, for alignment or rotation. 
(b) Combined with elastic ligatures. 
(c) With an ordinary plate for moving, shortening, lengthening 
and rotating teeth. 
"4. Combinations of the above." 
John Stockton Hough, in the New York Medical Record, 1873, on "The 
Laws of Transmission of Resemblance from Parents to Their Children," 
claims that "the question of resemblance of children to their parents is 
one which many ancient and a few modern authors have found a field 
for much close observation and profound philosophy, carrying their dis- 
cussions and deductions to all possible degrees of differentiation and NORMAN W. KINGSLEY 
541 
detail. Some of their reasons and conclusions as to causes are scarcely 
plausible, but many of them bear evidence of close observation and care- 
ful consideration, for modern research has in several instances discovered 
proximate causes which fully corroborate these ancient opinions. 
"It is the object, then, of this paper to bring before the reader such 
facts as are at hand to determine the general laws which are brought to 
issue in the following questions: 
"I. Do children derive their resemblance and inherit diseases more 
frequently or more easily from their mothers than from their fathers? 
"2. Are males more apt to inherit the diseases of their mothers, and 
females those of their fathers; or is the reverse the case? 
"3. What are the laws of physical and physiognomical inheritance? 
"4. Is there any constant relationship between the physiognomical 
resemblance of an individual to an ancestor, and the likelihood to the 
same constitutional affections, or the reverse? 
"The various aspects of resemblance by relationship are as follows: 
In General.-"1. Children resemble their mothers more than their 
fathers. 
"2. Males resemble their mothers, and females their fathers. 
"3. When children do not resemble their parents, but their grand- 
parents, males resemble their maternal grandfather, and females their 
paternal grandmother. 
Exceptionally.-"1. Children resemble their fathers more than their 
mothers. 
"2. Males resemble their fathers, and females their mothers. 
"3. Male resembles paternal grandparent, female maternal grand- 
parent. 
"4. Offspring resembles male by whom female was previously impreg- 
nated more than its natural father. 
"It seems therefore from all authorities cited to be pretty generally 
believed that mothers impress their children of both sexes with their 
physical and moral peculiarities, their constitutional tendencies and he- 
reditary diseases and defects; in short, a general resemblance more 
marked than that derived from their fathers; and it is not at all sur- 
prising that this should be so, for the child is for a considerable period, 
amounting to at least two years, under the exclusive control and influ- 
ence of the mother and her varying physical condition during this time. 
"In the first place, it may be well to inquire, when and where either 
parent begins to impress the product with a resemblance of themselves. 
For convenience we may divide the time and place of impression into 
four parts, viz.: 1. Impression on either element lief ore fecundation. 
2. Impression from the instant of fecundation until the product loaves 
the graafian follicle. 3. During gestation. 4. During lactation. At 542 
ORTHODONTICS HISTORICAL REVIEW 
each one of these periods the ovum or product of conception usually re- 
ceives impressions, but most in the second, or indeed principally there, 
as some authors have it, for they say that both resemblance and hered- 
itary disease are communicated during this period. Constitutional dis- 
eases and peculiarities are probably communicated during this time, 
though the period of gestation must be reckoned to have great influence 
on the tastes, inclinations, and qualities of the physical and mental 
faculties. 
"It is quite probable that the ova of the female have an initial exist- 
ence, as primordial cells or germs, at a very early period in the life of 
the child, and are in some degree capable of receiving and retaining 
impressions which may influence the products derived from them. 
"On the other hand, the spermatozoa are probably not in a condition 
(if indeed they have an existence) much before puberty to receive or 
retain the result of impressions made upon the man. So then, before 
impregnation, the female element has, in all probability, been subjected 
to the varying physical conditions of the woman for a much greater 
length of time than the male element has been to the varying physical 
states of the man; and the former is, moreover, much more susceptible 
to such impressions than the latter. Some may think that the ova are 
not susceptible of being influenced by such methods as I have suggested; 
to these T can only point to the great difference in appearance, consti- 
tution, viability, tastes, and inclinations of children by the same par- 
ents, while twins are proverbially alike in some one if not all these par- 
ticulars. 
"We conclude, therefore, that there are few, if any, physical, moral, 
or mental acts of a woman's life that are not without some influence, 
however inappreciable, on every child which she may subsequently bear. 
And every succeeding child is influenced by the impressions left on the 
maternal organism by each and every preceding child, though they may 
all have been of the same father, and this influence is increased with the 
number of fathers. This brings us to the subject of resemblance of a 
child by a second husband to the first, which is not within the limits of 
the subject under discussion. 
"After or at the time of impregnation, the father begins to exert a 
combined influence with the mother, though this influence is much less 
considerable than that of the female, for in addition to the influence ex- 
erted before impregnation, she has begun a new process, which only 
ceases at the completion of the term of gestation. During lactation the 
child is impressed in some degree, however slight, by the varying con- 
ditions of the mother. Through this source it may imbibe cachexias, 
diseases, tastes, and inclinations. Indeed some writers have made this 
an argument against the use of the milk of the lower animals, lest the NORMAN W. KINGSLEY 
543 
child should be brutalized by such food. Tupper contends that children 
are even educated in their mother's milk. 
" Every child a woman bears inoculates, so to speak, her constitution 
with some of the peculiarities of the father of the product; and, other 
things being equal, it is probable that the greater the number of chil- 
dren the greater will be the impression made upon her system by the 
husband, until she will finally come to resemble him in some degree at 
least. This influence is probably greater in the cases of gestations with 
daughters than with sons, for three reasons, viz.: 1. The father's influ- 
ence begins earlier in the case of female conceptions, as the ovum is 
fecundated at an earlier period of development. 2. Female fetuses sap 
the vitality of the mother more than males. 3. Daughters resemble the 
father more than sons. From these reasons, then, it is only fair to infer 
that a woman who had borne a certain number of daughters ought to 
resemble their father more than after bearing the same number of sons. 
The husband will therefore lose a part of his individuality, or rather his 
wife will have acquired a share of it. If this be true, the younger chil- 
dren ought to resemble the father more than the elder; and, if the moth- 
er's system can be inoculated with his defects and diseases, even though 
they be constitutional, as is certainly the case in syphilis, it is only fair 
to infer that the younger children would be more likely to inherit a 
predisposition to these affections than the elder and consequently have 
relatively a lower viability." 
During the convention of the Southern Dental Association, 1874, the 
question of "Irregularities of the Permanent Teeth," their causes and 
treatment was considered by a great many dental practitioners and the 
discussion will undoubtedly prove interesting in illustrating the general 
thought of the time. 
James S. Knapp (1823-1907), Pennsylvania Journal of Dental Science, 
vol. 1, 1874, page 449, in opening the discussion, said that the causes of 
irregularity have, to some extent, been touched upon in the discussion 
of the deciduous teeth. He thought that a premature extraction of the 
deciduous teeth led to a contraction of the jaw, and thus often produced 
very troublesome irregularities. 
"In correcting irregularities great care should be taken, and the pres- 
sure should be as direct and regular as possible. This will bring the 
teeth which are out of line gradually into place. When the incisors 
project so much over the teeth as to cause a deformity, it is much more 
difficult to draw them into a normal position, than it is to spread the 
arch if too much contracted. It is not only the difficulty of getting them 
in place that makes the operation so objectionable, but they must be 
held long enough to allow a deposit of bone to be made in order to make 
the operation successful. If plates are used, great care should be taken 544 
ORTHODONTICS HISTORICAL REVIEW 
that they fit accurately to the teeth, or the gum will become inflamed; 
if this should occur, nitrate of silver or iodine should be used as a rem- 
edy. If ligatures or rubber rings are used, they should be kept from 
slipping up onto necks of the teeth, thereby preventing inflammation, or 
a premature absorption or recession of the gum. By observing these 
principles some of the dangers attending this tedious operation will be 
avoided, and the results will be most satisfactory." 
J. R. Walker in the same journal said "he used rubber rings first to 
get them into line with each other, and then constructed a scaffolding 
on the boy's face in order to get a proper purchase to bring them into 
a natural position. This consists in placing a wooden appliance, care- 
fully fitted to the teeth, across them in front, the ends extending beyond 
the mouth on either side, and attached by elastic bands to a pad on 
the back of the neck. In this way he succeeded in righting this most 
disagreeable wrong in three months' time. He uses ligatures and rubber 
rings in regulating teeth, and when a plate is needed he uses aluminum 
in preference to any other material." 
William Henry Morgan (1818-1901) uses the jackscrew, and approves 
of it as an appliance for regulating teeth. Tie described a case in which 
he used jackscrews imbedded in a rubber plate, the heads so arranged 
as to bear against the teeth to be moved, and then by a turn or two 
every day spread the arch successfully. 
"S. Welchens desired to speak more particularly upon the subject of 
what is termed heroic treatment of irregularities. Believes in moving 
teeth as rapidly as possible, and in such treatment is not at all solicitous 
as to the age of the party operated upon. Care should be taken, of course, 
not to produce undue inflammation in patients a little advanced in life. 
Heroic treatment is safer and less liable to bad results in the case of 
young and healthy persons, when the vigor of youth will effect a speedy 
and successful recuperation. In every case care should go hand in hand 
with intelligence and good judgment." 
John Nutting Farrar. Through an error the chapter on Farrar, which 
should appear here, was omitted. It has been inserted under Chapter 
XXX, p. 863. CHAPTER XXIV 
SIMEON II. GUILFORD TO JULIUS PARREIDT 
Simeon H. Guilford, A.M., Ph.D., D.D.S. (1841-1919), in the Pennsyl- 
vania Journal of Dental Science, 1874, in an essay on ''Irregularities of 
the Teeth, and Their Treatment," said, "The causes tending to produce, 
and the means applied to prevent and correct irregularities of the teeth, 
have received some attention from us as a, profession, but they have not, 
I believe, received nearly the same attention which their importance 
demands. 
"While we trace the filling of teeth and the wearing of artificial sub- 
stitutes back a couple of centuries, we have nothing to lead us to believe 
that great irregularity was known very long ago, and hence no cause 
excited for its correction. 
"The primitive mode of life had much to do with this; but modern 
civilization, or civilization as it has existed within the past fifty years, 
and more particularly within the last twenty, has made sad havoc, not 
only with the tissues of the teeth, but with the time and manner of their 
eruption and their respective positions in the dental arches. 
"Our present manner of living, which induces, indeed almost compels, 
us to avoid eating those portions of food which were designed by an 
all-wise and beneficent Creator for building up and sustaining the frame- 
work of our bodies, and further keeps us from giving the dental organs 
the poor amount of activity and work to insure their strength and health- 
fulness, is the primary cause of irregularity among them. 
"Were there a sufficient proportion of lime salts in the alveolus and 
tooth substance, placed there in the economy of nature by the eating 
of proper food, this same food giving health and tonicity to the blood, 
strength to the nervous system and density to the muscles and soft 
tissues, and did we at the same time give our teeth enough hard work 
to do, it is safe to say that in the second succeeding generation irregu- 
larity would be unknown and decay almost so. 
"We as a profession, like the medical faculty, are gradually working 
up to that higher standard, which has for its object the prevention, 
rather than the cure, of disease. Let us press faithfully on toward this 
mark, and while we go let us endeavor by our best efforts of mind and 
body to relieve and remedy defects as they now exist. 
"Among the things that are most usually regarded as the causes of 
irregularity, and so laid down in the textbooks, are the too early extrac- 
545 546 
ORTHODONTICS HISTORICAL REVIEW 
tion, or long retention of the temporary teeth; disease of these teeth, 
resulting in abscess and disintegration of the alveolus, and blows or ac- 
cidents, either to the temporary teeth or to the permanent ones in the 
course of their eruption. 
"Among those cases to be begun before all the temporary teeth have 
been shed, may be mentioned: the protrusion of the lower jaw, to be 
corrected as soon as possible by bandages; and the throwing out or in 
of a permanent tooth that has by some means been moved out of position 
and shuts respectively outside or inside the opposing arch. 
"Among those, however, most usually met with, are protrusion of the 
lower jaw, thus allowing the lower teeth to bite outside the upper ones; 
a narrow and contracted superior arch, very much resembling a "V" 
with the angle of the letter resting between the central incisors; the 
superior incisors falling inside the lower arch, and the cuspids in con- 
sequence protruding from the alveolus outside of their proper arch, prob- 
ably resting upon the laterals and first bicuspids, giving an undue promi- 
nence to that portion of the upper lip just over them, and producing a 
general disfigurement in the person's appearance. 
"Unless all these conditions are met in the beginning, it will be use- 
less for the operator to waste his time and the patient his money in mak- 
ing any attempt at improvement. The means employed from time to 
time for the correction of irregularities have been varied and numerous, 
the prime factors in such cases, as in physics generally, being the in- 
clined plane, the wedge and the screw. 
"The inclined plane for moving the upper incisors from within out- 
ward, was probably used at a very early period, and continues today 
to be one of the best means employed for that purpose. The wedge, or 
principle of it, was used in spreading the teeth apart, thus widening the 
arch, or in producing space generally between two points. The screw 
was used for the same purpose, where greater power was needed, or 
where it could be more advantageously brought into play. 
"The three motions to be produced in treating all such cases are ex- 
pansion, contraction and rotation, or, if you please, tension, traction and 
torsion. Produce any or all of these motions as the case may require, 
and you have all that you will require to correct the worst case of ir- 
regularity that may present itself. 
"What then, let us inquire, are the best means of producing these 
various motions, so that we may apply them to particular cases? 
"Tension, or expansion, of the dental arch, or of several teeth on 
either side, was formerly, before the general use of rubber, produced 
either by a metal plate extending across the mouth, with slots filled with 
fusible metal opposite the teeth to be moved or instead of the fusible SIMEON II. GUILFORD 
547 
metal having pieces of wood which, when moist, would swell and expand, 
or it was produced by clasping the teeth to be operated upon and press- 
ing them apart by means of a jackscrew extending across the arch of 
the mouth. 
Since, however, soft and hard rubber have come into general use, they 
have very much superseded metal for this purpose. 
"To produce this expansion of the arch easily, rapidly and with com- 
fort to the patient, it is only necessary to prepare a hard rubber plate 
closely fitting and covering the hard palate and lingual surfaces of the 
teeth to be moved, and inserting wooden pegs in holes drilled for the 
purpose in the plate just opposite the teeth. These pegs placed in the 
mouth dry and tightly fitting, will when wet expand and press the teeth; 
not only that, but you gain the benefit of the elasticity of the rubber plate. 
The advantages of such an appliance are, that it is very little in the way 
of the tongue; has nothing hard in its composition to injure the teeth; 
is easily removed by the patient for cleaning; does not show from the 
outside, and is thoroughly effective. I have been extremely successful in 
the use of these plates for the past eight years. 
"Torsion, or rotation, frequently necessary, is perhaps one of the most 
difficult duties in correcting irregularity. The superior incisors very 
frequently require it, sometimes the canines and bicuspids, and not in- 
frequently the lower incisors call for its performance. This may be 
done in several ways. 
"One way is to tie a loop with silk or strong gdling twine around the 
tooth, over the opposite angle, attaching a rubber ring to it and fastening 
it at some point far enough away to produce very strong traction. This 
has a tendency to rotate the tooth. 
"Another way, which was first used by Dr. Magill, of Erie, Pa., con- 
sists in fitting to the tooth a metallic band or ring and to the outside 
of this soldering a bar of platina-gold in such a way that when in posi- 
tion this bar will be at an angle of about forty-five degrees to the teeth 
on the side to which it is to be attached. 
"When made, the band is fitted to the twisted tooth with ox. chi. zinc 
and the bar sprung down and tied to the/ second or third tooth from it. 
"Here the elasticity of the gold bar will usually very quickly pro- 
duce the desired result. 
"It is an old saying that 'an ounce of prevention is worth a pound of 
cure,' and on this principle, I feel convinced, from many years' experi- 
ence and observation, that if we can in any way prevent or arrest the 
course of irregularity in teeth, it should be done. That this may be 
done in very many cases by the judicious extraction of the first per- 
manent molars, I most firmly believe." 
In the first edition of the American System of Dentistry published in 548 
ORTHODONTICS HISTORICAL REVIEW 
1887, Guilford prepared the chapter on "Orthodontia," pages 305-358. 
This article treated the subject more comprehensively than had yet been 
done by any author in this country, excepting Kingsley and Farrar's, 
whose work appeared the preceding year. Full descriptions were given 
of the various systems of correcting irregularities of the teeth, which had 
been brought to the attention of the profession by various men as well 
as some appliance original with Guilford, the article being illustrated 
with fifty-eight cuts and described in detail. "It also contained a for- 
mulated set of rules governing the application of force, and another set 
Fig'. 216.-Simeon Hayden Guilford (1841-1919) 
by which to determine whether or not extraction should be resorted to 
in cases presented for treatment." 
Guilford's first edition of "Orthodontia'' was published in 3889, at the 
request of the National Association of Dental Faculties, to be used as 
a textbook in the schools of the Association. It was written for the 
student and not the practitioner, and with that in view the matter was 
arranged in progressive form, leading from the simplest beginnings up 
to the practical treatment of the most difficult cases. This was the first 
textbook for students upon the subject of "Orthodontia" published. Suc- 
cessive editions followed in 1893, 1898, 1905. Also transcribed in French 
and Spanish. SIMEON II. GUILFORD 
549 
In the above chapter relating to orthodontia, Guilford states: "The 
teeth of man when in their normal position are arrayed in symmetrical 
order, side by side, their outline as a whole describing very nearly a 
parabola or semiellipse, their variation from these geometrical figures 
consisting principally in a slight flattening in the region of the incisor 
teeth, and a tendency to angularity in the region of the cuspids, owing 
to the marked prominence of these teeth. 
"While this arrangement is generally regarded as normal and most 
in harmony with agreeable expression, it is nevertheless slightly variable 
in regard to the various national types, some having the outlines of the 
curve more flattened and angular, while others approach more nearly to 
the true parabolic curve. 
"Whatever the national type, however, in respect to outline, the teeth, 
to be normally situated, must occupy their respective and regular posi- 
tion of this line. Any deviation from this constitutes what is known in 
dental science as an irregularity. 
"Dental irregularities are usually of two general kinds: one, where 
certain individual teeth (one or many) stand out of line or are improp- 
erly placed in line, but where those still in place describe the normal 
outline of the particular jaw; the ■ other, where the teeth all stand in 
line, but where their outline is so changed from a normal standard as 
to constitute a deformity or malformation. Either of these or a com- 
bination of the two is what generally calls for the interference of the 
dental practitioner. 
"Irregularities, as to their origin, may be either hereditary or ac- 
quired, the one resulting from causes operating before the birth of the 
individual or the eruption of the teeth, and the other from circumstances 
attending their eruption or subsequent to it. * * * 
"Whether the deviations from a normal standard, both in regard to 
the shape of the arch and the arrangement of the teeth in line, are 
more frequent now than formerly is an unsettled question in the minds 
of many; but certain it is that the subject of the correction of such 
deformities is steadily growing in importance and attracting an amount 
of attention that was formerly unknown. In the early days of the dental 
profession but little attention was given to this subject, both from its 
then seeming unimportance and from the great difficulties that attended 
its accomplishment, owing to the crude character and limited number 
of appliances then at command for dealing with it. 
"Today, however, with the better knowledge of the character of the 
lesion and the multiplication and perfection of appliances, added to a 
greater facility of adapting the means to the end, the correction of ir- 
regularities has been greatly simplified, and with the means now at our 
command we are not only able to bring about almost any desired change 550 
ORTHODONTICS HISTORICAL REVIEW 
in the dental organism, but also to prognosticate our success with com- 
parative certainty. 
"Closely related, however, to the possibility of accomplishment is the 
advisability of it under certain circumstances; and in the determining 
of this, our action will necessarily have to be governed by certain at- 
tending conditions. 
"Prominent among these are the age, sex, condition of life, health, 
family type, etc., of the patient. What may be the proper course to 
pursue under certain circumstances might be the improper one under 
other circumstances, and what may be advisable or expedient in one 
case might be totally inexpedient in another. 
"Thus, in considering the question of the age at which the correction 
of an irregularity should be undertaken, we have to be governed largely 
by the character of the operation required. An operation might be 
undertaken very early in life of so extensive a character as to very 
severely tax the vital powers at a time when there is no life-force to 
spare, and where the results, if attained, would be hard if not impossible 
to retain. The same operation, delayed until a later period, when health 
and strength are better established, might not only be more easily ac- 
complished, but attained with better results. 
"So, too, an operation delayed too long may become associated with 
complications and difficulties that would have been avoided had it been 
undertaken earlier, when the treatment, in the nature of the case, would 
have had the element of prevention linked with it. 
"The correction of irregularity can usually be begun and accomplished 
at any time between the eruption of the teeth and late in life, but the 
judgment of the operator will have to be exercised to determine at just 
what period of life it would be best to undertake it. 
"Should the surrounding conditions favor it, the earlier the correc- 
tion is taken, the better it will be in most cases. The bony tissues of the 
socket are then in their most pliable condition, making the labor easier 
and the time shorter; and the foramina for the entrance of the nutrient 
vessels being then quite large, there will be less liability to trouble from 
strangulation of the pulp and its consequent devitalization. The old rule 
that once prevailed of not beginning to correct an irregularity until all 
the permanent teeth were in place, for fear that the later arrivals by 
their crowding or pressure would disarrange those that had been brought 
into place, is now, we think, generally considered obsolete. True, such 
things may happen and have happened, but it is equally true that such 
a result may easily.be prevented by the exercise of judicious care and 
watchfulness. 
"Many years of attention to this subject, aided by a large experience, 
have firmly convinced the writer that wisdom and prudence alike dictate SIMEON II. GUILFORD 
551 
early interference in cases of irregularity. By this we would not be 
understood to mean meddlesome interference, for certainly such a thing 
is possible. 
"There is a law of Nature tending strongly to harmony, and when 
accident or unusual circumstances bring about an irregularity in the 
dental arch, Nature will do all in her power to combat the opposing in- 
fluences and bring about harmony. To enable her to do this it is neces- 
sary that she have time to accomplish it, and occasionally a little assist- 
ance from the dentist. Judicious interference is right and proper, but 
meddlesome interference will often only accomplish that which a little 
later Nature would have accomplished unaided. 
"For instance, during the eruption of the permanent incisors, both 
superior and inferior (especially the latter), there often appears a slight 
irregularity. In most cases Nature by her strong inherent powers will 
correct this condition if time be allowed her; and it is certainly better 
in every respect, to allow her to do so than for us to unwisely interfere 
in the matter. 
"So, too, a tooth is very often forced out of position or kept out by 
another tooth of less importance partly occupying its place. Nature 
alone cannot correct this condition of affairs, but if we aid her by re- 
moving the obstructing tooth she will in most cases, unaided (if the 
patient be young), bring the malposed tooth into line. * * * 
"The surgery of the mouth, in the very nature of the case, is associated 
with many difficulties not met with in operation upon other portions of 
the human frame. Could we, like the general surgeon, perform our work 
heroically and at once by laying open the part, removing such tissue 
as we wish displaced, move the organs into the desired positions, fasten 
them there and bind up the part to give it rest and await the favorable 
action of Nature's recuperation, and labor would be greatly lessened. 
Such favorable conditions, however, are not vouchsafed us. 
"Operations for the correction of irregularity must be slow and grad- 
ual in their character: instead of removing tissue that stands in our 
way, we must depend upon Nature to remove it by her slow method of 
absorption under the stimulus of pressure; the individual organs whose 
position we desire to alter are deeply and solidly implanted in a strong 
bony structure, and, aside from the mechanical difficulty of moving 
them, we must exercise the greatest care, for they are tender organs, 
and sudden violence offered them may easily result in their devitaliza- 
tion and possible loss; the pressure exerted to bring about the change 
we desire must be positive in its character, and continuous as well, and 
the appliance employed must not only be strong, but neat in character 
and occupy little space, so as not to interfere with neighboring organs. 
More than this, they must meet the hygienic conditions of the cavity in 552 
ORTHODONTICS TIISTORICAL REVIEW 
which they arc placed by being made of such substances as shall not 
exert a deleterious influence upon the oral fluids and the stomach, nor 
yet rest unduly upon or irritate the soft tissues surrounding them, and 
thus bring on a morbid condition. * * *" 
Guilford's formulated rules governing the application of force were 
described as the following: 
"In bringing malposed teeth into their proper places, certain move- 
ments must take place and proper forces be applied to bring about these 
movements. The movements generally required are either outward, in- 
ward, forward, backward, rotary, or general expansion, sometimes a 
combination of two or more of them being required. To cause these 
movements we must bring to bear forces sufficient to accomplish them; 
and this we do through the medium of such mechanical appliances as 
seem best to serve our purposes: 
Fig. 247.-Spring bar and band for rota- 
tion (Guilford.) 
Fig. 248.-Increased anchorage 
(Guilford). 
"According to well-known physical laws, the greatest good can be ob- 
tained from any force only when it is exerted in a direct line with the 
movement desired. * * * 
"The force applied must be sufficient, but it should not be more than 
sufficient nor too abruptly applied. * * * 
"The point of resistance and the point of delivery of the force must be 
fixed points. * * * 
"The resistance at the point from which we exert pressure must be 
greater than the resistance to be overcome by the pressure. * * * 
"Before applying force it should be seen to that there is space suffi- 
cient to accommodate the tooth in the new position it is to occupy. * * * 
"Pressure may be either constant or interrupted. * * * 
"Pressure should be exerted as nearly as possible in a line at right 
angles to the long axis of the tooth." 
Guilford then described in detail the different methods in use up to 
that lime, as well as the eruption and time of eruption of the teeth and SIMEON H. GUILFORD 
553 
laid down the following rules governing extraction as it pertains to the 
permanent teeth and the treatment of irregularity: 
"Always avoid if possible, extracting any of the six anterior teeth in 
the superior arch. * * * 
"In the lower jaw any of the incisors may without harm be extracted 
to gain space. * * * 
"Back of the anterior teeth, if all are equally good and one must be 
removed, select the one nearest the posterior to the one out of position. 
"If a tooth other than the nearest to that in malposition be defective, 
and not too far distant from point of irregularity, extract it instead. 
'A' "Ji? 
"If a tooth must be lost, either to allow a more important one to fall 
into line or to create space, it should be done withozit delay to accomplish 
the best results. * * * 
"If a tooth must be removed on one side to obtain space, it does not 
necessarily follow that its opposite mate should also be extracted. * * * 
"Where there is disparity in size between the two jaws, and, two teeth 
need to be extracted from the more prominent one, it would be a serious 
mistake to extract also the corresponding teeth in the other and smaller 
jaw. * * * 
"If appearances indicate that certain teeth may have to be removed at 
some time before the case is complete, though not in the beginning, per- 
form all the work possible first, and then extract if necessary. * * * 
"Needless extraction should be carefully guarded against. * * * 
"If a crowded arch calls for or will admit of expansion to advantage, 
do this in preference to extracting." 
The contents of Guilford's first edition of "Orthodontia or Malposition 
of the Human Teeth," is divided into three parts. Part I, Principles 
Involved; Part II, Material and Method; Part III, Specific Forms of Ir- 
regularities and their Treatment. The greater part of the work treats 
of the methods of his predecessors. Under Part III, page 107, he states: 
"Specific Forms of Irregularity and Their Treatment." 
"While principles and methods may be well understood, illustrations 
of their application in certain forms of irregularity will be necessary in 
order that the student may properly comprehend their practical rela- 
tionship. 
"So far as ease or difficulty of treatment is concerned, cases of ir- 
regularity are naturally divided into two general classes; in one the 
cases are brought to our notice as soon as the irregularity begins to 
manifest itself, while in the other the deformity is fully established and 
confirmed before the presentation for treatment. In the first class, oc- 
curring usually in children, we have the advantages of easy movement 554 
ORTH ODONTICS HISTORICAL REVIEW 
and freedom from complications; while in the second, we have to con- 
tend with slow and difficult movement and a variety of unfavoring 
conditions. 
"For these reasons it is deemed advisable to treat of certain forms of 
irregularity, especially those involving the six anterior teeth of each 
jaw, under separate heads, according as they present before or after 
dentition is complete, for the treatment in one case will vary consider- 
ably from that required in the other. * * *" 
We do not find, however, a classification, although in this part he has 
divided the subject into ten chapters as follows: 
"1. Incisor Teeth Erupting Outside or Inside of the Arch. 
"2. Delayed or Mal-Eruption of the Permanent Cuspids. 
Fig-. 249.-Occipito-Maxillary appliances of Guilford. 
"3. Incisor Teeth Situated Outside or Inside the Arch After 
Dentition Is Complete. 
"4. Cuspid Teeth Situated Outside or Inside the Arch. 
"5. Misplaced Bicuspids. 
"6. Torsion. 
"7. Contraction of the Arch. 
"8. Protrusion of the Upper Jaw. 
"9. Protrusion of the Lower Jaw or Prognathism. 
"10. Miscellaneous. 
Lack of Anterior Occlusion. 
Reduction of Elongation of the Anterior Teeth. 
Assisted Eruption of the Anterior Teeth Tooth Shaping." 
Not until the fourth edition in 1905 do we find any definite mention 
of a classification. Under Part UI, Page 139: SIMEON II. GUILFORD 
555 
"Classification of Irregularities and Practical Treatment." 
"In the classification of irregularities it has seemed best not to base 
the varieties upon simple occlusion of the teeth but to arrange them 
into groups or classes, each class having certain distinctive characteris- 
tics; in any case it may easily be referred to its proper class, where all 
matters relating to its treatment will be found. 
"Occlusion has much to do with both the causes for and the proper 
treatment of irregularities, but to base a system of classification entirely 
upon it would be at variance with the custom prevailing in other depart- 
ments of natural science where marked physical characteristics, their 
correspondence or their variation are made the basis for arrangement 
into separate order of classes. 
Fig. 250.-Guilford's combination for retrusion. 
"There are two natural general divisions which include all forms of 
irregularity commonly met with. 
"The first of these is 'Simple Irregularities,' including all those lesser 
malpositions in which few teeth are involved and where such malposition 
bears no important relation to facial harmony. 
"The second division is 'Complex Irregularities,' which must include 
all cases where there is extensive malposition of the teeth or jaws and 
corresponding dentofacial deformity." 
Division I. 
Simple Irregularities 
Class 1. Labial and Lingual Malposition 
Class 2. Mesial and Distal Malposition 
Class 3. Extrusion and Intrusion 
Class 4. Torsion 556 
ORTHODONTICS HISTORICAL REVIEW 
Division II. 
Complex Irregularities 
Class 1. Malposition of Anterior Teeth 
A. Normal Buccal Occlusion 
j Unilateral 
B. Abnormal Buccal Occlusion 7 
I Bilateral 
Class 2. Upper Protrusion 
A. Lower Normal 
B. Lower Retiuded 
Class 3. Lower Protrusion 
A. Upper Normal 
B. Upper Retruded. 
Class 4. Upper Retrusion-Lower Normal 
Class 5. Lower Retrusion-Upper Normal 
Class 6. Bimaxillary Protrusion. 
Class 7. Nonocclusion. 
The following is a list of Guilford's most important articles: 
"Orthodontia Technology," Items of Interest, 1904, p. 501. 
"When Is Radical Treatment-Orthodontia, Justifiable?" Items of In- 
terest, August, 1905. 
"Extraction--When Justifiable in Connection with Orthodontia Opera- 
tions," Dental Cosmos, September, 1905. 
"Nomenclature in Orthodontia," Dental Cosmos, February, 1906. 
"Methods of Teaching Orthodontics to Dental Students," Dental 
Cosmos, March, 1916. 
George T. Barker (1836-1878) before the same society discussing Guil- 
ford's paper stated: 
"He was glad to find his views, as expressed two years ago, at Gettys- 
burg, on the extraction of the six-year molar, so well sustained here. 
He hold that the structure of the human body is becoming rudimentary, 
and that as a rule the jaws are becoming more contracted, so that there 
is not room enough for thirty-two well-developed teeth. We should 
preserve the symmetry of the features and try to develop a good regu- 
lar denture. This could be done only by extracting the six-year molar 
when the patient is yet young. In correcting irregularities he always 
secures the cooperation of the parents as well as the child, and is care- 
ful to let them know the probable cost of the operation, as well as the 
inconvenience and pain it may produce. He uses rubber rings and liga- 
tures mainly, in his treatment of irregularities, and thus obviates the use 
of plates. In extracting for such correction he prefers the removal of 
the six-year molar." 
Before the Association of the Pennsylvania College of Dental Surgery, 
Dental Cosmos, page 239, 1874, in a lengthy oral address upon "The Old 
and Nexv Methods of Correcting Irregularities," Barker stated "that the SIMEON H. GUILFORD 
557 
old methods were intricate, the appliances worn with great discomfort, 
and that attempts to regulate were something that every operator avoided 
if possible, because attended with a great amount of labor, the compen- 
sation being slight. He deprecated the use of plates and the inclined 
plane, claiming that by such practice the proper articulation was likely 
to be destroyed. In all cases before commencing the operation, it is 
necessary to have the patients not only willing, but anxious that it be 
done, for then they do not object to the discomfort necessarily attendant. 
Whenever a tooth is moved there must be absorption and correspond- 
ing deposition of new tissue, and this is best brought about by having 
the will of the patient enlisted, such state being conducive to nutrition. 
He regulates by elastic ligatures entirely, and expects success in three 
or four weeks. Most operators have difficulty in preventing ligatures 
from slipping up at the neck of the tooth and causing irritation. This 
difficulty he obviates by passing a gilling-twine ligature posteriorly above 
the basilar portion of the tooth, bringing it anteriorly to about the middle 
of the labial surface; here it is tied in a surgeon's knot (by passing the 
end of the string through twice) ; it is then carried posteriorly to a 
Fig. 251.-Hawes' method of rotating' incisors. 
point midway between the basilar ridge and cutting edge, the ligature 
being brought over the anterior face, when it is tied with the knot first 
made. This is, to al] intents and purposes, two ligatures joined at about 
the center of the labial surface, and, as each holds the other in position, 
there is no possibility of either of them slipping. If it is desired to 
rotate a tooth, the knot may be placed on one side or the other as may 
be necessary to apply the force in the proper direction to produce the 
desired result. The elastic band is attached to this double knot and 
passed anteriorly to those teeth that are outside, and posteriorly to those 
that are inside the arch. He attaches the band to two or three other 
teeth, that their resistance may be greater than the force required to 
move those teeth which it is desired to regulate. A number of models 
of eases that were successfully treated by him in this way were shown, 
and the modus operandi explained at length." 
Arnold C. Hawes (1813-1895), before the First District Dental Society, 
New York, 1874, {Dented Cosmos, page 426) described a simple appli- 
ance he had devised for bringing central incisors into line when rotation 
is required. "From the diagram the principle will be easily understood. 
(Fig. 251.) (a) The centrals to be rotated. (5) The bolt passing be- 558 
ORTHODONTICS HISTORICAL REVIEW 
tween the teeth, its head resting against the labial surfaces, and the 
shaft made to screw into the short bar. (c) With this simple appliance 
he had succeeded admirably, without encumbering the mouth with a 
large and troublesome apparatus." 
J. R. Walker in the same journal, page 490, "spoke of a case where 
the teeth in the lower jaw had fallen back by reason of the loss of the 
six-year molars, so that the upper projected half an inch, while the teeth 
were so short that it was impossible to get a hold on them. He had used 
an appliance consisting of a stick across the front teeth, the ends of 
which were attached to elastics which went behind the neck, and suc- 
ceeded in drawing the teeth back in three months." 
Alexander Ogston (1844- ) in the Glasgow Medical Journal, 1874, 
considered a subject which at that time attracted but little attention but 
today may be considered of the greatest importance: "On Congenital 
Malformations of the Lower Jaw." 
"The difficulties inherent in the subject arc twofold. Tn the first place, 
cases of these malformations are very rare, forming a marked contrast 
in this respect to those of the upper jaw, so fully studied and so usual 
in the experience of every surgeon; and, in the second place, the cases 
which have been put on record by no means harmonize, at first sight, 
among themselves, and have even been deemed capable of very different 
explanations. 
"The immunity of the lower jaw from deformity, already alluded to, 
seems to be as marked a feature in its later as in its earlier stages of 
development. It is found that irregular position of the teeth (a mere 
mechanical accident), and the formation of tumors, are equally common 
in both jaws; but what may be called vital processes, such as the mal- 
formations of congenital syphilis, and the deformities specially connected 
with mental development, are most marked and most frequent in the 
upper jaw. 
"The congenital malformations, which are alone treated of here, exist 
in various forms and degrees." 
Ogston divided the subject as follows: 
"Nondevelopment of the inferior maxilla. 
"Excessive development of the lower jaw. 
"A. Congenital smallness of both halves. 
"B. Congenital unilateral smallness of the lower jaw. 
"Congenital dislocation of the lower jaw. 
"The cases adduced above, which are all, or almost all, that have been 
recorded, are too few in number to enable any very valid deductions to 
be drawn. So far as may be judged from them, however, congenital 
smallness of the lower jaw does exist, though rarely, and is usually con- 
joined with symmetrical deformities elsewhere, such as cleft-palate, etc. SIMEON H. GUILFORD 
559 
In some cases the jaw so affected carries a diminished number of teeth, 
in others this is not the case, and at all events the absence of some of 
the teeth is more probably a consequence of the cause which has produced 
the smallness of the jaw, than itself capable of explaining the origin of 
the smallness. It seems further justifiable to conclude that, where the 
subjects of this deformity survive to adult life, they are not unlikely to 
become affected by such superadded deformity. 
11 Having now given as complete a resume as lies in my power of the 
various congenital malformations to which the lower jaw is subject, and 
interpolated, where it seemed necessary, explanations sufficient, I hope, 
to have rendered clear the views of these which we seem justified in 
adopting, it only remains for me to embody in a series of propositions 
the conclusions we seem warranted in drawing from our present knowl- 
edge of these deformities. These are as follows: 
^1. Congenital deformities of the lower jaw are very rare. 
"2. Nondevelopment of the lower jaw has been recorded in animals, 
but never in man. 
"3. Excessive development of the lower jaw appears to occur, though 
very rarely, and minutely recorded cases of it do not exist. 
"4. Preponderance of size of the lower jaw has been observed as the 
result of deficient development of some of the other facial bones. 
"5. Congenital smallness of the whole lower jaw occurs, and is gener- 
ally associated with symmetrical deformities elsewhere. 
"6. Congenital smallness of the whole lower jaw may lead in after- 
life to acquired deformities of the bones of the cranium and face. 
"7. Congenital smallness of the lower jaw has been found in one case 
with, and in two without, formation of the temporomaxillary articulation 
of the same side, and coincided in all asymmetry of the cranium. 
"8. Congenital dislocation of the lower jaw is said to have been met 
with in a single imperfectly recorded case." 
S. Janies A. Salter (1825-1897) in his book Dental Pathology and Sur- 
gery, 1874, devotes considerable space to "Irregularities in the Position 
of the Teeth, Causes," etc., and from it we gain a great deal of knowl- 
edge as to the treatment and theory of this branch of dental science, 
during this interesting period of orthodontic growth. This work gives 
us the best analysis of this subject, in England, during the seventies, and 
demands careful examination and study. 
"Irregularities of the teeth, as regards their relation to each other 
and to the laws containing them, constitute some of the most important 
considerations in the practical treatment of the teeth, and they are not 
without interest theoretically. 
"Irregularities of the temporary teeth are uncommon, and are not of 
much importance. The incisors sometimes have a distorted position, but 560 
ORTHODONTICS HISTORICAL REVIEW 
the commonest form of irregularity in the teeth of the first set is that 
which is relative in the two jaws. It is not very rare in families where 
there is a strong tendency to what is known as an 'underhung bite,' 
for the temporary incisors, or even the canines of the lower jaw, to 
project beyond those of the upper. And though this may not be attended 
by any irregularity of the relative position of the teeth in either jaw, it 
still constitutes a serious irregularity of the teeth as taken collectively. 
"These irregularities of the temporary teeth may not require imme- 
diate interference, but they indicate the propriety of most careful superin- 
tendence during the advent and progress of succession. 
"Irregularity of the teeth appears to be one of those conditions in- 
duced by artificial life, and progressing in degree during the lapse of 
time in successive generations. It is almost unknown among the lower 
animals in a wild state; but it has been induced in some through domes- 
tication. 
"This subject may be treated with almost endless extension, and with 
profuse illustration, as the conditions of irregularity are almost without 
limit in their variety, and may be complicated in cause. 
"I propose to consider them here briefly and practically, and prin- 
cipally by illustrative cases that have occurred in my own practice. 
"The causes of irregularities may be (1) congenital and hereditary, 
(2) the prolonged retention of temporary, (3) accidental mechanical in- 
fluences, (4) disproportion of the size of the teeth and jaws, (5) faulty 
development of the jawbones. 
"There are few conditions in which hereditary influences are more 
manifest than in the irregularities which occur in the teeth; and these 
show themselves often in minute particulars, and are displaced with 
distinctness by collateral relations. The prolonged retention of tem- 
porary teeth is frequently associated with irregularity in their succes- 
sors of their permanent neighbors, and is probably often the cause of 
such irregularity; though perhaps the imperfect or tardy growth of the 
permanents may be at least partially the reason why temporary teeth 
are so retained. Accidental mechanical influences, such as thumb-sucking 
or hypertrophy of the tongue, will cause certain irregularities. But by far 
the most common cause of irregularities in the teeth is their being dispro- 
portionately large in comparison with the jaws. This is a condition 
which has been progressing in development for a long period of time and 
very many generations, and appears in some way dependent on civilized 
life. The disparity is such as to lead to the crowding of the teeth so 
constantly seen, and which is sometimes so excessive as to altogether 
exclude some member of the dental series from eruption, and hold it 
permanently impacted in the substance of the jaw. 
"This condition is not infrequently induced by the premature extrac- SIMEON II. GUILFORD 
561 
lion of the temporary teeth, which permits contiguous permanent neigh- 
bors to approximate each other to the displacement or partial exclusion 
of the successor of the extracted tooth. 
"Malformation of the jaws is much less common, and is only certainly 
displayed in some peculiar irregularities, as in the V-shaped jaw. 
"In considering irregularities of the teeth in regard to their treat- 
ment, this may be divided with much practical advantage into (1) 
simple (2) compound or contingent. 
"Simple irregularities are those in which the misplacement is absolute 
as regards the jaw affected, and independent of the position of the teeth 
in the opposite jaw. They may affect both jaws in the same individual, 
but they are uninfluenced by each other. 
"Compound irregularities are contingent on the position of the teeth 
of the opposite jaw, as to cause or maintenance, and arc dependent on 
the 'bite.' 
"The importance of these distinctions will be manifest in considering 
the treatment of these cases. In curing irregularities it will be neces- 
sary to remove all obstructions which prevent the teeth from assuming 
a regular arrangement; and it may be necessary to apply mechanical 
elastic force to complete that result. Both these elements of treatment 
may be requisite in a single case. Again, there is a peculiar method of 
applying mechanism where no force is involved, namely, in those cases 
in which the irregularity is contingent on the bite, and where the closure 
of the mouth causes its maintenance. In such cases the jaws must be 
kept apart during treatment, and this is accomplished by the passive 
mechanism of gagging. 
"Very much depends on the age of the patient when the irregularity 
comes under treatment. For instance, where it is brought about by 
crowding, the mere removal of some tooth or teeth in a young patient 
may allow the remainder to assume the natural arch, and this they will 
generally do without assistance; whereas the same condition in an older 
patient will require mechanical pressure to place the teeth in proper 
range, and it may be necessary to maintain them in this position by 
similar means for a considerable period, as when once firmly established 
they have a tendency to return to their original relations." 
The question of extracting teeth to correct irregularities seems to have 
been a very potent problem even at this period and Salter's views will 
give us some idea as to the controversy existing even then. 
"It has appeared to me that this subject may be conveniently treated 
by the consideration of typical examples of irregularity where the upper 
canine tooth, from insufficient room, makes its appearance high up, and 
in front of the range of contiguous teeth. I refer to this form of ir- 
regularity, first, not only from its frequency, but because its considera- 562 
ORTTIODONTIOS HISTORI CAL REVIEW 
tion involves many general questions of importance bearing on the whole 
subject. It may arise from the premature removal of the temporary 
canine tooth, thus allowing the bicuspid and lateral incisor to approach 
close to each other. 
' ' This condition usually manifests itself between ten and thirteen years 
of age, and, if uncomplicated, it is readily cured by the extraction of a 
tooth behind the coming canine; and in the simplest cases the removal 
of the first bicuspid, effects the remedy at once. Circumstances, however, 
may suggest the desirability of sacrificing another tooth, the second 
bicuspid, or even the first molar; and this point requires careful con- 
sideration. And it should further be remembered that much may be 
done by nature, through the expansion of the jaw itself; and this is 
especially the case where the permanent teeth make their appearance 
very early, and at a time when the jaw, from the age of the patient, 
may be supposed to be too soon invaded by its large and many occupants. 
I have sometimes known bicuspid teeth removed to make room in young 
patients with much crowding, when afterwards it has been apparent that 
such a proceeding was unnecessary,-the jaw growing to such an extent 
that considerable spaces were developed between the remaining teeth- 
spaces which in the aggregate would have accommodated the teeth that 
had been extracted. It is a question, therefore, with young patients to 
consider how much may be done by Nature in time, before a sacrifice is 
entailed which cannot afterwards be remedied. 
"In estimating which of the three teeth (first or second bicuspid, or 
first molar) should be extracted in any given case, many points arise 
which should be carefully balanced in the mind of the operator before 
he makes his selection. The respective value of the teeth must be con- 
sidered as features, as organs of mastication, and in relation to their 
prospective durability and their soundness at the time. These are all 
important points for consideration, irrespective of the cardinal question 
as to which tooth would, by its removal, best effect the required object, 
furnish the needed room, and allow the misplaced anterior tooth or teeth, 
to range in proper order with the others. Unquestionably the bicuspid 
teeth are superior as features to the molars; indeed, the farther forward 
in the mouth a tooth is situated, the more does it modify the form of 
the lips, the more is it seen in expression, and consequently the more 
would its absence be remarked. It must be recollected, however, that 
there are two bicuspids, so much alike that when one is lost the other 
takes its place as far as appearance goes. As an organ of mastication a 
molar is of greater value than a bicuspid. The present soundness or 
otherwise of the bicuspids and molar is a question of the greatest im- 
portance, and must often decide finally and peremptorily the question 
under consideration. Provided the loss of either a bicuspid or a first SIMEON II. GUILFORD 
563 
molar would give the necessary space with equal ease and certainty, or 
nearly so-one being carious and the other sound-there can be no hesi- 
tation as to which should be extracted. The decayed tooth should be 
taken out, and a double good will thus be effected, the regulation will be 
achieved, and a source of future or perhaps present pain will be removed. 
It must be recollected, however, that it will take a far longer time for the 
crowding of the canines and incisors to obtain relief by the removal 
of a molar tooth than by the loss of a bicuspid; and in patients who have 
reached some fourteen or fifteen years of age, or in whom the irregu- 
larity has existed for some time, it may be doubtful if the loss of a 
molar will extend forward the required relief. And this leads to the 
consideration of another very important point. The 'te' of the bicuspids 
in the two jaws may be interlocking; the cusps of the lower bicuspids 
may so abut, when the mouth is closed, upon the posterior aspect of 
the cusps of the upper bicuspids as to prevent the latter from moving 
backwards after the removal of the first molar; and thus, though the 
room may be furnished, the crowded upper front teeth are mechanically 
prevented from obtaining the benefit of it. The operator, therefore, 
should well look to this point before deciding on the removal of a molar. 
I urge this, not on theoretical grounds, but because I have more than 
once seen a molar removed under these circumstances; and, the bite 
keeping the upper bicuspids immovably forwards, no improvement in 
the irregularity took place. Finally, the question of relative prospective 
durability, as between the bicuspids and first molar, supposing each to 
be sound, is a point the importance of which cannot be overestimated. 
This matter is not so easily decided by the statistical records regarding 
the decay of the two teeth as has been imagined. No doubt first molars 
are more prone to decay than bicuspids, and it may be prognosticated as 
probable that at the time any particular first molar is cut its term of 
soundness will be shorter than that of any particular bicuspid, when it 
first comes into the mouth. But that does not state the case fairly. The 
question is, which tooth, supposing both to be sound at the time when 
regulation is required (say at about twelve years of age), has the best 
prospect of prolonged soundness and usefulness? It should be remem- 
bered that a first molar tooth at that time has been in the mouth some 
six years and if then sound, it has for that long period resisted the in- 
fluences of decay. The bicuspid, though also sound, has only been ex- 
posed to like influences for a year, or a few months. The existing evi- 
dence therefore, though negative in its nature, is, as a matter of prob- 
ability, altogether in favor of the molar on the score of prospective 
soundness; and my own experience is that if a first molar is free from 
decay at twelve years of age, it is nearly as likely to remain sound as 
any other molar; whereas no such estimate can be formed of the pros- 564 
ORTHODONTICS HISTORICAL REVIEW 
pective durability of a bicuspid that has been in the mouth only a few 
months. This is the real question as between a sound bicuspid and first 
molar at the usual time for removing one of them to make room, and 
it is in favor of the retention of the molar. 
"I would, therefore, say, as a summary of these arguments: Provided 
the removal of either tooth would be equally efficacious, or nearly so, re- 
move a decayed tooth rather than a sound one; this will lead to the very 
frequent extraction of the first molar. If both the bicuspids and first 
molar are sound, extract one of the former; and the regulation, though 
not more effectually perhaps, will be more speedily accomplished than 
by removing the molar. 
"The foregoing observations have been written with special reference 
to the upper teeth, but they may be applied to those of the lower jaw. 
The greater durability of the inferior bicuspids, however, and the more 
easy cutting and more forward position of the lower wisdom-tooth which 
result from the removal of a first molar, would tend to balance more 
evenly the claims of the two teeth respectively; still, where both are 
sound at twelve years, I would remove a bicuspid and retain the molar. 
As regards the first and second bicuspids respectively, the removal of the 
former I consider preferable. 
"This crowding of the canine tooth in the upper jaw upon the lateral 
incisor, entailing the loss of a tooth to remove unsightly irregularity, not 
infrequently involves another question of much nicety and requiring a 
judicious balance of opposing arguments. The question I refer to does 
not relate to the loss of a bicuspid or a molar, to make room for more 
forward teeth, but it is this: In a confirmed irregularity in a patient 
of more advanced years, when posterior room cannot be expected to 
allow the canine and lateral incisor to range in proper arch, the dis- 
figurement being great, which of the teeth in question ought to be sac- 
rificed? Such cases constantly occur. 
"An overlapping and crowding of the upper incisor teeth is not uncom- 
mon, and may exist in various degrees and forms. The accompanying 
illustrations are of a sufficiently characteristic example (Fig. 252), and 
show the treatment which rectified the irregularity in this instance. The 
left central incisor projected beyond the normal arch, while the right 
central and both laterals were within it. To obtain room the first left 
bicuspid was extracted, and then a plate (Fig. 253) was adapted, in 
which processes a and I) pressed out the in-standing teeth, while a band 
of hard elastic gold, c, drew in the projecting incisor. 
"An incisor tooth being twisted and placed more or less across the 
line of the maxillary arch, is another not uncommon irregularity. 
"In contingent irregularities, where the bite is intersecting, or alto- 
gether 'underhung' where some or all of the upper six front teeth shut SIMEON II. GUILFORD 
565 
behind the lower in closing the mouth, it will be necessary to adopt the 
passive mechanism of gagging, cither alone or in combination with elastic 
pressure; for, if the jaws are not separated somewhat, the misplaced 
teeth are persistently held in their wrong position every time the mouth 
is closed. 
"The gag consists of a little 'cap' (Fig. 254) made to a model of one 
of the molar teeth, and upon it are soldered thicknesses of metal enough to 
separate the front teeth; it is made to clip firmly the neck of the tooth, and 
it remains on permanently. In Fig. 254 the cap is seen embracing the 
second temporary molar tooth, which is the one I usually fasten it to. 
When the displaced upper teeth have advanced sufficiently to allow the 
Fig. 252.-Salter's metal plate, applied to 
the teeth (1875). 
Fig. 253.-Salter's metal plate. 
Fig. 254.-Salter's "g'ag'" or crown applied to deciduous molars to open the bite (1875) 
lowers to shut behind them, the gag should be removed, and then closure 
of the mouth completes the cure, by forcing forward the teeth which 
had been too backward. 
"Crowding and overlapping of the inferior incisor teeth is a common 
form of irregularity. It very frequently occurs as a transient condition 
in changing the teeth; but, when it threatens to become permanent, 
treatment should be adopted, either by giving lateral relief, removing 
a bicuspid tooth, or by extracting one of the irregular incisors, and of 
these it is usually desirable to remove the most prominent. The gap 
readily fills up, and the loss of the tooth is scarcely to be observed. 
"Separation of the teeth of the two jaws in the front of the mouth, 
while the molars are in contact, is occasionally met with. 
"It may arise from (1) congenital malformation of the lower jaw. 566 
ORTHODONTICS--HISTORICAL REVIEW 
It may be induced (2) by contraction of the cicatrix of a burn in the 
throat, pulling down the front of the lower jaw; or (3) by the protrusion 
of an hypertrophied tongue. 
"The treatment of these cases is tedious and often unsatisfactory. It 
may be sought to obtain two results-an increase in the width between 
the bicuspid teeth, and a diminished projection of the incisors and their 
sockets. The first object may be accomplished more or less by a palatal 
plate pressing the teeth outwards, the force being established and main- 
tained by the width of the plate being in excess of that of the. interval 
between the teeth, and the pressure kept up by increasing the width as 
the teeth yield. This may be accomplished either by a metal plate, or 
by vulcanite or ivory, with the addition of compressed wooden pegs. 
"A plate fastened to the first molar and second bicuspid may be the 
fixed attachment, from which the force is applied, and this may consist 
of metal bands extending round the front of the teeth, bent in from 
Fig. 255.-Another appliance of Salter's with spiral springs to retract lower teeth. 
time to time as the teeth yield; or, what I prefer, an apparatus such as 
is figured (Fig. 255). In this a frame, c, fits over the incisor teeth, and 
from this a spiral spring, 5, extends to a swivel and screw, a. The 
elasticity of the spring soon brings in the teeth, and it should be tight- 
ened by shortening as the case progresses. Care should be taken that 
the bar across the palate does not obstruct the recession of the teeth and 
alveoli. 
"Transposition of teeth is an occasional though rare form of irregu- 
larity. 
"Inversion of the teeth is another and very rare form of irregularity." 
Heinrich Potpeschnigg, in the Deutsche Viertel-Jahrsschrift fur Zahn- 
heilkunde, January, 1875, describes "A Tooth Regulating Machine," as 
follows: 
"The difficulty often experienced in bringing an upper front tooth 
from within the normal arch even with its neighbors; the frequent com- 
plaints that children will not wear a machine in the mouth, or with SIMEON II. GUILFORD 
567 
difficulty can be watched, and the circumstance, that for every individ- 
ual case a new contrivance must be made, led me to the construction of 
the accompanying machine (Fig. 256). 
"Description: (a) is a well padded leather cap, which embraces the 
back of the head, and in which is sewn firm a little below the external 
occipital protuberance in the direction of the sagittal suture forwards- 
a steel splint (1" wide, 1%" thick), which ends horizontally in (6) half 
an inch away from the head, and, therefore, cannot press the same. To 
the middle of the posterior border of the cap, at the beginning of the 
splint, is attached a small brass ring, through which the cord (J) runs, 
passing on either side under the armpits backwards, where the ends are 
securely tied, making it impossible to draw the cap over the face, (e) 
Fig. 256.-Method adopted by Potpeschnigg to correct irregularities of the teeth (1875) 
is a strong elastic bandage to be lengthened or shortened at will, and 
which prevents any lateral movement of the cap. 
"A round steel rod, the thickness of a pencil, 18" long is connected at 
(ft) to the free end of the splint; through the united ends runs a perpendic- 
ular rivet, on which the steel rod turns from side to side. The end of the 
rod (c) is bent upwards. A firm point is now secured opposite the teeth 
from which a traction power can be exerted on the tooth within the arch, 
which is effected by means of an elastic ring. This traction acts on the 
steel rod like a weight suspended at (c) ; that is, it causes at (&) a 
fixture either to the right or left. If now the tooth be embraced close 
to the gum by the elastic ring, and this is slowly stretched over the 
end of the rod (c), it is possible to move the point (c) 90° either to the 
right or left, and it can readily be fixed at any degree desired. One 
is consequently in a position to draw the tooth, not only forwards but 568 
ORTHODONTICS HISTORICAL REVIEW 
at the same time either to the right or left. The point (c) is so far off, 
that the patient can look at it without squinting. Unable to do more 
than point to a result, I now offer the following for consideration: 
"1. The traction is constant and can be regulated. 
"2. The moving of the tooth ensues without periostitis. 
"3. The patient cannot interfere with the action except by removing 
the elastic, which is easily controlled. 
"4. The patient can eat, drink, talk, and play about without risk of 
injury from a fall, as the rod can give way in either direction. 
"5. The contrivance is suitable for any case of the kind, as the cap 
can be reduced by tightening the bandage. 
"6. The whole contrivance costs three dollars. 
"The boy never complained of headache or pressure, and only once 
of an itching of the head after wearing the cap four hours." 
Felix Weiss (1822-1892), in a series of articles presented in the British 
Journal of Dental Science, 1876, under "Notes From a Dentist's Case- 
Book," explains the condition of dentistry then in England, as we can 
see from some of the following extracts: 
"In glancing at the labors of more than a quarter of a century, with 
all its variety of incidents, experiences, successes, and failures, I feel half 
inclined, at first, to believe that there is but little that is but really new 
in our modern treatment of disease, and that our facts, in the main, 
have during the past fifty years, been but sparingly added to. 
"Our daily practice appears at a first glance to be made up of the 
same cases with some slight modification, the same treatment with per- 
haps some trifling improvement; and while the whole world goes on 
repeating itself, we are irresistibly drawn to the conclusion that, after 
all, we are but as miners turning up the rich soil of past experience, to 
lay down another layer that an after generation will perhaps exhume; 
picking out a fact here, and disputing an inference there, but with all 
making up the bulk of our daily toil by repeating over and over again 
the same words, giving the same advice, and following out very nearly 
the same treatment." 
Under "Hereditary Transmission of Peculiarities in Arrangement" 
Weiss says: "These may be divided into two classes: 1st. Hereditary 
variations in the position of the teeth themselves. 2nd. Hereditary 
variations in the relative position of the superior and inferior maxillae. 
"Under the first of these heads we have a numerous group of cases 
where irregularities have been transmitted from parent to child, with 
but little modification, from one generation to another, but they are most 
of them of so usual a character and so frequently met with they hardly 
require particularizing here. The crowding of the upper or the lower 
jaw to the exclusion of one or more teeth, the canine being, perhaps, SIMEON H. GUILFORD 
569 
the tooth most usually thrown out of position. A class of cases in which 
the removal of a bicuspid or the first molar on each side, at the same 
time preventing the antagonism of the back teeth, is gerenally recom- 
mended. 
"Again, we have peculiarities in the position of individual teeth dis- 
tinctly traceable to hereditary causes. The overlapping of the central 
incisors, a distinctive mark, that in one family I am acquainted with, ran 
through all branches on the female side, and was called, so I am told, 
from the frequency with which in presenting itself, T-y's mark. Two 
Fig. 257.-Felix Weiss (1822-1892). 
of the sisters I have seen, and a child just cutting her inferior incisors- 
a case watched with considerable interest. 
"Hereditary variations in a relative position of the jaws themselves, 
although by no means uncommon, is not so frequently met with as the 
mere irregularity of one or more teeth. 
"We now come to a class of irregularities presenting precisely the op- 
posite appearance to those we have been describing. The upper teeth, 
instead of standing out far in front of the lowers, are inside the in- 
ferior circle, giving to the face that expression we are accustomed to see 
in persons said to be 'underhung.' This is an irregularity met with, if 570 
ORTHODONTICS HISTORICAL REVIEW 
anything, more frequently than that of the opposite character, and al- 
though in the generality of cases it is more readily remedied, or at least 
the appearance improved, it is extraordinary how frequently its regu- 
lation is neglected." 
"On the Retarded, Eruption and the Absence of Permanent Teeth," 
Weiss wrote: 
"Although the usual period for the eruption of permanent teeth may 
have long passed over, we have no reason to infer that the missing tooth 
or teeth have not been developed; indeed, in every case that has come 
under my observation, as far as the twenty-eight teeth of the second set 
are concerned I have never been able to do more than demonstrate that 
the eruption of one or more teeth has been retarded. Different individ- 
uals may vary as to the time of cutting, and although the molars are the 
most regular in their appearance, still they may deviate to the extent 
of fourteen or sixteen months or even longer. We find in some families 
an hereditary predisposition to cut the teeth of the permanent set in a 
particular order, the bicuspids, for instance, coming soon after the erup- 
tion of the incisors. We also find an hereditary absence of particular 
teeth, the lateral incisors, for instance, not appearing until late in life 
and indeed sometimes not appearing at all until hastened by the wearing 
of a piece of mechanical work. 
"That the temporary teeth may be extracted without occasioning any 
reduction in the ultimate size of the jaw I think we have plenty evi- 
dence to prove, but the early loss of these deciduous teeth to my mind 
is a fruitful source of irregularity in the coming set. Not only do we 
lose the directing agent which in many instances guides and controls the 
coming teeth, but we give the advancing organ increased labor, the bone 
has to be absorbed and the place which should have been reserved for 
it is already occupied. This is particularly observable when at an early 
date, owing to the crowding of the centrals, the temporary eyetooth is 
sacrificed, a practice I greatly object to. The permanent canine is com- 
pelled to take a position outside the circle or so far in the palate as to 
seriously affect the articulation." 
F. H. Balkwill, also in the British Journal of Dental Science of 1876, 
in a series of articles to treat irregularities of the teeth described various 
"Regulation Plates." He says: 
"A plate was made to cover the palate, cap the molars and bicuspids, 
and come clown outside them an eighth of an inch on the gum. It was 
not allowed to fill the gap between the left lateral and bicuspid, but 
at that part the palatal rubber was carried up rather higher than the 
tops of these teeth in order to carry a hole for a plug of compressed 
wood. The plate was filed a quarter of an inch back from the right 
lateral to allow this tooth to move in. (Fig. 258.) SIMEON IT. GUILFORD 
571 
"The elastic rings used were cut from the black India-rubber tubing 
sold with Maw's feeding bottles for the nursery. 
"In order that a frame may act efficiently in a case of any difficulty 
it is important that it should be firmly tied in the mouth. (Fig. 259.) 
"The second bicuspid being chosen as the most convenient tooth for 
the attachment of the ligatures, holes are drilled through the outside 
of the regulation plate about a quarter of an inch apart, so as to enter 
the impression of the second bicuspid nearly at the place to be occupied 
by the highest part of its outside cusp, that is, in the deepest part of the 
impression. (Fig. 259, c c c.) Fine mohair is passed around the neck 
of the tooth, and tied tightly on the outside at the margin of the gum in 
a knot. (Fig. 259, a a.) The fellow tooth on the opposite side of the 
mouth having been treated in the same manner the loose ends of mohair 
Fig. 258.-Balkwill's method (1876). 
Fig. 259.-Method of attaching- 
Fig. 258. 
which have been left about six inches long on purpose are threaded 
through the holes (Fig. 259, c c c) in the regulation plate, which is then 
slid up the ligatures into its place. The patient is now directed to bite 
hard; the ends opposite each tooth are drawn tightly, tied, and the 
superfluous ends cut away. (Fig. 259, ft &.) 
"Before the plate was put into position, however, holes were drilled 
at the posterior ends on the outside and an elastic ring, made by cut- 
ting a quarter of an inch off the black elastic tubing sold with Maw's 
feeding bottles, tied on at each end. (Fig. 258, a &.) A square-headed 
peg of compressed wood (Fig. 258, c') was placed in the hole (Fig. 258, c), 
so that in expanding when in the mouth it should drive the left lateral 
ami first bicuspid asunder, and virtually, the bicuspid being supported, 
drive the lateral towards the central. A ligature was then placed around 
the canine. This tooth was not fully through the gum, which was there- 572 
ORTHODONTICS HISTORICAL REVIEW 
fore slit to allow of the mohair being pushed under it until a firm hold of 
the tooth was obtained. L may here remark for the sake of young prac- 
titioners that this is more easily done than appears probable, as there is 
no adhesion between the gum or periosteum and the enamel of any tooth. 
"The right lateral was a very long and prominent tooth; it seemed, 
therefore, desirable to pull it from as near the top of the crown as pos- 
sible. This was done by beginning at the neck and crossing the ligature 
to and fro, tying a knot at each angle of the zigzag, as seen in Fig. 258, c. 
"The mouth and plate being now both ready to be brought together 
the end of one of the ligatures on the lateral (Fig. 258, /) was slipped 
through the elastic ring &, also one of those on the canine g through the 
ring a. 
"The ligatures for tying the plate on to the bicuspids were threaded 
in their respective holes as previously described, and the plate placed in 
the mouth and tied by them (Fig. 258, 7i). 
"By drawing upon the ligature (Fig. 258, /) the elastic 5 was brought 
up to the knot e, and whilst held there by a blunt instrument, tied. The 
same thing was now done to the canine on the other side by drawing upon 
the ligature g and tying it at d. The distance between the knot d and 
the knot which tied the elastic a on to the plate was 1%6 inch, and the 
stretch of the clastic on the other side was the same. 
"It being deemed advisable to try and bring the left lateral more out 
into the range of the teeth, it became a question for consideration whether 
it was better to draw it by an elastic or push it by compressed wood. The 
tooth being comparatively short, it was decided to draw it out by elastics, as 
compressed wood acting on the inclined plane of the back of an incisor has 
a slight tendency to thrust it farther into its socket as well as outwards. 
"The plate (Fig. 260) was therefore made, and fitted and tied in as the 
previous one. It carries a band of vulcanite, a a, in front of the incisor 
teeth without touching them; this was about half an inch deep and the 
tenth of an inch thick; it passed in front of the left incisor at a distance 
of a quarter of an inch. Through this band a hole was drilled at b, just 
opposite the tooth and rather above the line of the gum, so' that the 
strain of ligatures passed through it to the lateral should be rather up- 
wards as well as outwards. The outside edge of the hole at 7; was well 
countersunk, rounded, and polished, so as to give as little friction as pos- 
sible Io the ligatures; there / / and e e having been previously tied to the 
lateral were brought through the hole ft, passed through the elastics 
at c and d, which were then stretched up to b and tied." 
Another appliance consisted of a plate with holes drilled in "in such 
a direction that the peg shall press rather hardly into the gum, as it is 
advantageous to press the teeth from as low down as possible; partly 
because the power of the peg is in proportion to the amount of wood SIMEON II. GUILFORD 
573 
acting, and perhaps partly because it sets up a little beneficial irritation. 
This must not be overdone: it is only meant that the wood should rather 
press on the gum than be just touching (see Fig. 261). A little wedge of 
wood driven into a small end of the peg after it is in the plate will hold 
it firmly, and prevent your being annoyed by its coming out and being 
lost on the carpet when fitting to the mouth with file or penknife (see 
Fig. 261, a a). The pegs may be changed twice a week whilst the space 
is very narrow, as the amount of wood being small we must make use of 
every little gain until a peg of substance is admissible, when visits of 
once a week will be preferable. 
Fig. 260.--Another means of using a vulcanite plate. (Balkwill, 1876.) 
Fig'. 261.-An appliance with wooden pegs drilled in. (Balkwill.) 
"When sufficient space to admit the canines is gained, the same plate 
will suffice for drawing them into it. 
"A stout elastic ring, got by cutting off a quarter of an inch from 
the black rubber tubing sold by druggists for enemas, is tied by the 
middle to the center of the palatal portion of the plate (see Fig. 261, 6). 
Tie ligatures to the canines, and pass one end from each of these through 
the holes previously occupied by the pegs, through the loop of clastic 
nearest to it and back again through the same holes. The elastic is then 
stretched up to the holes by drawing on these ends, and the two ends of 
the ligatures being tied keep it there, by its reaction to draw in the 
canines (see Fig. 262). 
"When an incisor above or below is crowded outside the range of 574 
ORTHODONTICS HISTORICAL REVIEW 
teeth, it can be brought in,, and the adjacent teeth pressed aside to make 
way for it, very advantageously, by a straight piece of elastic interlacing 
them. A plate must be made which may cap the back teeth and come 
across the mouth behind the tooth to be operated upon, leaving room 
for its inward progress. Holes are drilled as near the proximal edge as 
is convenient, about half an inch on each side of the offender. 
"Take an clastic ring, such as can be purchased at any stationer's, 
about a quarter of an inch in width, and as thick as a shilling. Cut a 
Fig'. 262.-Method of bringing incisor teeth into line. (Balkwill, 1876.) 
Fig. 263.-Another method of accomplishing the same purpose. 
piece from this of such a length that when its ends are tied at the holes 
previously drilled it will lie a little stretched between its attachment. 
The plate is now tied in the mouth to any convenient teeth, the elastic 
lying across the gap behind the prominent tooth. With a blunt instru- 
ment draw it through this gap, and slip the loop thus formed over its 
crown. Should there be any tendency to slip off it can be tied by a 
thread embracing crown and elastic diagonally. 
"Fig. 263 shows a bird's-eye view of such an arrangement for the 
lower jaw: (a) central incisor; (&) strip of elastic rubber fastened to 
the frame at (c c)." SIMEON H. GUILFORD 
575 
E. Balding, in the same journal, same year, page 531, "On the Treat- 
ment of Irregularities of Permanent Teeth," wrote: 
"In the course of my practice, treating cases of irregularities in the 
upper central and lateral teeth when they fall behind the lower ones, I 
have tried various plans. 
Fig. 264. 
Fig. 265. 
Fig. 266. 
Fig. 267 
Figs. 264-267.-Sauer's method of correcting' irregularities (1877). 
"I have, instead of the compressed wood, used with better results 
large-headed swivel pins; but each of these methods seemed to me more 
or less defective. The success of the first depending too much on the 
voluntary efforts of the patient. 576 
ORTHODONTICS HISTORICAL REVIEW 
"In the second, the compressed wood required removing every day or 
every other day. 
"In the third, the pins needed frequent readjusting as the teeth were 
moved forward to keep up the necessary pressure. All this in my judg- 
ment occupying too much valuable time, and entailing an unnecessary 
number of visits on the part of the patient. 
"In thinking over the subject it occurred to me if the principle of the 
inclined plane could be introduced into the upper instead of the lower 
plate, it would accomplish the object desired in less time and much more 
easily." 
Carl Sauer (1835-1892) in 1877 contributed a great deal toward the de- 
velopment of orthodontia. He stated "that irregularities of the teeth 
were due, in part, to the influence of the cheeks, the lips, and the 
tongue." He studied many cases where the projecting teeth seemed to 
be caused by tongue sucking. Figs. 264-7 show some of his devices to 
correct malocclusion of the teeth. 
Emile Magitot (1833-1897). We must look to France during the early 
and part of the last half of the eighteenth century for our information 
pertaining to dentistry. In that country, more than all the others, our 
science made its greatest stride and among her people we find some of 
our most renowned men of that period. Undoubtedly the foremost of 
the French authors was E. Magitot, member of the French Academy of 
Science, and other prominent societies. An indefatigable worker, credited 
with some forty odd treatises on various dental topics published in nearly 
all the scientific journals, such as the Journal d' Anthropologic, Archives 
De Tocologie, Archives Generates De Medicine, Journal De LT Anat. Et 
De La Physiol., Gazette Hehdomadaire, etc. 
Anomalies of the dental system are numerous and varied and are the 
most important to be understood, yet up to the time of the services 
rendered science by the production of Magitot's work, all facts relating 
to this subject had to be looked for among documents scattered in every 
direction, there being no connection by which the literature of the sub- 
ject could be traced. To Magitot the greatest credit is to be accorded, 
he seeing the importance of gathering this knowledge together, and 
combining all of the odds and ends, and what is of infinitely greater 
importance, he so arranged and classified these anomalies as to afford 
the practitioner at large an interpretation of them. 
In 1877, twenty years after his first publication, Magitot published 
his great work entitled, "Traite des Anomalies du Systeme Dentaire Chez 
L' Homme et Les Mammiferes." (Treatise Upon Anomalies of the Dental 
System in Man and Animals.') This volume of 305 pages and twenty 
plates is the most elaborate and scholarly essay upon the subject that SIMEON II. GUILFORD 
577 
•up to that time appeared. It is an exhaustive study of the whole sub- 
ject of dental variations and malformations. The author does not con- 
fine himself to his own observations, but embraces the results of the 
labor of others. The work is divided into nine chapters and a general 
introductory essay. His method is essentially the same as that employed 
by classical French writers, such as Etienne Geoffroy Saint-Hilaire, M. 
Davaine and others. 
Fig. 268.-limile Magitot (1833-1897). 
As was established by Saint Hilaire, the founder of teratology, all 
troubles arising in the organization have origin in embryonic defects; 
it is there that the seat of disease is to be sought. The study of an 
anomaly existing in a given organ commences with the embryonic pecu- 
liarity. Magitot says, "With this understanding one has no difficulty 
in recognizing the cause for the little that is known concerning the pecu- 
liarities in the dental system." 
Dental histogeny is a direction of science that has revealed its mys- 
teries to but few. To even appreciate the labor expended in the dis- 
coveries made by Kblliker and Waldeyer in Germany and by Chas. Robin, 
Legros and Magitot in France cost in itself great zeal and research. 578 
ORTHODONTICS HISTORICAL REVIEW 
What Geoffroy Saint-Hilaire has done for general teratology, Magitot 
has done for the monstrosities of the general system. 
Magitot calls all dental anomalies deviation from the specific type. In 
the comparison he made between embryogeny and anatomy lies the ap- 
Fig. 269.-Skeleton cribs as devised by Magitot (Nos. 4 and 5). Screws inserted in 
crib. Vulcanite plate (No. 2) (1877). 
preciation of the phenomena associated with the diverse trouble of ab- 
normal development, of suspension, of complete detention and of hyper- 
trophy. 
In studying morphology, Magitot found himself led to look on the SIMEON II. GUILFORD 
579 
dental display in the animal series as being derived from a single pri- 
mordial origin. This primitive type, or dental unity, the agent principle 
of the second aspect, is found in a simple form in the very lowest of ver- 
tebrata. Fishes are found provided with teeth in great numbers: all 
more or less conoidal in shape. This is on the common principle that 
Nature, always faithful to unity, modifies only according to requirements. 
In the more highly developed organisms of man the cusps of molars are 
recognized as modifications only of that which is the primal type. It is 
not, however, the case that modifications which present in the ascending 
scale follow always rigorously in a zoologic order. One is, however, 
able to say that, from a general method, the primitive type is forsaken 
according as the teeth diminish in number; the less the number the more 
complex being the form. The studies of M. Magitot are directed gen- 
erally to that view of the subject which considers it from the standpoint 
of principles; his anomalies follow in the series of mammifera. He 
shows us the essential relative character. He makes us see by example 
that what is normality in one species is an abnormality in another; that 
many of the anomalies constitute in truth phenomena of return to one 
of the coherent halting-places, expressive of the morphologic changes of 
the dental types. Pursuing farther, in man, these philosophic studies, 
the author is drawn to establish certain deviations seen in the dental 
system representative of the human species as unquestionable anomalies 
that take an ethnologic character. 
But the point, certainly the most original with M. Magitot, is that 
which has for its subject the "teratogeny" proper of dental anomalies, 
and which are divided by him, following the anatomic method into nine 
classes: 
1. Anomalies of form. 
2. " " size. 
3. " " number. 
4. " " position. 
5. " " direction. 
6. " " eruption. 
7. " " nutrition. 
S' " " structure 
9. " " arrangement. 
The first in rank of the causes and laws which preside at the produc- 
tion of the greatest number of the dental anomalies is hereditary influ- 
ences. The hereditary transmission alluded to by M. Magitot exists in 
that sexual affinity which may continue through generations, or which, 
by relation with new sexual influences may suddenly disappear; and 580 
ORTHODONTICS 11ISTORICAL REVIEW 
which, assuredly in time, will disappear by reason of that natural law 
which of itself tends to the correction of irregularities. 
As illustrative of M. Magitot's manner of dealing with his subjects, 
we direct attention to a few of his conclusions. "Number," he sug- 
gests, "lies in secondary buds. The irregular development of a bud 
explains the anomaly by numerical augmentation; absence of a bud 
explains absence of a tooth." Deviations in setting Magitot attributes 
to simple displacement of a tooth on the jaw, or in the neighborhood of 
the unrolling epithelial migration of the membrane forming its cyst. 
The great difference in jaws leads Magitot to discuss as a prominent fea- 
ture in teratogeny certain deviations in the epithelial structure, which 
deviations allow of the development of a tooth after that same manner 
in which neoplasms come into existence, namely, by the migration of 
tissues from neighboring parts. 
Apropos of the anomalies of structure, M. Magitot advances a very 
interesting question, namely, that the corrosive markings of permanent 
teeth, congenital alterations in shape, furrows, indentations, etc., often 
considered, most wrongfully, as a pathognomonic sign of predisposition 
to certain diseases, the hereditary syphilis, for example, are to be es- 
teemed as indelible and permanent traces of invasions of infantile affec- 
tions, especially convulsions. If this inference, based on a certain number 
of facts, but still contested, is found verified, the hypothesis put forth 
by Broca, that the prehistoric trepanations of children affected with 
convulsions was for the purpose of permitting the escape through the 
opening in the skull of a malicious spirit, may be accepted as the true one. 
Magitot describes, in treating this subject, three methods of applica- 
tions according to three phases, as follows: 
1. The anomalies embryonic in origin, which include the deviation of 
position and number. 
2. The anomalies of nutrition. Those forms, represented by the form, 
by volume and by structure (intrafollicular with odontomis and cysts). 
3. Anomalies of development, eruption, direction and arrangement. 
A synopsis of Magitot's classification of the anomalies of the dental 
system of man is as follows; each of the chapters is devoted to a special 
topic: 
"1. To anomalies of form. These comprise the modifications in the 
form of the tooth, and either embrace the entire tooth-structure or are 
confined to the crown or the root. 
"2. Anomalies of size. These are of two orders: augmentation of the 
normal volume, or geantisme; diminution, or nanisme. 
"3. Anomalies of number. These present three varieties: congenital 
absence, numerical diminution, and augmentation. SIMEON II. GUILEORD 
581 
"4. Anomalies of position. These are divided into three groups: sim- 
ple transposition, heterotopy by migration, and heterotopy by genesis 
(embryonic). 
"5. Anomalies of direction, comprising four classes: retroversion, ante- 
version, lateral inclination, and axial rotation. The practical interest 
which is associated with these anomalies relates to the fact that the great 
majority of them are curable. 
"6. Anomalies of eruption. These include the accidental disturbances 
in the order of eruption, retarded eruption, precocious loss, retarded loss. 
"7. Anomalies of nutrition. These comprise all the functional dis- 
turbances attacking the nutrition of the tooth during its formative stage. 
They may include the entire organ, or be confined to one or more of its 
tissues. 
"8. The anomalies of structure. In this group are included all altera- 
tions of an anatomic description situated in the different dental tissues; 
Fig. 270.-Another skeleton crib of Magitot (1867) 
they are either general or limited, according to the nature of their pro- 
ducing cause, and determined by the time and duration of their appear- 
ance. 
"9. Anomalies of arrangement. This last division includes a certain 
number of deviations from the normal standard, comprising amalgama- 
tion by anomalous division and a variety of troubles incident to defor- 
mation of the jaws." 
The table on p. 582 explains in greater detail his subdivision of this 
classification. 
The author assumes that the typical form of the tooth is conoidal. 
After reverting to the characteristic features of teeth in fishes, he passes 
in succession to the different classes of animals, making general remarks 
upon the number of teeth in animals, notably those of the quadrumana. 
Tn speaking of the diastema, he remarks that this peculiarity does not 
imply necessarily the suppression of the canine, since it is found in the 
greater number of mammals; and that in the upper jaw it is situated 582 
ORTHODONTICS 11ISTOKK'AL REVIEW 
TABLEAU SYNOPTIQUE DES ANOMALIES DU SYSTEME DENTAIRE CHEZ LES MAMMIFERES 
Anomalies totales. 
Anomalies coronaires. 
Anomalies radiculaires. 
1° Anomalies de forme 
2° Anomalies de volume 
Diminution ou nanisme 
Augmentation on geantisme . .. 
total. 
partiel. 
total. 
partiel. 
3° Anomalies de nombre 
Absence congenitale. 
Diminution numerique. 
Augmentation numerique. 
'Transposition. 
Heterotopie par 
4°Anomalies de siege. Heterotopie 
' migration follicu- 
laire. 
< introrsion blasto- 
dermique. 
heteroplastic. 
'absolues on to- 
1 tales 
relatives 
Prognathisme aceidentel. 
Opistognathisme aceidentel. 
5° Anomalies de direction .... 
f Anteversion. 
I Retroversion. 
। Inclinaison laterale. 
Rotation sur 1 'axe. 
6° Anomalies de 1'eruption 
'Eruption preeoce. 
Eruption tardive. 
Chute preeoce. 
Chute tardive. 
Atrophic. 
Hypertrophic 
ou 
hypergenese. 
Odontomes. 
Transformation kystique. Kystes folliculaires . 
embryoplas- 
tiques. 
fibreux 
hulbaires . 
odontoplas- 
tiques . . 
cementaires. 
■ radiculaires ... n .. 
dentinair.es. 
avec on sans grains 
phosphatiques. 
avec on sans grains 
dentinaires. 
7° Anomalies de, 
nutrition. . 
'cementaires. 
dentinaires . . . 
adamantins . .. 
circonserits. 
diff us. 
Tumeurs heteroto- 
piques de 1 'email. 
rpredentinaires. 
odontoplastiques. 
^eoTonaires. 
Defectuosites 
de la totalite 
de 1 'organe. . 
Erosion. 
Colorations anomales des dents. 
accidentelles. 
diathesiques. 
totales 
partielles 
8° Anomalies de 
structure.. 
' Sillons et defectuosites de 1'email. 
1 Vices de structure de 1 'ivoire. 
Vices de structure du cement. 
Anomalies par continuity reunions anomales. 
- par disjonetion, divisions anomales. 
- par asymetrie des ar- 
cades dentaires ... 
Rapports anormaux des arcades 
9° Anomalies de 
disposition. 
Atresie de 1'arcade dentaire. 
Augmentation des diametres de 1'ar- 
cade. 
dentaires. SIMEON II. GUILEORD 
583 
between the canines and incisors, and in the lower jaw between the 
molars and the canines. 
Under the head of the anomalies of the dental system, as considered 
in the human race, he treats of two different phases of the subject: 
1. The relations existing between the teeth of primitive and recent man. 
2. The variations occurring within the teeth of modern man alone. 
It has been reported that in the teeth of some fossil men a fifth tubercle 
has been found upon the upper molars, as well as a fifth root to the infe- 
rior wisdom; the root of the inferior canine bifid, while the diastema is 
present. 
M. Broca has observed the difference in the type of the Egyptian peo- 
ple with respect to the shape of the nose. It is found modified in form 
after the first Ethiopian invasion; but nothing beyond this analogy would 
seem to imply that any dental variations followed. The author quotes 
freely from Mr. Mummery as well as from Trousseau with respect to the 
dental variations in ancient skulls, which go to prove that dental anom- 
aly was as frequent formerly as at the present time. 
An interesting section is devoted to the relations existing between 
dental anomaly and active morbid processes; thus their serving as the 
exciting causes of cysts, ostitis, fistula, etc. Nor is the subject of anom- 
alies as they occur within dermoid cysts neglected; and that strange 
phase of development by which teeth and hair are found well developed 
in localities where no such organs normally appear is thoroughly con- 
sidered. 
In 2000 cases of dental anomalies Magitot examined, he recorded as 
follows: 
Anomaly of form 92. 
" size 120. 
" position 193. 
'' eruption 154. 
" arrangement. . . .244. 
" nutrition 208. 
" structure 168. 
" " position 381. 
" " number 440. 
2000. 
Under the head of anomalies of volume are discussed the malforma- 
tions due to disease, notably those presumably excited by constitutional 
disease. 
Elaborate tables of dental formulae are presented, indicating not only 
the changes in the permanent dentition, but also those of the deciduous, 584 
ORTHODONTICS HISTORICAL REVIEW 
and giving likewise a detailed account of the number of the teeth in 
mammals. 
The plates are handsome lithographs, each containing from one to 
twenty-seven figures, accompanied with a very full table of description 
and explanation, and not infrequently figuring apparatus designed to 
correct malplaced teeth. 
The large number of 274 figures in all, illustrate this elaborate study. 
Nos. 5 and 9 from Plate XI of Magitot's work (Fig. 271) illustrate 
the devices mentioned by him and are similar to those used by Richard- 
son and Redman and others. They were used to regulate the upper teeth 
by means of wooden pegs sot in holes throughout the plate. The pegs 
bear upon the teeth so that they will tend to move in the direction de- 
sired. The appliance may be of vulcanite plate as shown in the illus- 
tration or skeleton crib form as in Plate XII (Fig. 3, Nos. 4 and 5) taken 
from Magitot's work, also Fig. 270. 
Magitot on the "Anomalies in the Eruption of the Teeth, in Man." 
1883. The anomalies in the eruption of the teeth are, as is well known, 
usually met with under one of the following forms: 1. Congenital ab- 
sence. 2. Early eruption of the milk-teeth. 3. Late eruption of the per- 
manent teeth. 
"The first form, congenital absence, may be divided into two vari- 
eties, the partial or total absence. The latter form has as yet never been 
met with, except as a sequel to grave lesions of the maxilla. The former, 
however, is frequently seen, and occurs as the result of the congenital 
absence of certain tooth follicles, or of the compression they are sub- 
jected to under certain circumstances. As an instance of this last vari- 
ety may be mentioned the absence of the lower wisdom tooth, which is 
wanting in many persons. This form of anomaly does not, however, pre- 
sent any practical interest. The same cannot be said of the two other 
forms, the early eruption and the tardy eruption. The appearance of 
the teeth at, or very shortly after birth, may be accompanied by a 
scries of accidents necessitating medical aid, as in a case previously re- 
ported by myself, in which the extraction of two teeth, cut on the sec- 
ond day after birth, was followed by intractable hemorrhage, and by 
the death of the child. On the other hand, the eruption of teeth at an 
advanced age is often attended with grave complications: compression 
of the dental arch, abscesses, tumors, etc. 
"The first point to be considered in these cases is the interpretation of 
the premature eruption of the teeth. Have we to deal with early super- 
numerary teeth or with preternaturally early milk-teeth? There can, I 
think, be no doubt in the matter. These teeth form part of the normal 
dentition; for if they happen to fail from any cause whatever, their 
places remain empty during the whole of the first dentition. It is there- SIMEON II. GUILFORD 
585 
fore a great mistake to look upon these teeth as superfluous and useless 
and upon their removal as attended with no evil results. 
"I venture to assert again- 
Fig'. 271.-Appliances as used by Magitot to correct irregularities of the teeth (Nos. 5, 9 
and 11). Vulcanite plate (1877). 
"1. That no interference of any kind should be allowed in the case of 
the early eruption of milk-teeth. 
"2. That in most cases these teeth may and do regain a certain degree of 
firmness, notwithstanding the short size of their roots. 586 
ORTHODONTICS HISTORICAL REVIEW 
"3. That the only serious inconvenience caused by them is the difficulty 
in nursing and that this may be remedied by the use of artificial teats. 
"4. That a sufficient reason for abstaining from any surgical interfer- 
ence is the possibility of accidents, and especially of fatal hemorrhage." 
Alton Howard Thompson (1849-1914). This review of orthodontic lit- 
erature would hardly be complete if we failed to take into consideration 
the writings of Thompson. Although these were not purely of an ortho- 
dontic nature, Thompson was undoubtedly the foremost dentist in this 
country who wrote on comparative dental anatomy. His contribution on 
this subject appeared in almost all the dental journals and extended over 
a period of some thirty odd years. He created an interest in this subject 
and lived to see it incorporated into our school curriculum. We, as ortho- 
dontists, have found it to be the basis of our studies, but only a few have 
clearly seen the importance of further and deeper investigation along 
this line of thought. Among a few of his papers we find the following, 
"Canines in Expression," Cosmos, 1873; "On the Ultimate Suppression 
of the Teeth in Man," Cosmos, 1875; "Facial Expression," Cosmos, 1889; 
"Origin and Evolution of the Face," Cosmos, 189'0; "The Architecture 
of the Upper First Molar," Dental Revietv, 1891; "The Evolution of the 
Complex Molar from the Simple Cone," National Dental Association, 
1909; "A Study of Comparative Occlusion and Its Bearing Upon Ortho- 
dontia," Cosmos, 1902. 
Under "The Dynamics of Dental Occlusion and the Structural Expend- 
iture of Their Maintenance," Dental Cosmos, 1876, page 174, he states: 
"The force with which the lower mandible is occluded against the 
superior maxillaries is, in the average mammiferous animal, probably 
without parallel in any department of animal mechanics. The principles 
of construction and motion of the specialized parts devoted to mastica- 
tion, and the precision and force with which this function is performed 
in the majority of animals possessing vertical mandibular occlusion, is 
wonderfully illustrative of the capacity of the animal mechanism for the 
display of power. The limited amount of tissue of which the apparatus 
is constructed docs not appear capable of the intense manifestations of 
force demonstrated. No other single part of the animal structure pos- 
sesses, dynam for dynam, so much power, even excluding the ratio of 
size and area; and the capacity exceeds all proportion to the area in- 
volved, compared with the average mechanical power of other regions. 
The arching, the leverage, the static, receiving pillars, and the strong, 
peculiarly distributed and attached muscular impactors, all quasicon- 
densed into comparatively limited area about the cephalic alimentary 
opening, and located on the anteroinferior aspect of the cranium, con- 
tain and expend force greatly in excess of other mechanical regions. SIMEON H. GUILFORD 
587 
"The maximum of area of the masticatory is attained by the herbivo- 
rous mammalia, where capacity for motion is more essential than for 
force direct. Trituration is here an important factor of digestion, espe- 
cially so in ruminants. The anatomic factors entering into the structural 
peculiarities of the masticatory region of animals of this class may be 
enumerated as follows: (1) the construction of the temporomaxillary 
articulation, allowing lateral, anteroposterior, vertical and oblique move- 
ments; (2) the extent of maxillary attenuation developed for the sup- 
port of extensive masticating area; (3) the suppression of density and 
diameter of the maxillary bones, thus economizing weight and structure; 
(4) the predominance of the rotatory over the elevating muscles; and (5) 
the peculiarity of construction of the masticating armature, the teeth,- 
i.e., the verticoparallel arrangement of the dental tissues and the abor- 
tion of the crushing teeth. 
"Another evidence of the occluding force in man (and one which the 
dentist and oral surgeon utilize in the important and beneficial operation 
of the correction of irregularity of the teeth) is the rapidity with which 
occlusion will cause movement and alteration in position in the alveolus 
of the teeth. This is observed in almost every denture, in its special 
manifestations, in causing the natural symmetry of position of the teeth 
while erupting, and in the too frequent negative evidence of irregularity 
and malposition owing to premature or retarded eruption. This is ac- 
complished by the occlusion of inclining surfaces, which is so powerful 
for movement. 
"Another indication of the force is the development of the bones and 
muscles that support the teeth. The growth of the maxillaries exhibits 
dependence on the occlusion of the teeth for perfect and symmetrical 
production. Being at birth mere shells containing the active, laboring 
tooth-forming pulps and growing crowns, as the teeth erupt and masti- 
cation comes upon them the bone solidifies and braces up the forming 
and formed roots to support the force. When the second denture comes 
into place the arch enlarges posteriorly, strengthens its substance, de- 
velops static force, and its arches and pillars of resistance but become 
more firm and dense with use. Negative evidence is again furnished by 
mal- and asymmetrical development, due to irregular eruption of the 
teeth, and the growth of bone prevented by the loss of the stimulus of 
occlusion. This force exercises a potent and wonderful influence in the 
acceleration of the growth of the bones and muscles, and the symmetrical 
moulding of the face in normal development. 
"The muscular system is dependent upon the irritation of use for per- 
fect development, and the rising teeth require employment to effect suc- 
cessful eruption. This need is so strongly felt that the desire to masti- 
cate in a child amounts to a passion, a ravenous desire, in reply to an ORTHODONTICS HISTORICAL REVIEW 
588 
imperative demand from nature. Not only is this true previous to erup- 
tion of the teeth, when it is mainly membranous, but subsequently the 
desire is so strong that its indulgence produces a decided pleasure to the 
parts. Occlusion seems a necessity to perfect development, for growth 
depends largely upon the irritation of use, and the desire to indicate a 
growing insufficiency of employment in the species. 
"With the presence of the teeth and their active use, the integrity of 
the jaws and muscles may be said to be maintained. As these are grad- 
ually lost as life passes on, the alveolus rapidly and the maxillaries and 
muscles slowly atrophy and become reduced. Slight irregularity, visible 
asymmetry results, and the final total loss of the denture produces the 
well-known shrunken face of edentulous persons, especially when aged. 
This sunken appearance of the masticatory region is not due alone to 
the loss of the teeth. Suspension of the irritation of use to the parts 
Fig-. 272.-Apparatus of vulcanite rubber, as used by Wilpart (1877) 
brings a marked atrophy of bones and muscles, from withdrawal of the 
nutritive supply and consequent reduction. Asymmetry is frequently 
observable in persons who acquire the habit of asymmetrical mastication 
when the teeth are yet present, owing to disease of the latter, or some 
other lesion, upon one side. The substitution of artificial dentures will 
not restore atrophied muscles and plumpness of visage, for the reason 
that the required force cannot be sustained, and is not attempted. Val- 
uable lessons might be drawn from this fact in artistic prosthesis. In 
age, disease usually renders the teeth, when remaining, unable to bear 
forcible occlusion, and in this way disuse accelerates the ordinary atro- 
phy of senility." 
Wilpart, Vierteliahrsschrift f. Zahnhcilkunde, p. 152, 1877. Wilpart 
used an apparatus made of vulcanite rubber with small hooks of gold 
attached to same. To these were fastened elastic rings, which wore put 
on the teeth to be moved. This appliance affords nothing new and is 
seen in Fig. 272. SIMEON H. GUILFORD 
589 
William E. Hyde, in the Dental Cosmos, page 406, 1878, described the 
following new rotating appliance: 
"The 'dipper' wrench, made by fitting the tooth with platinum foil, 
and afterwards covering with solder, and the 'box' wrench of Dr. Farrar, 
while both excellent, are, nevertheless, somewhat expensive, and some- 
times difficult to apply, while this device can be made in five minutes, 
and at a nominal expense, and can be adjusted to any tooth. It may be 
old to others, but in my office it is a two-weeks' infant, yet it promises 
great things. 
"Take a piece of fine gold, silver, or platinum wire, five inches long, 
and bend it into a double loop, as shown in Fig. 273, 1. Put the point 
of an excavator through at (a) and, taking hold at (IP) with thumb and 
finger, twist the four wires into a cable (c) (Fig. 273, 2), the excavator 
making the loop at (d). Now cut open the small loop (e), and bend the 
Fig. 273.-Rotating- appliance described by W. E. Hyde (1878) 
ends back on the long ends as in Fig. 273, 3, and place a bit of solder 
at (/), holding it in the blaze until the short ends are soldered down 
so as to make a firm, rigid base for the lever (c). Pass the long ends 
around the tooth to be rotated, and bring them back to the lingual sur- 
face of the tooth. Fasten securely by twisting together. You have a 
wrench which can be bent up close to the roof of the mouth, or any de- 
sired angle, and will remain perfectly firm. Apply the rubber as usual." 
Geo. S. Allan, before a meeting of the New York Odontological Soci- 
ety, November, 1878; Dental Cosmos, page 92, 1879, presented a paper 
entitled, "Protrusion of Lower Jaw and Treatment." "In April last a 
little girl was brought to me for dental treatment only, but noticing that 
the lower jaw presented a very marked protrusion, I advised that it 
should be immediately treated with a view to the removal of what was 
a positive deformity, and was asked to undertake the treatment. The 
deformity was entirely in the under jaw, which was, as usual in such 
cases, of abnormal width, and projected so that the lower arch extended 590 
ORTHODONTICS 11ISTORIC AL REV IEW 
outside the upper throughout its whole circuit. Usually, in such cases, 
I direct delay, before beginning to operate, until the permanent teeth 
are all in place. But, after consideration, I adopted for this case a dif- 
ferent plan. As the irregularity appertained to the jaw itself and not 
to the arrangement of the teeth, I decided to operate upon the jaw alone, 
and to bring about a correct articulation of the teeth as a sequence. My 
first plan was to construct two dental splints or plates of rubber, one 
each for the upper and lower jaws, having a protuberance on each in 
the nature of an inclined plane, which would act, during closure of the 
jaws, to force the lower one backward. But I did not persevere in this 
direction, for I soon found that it would be of little use. Then, direct- 
Fig-. 274.-Head and chincap devised by Geo. S. Allan (1878) 
ing the child to continue wearing the upper plate, I set to work to make 
an apparatus that would pull the lower jaw back, keeping the upper 
splint alone in place. As you will see from the photograph (Fig. 274) 
taken at the time she was wearing this apparatus, it consists of two parts. 
I or the lower part I made a brass plate to fit the chin, having arms with 
hooked ends reaching to a point just below the point of the chin. These 
arms were arranged in such a way that the distance between them could 
be altered at will by simply pressing them apart or together. The upper 
part consisted of a simple network going over the head and having two 
hooks on each side, one hook being above, and the other below the ear. 
When this apparatus was completed and in use, there were four ligatures 
of ordinary elastic rubber, pulling in such a way as to force the lower SIMEON H. GUILFORD 
591 
jaw almost directly backward. I relied upon the elastics attached to 
the lower arms to do the main work. The upper elastics were simply 
used to keep the mouth closed so that the lower elastics would not pull 
it open, the upper elastics being made just strong enough so that the 
child, in the natural operations of eating and talking, would not have to 
strain the muscles of the mouth to keep the jaw open. The work pro- 
ceeded very rapidly, much more so than I had expected, so that at the 
end of two months, instead of six (as I had told the mother of the child 
it would take), the irregularity was almost entirely cured. At about 
the end of the first month there came a stop, and for two weeks I could 
not get the jaw to move one particle, which puzzled me very much. The 
mother said the child wore the apparatus regularly, day and night, and 
she knew of no reason why the work should not go on. I had the child 
brought down to the office in the morning and kept her there all day 
watching her, and I found that when she was busy at reading or play, 
she would push the network on the head back so that the clastics did not 
pull. Thus that puzzle was solved. I then directed the mother to watch 
her carefully, and keep the band of the network well on the forehead, 
and also more carefully directed the young miss herself and warned her 
that she would lose all that had been done if she was not more careful in 
the future. After this the work went on steadily to completion. In a 
little over two months the under teeth were completely inside of the 
upper. 
"I was puzzled at first to understand how I had obtained so great an 
amount of recession in the lower jaw, but on carefully examining the 
skull and position of the parts at the child's age, the proper solution of 
the problem soon presented itself. The jaw at that period of life is com- 
pletely developed and hardened. When a child is one year old the union 
between the two lateral halves of the jaw takes place, and at eight years 
the jaw is solid. Consequently any efforts that may be made will not 
affect the jawbone itself. The only way in which the change can be 
made is by pushing back the condyles of the jaw into the glenoid cavity. 
Allow me just here to show you the skull of a child about five years of 
age. The articulation between the glenoid cavity and the condyle is 
peculiar, in that there is a double synovial membrane between which 
there is a cartilaginous bursa. This cartilage gives way and absorption 
takes place at the posterior side of the condyles, with filling in of the 
anterior, so that the whole operation consists in pushing the condyles 
of the lower jaw into the glenoid cavity of the temporal bone. Until the 
articulation has again receded by the natural protrusion of the teeth, 
I suppose the child will have to wear the apparatus more or less. I had 
it taken off to bring here this evening. I should certainly in any similar 592 
ORTHODONTICS HISTORICAL REVIEW 
case presented hereafter, even at twelve or thirteen years of age, before 
attempting any other procedure, try this first and thoroughly." 
Georges Gaillard, "Des deviations des arcades dentaires et de leur traite- 
ment rationnel," 1881. This work of some two hundred pages, with 
eighty illustrations, was devoted to irregularities of the teeth. Gaillard 
first reviewed in a short historical resume those books in French that 
he was able to obtain. The first part he then devoted to the evolution 
and development of the teeth, the second to anomalies in position of the 
teeth and the third part to treatment of irregularities of the teeth. 
Not satisfied with the classification of Magitot's, Gaillard proposed the 
following six divisions, according to the position of the teeth: 
1. Heterotopic. 
2. Anteversion. 
3. Retroversion. 
4. Lateriversion. 
5. Rotation. 
6. Emergence. 
Fig. 275.-Platinum "caps 
or crowns" with "platinum 
bar." Occlusal view (George 
Gaillard, 1881). 
Fig. 276.-Side view 
of same appliance 
(George Gaillard). 
Fig. 277.-Front view of 
same appliance (George 
Gaillard). 
In the treatment of cases under 2, 3, 4, 5, Gaillard arranged his appli- 
ances to work in the following manner: 
Anteversion 
fa pressure posterior. 
1 a traction anterior. 
Retroversion 
'a pressure interior. 
ya traction posterior. 
Lateriversion 
fa pressure lateral, 
a traction lateral. 
Rotation 
fa pressure double or single, 
a traction double or single. 
He used one type of appliances for all cases; this consisted of caps or 
crowns of platinum joined together by a platinum bar. The crowns 
wore generally placed on the first molars and bicuspids. To these a 
platinum wire was soldered extending from left to right across the buc- 
cal and labial surfaces. To this arch wire, opposite each tooth, were SIMEON n. GUILFORD 
593 
soldered, small rings of platinum wire. (Fig. 275.) Silver wires were 
drawn through small triangular openings (Fig. 276, c) on the buccal 
surface of the appliance. These wires held the apparatus in place. As 
the metal rings rested against the teeth, they acted as a fulcrum, rubber 
bands being used to draw the teeth to the arch. (Fig. 277.) 
The success in using this appliance is shown by nineteen recorded 
observations, all differing in the type of case, with illustrations prior to 
and after treatment. 
Thomas Wardle (1819-1887), under "Protrusion of the Lower Jaw," 
{Dental Cosmos, 1879, page 371), for a young lady of nineteen, prescribes 
the following method of treatment: 
"The arch of the upper teeth was much less than that of the lower, 
the outer cusps of all the latter were outside of the former, necessitating 
an expansion of the upper jaw as well as a reduction of the protrusion. 
To accomplish the first object a self-acting plate was designed, illus- 
trated in Fig. 278. The plate, which was of gold, was made to fit the 
Fig. 278.-Gold plate as used by Thomas Wardle (1879). 
arch of the mouth as for an upper denture. To this were soldered two 
posts of platinized gold, set opposite the palatal faces of the bicuspid 
teeth and about three-eighths of an inch distant from them, their lower 
ends being on a line with the cusps of the teeth to be acted upon. At 
right angles with these were soldered oval tubes, closed at their palatal 
ends by the posts to which they were soldered. To these oval tubes 
were fitted sliding bars having semicircular clasp-shaped cross pieces 
neatly fitted to the bicuspid teeth. In the application of this plate to the 
mouth, small pieces of soft rubber were inserted into the tubes and in- 
creased from time to time as required, which maintained a gentle con- 
stant pressure, resulting in a short time in the desired expansion of the 
jaw and a lowering or flattening of the palatal arch about three-eighths 
of an inch. This little appliance was worn with entire comfort, and the 
patient soon learned to adjust it herself. 
"Previous to any attempt to overcome the protrusion of the lower jaw 
it was necessary to extract the last tooth on one side of the upper jaw, 
because of its antagonistic relation to the lower teeth. A cap was made 594 
ORTHODONTICS HISTORICAL REVIEW 
of strong twilled silk, lined with unbleached muslin, covering the head 
completely, the sides coming a little below the upper part of the ears, 
and was cut out to fit around them. A chin piece was made of morocco 
leather, which was lined and fitted to the chin, covering the space be- 
tween the bicuspid teeth. To the ends of this chin piece were attached 
straps for attachment to the cap behind the ears. Two other straps were 
attached to the upper edge of the chin piece, arranged to join the head 
cap about the center of the attachment of the temporal muscles. The 
four straps were thus attached to the head cap, divided in their centers, 
and provided with buckles so arranged as to prevent their coming in 
contact with the patient's face. The whole apparatus was so simple in 
its construction that the patient could remove or adjust it at pleasure." 
L. Renard, "Ethnological Variation in the Lower Ja/w," after giving an 
account of the present state of knowledge with regard to the lower jaw, 
comes to the following conclusion: 
"From the consideration of the development of the lower jaw in vari- 
ous races, and at various periods of life, it is easy to see that race 
varieties result from variations in degree of development. Throughout 
the period of development, it is the teeth that determine and direct its 
course. The teeth do not take possession of preexisting crypts, but the 
crypts grow up to surround the teeth, and disappear with them. All 
morphologic modifications of the jaw depend upon the alveolar por- 
tion for their cause. 
"The differences do not begin till after the first dentition, the negro 
infant is not prognathous. As soon as the permanent germs appear, the 
temporory set are gently pushed forwards, together with their alveolus; 
the degree of this pushing forward regulates the variations of the in- 
clination of the symphysis. Prognathism, orthognathism, and opisthol- 
nathism are therefore exactly proportionate to the number and size of 
the teeth. 
"The thickness of the bone depends upon the teeth, but not its breadth 
(from side to side), the latter only varies with the cranial diameters. 
The modifications depend mainly upon the rapidity of the complete 
evolution of the permanent set. In negro races the wisdom teeth are 
early developed, before the ossification of the jaw is finished, and there- 
fore while it is still capable of adapting itself without inconvenience of 
crowding to their presence. The wisdoms are finely formed teeth, some- 
times with five cusps; and hardly ever is their eruption attended with 
those accidents and derangements so common in Europe. The negro jaw 
is, therefore, perfect in its development as contrasted with the European 
jaw with its tardily erupted wisdoms, for which it can so hardly find 
room at all." SIMEON II. GUILFORD 
595 
Thomas Brian Gunning (1814-1889), before the Seventh International 
Medical Congress, 1881, (Vol. iii, page 548, proceedings), presented the 
following paper: "Causes of Irregularities of Position of the Teeth," 
under which he said: 
"The most trusted teachers and writers upon irregularities of the posi- 
tion of teeth ignore the facts of Nature, and teach others to work, not 
only outside of, but in opposition to, her processes. 
"At the seventh week of fetal life the germs of the teeth begin to 
start from the mucous membrane, which lies between folds somewhat 
firmer than itself; and by the thirteenth week the papillae of all the 
deciduous teeth are enclosed in open follicles. At the fifth month, the 
germs of the ten anterior and of the first molar teeth of the permanent 
set start; and as the deciduous teeth with the sacs of the ten permanent 
ones grow, and take up more space, the permanent molar is forced into 
the tuberosity of the upper jaw, or into the coronoid process of the 
lower. They occupy these positions until the eighth or ninth month; 
during these two months, the basilar portion of the lower jaw, which 
supports the alveolar process and teeth, and also gives attachment to so 
many muscles, is rapidly developed; yet at birth it is comparatively in- 
complete. 
"In nursing, the upper jaw is supplemented by the lip, the nipple 
being held against the roof of the mouth by the stronger and more 
active lip, assisted by the less-developed jaw. This keeps the lower jaw 
back, and the upper jaw projecting, in accordance with the earlier de- 
velopment of its teeth in fetal life. In general, the central incisors of 
the lower jaw appear first; but when those of the upper come, they are 
soon joined by their lateral neighbors, the lower lateral incisors emerg- 
ing later from the jaw, which is still without bony union at its symphysis. 
Thus, the lower teeth are kept back inside the upper. The lower jaw is 
more easily observed than the upper; it is therefore, referred to in 
preference. 
"The deciduous set of teeth which begin to appear about six months 
after birth, are by three years of age arranged in the mouth. At six 
years the lower jaw is seen to be much deeper and larger in every way, 
as it holds the temporary set of teeth and also the permanent, so far as 
developed. 
"The jaw generally lengthens until three large molars have come 
through on each side behind the semicircle which held the deciduous set. 
The third molars come down like the second and first molars into the 
dental range, the horizontal portions of the jaw growing an inch or more 
in front of the ascending ramus in the lower jaw, and an equal length 
in the upper jaw. 596 
ORTHODONTICS HISTORICAL REVIEW 
"It is apparent that from the start the vital force is specially exerted 
to perfect the teeth, and form the jaws for their protection and arrange- 
ment in the mouth. The alveolar process develops with the teeth, and 
the basilar part of the lower jaw, which grows rapidly just before birth, 
continues to enlarge in proportion to the development of the teeth; this 
is shown clearly in its growth to admit the permanent molars. 
"Now all this change of the jaw from before birth until adult life is 
in connection with the development and arrangement of the teeth; and 
enough has been shown to prove that the growth of the jaws is gener- 
ally controlled by the development of the teeth." 
Gunning then showed that the size and the shape of the jaws may 
cause irregularities of position of the teeth: (1) Diseases of the teeth 
may cause irregularity, when, except for it, all would be normal. (2) 
Premature loss of temporary teeth more than undue retention of them, 
causes irregularities. (3') Disease of one or more of the temporary or 
permanent teeth, or loss of either may deform the lower jaw and also 
displace it. (4) Mistaken views in respect to the treatment. 
"In cases of projection of the lower jaw, caused by muscular action 
drawing the condyles toward the eminentiae articulares, a plate which 
projects out from under the upper incisors down in front of the lower, 
will gradually press the jaw back, and, at the same time, it may be used 
to correct the positions of the teeth which caused the jaw to come for- 
ward. Or, if required, a plate on the lower teeth will throw the jaw 
back. 
"A projecting jaw, which is well seated in the. glenoid cavities, can- 
not be pressed back by any apparatus in the mouth, nor by any outside 
around the head and jaw, whether as pictured in the books or otherwise. 
If the condyles were pressed back from their natural position, the ears 
would be closed. 
"Except for the relation between the teeth and jaws, and for the 
changes which are usual to them in the earlier years of life, the most 
intelligent treatment could be of little avail in preventing or in remedy- 
ing malformation. 
"The fact that when the teeth are lost the jaws are still able to act 
in functions other than mastication is no justification of the misleading 
statement that the teeth and jaws are independent of each other. 
"If the teeth, as a whole, are too large for the jaw, they should be 
kept in to encourage the growth of the jaw, as long as this can be pro- 
moted, and then such of them extracted as can be best spared to make 
room for the others. If a jaw is too large prospectively, remove the 
necessity for its growth, whether in the least important teeth, or in their 
position, and especially guard against habits which tend to this deformity. SIMEON II. GUILFORD 
597 
"If irregularity be treated by appliances, they should act naturally; 
those just prescribed press the teeth either through their own growth, 
or similarly; when the jaws close, they give the shock usual in natural 
movements, but upon the intervening appliance. Thus, if the teeth are 
moved, they are never lifted from their sockets. The teeth, as a whole, 
support each other, or are affected naturally, and are not moved un- 
necessarily in other functions. This is especially so with these regulating 
plates, they having gold hooks imbedded in them, and being used without 
anything more elastic than hard wood, which deprives each tooth by 
direct pressure; in this way the apex of its root is carried out with its 
crown, especially in the lower incisors and the upper laterals, whose thin 
roots move readily in the alveolar process, when their crowns are held 
back by the adjoining teeth, or their cutting edges restrained by gold 
hooks." 
Here we observe Gunning noticed as early as 1881 the bodily move- 
ment of teeth; ' ' the apex of its root is carried out with its crown. ' ' 
J. Oakley Coles before the same Congress spoke "On the Origin and 
Treatment of Certain Forms of Irregularities of the Teeth." He referred 
to his classification of deformities of the upper jaw, already described, 
as well as a consideration of the influence of the antrum in regard to 
certain irregularities of the teeth, and was of the opinion that an ir- 
regular growth of the external wall of the antrum was a cause of "hypog- 
nathism." There was a relation between this the sphenoid, premaxil- 
lary bones of the antrum, in reference to dental and maxillary irregu- 
larities of form and arrangement. He then considered certain points in 
the mode of treatment: 
"(1) If expansion is tried it should be expansion of the jaw with the 
teeth in situ in the first instance, and regulation of the teeth individually 
as a subsequent operation, rather than expansion of the dental arch by 
pressure applied to the teeth and their alveoli. (2) And next the de- 
sirability of extracting the teeth that are out of position, and then 
restoring the contour of the arch by expansion. This treatment, of 
course, applying only to the more severe cases." 
Josef Iszlai (1816-1866) (Proceedings of the Seventh International 
Medical Congress, page 555) read a paper, "Illustrating Sketches to 
Carabelli's 'Mordex Proms' and Its Relation to 'Prognathia Ethnologica' 
and Meyer's 'Crania Progenaea' " 
Exact determination of objects and their nomenclature is important. 
He attempted to prove by a critical survey of Carabelli's work that the 
different types of closure of the anterior teeth regulated this, and Cara- 
belli's lack of exact determination interfered with his classification. 
lie proposed a new nomenclature according to the various ways of ORTHODONTICS HISTORICAL REVIEW 
598 
"biting" as well as to the anomalies of the position of the teeth. The de- 
scription of Wedl, Baume, Miihlreiter, Carabelli, Magitot and other 
authors lacked clearness and understanding. 
Iszlai then quoted the classifications and definitions used by Cara- 
belli and other authors, pointed out numerous obscurities and contrac- 
tions, and ended by describing a new system of classification suggested 
by himself. He showed an instrument invented by himself, by which the 
amount of deviation of the teeth from their normal line could be meas- 
ured, and also an interesting collection of skulls illustrating the different 
varieties of prognathism to which he had referred. 
Ten years later, in 1891, Iszlai published a short paper on the same 
subject in the Oesterreichisch Ungarische Vierteljahrsschrift fur Zahn- 
heilkunde, which paper may be considered a revised and condensed edition 
of that which he read in 1881. 
Iszlai suggested a new classification for the various ways of biting 
and the anomaly of the position of the teeth. He considered the classi- 
fications heretofore given as inadequate and not clear, and distinguished 
the following as the chief forms of irregularities, using the upper teeth 
as a basis. 
In the Fourth International Dental Congress, 1904, page 326, vol. IT, 
we find Iszlai's classification. 
"(I) The front teeth of the lower jaw strike back of the upper teeth: 
Enarmosis. 
"(II) The front teeth of the lower jaw strike in front of the upper: 
Protrusion of the lower teeth: Epharmosis. 
"(Ill) The cutting edges of the lower teeth meet the same edges of 
the upper teeth: Edge-to-edge bite: Prosarmosis. 
"(IV) Between the upper and lower teeth there is an open space: 
Open bite: Opharmosis. 
"(V) The lower teeth cross the upper teeth: Cross bite: Dicharmosis. 
"(VI) The odontharmosis is mixed up: Mixed bite: Tyrpharmosis. 
"Genus I. Enarmosis: Normal bite. The teeth of the mandible strike 
back of the lingual surface of the upper teeth, leaving hardly any space 
between them, the teeth of the mandible being overlapped by those of the 
maxilla by one or two millimeters. 
"Species 1. The same relationship as preceding, with the difference 
that there is a greater distance between the labial surfaces of the lower 
teeth and lingual surfaces of the upper teeth: Di-enarmosis (away from). 
"Species 2. The same relationship as in species 1, with the difference 
that the lower teeth are here overlapped to a greater extent by the 
upper teeth: Deep overbite: Dys-enarmosis (wrong). 
Both classes appear either separate or combined; in the latter case 
we have protrusion with a deep overbite: Dys-di-enarmosis. SIMEON H. GUILFORD 
599 
"Genus II. Epharmosis: Protrusion of lower teeth. Here the rela- 
tionship between the lower ancl the upper teeth is reversed. The lower 
teeth stand in front of the upper and are overlapped by the upper teeth 
to the extent of one or two millimeters. 
"Species 1. The same as species 1, genus I, but reversed: Protrusion 
of the lower teeth, but being greater it is called Di-epharmosis. 
"Species 2. The same as species 2, genus I, but reversed: Deei> bite 
with lower teeth in front-Dys-epharmosis. Where both species are 
combined we have more or less protrusion with a deep bite: Dys-di- 
epharmosis. 
"Genus III. Prosarmosis: Edge-to-edge bite. Tt comprises those cases 
where the cutting edges of the lower teeth meet the cutting edges of the 
upper. (No species.) 
"Genus IV. Opharmosis: Open bite. Here are included those cases 
where on closing the mouth the molars and premolars or the molars alone 
meet, leaving an opening between the front teeth. (No species.) 
"Genus V. Dicharmosis: Divided, cross bite. Characterized by a 
combination of the foregoing genuses; one side may be enarmotic, the 
other epharmotic, etc. 
"Genus VI. Tyrpharmosis: Mixed bite. Here the odontharmosis is 
so mixed up that it cannot be grouped under any of the genuses enum- 
erated, either in one or two combinations." 
James W. Smith (1854-1889), before the Harvard Odontological So- 
ciety, (Cosmos, 1881, page 224) spoke "On Relations of the Teeth and 
Stirrounding Tissues in the Correction of Irregularities," as follows: 
" Since the difficulty of correcting dental irregularities increases with 
age, as soon as it becomes evident that a permanent deformity exists, 
treatment should be commenced without unnecessary delay. This is ap- 
preciated by the dental profession, but, from various causes, many cases 
are neglected until at or beyond maturity before advice is sought. When 
thus deferred, the correction of the irregularity is often difficult, and 
the results of treatment are frequently uncertain. What I have to offer 
with reference to lessening this uncertainty is the result of some study; 
limited experience has seemed to confirm my conclusions. 
"We have no definite knowledge of the chemico-vital processes in- 
volved in the solution of bone under any circumstances. As manifested 
in correcting irregularities, the process seems to me quite analogous to 
the absorption of bone during the formation of callus in the healing of 
bone fractures. Dr. Theodor Billroth suggests that in this process there 
may be developed lactic acid, which changes the carbonate and phos- 
phate of lime into soluble lactate of lime, which is taken up and removed 
by the vessels. But this is only hypothesis. 600 
ORTHODONTICS HISTORICAL REVIEW 
"By means of the appliance shown in Figs. 279 and 280, the left supe- 
rior first bicuspid, cuspid, and lateral and central incisors were moved 
to the left sufficient to almost entirely take up the space left by the ex- 
tracted bicuspid, and enough to make room for the overlapping central 
incisor. On account of its strength, Japanese grass-line was used instead 
Fig. 279 
Fig. 280. 
Figs. 279 and 280.-J. W. Smith's appliances for the correction of irregularities of the 
teeth (1881). 
Fig. 281.-Key used to turn screw as employed by J. W. Smith (1881). 
Fig, 282.-Retaining plate used by J. W. Smith (1881) 
of silk or linen in connection with the plate and screw. This appliance 
was entirely under the control of the patient. It was removed once a 
day for cleansing, and the screw tightened once in twelve hours. Fig. 
281 illustrates the key used to turn the screw. The prominent central 
and the depressed lateral incisor were easily moved by simple means. 
"A retained plate (Fig. 282) holding in position the right central in- 
cisor, is all that is now required." SIMEON H. GUILFORD 
601 
M. J. Museler, in the October number of the Correspondenz Blatt fur 
Zahnarzte, .1881, presented a new method of correcting the protrusion of 
the mandible. Figs. 283 and 284 illustrate the type of appliance that was 
used. Both are of vulcanite and were applied to the mandible. After 
Fig. 283 had been used for several days, Fig. 284 was applied, by turning 
the screws the lower teeth were forced backward until they articulated 
within the uppers. 
G. L. Simpson on "Irregularities," Ohio State Journal of Dental Sci- 
ence, page 512, 1882, before the Odontological Society of Western Fenn- 
sylvan ia, said: 
"I made a plate of vulcanite, with gold clasps around the two first 
bicuspids, then allowing the rubber to extend up over the second bicuspids 
and molars. This served as a gag, and at the same time made mastica- 
tion possible. The plate just back of the incisors was made thicker than 
usual to admit of holes being drilled. Into these holes every third day 
I placed a piece of dry burnished wood. One tooth requiring a little 
Fig. 283.-Museler's appliance of vul- 
canite to correct the protrusion of the man- 
dible (1881). 
Fig-. 284.-Another appliance, illustrating 
the use of the screw. (M. J. Museler.) 
rotating, against this tooth I placed two pieces of wood, one longer than 
the other. This worked so well that in six weeks' time I removed the 
blockade from between the teeth, and in four weeks more I removed the 
plate, leaving the teeth to the care of articulation, which, thanks be to 
it, has performed its part well. Although I used a rubber plate in this 
case, and have done so in other cases, yet contrary to the general prac- 
tice, I prefer to use a swaged silver plate; it being thinner is less objec- 
tionable to the patient, and in my experience is every way preferable. 
With a blowpipe attached to the foot bellows, it is but little trouble to 
make any desired change. If you wish a loop through which to pass a 
ligature, a hook for a rubber band, or a shoulder for a bolt and nut, all 
can be completed in a few minutes and at any time. Tn a number of 
cases of very prominent cuspids, where the six-year molars were badly 
decayed, I extracted them. The second molars being very short, could 
not assist in bringing the erring cuspids to place, so I used a silver plate 
with four loops, so placed that when the ligatures were thrown around 
the cuspids and first bicuspids, they had the effect of holding the plate in 602 
ORTHODONTICS HISTORICAL REVIEW 
position, and, at the same time, drawing the bicuspids back and drawing 
the cuspids backward and inward. It will sometimes be necessary to 
place a wire or ledge opposite the teeth around which the ligatures are 
to be placed to prevent them from impinging upon the gums. I use for 
ligatures spool embroidering silk, E or EE. 1 use ligatures in every case 
where it is possible, preferring them to rubber bands, or even bolts and 
nuts. Teeth standing inside of the arch can be (if there is space suffi- 
cient) readily brought to place by the use of a band around the labial 
and buccal surfaces of the teeth, and for this purpose I use 10-karat 
gold wire. 
"To each end of this wire solder a piece of flat gold or silver. By 
punching holes through these the band can be made fast to either the bi- 
cuspids or molars with light platinum wire or gold bands and nuts. 
Then draw the teeth out to position with a waxed ligature. My reason 
for using 10-karat gold wire is that it is stiff and strong even when very 
light, answering every purpose, and its appearance is less objectionable 
than that presented by a flat band of 20-karat gold. 
"With a little care in forming this band, teeth can often be rotated 
very nicely with the ligature. For more difficult cases, take a thin ribbon 
of platinum and form this around the tooth to be rotated, allowing both 
ends to extend out some distance side by side, then double back on itself, 
solder this, flowing the gold all over the outside of the band, then you 
have a band with a handle to it. Drill a hole through the point of this 
lever, and, with a ligature, you can turn any tooth that you might wish; 
but great care must be exercised not to do the work too rapidly." 
At the twenty-second annual session of the American Dental Associa- 
tion, 1882, papers were read by W. N. Morrison, W. II. Atkinson, E. T. 
Darby and others. Nothing new or important was brought forth, al- 
though all contended that their method was the method for regulating. 
John Joseph Ravenscroft Patrick (1828-95), in 1882, before the Illinois 
Dental Society, described his new and novel method of aligning the 
teeth in either arch. This appliance, seen in Fig. 286, consisted of "a 
half-round gold and platinum bar (A,A), curved to correspond with the 
shape of the" arch, having upon it a number of sliding rings, by means 
of which anchorage is secured and attachment made to the teeth to be 
moved. The bar is bent with its flat surface inward, and is of sufficient 
length to allow its ends to rest gently on the external lateral surfaces of 
the first or second molars as desired. The slides are fitted accurately, 
so as to move steadily. Two of these which are made longer 
for the purpose are used to secure anchorage, by soldering to 
their inner surfaces thin gold bands (B,B), previously fitted to 
the teeth selected. The bar is held in position by set screws (C,C), 
passing through them. Small buttons are soldered to their ex- SIMEON H. GUILFORD 
603 
ternal surfaces, through which the screws pass to give them greater pur- 
chase. To the smaller slides the different appliances for moving teeth 
are attached, as wedges, hooks, T-bars, loops, and bands (D,E,F,G,TI,1), 
of various sizes and shapes as required. The mode of operation is very 
Fig. 285.-J. J. R. Patrick (1828-1895). 
Fig. 286.--Patrick's appliance with bands, 
arches, and sliding attachments (1882). 
Fig. 287.-Screw clamp band sub- 
stituted for set screws and plain 
bands. (Patrick, 1887.) 
simple. The apparatus acts as a lever, of which the power is the elas- 
ticity of the bow-spring, the fulcrums the points used for anchorage, and 
the resistance the tooth or teeth to be moved. If these are outside the 
arch, the bow-spring is adjusted so that its flat surface touches all of 604 
ORTHODONTICS HISTORICAL REVIEW 
the projecting teeth, and is firmly set with the set-screws. The wedges 
are then forced together between the teeth to be moved and the bar; 
should the wedges cease to act before the teeth are properly placed, the 
set-screws are loosened, the wedges separated, and the bar taken up until 
its inner surface is again pressed against the projecting teeth, when it 
is again set firmly, and the wedges are again brought into play. To 
move teeth outward, the elasticity of the bow-spring is made to draw 
upon them by means of the proper appliance. Rubber bands or ligatures 
may be made usefid auxiliaries. This appliance can be used on either 
jaw. Should the bar at any time exhibit a tendency to slip toward the 
gum, it can be held in its proper place by snapping one of the slides 
provided with a hook over the cutting edge of a tooth." 
As will be seen, this mechanism comprises nearly all of the valuable 
features that are to be found in our present-day "expansion arches." 
In 1887 Patrick substituted screw clamp bands for the plain anchor 
bands with set screws as shown in Fig. 287. 
Jean Redier in 1882 proposed a classification which was general in char- 
acter and similar to Magitot; he however lays stress on the importance 
of the interdigitation of the cusps. 
Theophile David (1851-1892), although he wrote a number of articles 
(1882-6) relating to irregularities of the teeth, failed to add anything 
that was new, merely reviewing historically what had been previously 
written and then follows closely the works, classification, etc., of Magitot, 
which he accepts as the final word. 
Richard Fanton-Touvet (1833-85) in his considerations of the anomalies 
of the human teeth first speaks of the development, ossification, eruption 
and then the abnormalities of the teeth and dental arches. He follows 
exactly Magitot's classification and fails to add anything that is new. 
Walter Coffin. To take an impression, the cup having been fitted- 
chiefly as to the bite-and a basin of cold water provided, another is lined 
with a cloth and filled with boiling water. In this gutta-percha in toler- 
ably thin sheets is placed and immediately softens; it is then lifted out on 
a smooth stick or glass rod, and just dipped into cold water for a second. 
It may then be manipulated with wet fingers and placed in the cup. Be- 
coming thus somewhat chilled, the filled cup is put into the hot water 
again for half a minute, then just dipped into the cold, and placed in the 
mouth, and the patient is told slowly and steadily to close the jaws upon 
it. It should be kept in the mouth for a minute and a half or two minutes; 
it is then carefully released from the bite, quickly removed, and at once 
placed in a basin of cold water, where it should be left until it is con- 
venient to cast. 
Coffin then pointed out the differences between impressions taken 
with plaster and with gutta-percha, the chief being that the latter SIMEON II. GUILFORD 
605 
shrinks in setting, whilst plaster expands slightly; a plate made from a 
gutta percha impression will, therefore, fit the mouth very closely, and 
is consequently more easily kept in place. 
W. R. Humby (Dental Record, London, 1882, page 49) describes "A 
New Method of Regulating the Incisor Teeth." 
"I first applied the rubber dam to the four incisors, then carefully 
cleaned them and dried them with an air syringe, and applied a layer of 
ether copal varnish. I then wound round each central a strand of silk, 
and tied it in a knot at the distal (or what should have been the distal) 
surface, leaving the ends of the ligatures free, as shown in Fig. 288. I 
then included in the silk of the one side a strip of the white vulcanized 
rubber dam in use in the hospital (the rubber was about a quarter 
INCISORS FROM CUTTING EDGES 
Fig. 288.-Method of reg- 
ulating the incisor teeth. 
(W. R. Humby, 1882.) 
Fi?. 289.-Sidp view of Fig'. 288 
(W. R. Humby.) 
Fig. 290.-Occlusal view of Fig. 288. (W. R. Humby.) 
of an inch wide and of the stoutest variety), and stretched the free end 
of rubber until the traction seemed to me strong enough for the pur- 
pose. I then included it by tying in the second ligature thus (Fig. 
289). I now varnished the silk, especially the knots, cut off the surplus 
rubber and silk, removed the protecting rubber dam, and requested the 
patient to see me in a week. He came, according to appointment, and I 
was quite delighted with the progress made--the teeth met in the median 
line, and the only thing remaining to be done was to increase the torsion, 
as the teeth, viewed on their cutting edges, had a slightly gothic archlike 
expression. I lifted the first strip of rubber and inserted beneath it a. 
small pad of the same material, and tied this to the first. (Fig. 290.) 
George Washington Keely (1822-88). In 1882 Keely began to contrib- 
ute in the Ohio State Journal of Dental Science a series of orthodontic 
articles under the title of "Regulating Teeth-A Case in Practice." He 606 
ORTHODONTICS HISTORICAL REVIEW 
favored the vulcanized rubber appliance, making use of ligatures, elas- 
ties, wooden wedges and the jackscrew in order to bring about the desired 
results. Some of his methods are as follows: 
Ohio State Journal of Dental Science, 1885, page 37: 
"A vulcanized plate was fitted to the roof of the mouth, with a brace 
around the second right molar, and one in a gap between the first and 
second molars, on the left, for the purpose of retaining the apparatus 
firmly in place. A strong ligature was cut from rubber tubing, put over 
Fig. 291.-George W. Keely (1822-1888). 
the erupting cuspid, and carried back and attached to a button made on 
the plate, opposite the buccal portion of the right molar (Fig. 292). As 
the removal of the bicuspid left such a large opening just where we 
wanted the cuspid, fears were entertained that it would be drawn back 
too quickly, but in this we were mistaken. A ligature was also placed 
on the first molar, and carried to the cuspid, for a double purpose, as 
we wished to draw the molar forward to help fill up the gap, and make 
it antagonize with the lower one. 
"It required nearly three months to draw the cuspid back where its 
point could pass out between the cusps of the inferior bicuspids. SIMEON H. GUILFORD 
607 
"At this time it was our purpose to make a new plate and adjust a 
jackscrew, which was not admissible before, for want of space to operate 
it. The apparatus was removed and for a temporary purpose, (as my 
time was limited), a bar was cut from a piece of compressed pine, beveled 
in the center, and placed firmly against the left bicuspid, and pressed 
firmly down to the margin of the gum. 
"A retaining plate of black vulcanite, with a bicuspid tooth to fill the 
remaining gap, was adjusted, fitting very firmly to the cuspid, forcing it 
out still further, and it is still worn with comfort." 
Ohio State Journal of Dental Science, 1886, page 107: 
"On the right side the plate is made thick to receive the end of the 
screw, a small hole being drilled for that purpose. The point of screw 
placed as seen in the cut, to move it out of the lock in the easiest pos- 
sible way, and also to give it a slight turn in its socket (Fig. 293). The 
Fig'. 292.-Method of correcting' a misplaced 
cuspid. (George W. Keely, 1885.) 
Fig'. 293.-Vulcanite plate with jackscrew. 
(George W. Keely, 1886.) 
point of a small broken drill was used to operate the screw. When the 
apparatus was properly adjusted, and the screw in place and tied with 
a thread to the plate as seen near the refractory tooth (this is done to 
prevent the loss of the screw as it is not a digestible substance), the 
screw is tightened two or three times a day, every time the patient in- 
sisting on vigorous work. The apparatus was removed every day and 
cleansed, and the patient was required to give his teeth a thorough 
brushing. 
"As the tooth moved to its normal position it disturbed, to some ex- 
tent, both the central and cuspid. At the end of the ninth day it was 
in place, and the apparatus was removed, and a retaining plate inserted 
and worn about ten days. In this case a retaining plate was not ab- 
solutely necessary, and was inserted only to hold it until the central and 
cuspid would fall back into place." 608 
ORTHODONTICS -HISTORICAL REVIEW 
(Page 250) "Recently an eight-year-old boy came to me, his tempo- 
rary centrals were in place, the right permanent central was caught about 
one-sixteenth of an inch-the left one just appearing. We removed the 
temporary centrals and gave him a stick of wedgewood, flattened at each 
end, to use as an incline to press on the left erupting tooth. 
"A perfect impression and model wore taken, a trial plate fitted over 
the roof of the mouth and posterior teeth, a bite taken to raise the teeth 
so the offending centrals would swing clear when moved to their normal 
position, and the patient have a masticating surface on the plate. Holes 
were drilled in the plate opposite the centrals, rhe plate reaching up to 
the cutting edges of the teeth. Sea tangle tent was first used to start 
them, then pins made from well-seasoned pine. The plate was removed 
daily and cleansed, and new pins adjusted.'' (Fig. 2'94.) 
Fig'. 294.-Vulcanite plate with pins of pine wood. (George W. Keely, 1886.) 
(Page 345) "Both arches were unusually well developed; the teeth 
strong and firm, all the posterior ones antagonized perfectly; all the in- 
ferior ones being in perfect line. The deformity appeared in the promi- 
nence of the six superior anterior teeth. Thumb-sucking was indicated 
as the cause of this unusual prominence, but I was assured by the mother 
that she had never been addicted to this prolific cause of such deformity. 
Unfortunately, she had a short upper lip, and in conversation she would 
expose the six anterior teeth, and the fourth of an inch of her gum, and 
could not use her upper lip in articulating words. She could cover these 
teeth only by drawing her lip down with her fingers. From the cutting 
edge of the superior incisors to the inferior, it was just one-half inch, 
one-fourth from the laterals, and one-eighth from the cuspids. 
"In this case the extraction of the first superior bicuspids was abso- 
lutely indicated, to make the necessary space to draw the cuspids back, 
and the incisors into line. The first apparatus used after the removal of 
the bicuspids, was a vulcanite plate, covering the roof of the mouth, and SIMEON II. GUILFORD 
609 
all the posterior teeth, with a grinding surface on the plate, raising the 
bite about one-eighth of an inch. We first separated the laterals and 
cuspids, as also the centrals, by drawing a piece of rubber between 
them, to make the necessary space to adjust around the cuspids, a very 
thin band of platinum, and secured in position with insoluble cement. 
(For this useful contrivance we are indebted to Dr. W. N. Morrison, of 
St. Louis.) Then we fitted a band of the same metal to the incisors, with 
hooks to go over the cutting edges of the centrals, and a hook passing 
between the centrals; or in other words a T arrangement. In the center 
of the plate a pin from an artificial tooth was fastened, and also four 
others both inside and out, opposite the first molars. To these we at- 
tached a strong rubber band, on each side, drawing them firmly and 
securing them to the bands on the cuspids. Then the T was put in 
Fig-. 295.-Chincap. (George W. 
Keely, 1886.) 
Fig'. 296.-An apparatus of vulcanite. 
(George W. Keely, 1887.) 
place, and a band drawn from the center to the hook on the T. Smaller 
bands were also carried from the inside pins to the hook. In this way 
we had three bands operating on the T to draw the incisors back, and 
at times doubled the power on the cuspids. The plate was cut away back 
of the incisors so as to wholly relieve all pressure on the parts in that 
region. This apparatus was worn for about two months, but removed 
and cleansed almost daily, and the patient required to cleanse her teeth. 
The bands around the cuspids, of course, were allowed to remain until 
their mission was accomplished. 
"At the end of two months a new plate was made, leaving ample space, 
so the incisors could be drawn back and into line. 
"The next apparatus used is like the one described by Prof. Norman 
W. Kingsley, as seen in his excellent work on "Oral Deformities," page 
134. This is shown in Fig. 295. ORTHODONTICS HISTORICAL REVIEW 
610 
"A perfect impression was taken of the six refractory teeth, and a 
vulcanized cap made on the model. The cutting edges fitting in the 
cap, arms an inch long extend out at each corner of the mouth. The 
skullcap was made of leather and strong rubber bands attached to it, 
the cap over the teeth adjusted and the bands drawn down and hooked 
on the arms. This apparatus finished the work of drawing the teeth in 
line, and at the same time forced them up into their sockets nearly one- 
eighth of an inch. At the end of four months she was dismissed, but 
required to adjust the skullcap arrangement at nights for about six 
Fig. 297.-William Henry Atkinson (1815-1891). 
months. She had no trouble in adjusting or removing it, and she seldom 
removed the rubber bands from the cap. She would simply draw the 
cap down and remove it, and readjust in the same way." 
Ohio Journal of Dental Science, 1887, page 202: 
"The following cut (see Fig. 296) shows an apparatus used in this 
case, but I rarely use it now, having almost wholly abandoned the use 
of the rubber band in front of teeth to be moved out of lock. When a 
perfect impression is secured, as also a model, the trial plate is fitted 
to the roof of the mouth and over the posterior teeth, adjusted, and a 
bite taken, raising the teeth apart barely enough to allow the refractory 
teeth to be moved to place. It is necessary to have the bite correct that SIMEbk 11. GUILFORD 
611 
the patient may have a surface for masticating purposes. A lead band 
should be fitted to the labial sdtfdces of the teeth to be moved, about as 
thick as the space required to draw the teeth to position, and a thin wax 
band on it with a button opposite each tooth. It is well to have the 
plate cover the palatine surfaces of the teeth to be moved, and either 
pins or wedges may be used at the same time the ligatures are operated. 
"It requires considerable skill to make and adjust a plate of this kind 
to remain firm in place, but when accomplished you are well prepared 
to begin work. Slots may be cut in the plate, opposite the teeth, for 
the admission of wedges, or holes for pins. Ligatures may be cut from 
rubber tubing, put over the teeth and drawn to the buttons, thus you 
will have the wedges and ligatures operating at the same time." 
Henry Clay Quinby (1832-1908), Notes on Dental Practice, 1883, in his 
chapter "Irregularities,^ says: 
Fig. 298.-Showing apparatus for 
moving- misplaced canine. (H. C. 
Quinby, 1883.) 
Fig. 299.-Showing- form of plate to take 
pressure off the back teeth, so as to allow 
them to elongate. (H. C. Quinby.) 
"The appliances necessary for operations of this nature have to be 
worn constantly, clay and night, at meal times and play time. They 
are sometimes so secured in the mouth that they cannot be taken out 
by the patient, but usually they can be removed for cleansing night and 
morning, and this is all the indulgence that can be permitted. They are 
often so constructed that bands or springs of gold or platinum are con- 
spicuously visible in the front of the mouth, and children wearing them 
have to make up their minds to give up parties for the time, or stand a 
little chaffing from their young friends, for they cannot have the plates 
out of their mouths for an evening's amusement. 
"Screws and springs, fixed in a vulcanite frame, as the case may re- 
quire, will move any number of teeth to any necessary extent, even 
when, as the following case will show, the patient is considerably beyond 
the age at which these operations are usually undertaken." 
One appliance is shown in Fig. 298 and illustrates the apparatus for 612 
ORTHODONTICS HISTORICAL REVIEW 
moving misplaced canines. Fig. 299 shows the "form of plate to take 
pressure off the back teeth, so as to allow them to elongate." 
In another case Quinby reports, he shys: 
"The next step was to move the bicuspids back, which was done by 
making a vulcanite plate to cover the upper molars, in order to take the 
bite of the lower teeth on the molars and the incisors, leaving the bi- 
cuspids so that the lower teeth could not touch them. A fixed nut was 
placed in the substance of the vulcanite opposite the buccal surface of 
the molar on each side. Then a narrow strip of very thin gold, shaped 
like a figure eight, was made to fit tightly over the bicuspids on each 
Fig'. 300.-Retaining plate in position. (H. C. Quinby, 1883.) 
Fig. 301.-Showing form of 
braces to be used in widening the 
upper jaw in connection with the 
jackscrew. (H. C. Quinby.) 
Fig. 302.-Showing another form of screw 
to be used in widening the upper arch, with 
the lever for turning the screw. (H. C. 
Quinby.) 
side, and a piece, shaped like a letter T, was soldered to the band, so 
that it would slip between the two teeth and the cross lie in the sulci, 
to prevent the band slipping too high up under the gum. A small ring, 
or rather a stud with a hole in it, corresponding to the size of the screw 
hole in the fixed nut, was also soldered to the band opposite the buccal 
surface of the second bicuspid. The apparatus was then placed in posi- 
tion, and a long screw, with a square head, was passed through the stud 
into the fixed nut, and screwed up. A key fitting the head of the screw 
was then given to the father of the young lady, with instructions to 
turn the screw every day as much as she could bear, and to see that the 
gums and teeth were sponged twice a day with a weak solution of car- SIMEON II. GUILFORD 
613 
bolic acid, letting me see the ease once a week, to take the plate off and 
clean it thoroughly. This treatment soon moved the bicuspids back. 
(Fig. 304.) 
"The plate for moving the front teeth was fitted over the molars and 
bicuspids. The fixed nut was placed opposite the first bicuspid and, of 
Fig. 303.-Showing the form of 
band and screw used in moving the 
bicuspids. The nut was fixed in the 
vulcanite plate. (H. C. Quinby, 1883.) 
Fig. 3 04.-Showing the form of the strip 
of gold that was used for moving the front 
teeth. (H. C. Quinby.) 
Fig. 305.-Showing the form of loop used 
for the canines. (H. C. Quinby.) 
Fig. 306.-Showing the regulating ap- 
paratus in position, with the loops for 
canines omitted. (H. C. Quinby.) 
Fig\ 307.-Showing the form of loop used in moving' the canines. The straight bar 
projecting' from the buccal surface of the plate is intended to prevent any outward 
movement of the teeth. (H. C. Quinby.) 
course, the plate had to be kept well back in the palate, allowing fully 
half an inch between its anterior edge and the lingual necks of the 
front teeth. A long strip of thin gold was cut in the shape of Fig. 
305, the lips being intended to be bent over the cutting edge of the 
central incisors to keep the band from slipping up onto the gum, and 
studs were soldered to the ends for the screws to pass through. The ORTHODONTICS HISTORICAL REVIEW 
614 
canines being always rather difficult teeth to move, I made a separate 
loop for each of them (Fig. 306) having holes through the ends, which 
were bent so that the holes would come opposite the holes in the studs 
at the ends of the long strip that went around the front teeth, allowing 
the screw to pass through both ends of the loop, as well as through the 
stud. (Fig. 307.) This soon forced all the teeth back to the required 
position. Another plate, with a plain band fixed in the vulcanite, pass- 
ing around the front or labial surface of all the teeth, with hooks, as 
before, bent over the cutting edge of the central incisors, to keep it from 
slipping, kept all these teeth in position until the alveoli were properly 
formed and the teeth quite firm in their new position." 
Fig. 307 of Quinby's shows "the form of loop used in moving the 
canines. The straight bar projecting from the buccal surface of the 
plate is intended to prevent any outward movement of the teeth." 
Fig. 300 illustrates a retaining plate in position. 
Quinby also made use of the jackscrew as shown in Fig. 301 showing 
form of braces to be used in widening the upper jaw in connection with 
Fig. 302. 
William H. Trueman (1842- ), before the Pennsylvania State Den- 
tal Society, 1883, (Independent Practitioner, page 521) being impressed 
with the value of the screw, read the following paper: "The Use of the 
Screw in Regulating Teeth/' 
"First, the advantage of the screw. It is positive motion; if it is 
moved one-quarter of a turn the tooth must move a corresponding dis- 
tance, for it is not dependent upon any action on the part of the patient. 
It is an unyielding motion; the tooth is moved and held firmly in its 
new position, and is not disturbed again for hours. That is the secret 
of its painlessness. It is not like a spring, that, when it has moved the 
tooth, allows some other force to move it back, and thus by a to and fro 
motion sets up severe irritation. It holds the tooth so firmly that in the 
most severe cases of interlocking there is no need of capping any of the 
teeth to keep the jaws apart. It works so rapidly that no injury need 
be feared from loss of antagonism while the tooth to be moved is taking 
its new position. 
"As each case requires its own special appliances, I can only give an 
outline of the manner in which the screw is fixed in position. 
"We first fit a band around the tooth to be moved, generally making 
it of platina-gold, as with it we obtain the greatest strength with the 
least bulk. If for one of the front teeth, we make it narrow, fitting it 
well down on the neck of the tooth, making it spring on tight, so that 
it cannot possibly slip over the crown. In putting it on, it is not, how- 
ever, slipped over the crown, but pushed through the little space always 
found at the necks of the teeth, from the inside of the mouth. It is SIMEON II. GUILFORD 
615 
well to let the ends come well through, and to make them pointed, so 
that when in place they may be tightened with pliers, as were the old- 
fashioned narrow bands on plates. 
"The bands fitted, we solder to each, with silver solder, a tongue of 
heavy silver plate to support the screw, and while soldering it to the 
front band extend a tongue to rest upon the palatine surface of the 
tooth, so that the band shall not press into the gum too hard. These 
tongues should not conform to the roof of the mouth, but be made 
straight, otherwise when the tooth moves they will be pressed into the 
gum. 
"We are now ready to attach the screw. First enlarge the holes in 
the bar to at least double their size, so as to admit an instrument strong 
enough to turn it when in the mouth. Now file the nickel-plating from 
both nuts, and so shape them that they will fit on the silver tongues 
snugly and present no sharp edges to the tongue, and then thoroughly 
coat them with tin, and also tin the lingual surfaces of the silver tongues. 
Now place the bands in position on the cast, lay the screw with the nuts 
Fig. 308.-Phosphor bronze band matrix with screw. (J. A. Woodward, 1885.) 
in position, screwed up nearly as far as they will go, and holding them in 
place, if needful, with a little plaster, thoroughly unite the silver tongues 
and nuts with soft solder; use it freely and be sure it takes hold well 
to avoid after trouble. The fixture is now complete. Before putting it 
in place oil the nuts and screw well; the surplus may be wiped off. but 
be sure there is plenty between the nut and the screw, or after a few 
days it will be impossible to turn them. It is often difficult to fix it 
secure enough to resist the force needed to turn the screw, and it is 
generally best to support it with the fingers, and to examine closely to 
see that it is not displaced before dismissing the patient. In screwing 
up turn gently and slowly and stop for a few moments if it goes hard; 
each time screw up as far as the patient can bear, and then from % to 
y4 of a turn more. The pain will cease in a few moments. It is best to 
go too slow rather than too fast, but that and many other little things 
are matters for the operator's judgment." 
J. A. Woodward. In reviewing the literature how often we come across 
an appliance used at the time for an entirely different purpose, meant 
to be foreign to that branch of dentistry, becoming obsolete as far as 
the original purpose is concerned and in time found to be incorporated 616 
ORTTIODONTICS HISTORICAL REVIEW 
in our science. Such an example is found in Fig. 308, Dental Cosmos, 
1885, and undoubtedly is the predecessor of our overlapping clamp 
bands. Woodward introduced it as a band matrix. It was made of 
phosphor bronze. No. 30 gauge and strip in form, bent to overlap around 
the tooth one-sixteenth of an inch. The screw was of steel (d) and fitted 
into a post made of piano-wire, (h) threaded and set back about one- 
Fig'. 309.-Vulcanite plate. (Cail Kuhns, 1885.) 
Fig-. 310.-Vulcanite plate, with an anterior attachment. (Carl Kuhns, 1885.) 
eighth of an inch and soldered to the strip with silver solder. The post 
in which the screw turns freely is set near the other end (c). 
Carl Kuhns (1850- ) in the Deutsche Monatschrift fiir Zahnheil- 
kunde, 1885, introduced in his treatment of irregularities of the teeth 
several additions to the vulcanite plate as seen in Figs. 309 and 310. 
There was little new, however, in his method of correcting irregularities. 
Thomas L. Gilmer (1849- ), in the Ohio State Journal of Dental 
Science, 1883, page 113, "Another Method of Regulating Teeth." SIMEON II. GUILFORD 
617 
"So much has been said about correcting irregularities of the teeth, 
that it may seem superfluous to add more; however, I am using an ap- 
paratus so serviceable that, not having seen anything similar described 
in our literature, it is possible that an account of it may be timely. 
"The object of all appliances for regulating teeth is to produce pres- 
sure in a given direction upon such teeth as need to be moved. An 
appliance capable of exerting constant pressure at a given point, one 
that is most easily made, that occupies the least space, and that when 
applied, needs the least attention, will give the greatest satisfaction to 
both operator and patient. In a majority of cases I have found that 
springs, held by bands around the teeth, more nearly meet these re- 
quirements than any other method known to me. 
"To form an appliance like that represented in Fig. 311, (being made 
in precisely the same manner, with the additional bands and connecting 
bar to be described later), secure a cast of the mouth, study it, and de- 
cide which teeth will best serve to carry the bands destined to hold 
the spring. In the case shown, the only remaining milk-tooth on this 
side of the mouth, and the first permanent molar, are selected. 
The bands may be made of gold, but platinum is preferable, because it 
can be worked thinner than gold, without danger of melting in soldering. 
They should be made to encircle the tooth or teeth completely in such 
a manner as to bring but one thickness of metal between the teeth; this 
may be done by using one piece of uncut metal for both bands, as fol- 
lows: Put the strip of platinum around the milk-tooth in such a manner 
as to bring the first line of solder to its distolingual angle; the free end 
is then carried around the first permanent molar and soldered to the 
band already around the milk-tooth, at its distobuccal angle. This com- 
pletes the two bands from one piece of metal. 
"In order to put the pressure on as many teeth as is convenient to 
prevent the possibility of moving them, solder a spur, A, to the anterior 
buccal portion of the anterior band, so that it will catch upon the bi- 
cuspid. Next, from the same metal form on a piece of wire, correspond- 
ing in size to that which is to serve as the spring, a tube, B, varying 
from one-fourth to three-fourths of an inch in length, as the case may 
demand. Before soldering this tube it should be filled with pumice or 
soapstone, to prevent the solder flowing into it and diminishing its 
caliber, thereby interfering with the easy adjustment of the spring. 
The tube is then soldered to the bands in such a manner as to hold the 
spring in its proper relation to the tooth or teeth to be moved. The 
bands should be from one-third to one-half as wide as the teeth are 
long, according to the case in hand, and of thickness, No. 28, or even 
less. For the spring I find nothing better than piano wire. The only 
objection that can be urged against it is that it corrodes slightly in the 618 
ORTHODONTICS HISTORICAL REVIEW 
mouth; this amounts only to a blackening of the wire, its polish being 
retained, and this is of little consequence, since it is usually out of 
sight. (If our dealers would furnish us with nickel plated piano wire, 
it would be just the thing needed.) Either platinum alloyed gold, or 
spring brass wire may be used in lieu of the steel, but the steel is 
preferable. 
"A wire of the same size as that upon which the tube was formed, is 
bent, without being heated, at a point corresponding in length to that 
of the tube, and in such a manner that when applied it will catch in the 
slot cut in the tube at C, to prevent the rotation of the spring while in 
Fig. 311.-Gilmer's method (1883). 
use; the remainder is shaped to suit the case in hand, so that it may 
exert its full force in the direction in which the tooth is to be moved. 
"It will usually be found necessary to have some means of fastening 
the spring where it comes in contact with the tooth, to prevent it slip- 
ping if pressure is made toward the tooth, or to fasten the ligature con- 
necting it with the tooth, if the latter is being pulled into line; in either 
case a turn may be made on the wire at this point, as shown in Fig. 
311, D, by means of which it may be securely tied to the tooth to be 
moved. 
"The teeth upon which the bands are to be placed, having been pre- 
viously wedged apart, the appliance, being now complete, is put in place, 
and the spring adjusted until the required pressure on the tooth to be 
moved is obtained, when, if necessary, it is secured to the tooth and the 
patient dismissed with the satisfaction of knowing that the work will SIMEON H. GUILFORD 
619 
go steadily on, rapidly or slowly, in proportion to the weakness or 
strength of the spring. 
"When the tooth has moved so far as to allow the spring to obtain a 
position of rest, the wire is readjusted in such a manner as to cause it 
to resume pressure. In determining upon the size of the wire to be 
used as a spring, it is necessary to take into consideration the length of 
the spring, the number of teeth to be moved, and the probable resistance 
which they will offer. 
"When it is desirable to rotate an incisor it may be done, soldering a 
tube or carrier to the labial as well as to the lingual sides of the bands, 
and forming for each a spring, one of which will make pressure upon the 
labial, while the other exerts its influence upon the lingual projecting 
angle of the tooth to be rotated. In such cases it will generally be found 
that the ligature is insufficient to hold the springs in their relation to 
the tooth, and the more substantial method of encircling the tooth with 
a band of platinum, which has catches upon it to hold the spring, will be 
necessary. If the occlusion of the teeth will permit, it may also be ac- 
complished by the use of one spring only, by attaching the tube or carrier 
of the spring to the tooth to be rotated, the free end of the spring being 
so adjusted as to rest against the neighboring teeth, and secured to 
them either by ligature or otherwise. 
"In some cases, owing to the difference in the size of the teeth at 
their necks and grinding surfaces, the bands, when applied, are too loose, 
and consequently are unfit for the purpose for which they were in- 
tended. To obviate this difficulty the bands may be applied and secured 
to the teeth by means of some one of the zinc preparations. This method 
of fastening bands to teeth was brought to my notice by Dr. Morrison, 
of St. Louis, he using it in connection with his jackscrews. If a tooth 
is to be rotated, the band upon it should generally be secured by this 
means, since we are thereby enabled to use much thinner platinum than 
otherwise. 
"The main points to be observed in the construction of these appli- 
ances are, to secure firm anchorage, and to form and adjust the springs 
so that they will make the desired pressure in a line corresponding to 
that in which the tooth is to be moved. No great skill is necessary in 
the construction of these appliances; a knowledge of mechanics and some 
acquaintance with the working of metal will be requisite, but, owing to 
its simplicity, anyone who has had even a limited experience in this line, 
will succeed." 
Amedee Dechambre (1812-1886), " Dictionaire Ency cl opeclique des Sci- 
ences Medicates," 1883. The whole of this volume is almost exclusively 
devoted to Dent (tooth) and Dentaire. The writer divides the subject 
tooth into seven chapters. In the first, descriptive anatomy, he gives us 620 
ORTHODONTICS HISTORICAL REVIEW 
a very full account of tlie anatomic characters of the teeth. 1 he second 
chapter is devoted to histology, and here we find a good description of 
the microscopic appearances of the various tissues. Tome's views as to the 
nature of Nasmyth's membrane are adopted in preference to Koelliker's. 
The comparative anatomy of the teeth forms the subject of the third 
chapter, which is written in conjunction with Dr. Cheuveau. The nu- 
merical characters of the teeth are first given; and secondly their seat, 
direction, and relations to the neighboring parts. Their dimensions, 
length, breadth, and volume are next considered, and lastly we have a 
clear description of the various forms of teeth. 
The fourth chapter, physiology, is one of the best and most complete 
of the whole work. It commences with the discussion of the origin and 
formation of the tooth follicle. The author's experience is based on a 
series of dissections of early embryos. The first was 3 cm. long (seventh 
week), and presented no vestige of epithelial lamina. The next one was 
5.5 cm. long (two months) ; the enamel organ and tooth-papilla could 
both be very easily distinguished, and an important point noticed was 
that the follicles of all the milk-teeth were at precisely the same stage 
of development in both jaws. Tn another embryo, 20 cm. long, the 
author was able to make out the first traces of the secondary epithelial 
cord, i.e., the germs of the enamel organs of the permanent teeth. The 
epithelial outgrowth for the wisdom is said to be formed from the cord 
of the second permanent molar, and to first make its appearance towards 
the third year. 
All the author's researches on this point show the analogy which exists 
between the formation of the tooth and hair follicles. 
The growth of the various dental tissues is then treated in detail, and 
in the paragraph on the formation of dentine, we are fold that the con- 
tinuity on the one hand, between the dentinal fibrils and the odonto- 
blasts, and on the other, between the odontoblasts and the terminal twigs 
of the dental nerve, have been satisfactorily made out, thus fully explain- 
ing the sensitiveness of all parts of this tissue. 
The laws of dentition are next discussed, and we arc told that there 
are no examples on record of either a third or fourth dentition. Some 
weighty arguments are brought forward against Darwin's views, which 
are also shared by Mantegazza and Broca, on the cause of the non- 
eruption of the wisdom tooth, viz., that it is a degenerating organ; the 
author inclines to the belief that this failure is rather to be attributed 
to the want of development of the jaws. Further, that a diminution in 
the number of teeth must be looked upon as a sign of degeneration in a 
race, but that the increase points to a degree of inferiority directly 
proportionate to the amount of ethnical prognathism, or obliquity of 
the jaws. SIMEON H. GUILFORD 
621 
The pathology of the teeth forms the subject of the sixth chapter. 
Pathology must be here taken in its French extended sense of etiology, 
morbid anatomy, and symptomatology. 
The various malformations of the dental apparatus are first very 
clearly described. Some curious instances are given of migration or 
malposition of teeth in various parts of the body. The treatment recom- 
mended for the different irregularities is chiefly mechanical, but the 
author expresses himself strongly in favor of the surgical treatment, i.e., 
luxation and turning, in appropriate cases. A very full description is 
then given of the numerous forms of erosion; but the view expressed as 
to their nature and cause will hardly meet with much support here. 
Julius Parreidt. "On the Causes of Disproportion Between the Size of 
the Jaw and the Teeth." Irregularities of the teeth are very often seen 
which arise from disproportion between the size of the maxillary arch 
and that of the teeth. It is the duty of the dentist to rectify this dis- 
proportion as far as possible, either by extending the alveolar arch by 
pressure from within or by extracting some teeth which would make the 
required room for the remaining teeth. Such irregularities are often 
handed down from parents to children. A child whose parents had 
strongly built jaws would probably have strongly built jaws itself, whilst 
parents with small jaws often bequeath them to their children. If one 
parent has broad and the other narrow jaws the children will some in- 
herit the broad and some the narrow. Very often the children's jaws 
are between the two extremes. All this happens only under normal cir- 
cumstances, through disease in the first years of life the size and form of 
the jaw can be greatly influenced. What has been said of the jaws is 
true in a much greater degree of the teeth. They often show some pecu- 
liarities of the father or the mother. Brothers and sisters can often be 
recognized by their teeth, but as a rule they do not have teeth alike. It 
is very unfortunate if the child inherits the narrow jaws of the mother 
with the father's broad teeth; but the opposite ease is better when nar- 
row teeth are found in large jaws. The development of all organs is 
dependent in a great degree on the common nourishment of the body, 
but disease and deficient nourishment do not affect all parts of the body 
in the same degree. The jaw and teeth are very different in this respect; 
the jaw can gnaw during the whole time of youth, but the teeth cannot 
be greater nor smaller than when they were formed in the embryo. The 
teeth which are cut from the age of seven to twelve years, exist in the 
embryo before the child is born; and after the birth, in the first three 
years of life, the premolars and second molars begin to form. The wis- 
dom tooth, which appears in the nineteenth year, has been forming since 
the eighth year. The tooth can under no circumstances have a less 
breadth of dentine mass than was laid for it at dentification. Disease ORTHODONTICS HISTORICAL REVIEW 
622 
and insufficient nourishment may work on the formation of the teeth, 
but only in diminishing the zone of the tooth bone. 
As to the enamel, it can with good nourishment increase in thickness 
until the destruction of the enamel organ, and insufficient nourishment 
will cause the layer to be thinner. 
Illness, too, in the first years of childhood, considerably influences the 
formation of enamel, and in honeycomb teeth, scarcely a trace of it is 
to be found on the crown. 
But the layers of enamel after all change so little in thickness, that 
the nourishment of the body does not visibly affect the size of the teeth. 
As a rule, all organs of the body which are much used are more 
strongly developed than parts that are allowed to remain idle; but in 
this respect the teeth are an exception, for they do not increase in size 
by much use, although the more they are used the more firm they become. 
But with the jawbones if is different, for the laziness or disinclination 
of some children to chew food that requires it, and to take only soft 
food is one of the most frequent causes of disproportion between the 
jaws and the teeth. 
Children should not be allowed to leave their crusts of bread, but 
should be made to chew them thoroughly and slowly. Very often at three 
or four years of age the teeth are disturbed, and the child finds difficulty 
in chewing and is given soft food, and so is disinclined to use his teeth. 
But it is the use of the milk-teeth which broadens the jaw and gives 
firmness to the remaining teeth. So we conclude that the influences of 
life only alter the size of the teeth before dentification; but that use or 
disuse will enlarge or decrease the size of the jawbone. So, as the jaw 
can increase in size for so much longer a period than the teeth, we see 
bow it can come about that there is constantly so great a disproportion 
between the size of the jaws and that of the teeth. 
Harry Sanford Burton. "The Etiology of Dental Irregularities." Ir- 
regularity of the teeth in the human subject is the result of a departure 
from the normal type, and to a greater or less degree as regards the form 
and capacity of the jaws; there being at the same time in the teeth no 
apparent degeneration in outward form and general proportion when 
compared with teeth of considerable antiquity. 
"True, instances have been recorded of displacement of the incisors, 
either congenital or the result of unfortunate habits such as thumb- 
sucking, prolonged use of an artificial nipple, etc., but, as a rule, we 
find such cases to be few and far between, and scarcely to be looked upon 
as matters of importance, unassociated as they are with any other pecu- 
liarities, neither being indicative of irregularity in the development of 
their permanent successors. If we examine the normal type of a decid- SIMEON H. GUILFORD 
623 
nous dental arch we find, as a rule, the teeth well formed and their posi- 
tions regular; yet associated with the development of the permanent set, 
are irregularities of the most astounding character. 
"To judge of abnormal conditions, it is necessary to be familiar with 
some standard of normality. In the dental arch, I conceive such a 
standard to be that ample capacity which admits of the perfect arrange- 
ment of the teeth, whether in the elliptic corresponding to the bracheo- 
cephalic type of skulls, or the round arch synonymous with the dolicho- 
cephalic form. 
' ' To put it otherwise, we may look upon our normal standard as a regu- 
lar curved line, which although differing in width and degree in various 
races, will still be an elegant curve, without any tendency to form an 
angle. Such a type I now present to your notice. All departures from 
this type must be classified as deformities. 
' ' Such being the case it behooves us to consider as carefully as time will 
admit of, the causes conducive to such an unfortunate state of affairs. 
And first, as to the theory of premature extraction of the deciduous teeth; 
the idea that a too early removal of the temporary teeth affects preju- 
dicially the development of their successors, rests upon the supposition 
that such action results in the contraction of the maxillae. Remove these 
teeth? Why the jaw will contract! Such remarks have doubtless often 
been heard by most of us, and it is astonishing how generally prevalent 
such an opinion is. 
"But experience does not bear out such a theory in the slightest de- 
gree. Mr. Tomes relates a case in which he removed from a child all the 
deciduous teeth prior to the eruption of their permanent successors, 
leaving the mouth for a time edentulous. Nevertheless in due time the 
permanent teeth developed in perfect regularity of sequence and of sym- 
metry. However the removal of many or most of the temporary teeth 
may affect the development of the permanent set, there is one thing 
which perhaps ought to be guarded against, and that is too early removal 
of the temporary canines. One occasionally sees cases where, from some 
cause the removal of these teeth has been effected, the space has closed 
up, and the permanent teeth have been misplaced, with every probability 
of the necessity of using artificial aid to produce a return to their nor- 
mal position. 
"This, then, is the theory. That during their eruption the permanent 
teeth are under the influence of a peculiar nervous force, pushing on 
their development regardless of a more tardy growth of the osseous 
system. Having no time to recover from this, they emerge in the same 
disordered arrangements in which the crowns were formed, this nervous 
condition being caused in the first place by requirements of civilization ORTHODONTICS HISTORICAL REVIEW 
624 
correlative with a too great stimulative of the brain. If hereditary, we 
may suppose such a condition to have been present in the antecedents. 
"To conclude, then, we have this argument. The cause of irregularity 
of the teeth other than accidental, lies in the insufficient development of 
the maxillae as compared with the size of the teeth, this being sometimes 
due to a retarded growth of the jaw coincident with an ample develop- 
ment of the teeth, or, on the other hand, an inheritance of large teeth 
out of all proportion to the size of the maxillae. CHAPTER XXV 
EUGENE S. TALBOT TO WM. G. BONWILL 
Eugene Solomon Talbot, M.S., D.D.S., M.D., D.Sc., LL.D., (1847-1925). 
In the Dental Cosmos of 1881 we find the first article on "The Regulation 
of Teeth hy Direct Pressure," written by Talbot. From that time until 
the present, his articles are scattered throughout the dental and medical 
journals; those presented before societies prior to 1888 were incorpo- 
rated in his first work-" Irregzilarities of the Teeth." This book has 
passed through some half a dozen editions and a great deal of material 
which is included was never presented in the dental journals or before 
societies. 
Talbot's (first edition) work, while covering the usual subjects of 
anatomy, etiology, development, etc., included some subjects heretofore 
but slightly treated. Tie approached the question of etiology of maloc- 
clusion from a standpoint not previously known and in the fourth edition 
we find the following: 
"The unwritten law in general medicine, 'that to know the cause is 
half the treatment,' is also applicable in the treatment of deformed jaws 
and irregularities of the teeth. Without the knowledge of etiology no 
one can successfully correct deformities as is evident in the many fail- 
ures by men who profess to make this a specialty." 
He has confined himself entirely to his own appliances and methods 
of treatment. "Systems" in the ordinary charlatan-like sense are not 
accepted as guides. In the author's opinion the practitioner should be 
familiar with the etiology of the case in hand; his knowledge of princi- 
ples and mechanics should suggest to him the most suitable appliances 
for the given case. Every force has its place in the treatment of these 
deformities. 
In the second edition we find the following: 
"Health of the body, like that of the mind, depends largely on the 
proper performance of the various bodily functions. The kind and de- 
gree of functional activity must be suited to the individual. When this 
accord exists we have happiness of mind and health of body. In a re- 
cent article in a medical journal, the baleful influence of idleness in 
prison life is discussed. It is stated that the consequences of the labor 
law of 1888 were the increase of insanity, a higher death rate, a shattered 
morale and an unprecedented deficit in the sum total of earnings as com- 
pared with expenditures. This illustrates a far-reaching principle. Not 
only is activity necessary to the well-being of the individual as a whole, 
625 626 
ORTHODONTICS HISTORIC AD REVIEW 
but to every organ. Excessive action or impaired function imply disease. 
The stomach, if overloaded or required to digest unsuitable food, be- 
comes enfeebled. Every organ depends for its integrity immediately on 
the nervous system. When nervous activity is impaired or lacks balance, 
the general balance of function is disturbed. Nowhere are results of this 
lack of equilibrium more visible than in the teeth. 
11 Malnutrition resulting from disease, from insufficient or unsuitable 
food and unhealthy environment, is the cause of idiocy, insanity, blind- 
Eig. 312.-Eugene Solomon Talbot (1847-1925) 
ness and other defects. Derangement of the nervous system usually un- 
derlies these conditions as found among the poor. But there is another 
class of individuals who suffer from neurotic conditions. They are those 
who are well fed and housed, but have overtaxed their nervous systems 
by improper modes of life and various forms of excitement. The two 
classes have this in common, that the functions of the nervous system are 
impaired, and they show similar results of defective nutrition. This want 
of balance produces an osseous system that shows excessive development 
in some of its parts, and arrested development in others. Nowhere is this 
more manifest than in the maxillae. Thus we have the causes of constitu- 
tional irregularities established. We see the disturbances of the func- EUGENE S. TALBOT 
627 
tions of the organs of the body as a whole result in constitutional irregu- 
larities. The impairment of the function of the teeth themselves gives rise 
to local irregularities. The importance of the correct performance of the 
function of these organs will be seen from a brief consideration of the 
results of the impaired activity. 
"1. Teeth to be clean must be used. When one-half of the arch alone 
is in use, the other half shows an unusual deposit of tartar, with hyper- 
trophy of the mucous membrane and gums. 
"2. The development of the alveolar process depends on the use or 
disuse of the teeth. When the bite is too close in the posterior portion 
of the arches, an effort is often made by Nature to correct this by length- 
ening the process in the anterior part. Cases of anterior protrusion afford 
study of these conditions. When forced to perform an abnormal function 
in these cases excessive development results. 
"3. Not only does the alveolar process lengthen when not in use, but 
individual teeth elongate as well when deprived of their antagonists. 
"4. Nowhere does interrupted function produce more mischief than in 
the derangement of articulation. The function of every individual tooth 
is indicated by its form. This shows that it should touch at certain points 
and antagonize at others. There is a certain degree of motion percepti- 
ble only by its effects. When the support of a tooth is withdrawn by the 
extraction of a neighbor, this motion is no longer sufficiently restricted, 
and there is more or less migration or tipping. The basilar ridges of the 
anterior teeth, and the cusps of the posterior, are resting-places for their 
antagonists. Let this support be taken from one or more teeth, and 
their function is destroyed in part and their health impaired." 
In order that our readers have some idea of the scope of this volume 
a portion of the contents of the fourth edition is given: Seventeen pages 
are devoted to History, followed by Heredity, Congenital Factors and 
Maternal Impressions, Postnatal Skull and Jaw Development and Peri- 
ods of Stress, Development of the Cranium and Face, Development of 
the Jaws, Development of the Alveolar Process, Development of the 
Vault, Development of the Peridental Membrane, Development of the 
Teeth, Social Consanguinity, Near-Kin, Early and Late Marriage, etc. 
The practical subject, which includes appliances, is not reached until 
the last chapter, under the head of Surgical Corrections, and this covers 
forty-four pages. It will thus be seen that the author has not regarded 
as of much importance the mere description of cases or the preparation 
of appliances used. 
In the chapter on the Development of the Jaws, this curious fact is 
stated, presumably on exact measurements. "The lateral diameter of 
jaws of existent races in Europe is greater than of the same races in 
America. * * * The jaws in older parts of the United States are 0RT1IODONTICS HISTORICAL REVIEW 
628 
smaller than jaws in the newer. The differences between jaws of the resi- 
dents of Boston and those of Chicago are thus in evidence. Presumably 
it is to be inferred that the farther west the child is born there will be 
a proportionate increase in the diameter of the jaw; a discouraging fact, 
if it be a fact, for those born on the Pacific coast, as they will rapidly 
develop into the large jaws of the American Indian." 
The author discards "dome," "palate," and "arch," in speaking of 
the roof of the mouth and adopts the word "vault." This includes the 
hard palate, the soft palate, and the alveolar process. 
Though Dr. Talbot may not have made great contributions to ortho- 
dontia from the mechanical treatment of irregularities, his extended 
researches of over forty years have, however, produced results which 
have had a great deal of influence in advancing both the science and 
practice of our specialty. Along the line of evidence of maldevelopment, 
Talbot observed that which he called degeneracy, but undoubtedly in the 
future will be recognized as disturbances of the internal secretory glands. 
Of his own devices he described and illustrated his coiled springs, jack- 
screw, etc., for expansion of the arch or for movement of the individual 
teeth. He also advanced and advocated surgical correction by removal 
of the alveolar process and tissue in the path of moving teeth. 
Returning to the journal articles of Talbot in 1881 we find him using 
the jackscrew as shown in Figs. 313, 314, 315, and 316, the use of which 
he describes in the following manner: 
"I secured a jackscrew of the proper length firmly to the canine upon 
the right side, allowing it to come in contact with the tooth I wished to 
move-the bicuspid of the opposite side. When this was forced laterally 
sufficiently, I removed the nut on the end of the screw and replaced it 
with a wedge, which was inserted between the bicuspid and the canine. 
The canine being firm and inflammation having been already produced 
around the bicuspid, it yielded readily to the powerful pressure of the 
screw and wedge. When this had proceeded as far as possible, the wedge 
was removed and a thicker one substituted. As soon as the tooth reached 
the molar, it was secured to it by ligatures and so hold in place. I fas- 
tened my jackscrews firmly to the canines and forced them laterally 
until inflammation set in. Wedges were put upon either end of the 
screw, inserting them between the canines and lateral incisors. The lat- 
erals being solid, acted as fulcrums, and the canines were easily forced 
into place. These were then fastened by ligatures. To move the lateral 
incisors I employed a short screw with wedges, in which holes had been 
drilled. To each central I tied a linen thread, carrying it around the 
lateral, over the end of the wedge on the screw, and passing it through 
the holes, tied it fast. By turning the screw the laterals wore not only 
forced outward, but were rotated in their sockets. When this was ac- EUGENE S. TALBOT 
629 
complished, I fitted a plate to retain the teeth in place and also to draw 
the centrals back into the arch. This was clone by running a piece of gold 
wire across the labial surfaces of the centrals, from which a rubber 
band was carried posteriorly to a loop in the rubber plate. As soon as 
they reached the proper position, another plate was inserted with a gold 
band passing over the outside of the teeth to hold them in place." 
Fig. 313.-Jackscrews as described by 
Talbot (1881). 
Fig. 314.-Jackscrews applied to a case. 
Fig. 315.-Jackscrews applied to a case. 
Fig. 316.-Jackscrews applied to a case 
(1881). 
In the Dental Cosmos for May, 1885, Talbot introduced coiled springs 
under "Dental Regulating Apparatus," as follows: 
"In many operations designed for the regulation of teeth, one of the 
first and most difficult things to be done is the spreading of one or both 
of the dental arches, and usually much time is consumed in efforts to 
obtain a fixed point from which movements may be made. The jack- 
screw is a positive and simple device, but it cannot be used from side to 
side of the inferior maxilla because of the intervening tongue; it also 
interferes greatly with vocal articulation, if so adjusted as to span the 630 
ORTHODONTICS HISTORICAL REVIEW 
palatine arch, and as the majority of cases to be regulated are those of 
children in attendance at school, they must thus be either kept out of 
school or be subject to great annoyance from the jackscrew impediment. 
"The Coffin cleft plate is an improvement in comparison with the 
jackscrew, but likewise interferes with the tongue if used on the inferior 
maxilla ; and when applied to the superior maxilla the complex character 
of the spring makes the fixture difficult to adjust in such relations that 
the expanding force shall be exerted in directly opposite directions, the 
spring having usually a tendency to thrust the plate out from the mouth; 
and, in cases where the teeth are not fully erupted, it is extremely diffi- 
cult to retain such plates in position. 
"An appliance by which I have obtained the most satisfactory results, 
with a minimum of hindrance or discomfort to the patient, will be de- 
scribed with reference to the accompanying illustrations. 
"One appliance shows a spring made of piano wire, coiled three times 
around a mandrel of the same or a little larger wire, and then bent down 
so that the arms will be in the same horizontal plane. 
"On an exact plaster model of the case to be regulated a thin, narrow 
vulcanite plate is formed, with a short vertical post fixed, either before 
vulcanizing or afterward by drilling, centrally in the plate on the median 
line. Grooves or slots are, with a wheel bur, cut in the sides of the plate 
to receive the ends of the spring and prevent its displacement after the 
coil has been placed on the post. Fig. 317 represents such an appliance 
in position on a plaster cast of the inferior maxilla, and it will be thus 
seen that the movements of the tongue would not be, as in practice they 
were not, seriously restricted. For the superior maxilla the plate is of 
like construction, and in some instances may be ligated to the teeth. 
The tension of the spring is changed by simply bending outward or in- 
ward its arms, and in many cases the apparatus may be inserted or re- 
moved with great facility, and its action be so continued and controlled 
that the required expansion may be obtained and maintained by the use 
of but one plate. In occasional instances the plate may be dispensed 
with, and by the judicious use of ligatures the spring-arm may be 
attached directly to the teeth to be moved, while the coil is likewise 
fastened to the front teeth." 
Fig. 317 is taken from his article, ''Spreading the Dental Arch," Cos- 
mos, 1886, page 19, and is a modification of his previous regulating appa- 
ratus and needs no further description. 
Fig. 318 is to be found on page 97 of the same journal, while Fig. 319 
illustrates Talbot's method of expanding the superior laterals. 
"Thin platinum collars were made to fit the laterals, on which, after 
drilling a hole in the side of each collar, they were firmly fixed with oxy- 
phosphate of zinc. A Norton-Talbot spring was bent into the form EUGENE S. TALBOT 
631 
shown, the ends of the arms being turned at a sharp angle and cut short 
as seen in the figure. 
"The spring was then put in place, the arm ends entering the holes 
in the collars, and the curved arms found to be so closely conformed to 
the surface of the gums and palatine parts that the fixture was no ob- 
struction to occlusion, and yet could be easily sprung out of position for 
Fig. 317.-Plate vulcanite, with coil in 
place (1886). 
Fig. 318.-Appliance for expanding supe- 
rior maxilla. 
Fig. 319.-Expanding the superior lateral. 
Fig'. 3 20.-Method of moving individual 
teeth by coiled spring (1886). 
cleansing purposes or for increasing the expansive power of the spring, 
by simply widening the lateral spread of the arms." 
Fig. 320 shows another method of moving individual teeth. 
"To force out central and lateral incisors, I have found the following 
methods useful: Around the tooth to be moved, and around the molars 
as nearly opposite the direction the incisor is to travel as possible, fit 
platinum collars. Solder cups upon the collars directly opposite and in 
line. Make a spring of piano wire, and spring it into the cups soldered 
upon the collars." 632 
ORTHODONTICS HISTORICAL REVIEW 
In regal'd to the extraction of the sixth-year molar, Talbot, in the 
Items of Interest for 1888, page 12, says: 
"If the temporary teeth are extracted, the first permanent molar will 
work forward and fill the space intended for the bicuspid tooth. In 
other words, the central incisor, lateral incisor, cuspids, temporary mo- 
lars, and the six-year molar, will all be in the jaw. If at the same time, 
from decay or other cause, the second temporary molar is removed, the 
first permanent molar will work forward and fill the space of the second 
temporary molar. 
"This will be better comprehended when you go home and examine 
the models and mouths of your patients. It will be seen that if the teeth 
have been removed on one side, the molar has worked forward from an 
eighth to a quarter of an inch, or as far as the crowns of the bicuspids. 
I have tried it time and again and it is invariably the same. If you will 
take your rule and measure from the middle line to the anterior surface 
of the first permanent molar, you will find that the space is narrower 
from the middle line to the anterior point of the first permanent molar 
by an eighth of an inch than on the other side of the jaw where the tem- 
porary molars are in place. When we consider how many of the tem- 
porary teeth are prematurely extracted, we need not be surprised at the 
number of irregularities of the teeth. It is quite common to find this 
condition. 
"In regard to the extraction of the sixth-year molar, I do not believe 
in the extraction of any teeth except in extreme cases. If we have the 
first permanent molar decayed to such an extent that the pulp is dead, 
and the roots are not properly formed so that they can be filled, that 
tooth should be removed. In some cases this will correct the irregularity, 
but will not serve for all, because the permanent teeth have a tendency 
to work forward to fill the spaces so that the other teeth cannot come 
through. 
"Another irregularity which is quite common is where the permanent 
cuspid has pointed up on the outer side of the alveolar process. It is 
quite common to find the first bicuspid tooth worked forward to such an 
extent that the permanent cuspid cannot come down into place, and the 
cause of that is extracting the temporary cuspid tooth. Then often, if 
the arch is large, I agree that the first bicuspid should be removed that 
the cuspid tooth may come down into position." 
It is in the July number of the Cosmos, 1888, that we find Talbot seri- 
ously considering the "Etiology of Irregularities of the Teeth." He 
treated the causes under the following subheads: Arrest of Develop- 
ment of the Superior Maxilla.-Consanguinity in Its Relation to Deformi- 
ties in General.-Scrofula.-.Drunkenness in Parents.-Prenatal Influence 
and Intrauterine Education.-Report of Cases of Arrested Development EUGENE S. TALBOT 
633 
and Excessive Growth of AU the Tissues, in Connection with Idiocy, Imbe- 
cile and Feeble-Minded Children.-Abnormally-Shaped Heads, and con- 
cludes his article with this resume: 
"1. Irregularities of the teeth cannot be justly said to be of congen- 
ital origin, since they do not exist at birth. 
"2. Irregularities of the teeth cannot occur until they have erupted, 
and thus show their relation to each other and to the jaw. 
"3. Irregularities of the teeth which I have denominated constitutional 
prevail to a greater extent among the idiotic, deaf and dumb, and blind, 
than among an equal number of strong and healthy persons. 
'A. It may be seen that not only is the brain matter deficient in the 
feeble-minded, but, as I have noted, many cases are seen which demon- 
strate that the osseous system is also generally defective. 
"5. Arrest of development is the result of malnutrition during embry- 
onal and infantile growth, influenced by consanguineous marriages, scrof- 
ula, drunkenness in parents, prenatal influences, intrauterine education, 
and constitutional diseases, or of inflammation of the osteophytic mem- 
branes in utero. 
"6. Irregularities of the teeth do not exist among normal or large 
jaws, while among' those who have abnormally small jaws, the majority 
have irregular teeth. 
"7. When premature ossification of the sutures at the basis cranii 
takes place, the anteroposterior diameter is shortened, producing ar- 
rested development of the superior maxilla. 
"8. When the bone tissue is arrested in development from malnutri- 
tion, the maxillary bones are also affected. 
"9. When arrested development of the superior maxilla occurs the 
face often presents a sunken appearance at the angle and root of the 
nose, with the nose broadened and the inferior maxilla prominent. 
"10. In another paper I shall attempt to prove that the irregularities 
of the teeth called constitutional are the result of small maxillae, and 
that Dr. Hammond's future man will not only lack hair and teeth, but 
the superior maxilla will gradually decrease in size and eventually be- 
come rudimentary. " 
This article was continued under the following subheads: 
"Arrest of Development of the Maxillary Bones Due to Racecrossing, 
Climate, and Soil.-Climate and Soil. (Subhead II, page 533.) 
"From the foregoing it seems legitimate to draw the following con- 
clusions : 
"1. The same influence which produces the small jaw in the idiot, deaf 
and dumb, and blind, will also produce the small jaw in strong-minded 
individuals. 634 
ORTHODONTICS HISTORICAL REVIEW 
"2. Heredity and conditions of life can give rise to a variety, and as 
the individual that has begun to deviate from the type becomes in its 
turn apparent, tending to transmit to its offspring the exceptional char- 
acters that distinguish it, the variations become more marked in the 
offspring, and heredity transmits the sum of these variations to the fol- 
lowing generation. 
"3'. Irregularities of the jaws and teeth are not found in pure races 
nor in aborigines. 
"4. Irregularities of the jaws and teeth are common in mixed races, 
and more common in the offspring of races differing widely from each 
other. 
"5. Such irregularities are not the result of high and selective breed- 
ing, since such breeding obtains only in pure races and aborigines, in 
which the irregularities are not found. 
"6. Conditions of life, climate, soil and food play an important part 
in irregularities of the jaws and teeth, when taken in connection with 
race-mixture. 
"7. In older parts of new countries in which a number of generations 
have lived, small jaws and irregularities of the teeth are more numer- 
ous than in the newer parts of new countries. 
"8. The shape as well as the size of the head has much to do with the 
shape of the jaw. 
"9. The prognathism of the jaw increases with the age of the individ- 
ual. It is, however, sometimes a natural growth, as noticed in the negro, 
and is characteristic of that race. In the American race it is due mostly 
to local causes." 
"Arrest of Development and Excessive Growth of the Maxillary Bones." 
(Subhead III, page 630.) 
"Development of the Inferior Maxilla by Exercise, and a Symmetry of 
the Lateral Halves of the Maxillary Bones." (Subhead IV, page 693.) 
"Asymmetry of the Maxillary Bones." (Subhead V, page 783.) 
"The Alveolar Process.-Hypertrophy of the Alveolar Process." (Sub- 
head VI, page 876.) 
Dental Cosmos, 1889, "The Origin and Development of the V- and 
Saddle-shaped Arches, and Kindred Irregularities of the Teeth." (Sub- 
head VII, page 1.) 
"The Origin and Development of the V- and Saddle-shaped Arches and 
Kindred Irregularities of the Teeth." (Subhead VIII, page 98.) 
Under "Compulsory Eruption of the Teeth," Dental Cosmos, 1889, page 
352, Fig. 321, explains Talbot's methods. Fig. 321 shows an appliance 
made of German silver, which possesses all the requisite qualities. I have 
three thicknesses of it ready for use, Nos. 29, 31, and 32, U. S. gauge. 
Strips are cut one-sixteenth to one-eighth of an inch in width, according EUGENE S. TALBOT 
635 
to the strength required, and bent with small round-nosed pliers into 
the shape represented at A, to fit the teeth. This is removed "every day, 
and with round-nosed pliers the ends are bent, the springs shortened, 
and forced to place upon the tooth. This little spring acts in two direc- 
tions: (1) to carry the teeth laterally and thus provide room, and (2) to 
draw the irregular tooth into position. This appliance can only be used 
when the crown of the irregular tooth is fully erupted. Teeth situated 
outside the arch may thus be brought into line as well as those which 
are situated inside. In the latter case it is necessary to wear a plate to 
keep the jaws apart while the tooth is in transit." 
In 1889 Cosmos, page 762, Talbot introduced a "Classification of Typ- 
ical Irregularities of the Maxillae and Teeth." 
"All irregularities of the maxillae and teeth may be traced to the fol- 
lowing causes: 
Fig'. 321.-Method for compulsory eruption of cuspid (1889) 
"I. Constitutional: malproportion and malrelation of the maxillae clue 
to excessive or arrested development. 
4'II. Local or circumstantial: 
(1) Improper occlusion; 
(2') Want of accord between waste and repair; 
(3) Neglect of function. 
"These causes are deviations from the general laws that govern the 
healthy relation and function of the teeth : 
"1. A proper relative size of the organs of mastication; 
"2. A proper occlusion of the teeth; 
"3. Accord between the processes of waste and repair; 
"4. Proper functional activity. 
"These form the basis of the classification adopted." 
In the Dental Cosmos, 1890, page 185, Talbot wrote the following: 
"On Making a Diagnosis of a Case of Irregularity." 636 
ORTHODONTICS HISTORICAL REVIEW 
"Irregularities have been divided into constitutional and local: the 
former affecting the body of the bone, the latter being accidental, af- 
fecting the teeth and alveolar process. 
"Frequently when a case of irregularity is presented we can tell by 
the general contour and profile of the face whether the case is one of 
the' constitutional or local type, the external proportions being affected 
by a decided V-shaped arch, excessively developed alveoli, or under- 
hung jaw. One of the first things a dentist has to learn is to observe 
carefully. In determining the correctness or incorrectness of the outline 
of the mouth and jaw, he instinctively takes it in as a whole, on the 
same principle that when we look at the picture of a friend we decide 
at once whether it is a good likeness or not, reserving our judgment on 
particular points until later. 
"Observe each jaw. See whether it has a normal outline or -whether 
it belongs to the V-shaped or saddle-shaped variety; this will help you 
to decide about the appliance to be used. 
"Now comes the important feature of a correct diagnosis. Examine 
the occlusion, letting the patient open and close his mouth slowly. No 
detail must go unnoticed. The beginner should familiarize himself with 
the individuality of each class of teeth both as to outline and occlusion. 
For this purpose he is advised to study the very excellent article by Drs. 
E. T. Starr and F. L. Hise, in the August number of the Dental Cosmos, 
vol. XXXI. 
"When there is an asymmetry of the upper and lower jaws, one being 
larger than the other, the occlusion from the cuspid back is usually 
wrong. In such cases it generally strikes in front of the lower cuspid 
instead of between it and the bicuspid, disarranging the articulation of 
every tooth back of it. We cannot stop here to speak of the different 
forms of malocclusion; the dentist who never ceases to be a student will 
see these for himself. 
"The difficulty in local irregularities is usually easily detected, for it 
is found cither in the alveolar arch or in the malposition of individual 
teeth. 
"Before giving your opinion, inquire into the family history. Dr. 
Kingsley justly remarks that it is useless to try to correct an irregu- 
larity peculiar to a family type: nature reverts to her original design 
notwithstanding long-continued efforts. For this reason it is usually well 
to wait until the patient is of an age when it can be determined what 
permanent form the jaw will assume. 
"When the arch is overcrowded and cannot be spread, or when it 
protrudes and the extraction of one or more teeth appears advisable for 
the purpose of obtaining space, care should be exercised in deciding upon 
the right ones. Examine to see which teeth .are carious or diseased. Do EUGENE S. TALBOT 
637 
not extract a first molar if it can be preserved with comfort to the pa- 
tient. The cuspid is the most important tooth in determining the out- 
line of the wing of the nose and upper lip and giving character to the 
face; for this reason never remove it when avoidable. 
" Eighteen years of experience in the correction of irregularities of the 
teeth and a practical knowledge of the laws of mechanics have taught 
me not to rely on any particular appliance. Frequently, though a cer- 
tain appliance has worked well in one case it may not be efficient in 
another case of a similar nature, and not infrequently two or three of 
the different forces are tried before one shows itself effective, this being 
due to the unknown factor of resistance which can be determined only 
by experience." 
Tn the conclusion of his paper, entitled "The Differentiation of An- 
terior Protrusions of the Upper Maxilla and Teeth," Talbot says: 
"It will be seen from a comparison of these six forms of anterior pro- 
trusion, that the phenomena that strike the casual observer as very 
similar are due to what I have termed constitutional causes, that is, an 
ill-balanced osseous system; the last is generally ascribed to diathesis, 
while the four remaining forms are accidental. In the first form the 
osseous system is affected, in the rest the alveolar processes and the 
teeth. Owing to these facts, in only the first form does the lower maxilla 
partake of the defect, while in the rest its form is independent,-that is, 
it may be normal, or subject to excessive or arrested development. For 
the same reason only in the first case is the facial angle affected by this 
irregularity. 
"In the first form the osseous portion of the upper maxilla is the 
force, while in the rest the alveolar process and teeth. The bite varies 
with the cause, but is defective in every case. The gums are necessarily 
affected in the last. The features that these irregularities have in com- 
mon are anterior protrusion and defective bite, varying in every case, 
but affecting the appearance of the patient in proportion to extent and 
duration. A diagnostic distinction of these irregularities is absolutely 
necessary to the determination of the methods used for correction. An 
upper jaw, the osseous plate of which is abnormally developed, with a 
normally developed alveolar process and teeth, is practically hopeless, 
while those forms in which the teeth and processes are abnormal are the 
proper field for the efforts of the practitioner. It would be useless to 
attempt the correction resulting from malocclusion due to the loss of 
posterior teeth by appliances that would be effective in the correction 
of the V-shaped arch, while a protrusion resulting from an excessive 
deposit of bone-cells requires entirely different treatment. 
"Failures in the correction of irregularities arc largely due to a want 
of recognition of etiologic differences. There is no department in den- 638 
ORTHODONTICS HISTORICAL REVIEW 
tistry that affords more interesting study to the etiologist than these 
cases, inviting careful observation and subject for thought in every in- 
stance." 
In this work it will be impossible to review all of Dr. Talbot's articles 
on account of lack of space. A few of the titles of his articles and where 
to find them are however included: "Dental and Facial Evidences of 
Constitutional Defects," International Dental Journal, 189'6, pages 261- 
286. "Teeth Irregularities and the Surgical Correction." Dental Cosmos, 
November, 1896, page 907. "Degenerate Jaws and Teeth," International 
Dental Journal, 1897, February, March and April numbers. "Etiology 
of V-shaped Arch," Dental Cosmos, 1897, November, page 927. "Etiology 
of Irregularities of Jaws and Teeth," Cosmos, 1898. "Deformities of the 
Dental Arch," Journal of the American Medical Association, Chicago, 1898. 
"Degeneracy-in Its Relation to Deformities of the Jaws and Irregulari- 
ties of the Teeth," Cosmos, 1898, September, page 734. "Unilateral 
Jumping the Bite," International Dental Journal, 1901. "Deformities of 
the Jaws Among the European Degenerates," Dental Summary, Toledo, 
1904. 
In the Dental Cosmos under "Teeth Irregularities and Their Surgical 
Correction," 1896, page 907, Dr. Talbot wrote the following: 
"Density of bone often makes it very difficult to obtain sufficient 
force to produce the absorption of this tissue required to bring the 
teeth back into place. Probably one of the most difficult operations is 
to carry back a cuspid, which is erupting in the vault of the mouth, back 
into its normal position. This not only requires considerable force, but 
time, to say nothing of the difficulty in attaching a cap for a point of 
resistance. Rotation of the teeth, especially the incisors and cuspids, is 
frequently difficult, if not impossible, owing to insufficient leverage. 
"For seventeen years I have adopted surgical treatment, but have 
not made public my methods, since incidental conversation with some of 
the best men from time to time revealed that they had not taken kindly 
to it. I therefore wished to give it sufficient trial before recommending 
it to the profession. I have met with such markedly uniform success 
that I do not hesitate to recommend it to all practitioners as perfectly 
safe and reliable with the antiseptic care required in surgical operations. 
This method consists in removing entirely the alveolar process in the 
line of travel of the tooth to be moved, leaving a small amount of process 
about the root of the tooth, holding intact the peridental membrane. 
This is accomplished with coarse-cut revelation burs, or those that will 
cut in all directions. They can thus be used as drills in certain con- 
ditions to be mentioned later on. 
"If the cuspids require to be carried backward, make an appliance with 
bands about the first and second molars, with cap upon the cuspids and EUGENE S. TALBOT 
639 
a bar with a screw and nut upon the end, as recommended by Dr. Farrar. 
Extract the first bicuspid, and adjust the appliance with a sharp new 
bur dipped in five per cent carbolic acid or one per cent corrosive sub- 
limate or listerine. Then resting the hand against the cuspid, cut out 
the palatine and buccal V-shaped plate, making a concave surface of 
the alveolar process, as illustrated in Fig. 322. If the superior incisors 
are to be carried back, cut semicircular spaces just posterior to the 
teeth to be moved (Fig. 323). To carry a cuspid into place which is 
erupting into the vault of the mouth, remove the alveolar process in the 
direction of the line of travel. (Fig. 324.) 
"In moving teeth laterally by a jackscrew, it will be found that not 
infrequently one tooth moves faster than the other. To bring both to 
their proper position cut out the alveolar process on the side of the 
Fig. 3 22.-Appliance used to retract 
cuspid, after first cutting out a concave 
surface of the alveolar process (1896). 
Fig. 323.-Concave surface removed from 
palatine surface. 
slowest-moving tooth, and both will come into proper position. (Fig. 
325.) To rotate a tooth, ent a circular groove as deep as possible around 
the tooth, leaving enough process to hold the peridental membrane in- 
tact. In this manner teeth may be moved very rapidly and without 
much pain. This should always be done by means of screws. By this 
method we have the tooth or teeth to be moved completely under con- 
trol. Any of the teeth in the mouth may be used for the fixed point of 
resistance, thus doing away with all unsightly appliances outside the 
mouth. When in place, they should be anchored in the usual manner. 
Antiseptic washes should be used from time to time, such as one per cent 
corrosive sublimate, listerine, or five per cent carbolic acid. 
"In operations of this nature the peridental membrane and also the 
periosteum arc apt to be injured. This was the particular question in 640 
ORTHODONTICS HISTORICAL REVIEW 
Fig. 324.-Moving cuspid forward after portion of surface has been removed. 
Fig. 325.-Method used by Talbot to increase space between cuspids. 
Fig. 326.-Appliance for "pulling out 
the central incisors.'' using the coiled 
springs in the vulcanite. (Talbot.) 
Fig. 327.-Method of retention used by 
Talbot. EUGENE S. TALBOT 
641 
recommending it to the profession. Although I have had a few cases of 
infection, I am quite certain now that such injuries are not of any serious 
consequence, since with proper precaution no bad results will follow. 
With this mode of treatment patients are saved time and money, and 
the operator worry." 
Some of the other appliances devised by Talbot are shown in Figs. 
326 to 331 inclusive. 
Fig. 328.-Method of causing the eruption 
of teeth. 
Fig. 329.-To increase the space for the 
second premolar. 
Fig. 330.-Coiled spring inserted in an 
eye attached to the tooth to cause the 
eruption of the premolar. 
Fig. 331.-Method used to rotate a central 
incisor. (Talbot.) 
Isaac Burnett Davenport (1854-1922). Before the New York Odonto- 
logical Society in April, 1887, Dr. Davenport read a paper on "The 
Significance of the Natural Form and Arrangement of the Dental Arches 
of Alan, with a Consideration of the Changes Which Occur as a Result of 
Their Artificial Derangement by Filing or by Extraction of Teeth." In 
1891 before the American Dental Society of Europe, Dr. Davenport am- 
plified his views in regard to what constitutes correct or normal articu- 
lation (occlusion) and the importance of trying to secure this occlusion 
in all regulating procedures. 642 
ORTHODONTICS HISTORICAL REVIEW 
In these papers we find for the first time a determined declaration that 
only by reestablishing normal occlusion can we hope to secure per- 
manent results in orthodontia. 
The profession had passed through the experience of and discussion 
upon Arthur's method of filing teeth on their approximal surfaces to 
prevent the extension of caries, and the practice had for some years 
been discontinued. So, also, the once common practice of extracting 
certain teeth, usually the first permanent molars, either to prevent ap- 
proximal decay or for the purpose of relieving a crowded condition of 
Fig-. 332.-Isaac B. Davenport (1854-1922). 
the arches, had for years been discussed and had come to be largely 
abandoned, but both practices had been considered and discussed from 
the standpoint of a desire to benefit the teeth in a general way and to 
promote their efficiency. 
The relation which such filing or extraction might bear to the efficiency 
of the masticatory apparatus as a whole had not yet been publicly con- 
sidered, and it was the object of Davenport's paper to discuss this rela- 
tionship and point out its great significance. While probably not so 
considered by its author, it was in very truth an epoch-making paper 
because it brought to light fundamental facts which had hitherto been 
overlooked and which, by virtue of their importance, opened the way for EUGENE S. TALBOT 
643 
marked changes in dental procedures. After presenting the anatomic 
features of the individual teeth, their relation to one another and the 
manner in which the occlusion of the upper and lower teeth served the 
best purposes of speech and mastication, Davenport proceeded to show 
how any change of form in any of the teeth, or loss of one or more teeth, 
so disturbed the normal relationship as to greatly lessen their efficiency, 
favor decay, and produce inharmony of the features. After showing 
numerous plaster models, divided so as to expose the occlusion of the 
inner cusps of the side teeth as well as the outer ones after their relation- 
ship had been altered by extraction and their efficiency consequently les- 
sened, he says: 
"But why extract at all? For, besides the loss of important organs we 
shorten the bite, contract the mouth, disturb the facial expression and 
secure at least an arrangement of the teeth less favorable for their 
preservation than existed at first. 
"While admitting that under unusual conditions slight extraction may 
sometimes be resorted to with favorable results, he strongly condemned 
the practice in general and makes the following significant declaration: 
'I am forced to believe that far more irregularities have been caused by 
extraction than could have been corrected by extraction.' " 
Dental Cosmos, July, 1887, page 413: 
"Nature had furnished man with two dental arches, so formed and so 
placed in relation to each other as to be best supported at every point, 
while permitting all the movements necessary for the perfect comminution 
of his food. 
"Each side of both arches, upper and lower, is furnished with its 
double row of molar cusps, so arranged that the outer, lower row works 
between the two upper rows, and the inner upper row works in the 
irregular groove between the two lower rows. 
"The double cuspid arrangement ceases at the angle of the mouth by 
the suppression of the inner row of cusps and the modification of the 
outer row into cutting-edges. 
"This suppression of cusps prevents an interlocking which would 
defeat the normal movements of mastication. 
"The upper incisors shut past the lower perhaps a little more than 
the height of the molar cusps. This permits of the cutting movements 
of the incisors without too much striking of the cusps. (See Figs. 333 
and 334.) 
"When the teeth articulate well, the lateral arrangement of cusps and 
furrows permits the greatest freedom of motion with the least separation 
of the grinding surfaces. (See Fig. 335.) 
"The palatal surfaces of incisors and cuspids are so directed, and have 644 
ORTHODONTICS HISTORICAL REVIEW 
such relations to the inclines of the molar cusps, as to permit contact at 
different planes of the surfaces. 
"Finally the general arrangement of the surface inclines throughout 
the mouth is such as to permit antagonism of the teeth over from about 
three-fifths to the entire extent of the dental arches, on every plane of 
articulation (except for the first part of the cutting motion), and to 
afford the greatest amount of contact surface for the articulation of food 
"One appreciates the beauty of the general relation of the articulating 
surfaces as one notes the effects of wear upon the teeth. For example, 
Fig. 333. 
Fig. 334. 
as the cusps wear down the lower jaw moves forward, and the inner 
surfaces of the upper incisors become thinner and thinner. When the 
flat surfaces of the molars alone remain, the cutting edges of the incisors, 
which projected over the lower teeth, have also been worn away, and we 
have the characteristic grinding surface called 'double teeth' all around. 
"So far our attention has been directed to an ideal dental apparatus 
taken as a whole, but in its various divisions there is an equal beauty 
of adaptation of means to ends, and each part is essential to the working 
of the whole as is any part of a finely-constructed machine. 
"First, we find the arches divided into thirty-two portions, each por- 
tion a tooth, having that form, size and strength best adapted to its EUGENE S. TALBOT 
645 
special office in the completed arch. Each tooth forms with the jaw a 
compound lever, intended to transmit its proportionate amount of force 
from the masticatory muscles to the object in contact with its grinding 
surface, the fulcrum being at the dentomaxillary articulation. The free 
end of each tooth antagonizes with two teeth of the opposite arch, while 
it is supported laterally by contact with its fellows, at the point where 
support is most needed, which is near the articulating surface. Several 
teeth are thus involved in every important act of mastication; and all 
are so interlocked and bound in by the articulation and lateral contact 
that the greatest grinding power is secured, while the strain upon a 
single tooth is reduced to the minimum. (See Fig. 334.) 
"The division of the arches into separate teeth permits the elasticity 
necessary for the dental apparatus, lessening the danger of shocks and 
Fig. 335. 
accidents; but its principal object seems to be to allow the slight move- 
ment essential for the accommodation of the irregular-shaped mastica- 
ting surfaces to hard substances in process of reduction. This elasticity 
is rendered more positive by the inclination of the axes of the teeth, 
instead of being stubbornly fixed in a vertical position. (See Fig.-335.) 
"The inclination of the teeth in one portion of the arch is exactly com- 
pensated by an opposite inclination at another portion or else by the 
inclination of the antagonizing teeth, and so tends to preserve the gen- 
eral form of the arch. Thus, we find that the upper molars are inclined 
outward, the lower molars inward, and the lower cuspids outward. All 
the teeth are inclined forward just sufficiently to overcome the opposite 
forces exerted by the orbicular and buccinator muscles. 
"When we examine the structure of the teeth we find nature not less 
wise. The hard, resisting, nonsensitive enamel exists not only on ar- 646 
ORTHODONTICS HISTORICAL REVIEW 
ticulating surfaces, but covers the entire crown down to the gum attach- 
ments, as though intended as a barrier against those corroding agents 
whose greatest havoc is upon the more highly-organized substructure of 
the teeth. 
"Attention is invited to these facts, as they have a bearing upon some 
of the dental practices of today. 
"While analogy teaches that nature's form and arrangement of the 
dental organs are those best fitted to preserve them, evolved as these 
organs were under the general law of adaptation according to the need, 
it is true that diseases have appeared which oftentimes have overcome 
nature's provisions; but as we have only just begun to learn the causes 
of diseases, we can hardly jump to the conclusion that man has so 
changed all of his conditions that nature is disposing of his dental organs, 
nor can we suppose that he would be better adapted to his present con- 
ditions by extraction of teeth, or by so filing the teeth as to secure for 
them isolation and such a conical form as was necessary during his 
reptilian stage of evolution. This position is strengthened by practical 
experience and observation, which prove not only the wisdom shown in 
the form and arrangement of the dental organs, but that this form is 
today the best form known in which to preserve the teeth and their use- 
fulness. 
"While it is not pretended that the teeth can usually be saved by any 
easy method, and without care on the part of the patient, yet, notwith- 
standing the old doctrine that 'contact is always dangerous,' I am fully of 
the opinion that they may be more easily saved by the preservation of their 
normal functions; and to do this we must imitate the form of perfect 
teeth, and their manner of support by firm contact with one another, 
however 'dangerous' that may seem to be." 
EXTRACTIONS CONSIDERED 
"If any one tooth be extracted from the above-described ideal dental 
arches, with their perfect articulation (excepting this one bo from among 
the six lower front teeth), there will occur no important change in the 
position of the other teeth: the space will remain nearly the same, as 
the remaining teeth will be held in position by occlusion of the opposite 
jaw. 
"If one of the lower incisors is lost, contact will again be secured by 
flattening of the lower arch, with the appearance of overprominence of 
the upper front teeth; or, the entire lower arch will, because of loss of 
central support, drop inward and become narrower. 
"This will be accompanied by a similar narrowing of the upper arch, 
and the forcing forward of the upper incisors and cuspids. EUGENE S. TALBOT 
647 
"Never after the eruption of the second molars can extraction of first 
molars be considered other than a misfortune. 
"After the first molars have been extracted the enormous strain of 
mastication is brought to bear upon the unsupported second molars, 
whose yielding sockets allow them to tip till they touch the bicuspids. 
The time required for this result varies from a year or two in young 
persons to several years, after late extractions of strongly-set teeth. 
"The upper molars rotate upon their axes and tip forward till the 
outer corner of the second molar touches the middle of the distal sur- 
face of the bicuspid, while the anterior approximal surfaces of the third 
molars rest in the concavity of the distal surface of the neck of the 
second molars. The articulating surfaces of each, reduced to one or two 
points, do not permit of any proper grinding movement. During the 
time occupied by the closure of the spaces mastication has been difficult, 
for added to the defective grinding surfaces is the great discomfort 
caused by the irritation of the gums by hard substances, and by the 
strain upon the sockets of unsupported teeth. The changed relation of 
the second and third molars renders their cleansing difficult, and when 
decay occurs, as often happens, it is most difficult to treat, especially 
when it appears in the mesial surfaces of the third molars. 
"After late extractions the teeth are often found so braced in their 
manner of contact, and so much tighter than they ever are when in 
their natural positions, that it is difficult to pass even fine waxed silk 
between them. 
"If the author of the expression that 'contact is always dangerous' 
made his study and observation upon such cases as this, there was a show 
of reason for his conclusions. But the fact is that the cause of recur- 
ring decay in such mouths is not contact, but the changed relations of 
the teeth, which, besides impairing their functions, renders cleanliness 
extremely difficult if not impossible. 
"But why extract at all? For, as is shown above, besides the loss 
of important organs, we shorten the bite, contract the mouth, disturb 
the facial expression, and secure at last an arrangement of the teeth less 
favorable for their preservation than existed at first. 
"It is not denied that in some cases decay is lessened between certain 
teeth during a part of the time that the spaces exist after extraction; 
yet I am inclined to think that the temporary advantage which any given 
space may afford is overbalanced by the greater danger that it offers 
when it is nearly closed, or while the teeth are loosely in contact. At 
this time food easily wedges between the teeth and requires extra efforts 
for its removal. 
"In uncleanly mouths we often find decay in the well-open spaces, for 
food left to ferment in contact with the teeth will cause decay as soon 648 
ORTHODONTICS HISTORICAL REVIEW 
upon surfaces not in contact as it will between those that are in con- 
tact and even sooner if quantity of fermentable products is a factor in 
the problem. Now, if extraction were practiced to prevent contact, it 
is a failure, for there has been contact all the time between many of the 
teeth, and finally we have it between all. The few spaces that were se- 
cured-say between bicuspids and cuspids-only existed for a time, and 
perhaps fortunately if the patient were not cleanly. 
11 Really there seems to be but one excuse for the extraction of the 
first molars: If their structure were so bad that they were sure to be 
lost later in life, we have done well in choosing a time for their extrac- 
tion when the spaces will close with the least tipping of the teeth, and 
with the least derangement of the grinding surfaces. 
"We need not hope to improve deformities at the front of the mouth 
by the extraction of the first molars, when there is a marked forward 
inclination of the front teeth, including the bicuspids. The overcrowded 
front teeth will usually retain their position, owing to the increased 
bracing caused by the shortened bite. But if such overcrowding is at 
all relieved, it can only be by a forward movement which increases the 
forward projection of the arches, and a production of a deformity worse 
than the one sought to be corrected. 
"If the deformity consists simply of a too great forward projection 
of the upper arch, this projection will only be increased by the loss of 
the first molars, for owing to the shortened bite the forward strain upon 
the front teeth will be increased. After such teeth have been drawn 
back into their desired positions by the use of appliances they will drop 
forward into their former positions, because the natural forces will con- 
tinue to act after the patient has tired of retaining plates and their 
accompanying evils. 
"Those who followed the description, at the beginning of this paper, 
of the form and inclination of the teeth in relation to the forces acting 
upon them, must see to what a mathematical certainty the matter is re- 
duced. So, if one takes the trouble to acquaint himself with a given 
case, he may safely predict what form the arch will take after certain 
extractions shall be practiced. 
"One hardly needs to consider the results of extraction of any other 
than the first molars, since these teeth have been made to bear the 
penalty of most dental sins, as well as sins of dentists. 
"While admitting the value of extraction as a means of correction of 
certain irregularities of the teeth, I am forced to believe that far more 
irregularities have been caused by extractions than could ever have been 
corrected by extraction." 
In the above review Davenport showed the principles of perfect articu- 
lation, illustrating same not only with models but by diagrams. In the EUGENE S. TALBOT 
649 
article found in the International Dental Journal, January 1892, under 
"Articulation of the Teeth," Davenport says: 
"One may recognize that a defect exists without recognizing all that 
it involves. In order to realize the real import of an imperfection one 
must know what perfection is, how manifest, and what it implies, other- 
wise the attempt to correct faults will often result simply in changing 
one defect for another, perhaps a worse one. 
"We benefit our patients in proportion as we make their teeth ap- 
proach the standard of perfection, and this cannot be done blindly and 
without a knowledge of what a correct articulation is and what it is able 
to accomplish, so it seems absurd to hear the statement that 'we always 
have to do with imperfect articulations, and therefore the perfect stand- 
ard is of no use to us.' 
"That argument ought to be made use of only by those men whose 
vision is so short that they go cutting and digging about the mouth with 
perhaps the one noble idea of tooth salvation, but apparently regardless 
of what the teeth were made for; but theirs is not 'whole salvation' 
which our Methodist friends would say 'brings happiness as its fruit,' 
but rather the miserable inheritance of unending repentance. 
"Nature never loses sight of perfection. Deformities and useless 
variations are eternally destined to die out sooner or later, and the 
fittest survive. In the slow process of evolution is one abiding faith. 
"The standard of perfection of an organ can never be lowered or 
diminished so long as its functional need exists. 
"While there are probably few perfect articulations, there are many 
that are imperfect; yet it is possible to learn what is perfect and what 
tends toward perfection, by observing articulations which most nearly 
answer the functional requirements; in time one comes to detect the dis- 
cordant elements which, eliminated, leave a correct idea of perfect artic- 
ulation. 
"Antagonism seems to express the prevalent idea of articulation; but 
antagonism is just what is most objectionable in an articulation. 
"In order to be well articulated the teeth must be regularly placed 
and correctly inclined. 
"The most common irregularity of the teeth is the irregularity of 
the position of the masticating surfaces, and yet but little attention is 
given this matter in works upon irregularities, the attention being mostly 
confined to the deviations of the external curves or alignment of the 
teeth; yet if the former were attended to, the latter would necessarily be 
corrected, and more permanently so than is usually the case. 
"When teeth are regular and well articulated, they remain so because 
the forces and resistances are evenly balanced. 
"On the other hand, as the articulation is made up of a series of per- 650 
ORTHODONTICS HISTORICAL REVIEW 
fectly balanced inclines, it follows that when anything removes one sur- 
face, whether an extraction, decay, operation, or badly constructed regu- 
lating or other apparatus, undue force falls upon other inclines with the 
certain result of changing the position of the tooth or teeth. 
"I have hardly ever found what I could call a good articulation a few 
years after teeth had been extracted, and the same is true when the teeth 
have been cut away between, or when the cusps had been carelessly re- 
moved while finishing fillings in the grinding surfaces. 
"Largely on account of bad articulation irregular teeth tend to be- 
come more irregular. Growth may improve some cases, but so far as a 
bad articulation goes it is always unfavorable to regularity of the teeth. 
"Much harm is done by the use of regulating appliances which change 
the articulation without improving it, and it is almost a universal fact 
that unless an improvement can be made in an articulation there will 
be no permanent improvement of the irregularity. 
"Finally, the articulation is the only permanent retainer to be de- 
pended upon. 
"The teeth will move till they find the best contact that circumstances 
can offer, and that movement often never ceases, because the forces 
never find equilibrium. 
"Before disturbing the articulation of a fixed irregularity, it is best 
to consider whether such disturbance can bo overcome, and the articu- 
lation again made as good; if not, the chances are that the result will be 
worse than the original condition, and for the ultimate result we must 
wait not only 'till the teeth become firm,' as we say, but until they 
cease to move. 
"There is much yet to learn in regard to the meaning of the elevations, 
depressions, overshutting, shelving, interlocking, binding, curves, and 
inclines of the articulation, in their relation to biting, cutting, tearing, 
crushing, and grinding movements of mastication. 
"In the treatment of our patients it is hoped that if we cannot all see 
our way clearly upon this matter, that we may at least see far enough 
not to make the articulations worse by our operations than they are 
when brought to us." 
Woodbury Storer How (1829-1911) describes in the Dental Cosmos, 
1887, page 479, his "Appliances for Regulating Teeth." 
"The fundamental feature of the principal contrivance is a piece of 
thin platinum wire .030 in diameter, an inch and a half long, and threaded 
to the distance of four-tenths (.4) of an inch from each end. This is bent 
in the form of a double curved bow, Fig. 337, the arms of which are 
separated to the width of an average sized molar at its neck. A gold 
coupling plate, Fig. 338, is so constructed that the bow-ends will pass 
through it and receive the nuts. All these parts are shown assembled EUGENE S. TALBOT 
651 
in Fig. 339 to constitute a molar yoke. A shorter piece of wire is also 
bent to form a bicuspid bow, and a suitable coupling-plate, is in like 
manner associated with this bow to form a bicuspid yoke, which is fur- 
thermore capable of adjustment on any of the oral teeth. The molar 
yoke is shown in position on an inferior left first molar, Fig. 340, and 
this result is easily accomplished by first pushing the threaded ends of 
the molar bow from the lingual side close to the gum between the molars, 
and between the molar and bicuspid, until the bow-ends project consid- 
erably from the buccal side of the molar. The coupling plate is then 
put over the bow-ends and the nuts turned on by means of the lever nut 
wrench, in the hollow end of which a nut is first put and held by friction 
while being carried to and started on one of the bow-ends. In some 
positions it may be necessary to place the nut in the wrench-end of the 
Fig-. 336.-W.'S. How (1829-1911). 
lever in order to start the nut on the bow. The manner of attaching the 
bicuspid yoke is in all respects similar to that of the molar yoke, and, 
by means of the clips observable on the coupling plates, a limit is set 
to the tendency of the plates under the clamping action of the nuts to 
impinge upon the gingival margins. These clips are easily bent with 
pliers to adjust the limit on varying lengths of teeth-crowns, so that in 
no instance need there be any encroachment of the wire upon the peri- 
cementum or the festoons of the gums, for, in the event of an unusually 
close approximation of the teeth, the wire may be made thinner with a 
file fine enough not to leave a rough bur on the cut-away threads of the 
opposite sides of the filed wire. In some instances it may be best to have 
the two sides incline towards each other, so that a cross section of the 
threaded portions of the wire would exhibit a rounded V-shape which, 
with the base of the V placed next the gum, would permit the passage 
of the wire without any interference with the gums. In fact, the chief 652 
ORTHODONTICS HISTORICAL REVIEW 
excellence of this contrivance consists in the facility it affords for im- 
mediately and firmly fixing a yoke upon any tooth, of any shape, and 
in almost any position in the mouth. If the inner surface of a tooth at 
its cervix shall slope so that the bow will tend too strongly towards the 
gum, then a limiting clip of gold plate may be soldered to the wire. This 
piece will also serve for the attachment of a ligature for moving that 
tooth, or others. For such moving purposes, however, it is better to 
solder on the wire a button, on which the ligature may be tied, or over 
which a rubber band may be caught, or from which these may easily 
be detached without disturbance of the yoke. The yokes are preferably 
so formed that the ends of a regulating bow-spring-like that of Dr. 
Patrick-will slide within them, and be clamped therein by the action of 
the nuts, which at the same time draw the yokes on the teeth. Thus 
the bow-spring may be quickly inserted, adjusted, and fixed in any 
desired position. Fig. 341 shows one anchored to a molar and a bi- 
cuspid. ' ' 
In the Dental Cosmos, 1891, pages 114 and 198, we find another ar- 
ticle by How under "Teeth Regulating Appliances and Related Devices 
of Thirty Odd Years Ago." How states: 
Fig'. 3 37 
Fig'. 338. 
Fig. 33 9. 
Fig'. 3 4 0. 
"Historically considered, many most useful contrivances will be found 
to have been reinvented from time to time until the successive periods 
have become so numerous that the names of the first originators are 
discovered only by painstaking research among remaining records, if, 
indeed, the earliest publication should no longer be accessible. A fur- 
ther element of uncertainty is the frequent obscurity and incomplete- 
ness of the descriptive terms in which the forms and arrangements of 
material structures were sought to be set forth; whereas an illustration, 
even if rudely drawn, would convey a clearer idea of the several parts 
of an operative device than many words, however skillfully chosen. 
"Pictorial representation is now largely relied upon to impart correct 
notions of the character of constructions in every useful form, and this 
is particularly true of appliances for the correction of irregularities of 
the teeth. Some of these as shown in modern publications have features 
familiar to dentists of long experience, yet the mere recounting of such 
personal recollections might not be deemed conclusive to an ordinarily 
skeptical mind, and it was therefore with some degree of individual in- 
terest that in a recent rearward glance over the files of some dental EUGENE S. TALBOT 
653 
journals there were discovered illustrations, some of which are appended, 
printed from electrotypes taken from the original woodcuts without 
the slightest change or alteration in any of them." 
After describing a great number of appliances by men well known to 
the profession How states (page 202): 
"Many other well-known old devices described without illustration 
might with advantage to the profession be given pictorial embodiment 
as in the preceding new cuts, but these old cuts in their unquestionably 
clear anticipation of later devices relating to dental regulation, crown 
and bridgework, will certainly prove serviceable, and are respectfully 
submitted to whom it may concern. 
"The devices which follow are some old and some new, but all em- 
body the ancient principle of a spring-push or pull on the tooth or teeth 
Fig. 341.-How's use of the "yoke" clamp band with labial arch attached and various 
attachments (1887). 
to be moved. A simple form of finger-spring is macle by first cutting a 
pattern from thin rolled block-tin and fitting it to a plaster cast of the 
teeth, although in some instances I have fitted it over the teeth in the 
mouth. From a piece of spring gold plate the regulator is then cut, 
closely following the pattern. In some instances it is desirable to get 
a close conforming fit by striking it on a metal die made from the cast. 
It is obvious from Fig. 342 that successive bendings of the spring finger 
will soon bring into line and place the errant cuspid, and as during and 
after the moving of the tooth regulator may be readily sprung off and 
on by the patient for cleansing purposes, it is also the fact that it serves 
as a retaining device which can be worn for any prescribed length of 
time. 
"A forthpushing finger-spring of like character is illustrated by Fig. 
343, both detached and in action after several days' use. 
"A crib and collar with a pulling spiral spring is shown by Fig. 344. 654 
ORTHODONTICS HISTORICAL REVIEW 
"A spring-jack for push or pull action is readily made from suitable 
half-round wire, or by filing to half-round shape two pieces of pretty 
thick wire, as shown in Fig 345. A spiral coil of fine spring-wire will 
then serve as a socket for the two half-round wires, and by simply 
touching the point of the soldering-iron to the ends of the spring they 
will be soldered to the. thick wire, and the jack be ready for action. To 
Fig. 342. 
Fig. 343. 
Fig. 344. 
Figs. 342 and 343.-Spring gold plate regulator. (How, 1891.) 
Fig. 344.--Crib and collar with the pulling' spiral spring. (How.) 
Fig. 345.-Spring-jack as devised b 
How (1891). 
Fig. 346.-Appliance (Fig. 345) applied, to 
a model (How). 
increase the push power, it is only necessary to pull open the spring 
slightly. Attached to collars as shown in Fig. 315 (center) it will either 
push or pull as desired, adjustment of spring tension being easily ef- 
fected by a touch of the soldering-iron; and as the springs are readily 
made, and kept at hand, a long or short spring can be quickly put in 
place. In Fig. 345 (bottom) little sliding collars will enable adjustments 
of tension to be made while the fixture is in place. It will be observed EUGENE S. TALBOT 
655 
by referring to Fig. 346 that when the two halves of the jack are in- 
closed within the spring, they are firmly prevented from rotation by the 
contact of their flattened sides, but they are free to slide forth and back 
as indicated by the arrows. 
"In Fig. 346 the device is shown in action as a pushing-jack, and the 
peculiar adaptation of the neck-wires for simple security of impinge- 
ment without disturbance of the gum-margins is apparent. For greater 
security ligatures are, of course, applicable, and can be added without 
difficulty. 
"These spring-jacks can be made very small and short, and are there- 
fore readily adaptable to clasps, and cribs, and plates of every kind; 
they can even be curved so as to act upon an arc of a.circle." 
F. E. Howard before the Seventh and Eighth District Dental Society 
presented a paper entitled "Irregularities of the Teeth and Their Treat- 
ment." {Independent Practitioner, 1886, page 359.) 
"A modification of the Coffin system will be useful in many different 
ways; for instance, if the arch is to be expanded in the main, a spring 
bent in the general form of a W is arranged in position about midway 
of the plate, and when vulcanized the plate is sawed through the center, 
the spring slightly opened, and the plate placed in position. From time 
to time this is spread as the case requires. 
"When the anterior portion of the arch is to be spread, a hinge made 
of two eyes and a bar, joined and vulcanized into the posterior portion 
of the plate will hold the posterior part, while the spring will act upon 
the anterior part alone, or this may be reversed and the back teeth 
spread at the will of the operator, as the case may require. 
"Instead of a hinge a more simple method will sometimes answer as 
well. Drill two holes in the back of the plate, and with a strong silk 
ligature or platinum wire bind the parts together, and this will hold them 
from spreading at this point. 
"A piano-wire spring, vulcanized into the plate, is also very effectual 
for moving a tooth out when it is inclined in the mouth and it is not 
desirable to use a jackscrew. For the movement of canines and bicuspids, 
a band of platinum with a projecting top or knob cemented to the 
tooth, is admirable to retain the rubber or silk ligature in position, and 
to draw the tooth in its proper course, the ligature being attached to 
some point on the plate, or to a hook attached to some tooth not likely 
to change position by the force exerted. 
"For the rotary movement of a tooth, a band of platinum with an arm 
attached and cemented to the tooth is a powerful agent for twisting 
such a tooth into position. Also a good and simple method for this move- 
ment, as applied to the four anterior teeth, is accomplished by tying a waxed 
silk thread to any of them, taking two or three turns around the tooth ORTHODONTICS HISTORICAL REVIEW 
656 
and attaching to a rubber ligature fastened at some convenient point 
in the plate. The force exerted is in a direction to unwind the ligature 
from the tooth, and thus it is turned in its socket." 
B. S. Byrnes under "Correcting Irregularities by the 'Spring' of Gold 
Bands," introduces several novel methods in orthodontic procedure as 
illustrated in the Cosmos, 1886, page 278. 
"In correcting irregularities of the teeth I have employed in a large 
number of cases a new device of my own invention which seems to 
possess many decided advantages over the methods in common use. A 
brief oral description presented to the last meeting of the Southern 
Dental Association, held at New Orleans, was so favorably received that 
it has seemed desirable to communicate the method to the profession at 
large. 
"The motive power employed is the 'spring' or elastic force of thin 
gold bands. My preference is gold of 20 carat to 22 carat fine, and as 
a rule the thinner the bands the better the result. It frequently occurs, 
of course, that for special cases or for a special purpose during the 
progress of any case the band must be doubled in thickness, but this 
fact does not change the rule as stated. The pressure exerted by the 
bands is gentle but constant, and the teeth upon which they operate are 
moved rapidly, with only the slightest inconvenience to the patient. No 
plates are used, the fixed points for the application of the motive power 
being supplied by such of the teeth as are suited to the purpose. 
"The method of application is in a general way as follows: The fixed 
points having been determined, the tooth or teeth to be regulated are 
connected to them by means of a thin gold band. In selecting the 
fixed points care should be taken to choose teeth which will offer greater 
resistance to the force to be applied than those which are to be moved 
will. The band is then manipulated so as to form it into a spring or 
series of springs so adjusted as to bear most powerfully on the misplaced 
tooth. Thus, suppose a projecting superior central incisor is to be drawn 
inward to align properly with the remainder of the teeth in the arch. 
A continuous gold band embracing the first molars on both sides is 
fitted around the outside of the arch. With a dull-pointed instrument 
like a burnisher the ribbon is then pressed into the interstices of the 
teeth over which it passes, thus forming it into a series of small springs. 
The incisor being the most prominent point will naturally be most af- 
fected by the pressure exerted by the springs, and in a short time it will 
be found to have moved away from the band so that it is no longer 
affected by the tension of the springs. As soon as this occurs the appa- 
ratus is removed, the ribbon is annealed, straightened, and a small por- 
tion, say a thirty-second of an inch, as may be required, is cut out of it. 
The ends are then soldered, and the appliance is replaced upon the teeth, EUGENE S. TALBOT 
657 
the connecting band being formed into a spring as before. Tension is 
thus kept up until the tooth has assumed the desired position. 
"In treating this case I aimed to compass four principal points: (1) 
the destruction of the 'peakedness' by producing a broader or more oval 
arch; (2) the reduction of the projecting teeth to their proper position; 
(3) the improvement of the articulation; and (4) the closure of the 
space caused by the loss of the right superior central. 
"Fig. 347 is the general plan of the apparatus. 
"A band was applied, clasping the first molars on both sides, and 
passing around the cuspids and behind the incisors. A wooden wedge 
was placed between the incisors and the band, and springs formed by 
pressing the band into the interstices between the cuspids and bicuspids, 
cutting and readjusting as before. 
"Fig. 348 shows a somewhat more complicated apparatus than any of 
those previously described. It was used in a case where the right cen- 
Fig. 347. 
Fig. 348. 
Figs. 347 and 348.-Byrnes' method of correcting irregularities (1886) 
tral overlapped the lateral. It illustrates how the method which I ad- 
vocate may be applied to turn a tooth where the force must be applied 
directly across the mouth. After the necessary room was provided, this 
fixture was applied. It accomplished its work in four days, after which 
a retaining device was applied, consisting of a simple band, clasped 
tightly around the central which had been rotated, and provided with 
wings tipping on the left central and under the right lateral." 
W. H. S., in the Cosmos, 1886, page 327, under "Seamless Collars," 
called attention to a new use of these: 
"They may be employed in the construction of regulating fixtures; 
for instance, to rotate a central incisor, take a fine wire and wrap it 
around the tooth close to but not under the gum, and cut the wire so 
that its ends exactly meet to measure the circumference of the tooth. 
Straighten the wire without stretching it; find its equal in length on the 
collar diagram, and select the medium width collar numbered under that 658 
ORTHODONTICS HISTORICAL REVIEW 
line. Take a piece of thick gold plate, shape it like Fig. 349, and solder 
it to the collar as seen in Fig. 350, using only solder enough to unite 
the end of the lever, without flowing any solder over the collar to pre- 
vent it from fitting close on the tooth. Dry the tooth, smear its neck 
all around with oxyphosphate cement, and force the collar over the 
tooth so that the lever will be in position to be pulled by a ligature, or 
rubber ring, after the cement has become hard, which should take at 
least ten minutes. The applied fixture is shown by Fig. 351. A bar 
regulator that is to be anchored to molars or bicuspids may be likewise 
soldered to collars, which can then be cemented on the anchor teeth; or 
the bar may be adjustably connected with the collars, which are then 
fixed by cement on the teeth. Such fixed collars also serve as fulcra for 
jackscrews, the points of which will take on the metal of the collars so 
as not to slip, and yet leave the enamel uninjured. 
"For cutting the collars to conform to the cervical curves, an engine 
corundum point or Herbst rotary file will serve the purpose." 
Fig. 3 4 9. 
Fig. 350. 
Garrett Newkirk (1847-1921), in the Dental Cosmos, 1886, page 601, 
contributed "Something About Regulating" and "Regulating Appliances." 
He made use of the vulcanite apparatus based on the so-called Coffin 
spring as illustrated in Figs. 352, 353, and 354. 
W. G. A. Bonwill's (1833-1899) early method of treatment has already 
been described. 
Tn the American System of Dentistry, 1887, vol. ii, page 486, Dr. Bon- 
will contributed a chapter on "The Geometrical and Mechanical Laws 
of the Articulation of the Human Teeth.-The Anatomical Articulator." 
"After more than thirty years of active life in dentistry I am fully 
persuaded that all that constitutes dentistry proper, the mechanical forms 
the basis. And yet to make anything that is beautiful in our art, especially 
in vying with nature in matching the teeth, we must be more than mere 
mechanics, more than capable of filling a tooth or treating an abscess; 
we must be dental artists. When we introduce a set of teeth upon which 
depends so largely the expression of the face from the soul beneath, we 
must bring to our aid not only the laws of mechanics and geometry, but 
the beauties of art. It is not enough that we accurately adapt the plate 
to the gums; that we so grind the teeth to the plate as to be water-tight; 
that we so make every joint that it cannot be distinguished; that wo so EUGENE S. TALBOT 
659 
polish the plate over with symmetrical curves that the tongue cannot 
find the least fault. We must do something besides this: we must impart 
action to these otherwise whited sepulchres; we must instill life therein 
or our labor will be in vain. A tooth may be elegantly shaped and col- 
ored, yet if it lacks the proper shape for the person for whom it is in- 
tended and is unskilfully set in the arch, it is a failure. The blocks 
from the same mould set by different operators may vary in effect in 
every case. For this the operator should have a number of blocks of the 
various shapes, colors, and sizes, and try them under the lips until his 
Fig'. 352. 
Fig'. 353. 
Figs. 352-354.-Newkirk's adoption of Coffin split plate (1886) 
Fig. 354. 
judgment tells him which to use. The dentist's taste can be so culti- 
vated that he will be apt to criticise his own selections. 
"I shall use the term 'articulation,' instead of 'occlusion,' for the very 
good reason that it is more in keeping with the functions or the motions 
of the jaw. If there was but one movement of the lower jaw, and that 
up and down, we might possibly say occlusion. But this latter term 
applies more properly to the shutting of the lips or closing the mouth, 
and not to the motion of the lower jaw dependent on the articulation of 
the same at the glenoid cavity, where the articulation is universal. Ar- 
ticulation is a word of action throughout, while occlusion answers to the 
mere act of closing the teeth and lips and keeping them closed; one is 660 
ORTHODONTICS HISTORICAL REVIEW 
active, the other passive. Before we can comprehend, then, what con- 
stitutes true articulation of artificial teeth, we must look at the anatomy 
of the human jaw and its functions. 
"We find from twenty-eight to thirty-two teeth in each jaw, ar- 
ranged in such manner that no two strike directly against each other, 
but antagonizing in such a manner as to prevent the whole denture from 
becoming very irregular, which would be the case if striking one against 
another. By this arrangement, when one tooth is lost the regularity of 
the arch is interfered with. As necessary as this is in nature, it is not 
positively necessary to follow it in artificial work, although for the sake 
of harmony it should be done. 
"It will be found in 95 per cent of cases that the upper teeth project 
over the lower, and that the depth of overbite varies as the depth of the 
cusps of the bicuspids are deep and shallow; the ramus will be found to 
come upward and backward in relative proportion to the length of the 
cusps and the overbite. 
"One point of very great importance has not been given in general or 
special anatomy: The peculiar tripod arrangement of the lower jaw, 
forming an equilateral triangle. 
"From the center of one condyloid process to the other four inches 
is about the average; and it will be found that from this same center of 
the condyloid process to the median line at the point where the inferior 
centrals touch at the cutting edge is also four inches. It is strange that 
it should have been overlooked; but it only shows when studied in a 
geometrical and mechanical sense, the great wisdom in our formation. 
It varies, but never more than one-half of an inch, which would make no 
difference in describing an arc of a circle. No matter what the width 
from the processes, the distance is the same to the median line of the 
lower jaw. Were the lines of the angle five feet, the teeth made in the 
anatomic articulator would fit the case. It will be perceived that in 
setting artificial teeth, one-fourth of an inch, the radius of the circle, 
would not materially alter the articulation. Without such an arrange- 
ment the teeth would have to be flat on their grinding surfaces to admit 
of lateral movement. Besides, there would not be the beautiful and wise 
curvature at the ramus for equalizing the force applied to the teeth in 
all directions. 
"Imagine the human jaw jointed in a line with the pharynx, or as is 
seen in the ordinary brass articulators. Can it be supposed that there 
would be greater wisdom displayed in such hinging or articulating a part 
destined to such varying motions and powerful wrenching force? No! 
The study of this one part of the head and jaws shows one of the most 
striking designs of an architect; and when studied it will be seen that 
every part of our frame is made by a positive law and to subserve def- EUGENE S. TALBOT 
661 
inite purposes, such a law being in consonance with geometry, physics, 
and mechanics. We must see the true use or function of the jaw and 
the teeth and the food destined for us, and how it should be comminuted; 
there is no chance work about it! Law and order pervade every part. 
The jaw forms a perfect triangle, for the purpose of bringing into con- 
tact the largest amount of grinding surface of the bicuspids and molars, 
and at the same time to have the incisors on one side at once come into 
action during these lateral movements. 
"It will also be found that from the cuspids, the bicuspids and molars 
run in nearly a straight line, instead of a curved one, back toward the 
condyloid process, enabling them to keep the largest amount of surface 
always presented for mastication. Another thing which has never been 
explained by anatomists or naturalists is the law of the normal relation 
of the upper to the lower incisors. The normal jaw should overjet, and 
also have a corresponding underbite. Without such a law the incisors 
would lose largely their functions, that of incising on the principle of a 
pair of scissors. Where the incisors strike directly upon each other the 
power to cut off food would be very much lessened. The length of cusps 
on the bicuspids and molars proves the law. 
"Another unobserved fact: where law is supreme, where there is an 
overbite and underbite just in proportion to their depth will be the 
length of the cusps of the cuspids, bicuspids, and molars. 
"By drawing two lines from T to F, Fig. 355, or T to A and E, Fig. 
356, we have the lengths of the cusps of the bicuspids, B, in the upper 
and C in the lower, and also D, the second upper molar. The depth of 
the underbite is one-eighth of an inch from the cutting edge of the infe- 
rior central incisor E to that of the superior central incisor A. Did the 
teeth extend as far back as AA, there would be flat surfaces at those 
points. But in articulating artificial teeth, when the superior second 
molar is reached, its distal cusp has to be raised from line TE to TA 
(Fig. 356), to allow the molar teeth on the opposite side, not in mastica- 
tion, to touch, for merely balancing the plate, otherwise the second molars 
would be of no use in lateral movement, nor would the first molars. This 
curvature at the ramus commences at the first molar, although it shows 
itself slightly in the bicuspids. Practically, it need commence at the first 
upper molar. This curve, then, will always be proportioned by the 
underbite at A, E. The length of the cusps and bicuspids will never be 
more than an eighth of an inch, normally; the groove deeper than that 
would cut the palatal cusp off, and make of it a cuspid. It would in 
reality be cut in twain. This is another unobserved fact. It always has 
been and will be found in the archtype of human jaws. 
"So that when a first superior bicuspid is seen it can very well be told 
from the length of the cusps whether the jaw from which it came had 662 
ORTHODONTICS HISTORICAL REVIEW 
a depth of underbite of one-sixteenth of an inch or more. Where the 
teeth all strike fairly one upon the other, without overbite, then there is 
no occasion for cusps. If originally there, they would soon be worn off 
from the abnormal articulation. 
"This provision of articulation is most wise, carrying out still more 
fully the exact law by which the anatomic movements of the lower jaw 
for perfect mastication are governed. So beautiful and mathematical a 
Fig'. 355.-Bonwill's equilateral triangle (1887). 
Fig-. 356. 
design cannot but call forth our admiration and wonder, and the study 
of no other part of the human body will give one a clearer idea of in- 
finite wisdom. This movement, we will find in the artificial sets arranged 
upon this law, will prevent the plates from tilting. In the natural den- 
ture the incisors are really the first teeth to be arranged, though the first 
molars emerge first to assist in the more perfect mastication of food and 
to keep the jaws at the proper distance. The incisors show a definite 
fixedness of purpose to arrange themselves after their typal shape, and EUGENE S. TALBOT 
663 
to form the overjet and overbite at a given depth for the accommodation 
of the bicuspids and molars, which are soon to appear, having cusps of a 
definite length, so that the law of articulation which has been premed- 
itated to a certain typal shape and construction be carried out. 
"It will also be found that the grinding surfaces of the bicuspids and 
molars have a typal shape, allowing them to meet with all their surfaces 
touching, for an express purpose, after a preordained and established 
law, from which the greatest area is gained for mastication, and that 
the inner cusps of the lower teeth are as necessary as the outer of the 
superior when laterally moved. The law is still farther carried out in 
the curvature at the ramus from the second bicuspid to the third molar, 
to permit of all the surfaces on one side to be in contact, while the other 
unused side is only partially so. The nearly straight line of arrangement 
from the cuspids to the last molar is also in keeping with the underbite 
(Fig. 356). It may well be asked, just where, 'Will the law hold good 
in an artificial articulator such as I use, applied to the setting of artifi- 
cial teeth?' As soon as the attempt to apply this principle is once made, 
the operator must certainly grasp this law, so wise and beautiful. There 
may be variations, but the general law will hold good, and where there 
has been much latitude or varying from it by abnormal mixtures of 
races or types, if Nature is given fair chance to right herself she will 
return to the normal standard of mathematical and mechanical preci- 
sion: to do otherwise would annihilate creation. Cells free to arrange 
themselves must develop the original creation, and perpetuate and keep 
it to the perfect standard, by selecting the highest type of perfection in 
shape, strength, beauty, etc. 
"Could the reader but stand beside me while 1 arrange a set of teeth 
in this articulator, he would of necessity become converted to my sys- 
tem as founded on law and not on chance. There is no other part of 
the human body that will permit of thus handling and unfolding, and 
again rearranging-no other that stands outside its own organic work- 
ings that will permit such demonstration. It is the key to the revelation 
of Nature's inner workings, and unfolds, without a missing link, what 
we were, absolutely perfect in cell and organism from the inception, and 
simply in conformity to an indefinite and all-wise law which cannot be 
blotted out. The teeth, individually, have been a great factor in science; 
and when they can be looked at from the point of view therein laid down 
and hitherto undeveloped, their significance will be magnified; and if 
we, as dentists, but take up the work as only belonging to our specialty, 
and scientifically prosecute it, our honors and standing will be enhanced. 
"This triangle can only be found within a perfect circle in which 
there are the greatest breadth and area of surface. No other geomet- 
rical angle would have given such perfect beauty and symmetry to the 664 
ORTHODONTICS--HtSTORICAL REVIEW 
face. The compactness brings the largest number of teeth nearest the 
center of motion. The double joint permits the greatest strength and the 
easiest lateral movement, with the greatest range of this at the least 
expense of power and compass. It permits the largest number of teeth 
to antagonize at every movement; and, not least of all, this very triangle 
is the means by which Nature develops the typal shape of the ramus and 
of the formation of the jaws, the underbite, etc. 
"This form of triangle is necessary, again, for the purpose of giving 
the largest number of muscles a chance to act on both sides simultane- 
ously and concentratedly, thereby keeping the circle or arch of grinders 
down to their work and equalizing the pressure on all sides. It enables 
the teeth on the side where the chewing is being done to arrange them- 
selves when erupting so that they will be very nearly in a line with the 
left condyle, which is now passive on this side, and forms one point of 
the dividers in forming the are of a circle; and by this condyle being 
where it is-four inches from the other--the molars and bicuspids, as 
well as the central at that side, all come in the most perfect contact for 
chewing and incising, thereby carrying out this absolute law of Nature 
of the perfect adaptation of geometry and mechanics to her uses, and 
having no lost motion or function in any part. 
"Again, the triangle gives an extra motion forward which brings the 
lower teeth in contact with the upper to incise or cut off food presented 
there. The type has been preordained, just as has the nose or the pecu- 
liar shape of the eye or any other part of the body. If in the arrange- 
ment of the teeth in the human jaw no type or design were laid down in 
conception or embryonic life, what malformed creatures we should be 
mentally and physically! And it will be found that just in proportion 
as there is congenital insanity or want of ivill or directing power, there 
will be a malformation in the arrangement of the teeth, while in shape 
they are perfect. 
"The Eqxbilateral Triangles within the Main Triangle.-1The outline 
drawings in Fig. 355 may be thought ideal. But anyone at all acquainted 
with geometry, who has followed me in my argument and description, 
must be struck with wonder at the marvellous ingenuity of the contriv- 
ance based alone on the equilateral triangle. It will be seen that per- 
fection must be the result, since each part is complete within itself and 
the whole supporting each individual part. 
"How have I arrived at this divination? The law is based on the 
measurement of over two thousand human skulls. First, make an equi- 
lateral triangle 4 inches each angle, A, A, F; draw a line from T to F. 
What is the guide to form the arch? Know the actual width of the 
superior central, lateral, and cuspid at their greatest diameter from 
mesial to distal surfaces-say 1%6, as in Fig. 355. Measure this off with EtJGENE S. TALBOT 
665 
the dividers, and place one arm at F, and describe an arc from D to D 
through I. Then place dividers at I, and intersect the line just made 
from F, and it will be found that at D will be the extremest point of the 
arch D, F, D, and will be the distal surface of the superior cuspid. 
Place the dividers at I, and describe the arc from D to D through F, 
which will constitute the normal and positive arch of the superior jaw. 
There will be an equilateral triangle from D, F, 1 on either side of the 
mesial line at F. The same will be found the base of each superior 
incisor. 
"Next draw a line from A to D on either side, which will be the guide 
for the bicuspids and molars as to width and depth. Then by placing 
the dividers at A and B, describe another arc to C, which will give the 
width of first superior bicuspid. The line from A to D passes through 
its palatal base, and will pass through center of base of triangle of this 
tooth. 
"Form another triangle by drawing a line from II to II, through B, 
which will pass through the center of the first molar, and will give the 
width between their palatal surfaces or their depth or thickness. Plac- 
ing the dividers at I and F, we intersect the line from F to T at Y. 
Draw a line through F to E, forming another equilateral triangle. From 
B to F is now the radius of another arc, which intersects the line from 
D to A at V, and the line A to D at 0. A line now drawn from E to E 
through Y intersects the center of the second molar at E, E. Get half 
the distance between the points at E on the line from D to A, and the 
width of the first molar is made, and also the second, which is the angle 
of the equilateral of each. This leaves room between the first bicuspid 
and first molar, and is the width of the second bicuspid: or it is shown 
by placing the dividers at A and Y, and intersecting line from D to A 
at W, same as from B to C, for the first bicuspid's width. The distance 
from D to D is the same as from D to the distal surface of the second 
molar. P to P through Z forms another equilateral triangle, giving the 
wisdom tooth's place in the arch. 
"The arrangement on the left shows the teeth in the act of mastica- 
tion, while on the right the inner cusp of molars of the upper and outer 
of the lower molars come in contact when not in use. There is double 
the surface touching at every lateral movement. 
"In conclusion, let me again impress all with the importance of culti- 
vating mechanical art in our calling; for I can assure the reader that it 
will pay tenfold in increasing his usefulness as an operator in every 
department, and in giving him powers of conception, and lead the way 
to original ideas and more practical development." 
Before the World's Dental Congress, 1893, Bonwill continued this in- 
vestigation under the title of "What Has Dentistry to Demonstrate Against 666 
ORTHODONTICS HISTORICAL REVIEW 
the Hypothesis of Organic Evolution?" and made the following thirteen 
claims: 
"Claim 1. That the human jaw and teeth show, beyond doubt, the 
workings of absolute laws which gave them the highest efficiency and 
from which organization there could be no change except retrogressive, 
not progressive; not to a higher form. 
11 Claim 2. The human jaw is based for its organization and workings 
upon the principles of the equilateral triangle, which, as well, underlie 
the shape of every tooth and the numbers to occupy that equilateral 
space. 
"Claim 3. Given the length of one arm of this triangle, say four (4) 
inches, and it can be shown from this alone how, whatever or whoever 
made the first human jaw, that with a pair of dividers and a straight 
edge the size, shape, and number of each tooth in both upper and lower 
jaws and their absolute places therein were made; and further, what 
should be the exact arch containing the six incisors in both jaws and the 
action in mastication and incising of food. 
"Claim 4. That the human jaw is no exception to this rule. That 
the proportions of the human body were founded on the equilateral tri- 
angle and unless so, no fitter organization could have ever existed or 
been brought into being nor could it ever have been reached unless by 
the same rule at the very beginning of its existence. 
"Claim 5. That if the hexagon cell of the bee, which cell existed be- 
fore man, is incapable of change to make it fitter for the object for which 
it was designed, then we can claim it as a precedent that the same prin- 
ciple in the human jaw is none the less true and demonstrable. 
"Claim 6. I claim not only to have discovered the laws by which 
organizations are made, but have perfected the drawings from these laws 
by which any skilled artisan or mechanic can reproduce and duplicate, 
artificially, what the working model here presented demonstrates and 
its action shows beyond doubt the highest efficiency in such an arrange- 
ment, based simply on the principle of the equilateral triangle. 
"Claim 7. If the human mind cannot conceive of a fitter organization 
than what is here demonstrated, and produce it from the laws and prin- 
ciples of evolution, then there can be no progression to a higher state 
that can form a basis of argument for the evolutionist. 
"Claim 8. That as no one can show any fraud in this work and the 
claim of 'an ultimatum having been reached' by a human being, it must 
follow that Nature, who had the first chance at the building of organ- 
izations, must have done her best and made the fittest in the beginning. 
"Claim 9. It is claimed that natural selection could only have re- 
produced a preexisting organ or organism or previous type and could EUGENE S. TALBOT 
667 
add no new organ or alter the form of the preexisting one to higher 
efficiency. 
"Claim 10. That mechanical means, which can only be externally ap- 
plied, cannot even reproduce an existing type, let alone form an additional 
organ or organism. 
"Claim 11. There is no proof that when any organ has once been 
lost that it has ever been reproduced in the same animal; in the progeny, 
the same organ will again appear, but Nature will patch up in order to 
prolong life, but never in one lifetime make the effort to ever reproduce 
the lost organ, or lay the foundation in the offspring to make an addi- 
tional organ either like the original or make one of a higher efficiency. 
"Claim 12. The human jaw (to the glory of dentistry) furnishes one 
of the strongest or most absolute proofs of Claim 10 in the reproduction 
of the temporary set of teeth, which when completely lost at the age of 
fifteen, again appear in the offspring when there was no such organism 
existing at the time of procreation to give birth to an entirely new tem- 
porary set in that offspring. 
"Claim 13. The dental apparatus affords the best proof of the work- 
ings of a practical scientific workman from preexisting laws, and nothing 
but intelligence and a personality could have ever conceived and made 
such organs and organisms, and no further proof is needed of the purely 
scientific productions given in this discovery. 
Banwill's "Method of Correcting Irregularities of the Teeth" has al- 
ready been described, but we find in The International Dental Journal 
for 1889 further studies and new appliances along these lines. Bonwill 
says he discarded his previous methods, they being: 
"My first essay on orthodontia was written in 1862. To make my 
own history more replete, however, it is necessary to show what I have 
done in this line of work since 1854. As the apparatus was then entirely 
new and the practice considered rather radical for the time, and as it 
has since been revived by others, I shall briefly present them here. 
"From the following language it will be seen that the 'Coffin plate' of 
rubber was anticipated by me, except that I used silver wire made spiral, 
and adjustable or detachable from the plate previous to 1862. 
"If the inferior jaw, I clasp, where possible, and when not, strike up 
a plate to cover the deciduous or permanent teeth, as they may be, and 
operate from this. From the inward inclination of the inferior bicuspids 
and molars (or molars alone of the temporary set) there will be sufficient 
firmness gained by making it to press outward at these points. 
"If there are no other means of holding it in the inferior jaw, an India- 
rubber plate made to fit accurately either the teeth or palate, or both; 
and if you desire, the surface of the vulcanized plate can be roughened ORTHODONTICS HISTORICAL REVIEW 
668 
to enable the patient to masticate thereon, and screw the spiral springs 
into this. 
"This I seldom use, being bulky and dirty, and far more liable to in- 
jure the faces of the teeth. More can be done with the spiral spring 
soldered to a metal plate. 
"The same principles of action I still adhere to; namely: 
"1st. To commence as soon as possible after the seventh year, or as 
soon as there is evidence of decided irregularity. 
"2nd. To watch all children's teeth from the third year and deter- 
mine by an exploring needle, every three months, the exact position of 
the coming permanent teeth as soon as the first permanent molar has 
appeared. 
"3rd. To preserve, by early treatment, the first and second molars- 
temporary-even to the treatment of their pulps, if the little patients are 
not brought in time to obviate it. 
"4th. To be sure the first permanent molars are preserved without loss 
of pulp, and to allow nothing to interfere with their full and free de- 
velopment in the arches, as upon these teeth more than upon any others 
are due the irregularity, from coming too forward in the arch, from decay 
of approximal surfaces of temporary molars, or from the tardy erup- 
tion of the permanent incisors. The six-year molar drives the arch into 
smaller space when the incisors have appeared out of or inside the arch. 
"5th. That all apparatus should be simple and, if possible, firmly 
fixed, so that the patient can have no control over it; and then see the 
case every few days. 
"6th. That constant and uninterrupted pressure is preferable. The 
antagonism of the opposite jaw will always be exerting a force to make 
them move back and forth in the sockets, and this makes sufficient in- 
termittent pressure. 
"7th. That while one plan, without some change in each case, will 
not do, yet the infinite number of apparatuses is a greater nuisance to 
patient and operator. 
"8th. That the impressions of both jaws in plaster and a duplicate 
from the first; so that the plaster teeth can be cut off and rearranged to 
see the effect, and these models placed in the anatomic articulator, where 
they can be studied in the lateral movements, so necessary. That this 
shall be studied carefully; and, before action is taken, have the patient 
call and study the case in relation with the plaster model; and if doubt 
exists as to the extraction of a tooth or teeth, better postpone a few 
days and send for patient again rather than make so great a blunder. 
"9th. That a tooth shall be held as sacred as an eye; and, while ex- 
traction is sometimes demanded, when the greater good of the patient EUGENE S. TALBOT 
669 
is at stake-when of weak constitution-yet do not too hastily resort 
to it. 
"10th. That without the combined assistance of parent and child 
better not commence. 
"11th. That nothing shall be withheld from the child or parent, but 
every detail, every risk, and the amount of patient endurance needed, 
the long time, and, when all is corrected, to allow of stay plates, that 
the work gained may be retained. 
"12th. Not least of all the factors, you must place such valuation on 
your services as will insure your interest and will drive the parties con- 
cerned up to their duties. 
"To these points I would now further insist on the great importance 
of utilizing as factors or fulcrums the temporary molars. 
"1st. By shaping them with a disk on all their sides or surfaces, so 
that a gold clasp can be securely placed thereon. 
"2nd. Where only a ligature is needed, to cut a groove with the disk 
on the buccal and palatal and lingual surfaces near the cervix, in which 
to place the silk ligature to keep it from working down under the gum. 
"These teeth will soon be lost, and no injury is done by shaping and 
grooving them. 
"3rd. By the use of gutta-percha, warmed and placed on the palatal 
or lingual side of the tooth, around which a ligature is to be placed and 
carried slightly up over the grinding surface to prevent the ligature from 
pressing down under the gum. This I use on permanent teeth. 
"4th. Where the tooth cannot be cut or gutta-percha used, then gum 
sandarach varnish or a thin solution of oxyphosphate zinc placed on the 
tooth will prevent the ligature from slipping when the tooth is being 
rotated, or keep it from pressing up under the gum. 
"5th. The immense importance of the anatomic articulator, with the 
geometrical and mechanical laws governing it. 
"The study of this alone will lead to the anticipation of so many ir- 
regularities, and will teach one to begin very early. It shows how in- 
variable is law; and, when violated, where the cause is and how to 
obviate it. 
"It shows what is an archetype, and demonstrates clearly how the 
highest efficiency is reached in the equilateral triangular jaw of man, 
and that nothing can be made more perfect either by nature or by man." 
The appliances used by Bomvill in 1899 are described in the follow- 
ing manner: 
Fig. 357 represents a curved bar made of platinized gold with four 
holes punched for the passage of silk ligatures. It is another way of 
applying Fig. 358, without band, and is used mostly for a single tooth 
in either jaw. ORT 11ODONTICS HISTORIC 'AL REVIEW 
670 
"Fig. 358 is this same bar with a clasp on one side of the arch. The 
bar is lengthened beyond the clasp to allow of the rubber tubing, tied at 
B, being attached far enough away from A in order to give sufficient 
power to move the teeth desired. 
"It was applied, Fig. 359, by clasping a first molar where the right 
central had to be twisted, and the lateral also, but in opposite directions. 
The bar rests upon the mesial buccal edge of the lateral while the silk 
ligature is carried twice around the central, bringing it up next the 
lateral, and is now drawn through the rubber band which has been tied 
opposite the molar. The rubber is stretched to the full length of the 
Fig. 357. 
Fig. 358. 
Fig. 360. 
Fig. 3 61. 
Fig'. 359. 
Fig'. 3 62. 
Fig's. 357-362.-Bonwill's appliances as used in 1889. 
bar. The cuspid was also drawn outward on the same bar by boring a 
hole directly opposite, which was made to twist the cuspid as well as to 
draw it outward. 
"Fig. 360 is the same bar applied for drawing out both superior 
laterals and expanding the arch. 
"The gutta-percha stay-plate (see Fig. 361) is for keeping the ligature 
off the gum at the cervix, on the first molar. A piece of pink base-plate 
gutta-percha was warmed and pressed up against the molar, letting it 
rest partially on the adjoining teeth; when cold, two holes were made in 
it for the passage of the ligature, which was tied on the buccal surface 
of the molar. A rubber band was tied to the inside before adjusting. 
A ligature was then cast around the right lateral, carried up between EUGENE S. TALBOT 
671 
it and the cuspid, and over it through the space where the first bicuspid 
was extracted, on the lingual side of the first bicuspid, and tied to the 
rubber band attached to the gutta-percha stay or helmet on the first 
molar, and stretched over the buccal surface of the cuspid. This drew 
the lateral out very forcibly. The arch was first expanded by the 
fixture shown in Fig. 362, made of piano wire, with half clasps of platin- 
ized gold at AA, made with small ears to rest on the grinding surfaces 
of the first bicuspids to prevent slipping down upon the gums. These 
clasps were soft soldered to retain the full temper of the piano wire as 
a spring. It is a very cheap and easy way of making such an apparatus 
and with a powerful spring which such cases demand. 
"Fig. 363 is another modification of Fig. .360, the single bar, and is 
applied in Fig. 362, where the four superior incisors are to be moved 
Fig\ 363.-Bonwill's sliding' "arch" and use of elastics (1889) 
forward from one-fourth to three-eighths of an inch and the whole arch 
expanded to meet the more perfect and larger arch in the lower. It is 
made of two flat bars of platinized gold sliding over each other for at 
least two inches. A loop is soldered to the end of each flat bar as guides 
to hold them in place while sliding through. A rubber band is shown 
attached to the end of each bar at AA, which, in contracting, enlarges 
the circle, and consequently not only throws out the incisors, but the 
bicuspids as well. 
"The attachments are made on cither side to a molar or a bicuspid, 
owing to the ease of clasping. I have utilized the decay on the anterior 
surface of a molar by filling with amalgam, and cutting a hole for one 
end of the bar to rest in instead of using a clasp. 
"Before the apparatus is placed permanently in position, the incisors 
are ligated with a loop, using gum sandarach varnish to prevent slip- 672 
ORTHODONTICS HISTORICAL REVIEW 
ping or turning on the tooth. The ligature should be so adjusted as to 
twist the tooth, if needed, while drawing it forward. These are then 
tied to the sliding bars, bringing them closely in contact with all the 
teeth in the arch. The rubber band is then tied between the two points, 
and the application is complete. It is easy to see not only its simplicity, 
but also its great effectiveness. It can be used equally well for con- 
tracting an arch. 
"Fig. 364 shows the worst case of protrusion of the upper jaw I have 
ever seen. It did not arise from an acquired habit, nor did it have any 
Fig-. 364.-Bonwill's application of the elastics, in extreme protrusion (1889) 
Fig-. 365.-Bonwill's "bite plate" as used in conjunction with Fig-. 3 64. 
precedence in heredity. The temporary teeth had proper arches. No 
cause could be assigned. They came as you see in Fig. 364. The lower 
incisors, when I first saw the case, were three-eighths of an inch from 
the superior incisors on their palatal surface, and were imbedded in the 
gums on the hard palate. 
"Before attempting to draw in the incisors I made a rubber plate 
(Fig. 365) to cover the hard palate, thickened where the lower teeth 
would touch, and opened the jaws at the bicuspids at least one-eighth of 
an inch. This was not only to drive the inferior incisors up into their 
sockets, but also to allow the bicuspids and molars to come down and EUGENE S. TALBOT 
673 
antagonize before the plate was removed. Two years were consumed 
in this. To this plate was then attached a rubber band carried entirely 
around the arch with a silk ligature, and a metal hook, with two holes, 
was carried over the cutting edge of the central incisors, through which 
the ligature passed. This kept the ligature down on the incisors near 
the cutting edges, and while it was aiding in drawing in the arches, it 
did another important thing: forced the centrals up into the alveolus. 
This was done by the tendency of the rubber band to work up towards 
the gums, and at the same time it pressed them up and made them 
shorter without grinding. This was a case parallel with the one de- 
lineated by Dr. Kingsley in "Oral Deformities/' but without any of 
the treatment given there. A gold band, running over the arch from 
the second bicuspids, which was soldered to clasps around the latter, 
and which could be adjusted or removed by the patient, was used to 
secure it in position. 
"The explanations of geometrical law, and the value of the anatomic 
articulator in showing how the first permanent molar plays so important 
a part in making the lower incisors roll over one another, and thus make 
the smaller arch with a very deep under- and overbite where seen. I am 
almost quite ready to say never extract the first permanent molar. Keep 
down the inferior incisors. Have the first permanent molar take its 
place soon and rapidly in the arch. Drive it backward toward the ramus 
rather than have it move forward to make the underbite too deep. 
"To a person of any comprehension these are simple devices and plain 
rules; the application can be made to any case of irregularity. Any 
one can surely make the apparatus. Whoever hereafter shall undertake 
this branch of practice should first read my article on the geometrical 
law of articulation and study the principles involved, and not attempt 
wildly to do what but few men have ever truly fathomed. Really, in 
every city, some one should make of this a special practice, and the pro- 
fession should encourage such by sending cases for inspection and con- 
sultation. And such a specialist should do all he can in return to teach 
by example and demonstrations by clinics, to enlighten those who are 
placed so far from large cities that they are compelled to take such cases. 
When we can have that understanding between us, then we may feel as 
banded brothers more fully equipped for these hitherto difficult and al- 
most thankless operations." CHAPTER XXVI 
THE INFLUENCE OF EDWARD II. ANGLE 
Edward Hartley Angle, M.D., D.D.S., D.Sc., (1855- ), founder of 
"Scientific Orthodontia." Provost Smith upon conferring of honorary 
degrees at the dedication of the Thomas W. Evans Dental Institute, 
1915, expressed tlie following tribute to our great teacher, in words that can 
hardly be improved upon, broad in their meaning and true in their 
statement: "Lover of art and nature, intimate friend of trees and 
flowers, but preeminently founder of the science of orthodontia, to which 
the best thought of a life has been given in experiments and in test." 
To Dr. Angle orthodontia, owes that renewed impetus this great thinker 
has instilled into our science. Probably no one man in dentistry did 
more to foster this branch of dental science causing its separation from 
the general practice, bringing about the specialization and advancing it 
to a recognized science. 
The first to incorporate in his teachings and writings the viewrs of 
Davenport and others, publicly emphasizing that extraction of the teeth 
in order to correct malocclusion was unnecessary and even criminal; the 
importance of restoring normal occlusion in order that the best results 
might be obtained and the teeth permanently retained. 
Dr. Angle read his first paper in December, 1886, "Irregularities of the 
Teeth," before the Minneapolis Dental Society, repeating this before the 
Minnesota State Dental Society in May, 1887, and then describing for 
the first time (in a paper read before the Ninth International Medical 
Congress, 1887) what is now recognized as the "Angle System." From 
this simple beginning there has developed that which we now recognize 
as the leading method of treating irregularities of the teeth. Seven 
editions of his "Malocclusion of the Teeth" have gone through the press, 
the last published in 1907, the first in 1887. The second "A System of 
Appliances for Correcting Irregularities of the Teeth," 1890. The third, 
"The Angle System of Regulating and Retention of the Teeth" appeared 
in 1892 and the fourth edition was issued in 1895 with a second part 
"Treatment of Fractures of the Maxillae," fifth edition in 189'9, while the 
sixth "Malocclusion of the Teeth and Fracture of the Mandible" in 1900. 
Each edition was more comprehensive than the preceding one and con- 
tained all of the advances made by the author in the intervening years. 
The first five editions were pamphlets, the sixth, however, was more of 
an elaborate work; in this he clearly sets forth at length his method of 
operating, the devices he designed and their method of construction, with 
674 THE INFLUENCE OF EDWARD II. ANGLE 
675 
the added advantage of numerous photographic reproductions of models 
showing various cases before and after treatment, thus greatly enhanc- 
ing the value of the work. The seventh edition brought out in 1907, a 
work of 628 pages, was the last published in English. This edition has 
been reprinted several times. Besides the English editions there have 
appeared at least three German translations, the last being a revised 
edition of the seventh, with the addition of the working retainer and 
the pin and tube appliance (1913). 
Fig. 366.-Edward Hartley Angle (1855- ). 
Iii the American Textbook of Dentistry, third and fourth editions, Dr. 
Angle wrote the chapter on "Orthodontia/' the last issued containing 
his more recent appliance. 
Angle's works have been translated into the French, German, Dutch, 
Scandinavian and Spanish languages. 
The greatest influence in fostering orthodontia and advancing its 
science was undoubtedly the establishing of the Angle School of Ortho- 
dontia in 1900, the first postgraduate school for the teaching of this 
branch of dentistry and medicine and the training of selected men to 
advance scientific orthodontia. From a small group of men, four in num- 676 
ORTHODONTICS HISTORICAL REVIEW 
ber, Henry E. Lindas, Thomas B. Mercer, Herbert A. Pullen and Milton 
T. Watson, the graduates now number more than one hundred and fifty 
men who later located in every large city in this country as well as in 
Europe and South America. Dr. Angle was actively at the head of ten 
sessions of his school. 
ANGLE SCHOOL OF ORTHODONTIA 
Dr. Angle was the first man to realize that orthodontia and general 
dentistry were radically different and constituted in reality separate 
specialties of medicine-dentistry being the study of the diseases of the 
mouth, orthodontia the study of the relationship of the teeth to the de- 
velopment of the face. To him it was not a part of dentistry, but a 
sister profession. 
Dr. Angle has told in his own words the condition which led up to the 
establishment of the Angle School and I will include that, as it was given 
by himself. But one who has looked at orthodontia only from the view 
of dentistry, cannot, I believe, understand this development. 
"In 1880 I had become very much interested in orthodontia, and I 
came to believe that some time, perhaps after a long time, orthodontia 
would be practiced as a specialty, for it seemed to me that its impor- 
tance entitled it to a closer study and application in practice and that 
only would enable anyone to become sufficiently familiar with its prin- 
ciples and master its technic, to overcome its difficulties and be success- 
ful in its practice. This conviction has constantly grown upon me in 
the years that have followed. 
"In 1896 I advocated its teaching and practice as a specialty in a 
paper read before the Western Pennsylvania Dental Association, which 
was published in the Dental Review. My experience in teaching ortho- 
dontia in four different dental colleges covering a period of thirteen 
years, convinced me that it was impossible ever to successfully teach it 
to dental students. This is abundantly proved, I think by the fact that 
although orthodontia has been a part of the curriculum of all the dental 
colleges from Harris9 time down, not one dental student in all that time 
has gained sufficient knowledge of the subject in the dental college to 
enable him to practice it with sufficient success to make it his sole means 
of gaining livelihood, in spite of the immense number of these deformities 
in every community. 
"I then tried hard to impress the management of the dental depart- 
ments of the Northwestern University and the University of Pennsyl- 
vania with the desirability of their forming special departments devoted 
exclusively to the study and practice of orthodontia. I proposed that 
orthodontia in these institutions should be made optional; those having 
an aptitude and liking for the work, giving after the second year, their THE INFLUENCE OF EDWARD II. ANGLI 
677 
entire time to its study and practice. The answer was, always, 'This is 
too Utopian,' or 'It is too early.' 
"Having become entirely discouraged with my experiences in dental 
colleges, I became filled with the belief that if orthodontia was to make 
any material progress, a separate school, entirely independent of dental 
schools, must be formed, which would amply provide opportunity for 
those with aptitude and liking for the subject to study in a broad, thor- 
ough and comprehensive manner, and where it would be relieved from 
all the blighting, handicapping influences which are necessarily thrown 
around it in dental colleges. Hence was founded the Angle School of 
Orthodontia." 
In the summer of 1899, at the meeting of the National Dental Asso- 
ciation at Niagara Falls, a few young men became very much interested 
in Angle and his idea of orthodontia. As a result of the interest awak- 
ened, four young men, Drs. Thomas B. Mercer, Henry E. Lindas, Milton 
T. Watson and Herbert A. Pullen, went to St. Louis and spent about 
three weeks with Dr. Angle in his office. This was the very humble be- 
ginning of the Angle School of Orthodontia. 
In 1902 Angle strongly advocated the separation of orthodontia from 
the general dental profession and making it a distinct specialty, thus 
fulfilling Farrar's prophecy. For some years previous he devoted his 
practice exclusively to orthodontia and by the training the men received 
in his school this branch has now become a distinct specialty of its own. 
One of the important factors in advancing Angle's "System" un- 
doubtedly is the classification devised by him and now accepted as the 
recognized standard in treating malocclusion of the teeth. This classi- 
fication, with his determined stand against extraction of teeth, will be a 
lasting memorial to him. This is based upon the different varieties of 
malocclusion, taking the "constancy of the upper first molar" as a 
guide, the various types of cases being placed in four groups, and for 
each group there is prescribed a definite line of treating. This classifica- 
tion has brought a chaotic condition into an orderly and scientific ar- 
rangement, best testified by its generally universal acceptance and adop- 
tion throughout the whole dental profession. A brief summary of Dr. 
Angle's development of his ideas is as follows: 
The introduction of metal tubes soldered to the band, 1886, providing 
a "simple, compact, and ready means of attachment between band and 
working appliance. ' ' 
"Irregularities of the Teeth," (Ninth International Medical Congress) 
1887, probably First Angle Edition. 
Introduction of Nickel Silver (German) in 1887. 
Introduction of Traction Screw in 1887. 
Introduction of Stationary Anchorage in 1887. 678 
ORTHODONTICS HISTORICAL REVIEW 
Introduction of first set of Angle's Appliances in 1889. 
Introduction of Silver Solder in 1890. 
"A System of Appliances for Correcting Irregularities of the Teeth," 
Second Edition, 1890. 
Introduction of Occipital Anchorage in 1891. 
Introduction of Occlusal Anchorage in 1891. 
"The Angle System of Regulation and Retention of the Teeth," Third 
Edition, 1892. 
Introduction of Adjustable Clamp Band, in 1892. 
Introduction of Angle Impression Trays, in 1894. 
Introduction of Soft Brass Ligature Wires, in 1895. 
Introduction of Wire Pinches, Under a New Method of Applying Force 
In Regxblating Teeth, in 1895. 
Fourth Edition of the "Angle System of Regulation and Retention of 
the Teeth," with an addition of "Treatment of Fractures of the Maxillae," 
in 1895. 
Introduction of the Band Forming Fliers, in 1898. 
Fifth Edition, of the "Angle System of Regulation and Retention of the 
Teeth, and Treatment of Fractures of the Maxillae," in 1899. 
Introduction of Resection of Frenum Labii, in 1899. 
Introduction of Head Gear, in 1899. 
Introduction of Chin Retractor, in 1899. 
Introduction of Classification of Malocclusion, in 1899. 
Introduction of Friction Sleeve Nut, in 1899. 
" M al occlusion of the Teeth," Sixth Edition, 1900. 
Establishing of the Angle School of Orthodontia, in 1900. 
Organized the American Society of Orthodontists, 1901. 
"Some Basic Principles in Orthodontia," in 1902. 
Metal Ligatures in Orthodontia, in 1902. 
Introduction of Specialization of Orthodontia, in 1902. 
Introduction of Normal Occlusion. The full complement of teeth, and 
that each tooth shall be made to occupy its normal position, in 1903. 
Introduction of Upper First Molar as a Basis of Diagnosis, in 1905. 
"Malocclusion of the Teeth," Seventh Edition, 1907. 
Established the American Orthodontist, 1907. 
Introduction of Working Retainer, 1910. 
Introduction of Pin and Tube Appliance, 1911. 
Introduction of Ribbon Arch, in 1913. 
Notes on orthodontia with a "New System of Regulation and Reten- 
tion." This paper by Dr. Angle was read before the Ninth Interna- 
tional Medical Congress in 1887, in which he says: 
"In this brief paper I shall confine myself to the consideration of 
movements of the teeth during treatment, and, later on, shall offer for THE INFLUENCE OE EDWARD H. ANGLE 
679 
your consideration some appliances for accomplishing these movements 
and the retention of the teeth when in proper position. In studying the 
conditions by which we may best accomplish the movements of the teeth, 
we may simplify matters if we remember the movements are but five, 
viz., forward and backward in the line of the arch, inward and outward 
in the line of the arch and partial rotation. These and their slight modi- 
fications (with the exception of elongation and depression, which are 
so rarely necessary that I will not here speak of them) are all we are 
called upon to perform. The principles governing all of these movements 
are the same, so that by understanding the principles governing one we 
may comprehend them all. Only one of these movements by means of 
a mechanical appliance should be undertaken at the same time, otherwise 
the liability to inflammation is greatly increased. After having moved 
a tooth the desired distance in one direction, it should be firmly stayed 
from retrogression, when other movements, if desired, may be accom- 
plished. In accomplishing a movement of a tooth by force, it matters 
little whether the pressure be continuous or intermittent, since the re- 
sults are the same. The movements of a tooth should be completely 
under the control of the operator, and should be fast or slow, as his 
judgment may dictate, system and accuracy being observed at every 
step. And perhaps no one of the mechanical powers so nearly fills the 
requirements in aiding the operator in this respect as the screw. It is 
powerful and compact and the many different ways in which an ingeni- 
ous operator may make use of it renders its application almost universal, 
and it may nearly always be used inside of the arch, thus avoiding the 
appearance of unsightly appliances. Next in value I should place the 
spring composed of piano wire. 
"In applying force to a tooth, it should be sufficient to accomplish 
the movements as rapidly as is consistent with the laws of physiology. 
"When pressure is once applied, it should continue without relinquish- 
ment, for there should be no retrogression of the tooth. Indeed, I attach 
so much importance to this fact that I believe that it may be laid down as 
a law in orthodontia, for I believe the frequent removal of pressure is 
contrary to the laws of physiology, and when occurring, as by slipping, 
breaking appliances, frequent adjustment of ill-designed appliances, or 
for purposes of cleansing or changing of appliances, is the cause of nearly 
all the soreness and pain; and, I may add, a very common cause of 
failure in regulating. And to this cause, directly, I believe, may be 
traced strangulation and death of the pulp, which is so often attributed 
to the too rapid movement of a tooth. 
"An appliance for accomplishing the movement of a tooth should be 
so perfect in design, construction, application and operation that there 680 
ORTHODONTICS HISTORICAL REVIEW 
should be no occasion for its removal until the object for which it was 
designed is accomplished. 
"In the movement of a tooth, it is necessary that the resistance, at the 
point from which pressure is exerted, should be sufficient to completely 
overcome the resistance of the tooth being moved, but the regulating ap- 
pliance should never be allowed to rest in contact with the gum, as no 
substantial resistance can be gained by so doing, and more or less in- 
flammation will be the result. 
"The practice of covering the crowns of the molars or bicuspids with 
metallic caps or vulcanite, thereby preventing the proper closure of the 
jaws, is unnecessary, and should be deprecated." 
RETAINING APPLIANCES 
"On this subject little has been given us, and to this question far too 
little importance is attached. After the malposed tooth has been moved 
into the desired position and proper occlusion secured, it should be firmly 
supported and retained in such position until it has become firm in its 
socket. 
"A retaining appliance should hold the tooth so firmly that there will 
be no movement to disturb or in any way interfere with the new bone 
formation. Absolute rest is essential to the most speedy and satisfactory 
results. The importance of a firm support and rest while the tooth is 
becoming firm, is well illustrated, says Guilford, in the necessity of plac- 
ing a fractured limb in immovable splints. 
"I greatly doubt if alveolar tissue, formed under unfavorable circum- 
stances (such, for instance, as would obtain in malocclusion, or in the 
use of appliances necessitating frequent springing in and out of place 
for the purpose of cleansing) would, on close examination, be shown to 
be normal. 
"A retaining appliance should remain stationary until the object for 
which it was designed is accomplished; at the same time it should be 
clean, and in no way irritating to adjoining tissues, as it must of neces- 
sity be worn for a long time. 
"The rotating appliance, a piece of piano wire about two and a half 
inches in length, is bent at one end into the form of an eye. It is shown 
in Fig. 367. Rotation by the means of this instrument is accomplished 
by banding the tooth to be rotated in the usual manner. Before cement- 
ing the band in position on the tooth, a piece of joint wire (the bore of 
which is exactly the size of the piano wire just described), one-fourth 
of an inch in length, is soldered to the band on the buccal portion, at 
right angles to the axis of the tooth. The band is now cemented in 
position on the tooth. The straight end of the piano wire is inserted 
into the little tube, the other end sprung around and made fast by THE INFLUENCE OF EDWzlKD II. ANGLE 
681 
means of wire ligatures to the tooth nearest the eye. Fig. 367 shows an 
incisor tooth being rotated by this method. After the tooth has been 
moved into the desired position, it is retained in such position by moving 
the spring and inserting a piece of gold-plated wire into the tube from 
the opposite side, long enough for the end to rest on the labial surface of 
the tooth adjoining, as shown in Fig. 367. For accomplishing the move- 
ment of a tooth from within outward into line of arch, the jackscrew 
is used in the following manner: The tooth to be moved is banded and 
piped, in the manner just described in rotating. Into the palatal side 
of the band is formed a slot, into which is inserted the flat end of the 
jackscrew. Resistance for the base of the jackscrew is gained by select- 
Fig. 3 67.-Means of rotating anterior teeth 
(1887). 
Fig. 368.-Upper, retaining appliance ; 
Lower, use of jackscrew. 
ing a sufficient number of teeth to completely resist the pressure of the 
moving tooth. These teeth are banded in the usual manner and piped, 
close to and on a line with the gum, and a piece of gold-plated wire is 
threaded through these little pipes, either before or after cementing 
the bands in position. Against this wire is placed the base of the jack- 
screw. Fig. 368 shows the screw in position in moving an inlocked canine. 
Force is applied by tightening the nut with a small wrench. 
"After the tooth is moved into the desired position, it is secured and 
firmly held in such position by passing a short piece of the gold-plated 
wire through the little tube previously soldered to the labial or buccal 
portion of the band, the wire being long enough for the ends to rest 682 
ORTHODONTICS HISTORICAL REVIEW 
upon the labial or buccal surface of the tooth on each side. Thus the 
tooth is effectually keyed into its new position, as shown in Fig. 368. 
"The movement of a tooth from without inward into the line of the 
arch is accomplished by banding and piping the tooth to be moved, the 
pipe resting to and on a line with the gum on the palatal side. The 
angle of the traction-screw is hooked into the pipe. Resistance is gained 
by banding, piping and wiring together (either gold or piano wire may 
be used) a sufficient number of teeth in the arch to overcome the resist- 
ance of the tooth being moved, the traction screw and nut drawing 
through and against a short piece of the joint wire soldered to the wire 
Fig. 369.-Traction screw (1887) 
Fig. 370.-Bringing cuspid into line. 
of resistance on a line with the screw. Fig. 3'69 shows the screw in 
position in moving a central incisor. After the tooth is moved into the 
desired position, it is retained by removing the angle of the screw from 
the pipe and slipping into its place a short piece of the plated wire, the 
ends resting against the palatal surface of the tooth on each side, as 
shown in Fig. 369. The movement of a tooth backward in line of the 
arch is accomplished by banding and piping the tooth to be moved (for 
example, a canine) same as for rotation; a suitable tooth for resistance 
is selected (for example, second molar), banded and piped, the pipe being 
soldered to the band on a line with the axis of the tooth. Into this pipe 
is hooked the angle of the traction screw. (A longer screw than the one 
first described is used, but of the same gauge.) The screw is passed THE INFLUENCE OF EDWARD IT. ANGLE 
683 
through the pipe in the tooth to be moved and the nut applied. Fig. 370 
shows appliance in position. The nut is tightened as often as necessary, 
and the screw, as it passes through the nut and becomes irritating to 
the lips, is snipped off. After the tooth has been moved back the desired 
distance, it is retained in such a position by the screw already in position, 
or the screw may be removed and the plated wire inserted in its stead. 
"The movement of a tooth forward in line of the arch is accomplished 
in the same way, only selecting a tooth of resistance from the opposite 
side. Such are the general ways of using these appliances, but the dif- 
ferent ways in which they may be applied are almost limitless, each case 
requiring some slight modification. Fig. 371 shows the manner in which 
Fig-. 371.-Traction screw used to move an "inlocked incisor" into position (1887). 
the traction screw may be used in moving into line an inlocked incisor, 
at the same time expanding the arch. 
"The ligature represented by a dark line in the drawing is composed 
of fine steel wire annealed. Fig. 372' shows the method in which the arch 
may be expanded by using two short jackscrews soldered to heavy pieces 
of brass wire bent to conform to the shape of the palatine arch. The 
screws in this case are about one-quarter of an inch in length; after 
the nut has been tightened until the .screw is nearly passed over it, it 
is removed and the bent portion of the heavy brass straightened or 
drawn out, in order to gain more purchase for the screw. Only one of 
these appliances is removed and straightened at a time, the other one 
remaining in position in order to prevent retrogression of the teeth being 
moved. 
"In conclusion, let me add, the greatest care and accuracy should be 
observed in the construction, application and use of these appliances. 684 
ORTHODONTICS HISTORICAL REVIEW 
The little tubes should be of gold and fit snugly the different parts of 
the appliances passing through them, and if you will derive as much 
satisfaction in using them as I have, I shall feel abundantly repaid." 
Extracts of this paper were also published in the Ohio Journal of 
Dental Science and The Items of Interest for 1887. 
In the January, 1888, number of the Ohio Journal of Dental Science 
under "The Angle System of Regulation and Retention" we find a con- 
tinuation of the above article with a few additional illustrations. 
Fig-. 372.-Angle's expansion arch (1887). 
Fig'. 373.-Original set of "Angle Appliances" (1888) 
"In former numbers of the above journal I gave the main principles 
of my system for correcting irregularities. I now propose to report 
from time to time cases in practice, illustrating more fully the applica- 
tion of the principles of this system." One of these reports is found on 
page 123 of the 1888 Ohio Journal of Dental Science. Another on page 
306. The following illustrations are from these reports and describe 
themselves. 
"Fig. 373, original set of Angle Appliances. 
"Fig. 374 shows a cuspid being drawn backward. THE INFLUENCE OF EDWARD II. ANGLE 
685 
"Fig. 375, means of expanding the posterior maxillary arch, as de- 
scribed by Angle: 
"The opposite ends resting against the bars of steel; expansion is 
gained by tightening the nut on the screw. A better method of apply- 
ing pressure against these two bars is to bend a piece of heavy steel wire 
to conform to the curve of the arch across from bar to bar. At the 
side near one end is filed a notch fitting neatly one of the bars which it 
is to rest against. The other end is beaten slightly flat and a hole drilled 
through at a point directly opposite the other bar on that side of the 
Fig. 374.-Moving cuspid into line (1888). 
Fig'. 3 76.-Fig. 3 75 applied. 
Fig'. 375.-Expanding' posterior maxillary arch (1888) 
arch. Through this hole is placed a screw for pushing as shown in Fig. 
375. The screw should not be over % an inch in length. This appli- 
ance is now ready to place in position as shown in Fig. 375. It is in 
position in Fig. 376. Pressure is exerted by tightening the nut. After 
the nut has traveled the length of the screw, the bent wire is removed 
and straightened a little that the screw may have more action. 
"It will be seen in the engraving that the two of these screws and 
braces are used, one is to remain in position while the other is being 
straightened, thus preventing the teeth from moving back, as would be 
the case if but one was used. The braces are moved along the bars for- 686 
ORTHODONTICS HISTORICAL REVIEW 
ward or backward according as pressure is needed. After the sides of 
the arch have been pressed apart the desired distance, they arc retained 
by a straight bar passing across the arch from cuspid to cuspid, the ends 
Fig. 377.-Retaining arch 
Fig'. 378.-Expanding' in cuspid region. 
Fig. 379.-Rotating teeth (1888). 
Fig-. 380.-Bringing forward the anterior 
teeth. 
Fig-. 381.-Use of traction screw. 
being bent sharply at right angles and hooked into pipes already de- 
scribed and attached to bands encircling the cuspids. The incisors are 
drawn into line by means of the traction screw, this cross bar serving as 
the wire of resistance for the traction screw to pull to. THE INFLUENCE OF EDWARD H. ANGLE 
687 
"This method of expansion may be applied to the lower arch as well, 
as little interference is offered to the movement of the tongue." 
Fig. 377 shows the retaining arch as used by Angle at that time. 
Fig. 378 is an appliance described on page 123 of the above journal. 
Fig. 379, means of rotating teeth. 
Fig. 380, method of bringing forward the anterior teeth. 
The International Dental Journal, 1889, page 323, contains another of 
the early articles of Dr. Angle's Regulating Appliance. The case in ques- 
tion was one of Excessive Protrusion. 
"The value of the occipital bandage, as a means of anchorage is, I be- 
lieve, becoming more and more appreciated, and is especially applicable 
to this class of cases. I am using the appliance herein described, in my 
sixteenth case, and I consider it much more satisfactory than any of the 
few devices which are described in our literature on this subject. This 
is shown in part in Fig. 3'82. 
"It is made and applied as follows: 
"The first molars are carefully and accurately banded. These bands 
may be made of gold or platinum; but what I regard much better than 
either, on account of its tensile strength, is German Silver, rolled to No. 
36 gauge, shown in F in Fig. 383. 
"Little pipes about five-eighths of an inch in length are soldered on 
the side of the arch to the bands. A wire of hard drawn platinized gold, 
about No. 19 gauge, and long enough to encircle the arch is now care- 
fully bent to conform to the shape of the arch, if the arch be correct 
in form; but if it be contracted or the teeth irregular, no attention is 
paid to the form of the existing arch, but an ideal arch for the case is 
made by bendng the wire arch to the exact shape to which we wish the 
teeth in the arch to arrange themselves when the operation is completed. 
"The ends of this ideal arch are now slipped into the pipes on the 
molars. The anterior part of the arch is kept from sliding up and im- 
pinging upon the gum, by resting in suitable niches formed in the delicate 
bands encircling, and cemented to the central incisors. 
"It will also be seen by referring to this cut that two small pipes or 
collars have been slipped on the wire arch, and are shown in the region 
of the cuspids. (Also shown at B in Fig. 383.) 
"These collars are prevented from slipping by being previously sol- 
dered into place, care being taken to use soft solder, that the temper may 
not be drawn from the wire arch. The collars are for the purpose of 
preventing the silk ligatures shown in the cut from slipping backward 
on the wire. These silk ligatures serve to attach delicate rubber liga- 
tures, which have been hooked over the ends of the little pipes on the 
anchor teeth, and are represented in dark lines in Fig. 382. The use of 
these rubber ligatures will be explained further on. A traction bar is 688 
ORTHODONTICS HISTORICAL REVIEW 
used in conveying the force from the occipital bandage distributing it 
to the wire arch. 
"A spur about three-eighths of an inch in length will be seen in the 
center of this bar, it has a deep niche in one end, which when in position, 
is placed in contact with the wire arch, at a point between the central 
incisors. Heavy rubber bands are now attached to the occipital bandage, 
the other ends being hooked over the traction bar. Shown in position 
in Fig. 384. 
Fig. 382.-Angle's appliance as used in 1889. 
Fig. 383.-Second set of "Angle Appliances, 
"If the reader is familiar with the appliance so far described, it will 
be seen that the force received from the occipital bandage, is distributed 
to the wire arch practically through a ball-and-socket joint, as the ends 
of the traction bar may be moved in any direction without interfering 
with the pressure from the bandage. 
"As for the bandage proper, T greatly prefer the common silk travel- 
ing cap, shown in the engraving, or the knit jersey cap, to the contriv- 
ance usually used for this purpose, as these fit the head snugly, thereby 
distributing the force exerted by the strong ligature over more surface, 
and are consequently more easily worn. Two ligatures should be at- 
tached to the cap, one above the ear, and one below, as shown in Fig. THE INFLUENCE OF EDWARD II. ANGLE 
689 
384. If the bands be of equal width, the force will be exerted in the 
direction of the meatus of the ear." 
Fig. 385 is from a "Report of Cases in Orthodontia," 1889, Ohio 
Journal of Dental Science. 
Fig. 386 is a modification of Fig. 382 and is described in Angle's third 
edition. 
Dental Cosmos, 1891, "Forcible Protrusion of Non- or Partially Erupted 
Teeth." The following four illustrations describe the method Angle then 
used to bring down these teeth. Figs. 387, 388, 3'89 and 390. 
Dental Digest, page 6, 1895, "A New Method of Applying Force in the 
Regtilation of Teeth." Here we find a new method of applying force by 
means of the Wire Stretching Pliers, Fig. 391. 
Fig'. 384.-Head cap. (Angle, 1889.) 
Dental Cosmos, March, 1899, page 248, "Classification of Malocclusion." 
In this article we find undoubtedly one of Angle's greatest contributions 
to orthodontia. 
"The term Irregularities of the Teeth, as it is usually applied to express 
teeth that are twisted or unevenly arranged, does not, in the author's 
opinion, properly express the full meaning of these deformities. It would 
seem that the term 'malocclusion' would be far more expressive; for in 
studying the subject, we must not lose sight of the importance of the 
dental apparatus as a whole and the important relations not only of the 
two arches to each other; but of the individual teeth to one another. The 
shapes of the cusps, crowns, roots, and the very structure are all de- 
signed for the purpose of making occlusion the one grand object, in 
order that they may best serve the purpose for which they are designed, 690 
ORTHODONTICS HISTORICAL REVIEW 
namely, the cutting and grinding of the food. Examined carefully, it 
will be seen that there can be no 'irregularities' of the teeth if they are 
in perfect occlusion, but that all must be regular and even, each con- 
tributing to the support of the others, and all in perfect harmony. Not 
only this, but the jaws, the muscles of mastication, the lips, and even the 
Fig. 385.-Increased anchorage (1889) 
Fig-. 386.-Modification of Fig. 382. 
found in the third edition of Angle's (1892 ). 
Fig. 387.-Forcible protrusion of non 
erupted or partially erupted teeth (1891) 
Fig-. 388.-Forcible protrusion of non 
erupted or partially erupted teeth (1891) 
Fig. 389.-Forcible protrusion of non- 
erupted or partially erupted teeth (1891) 
Fig-. 390.-Forcible protrusion of non- 
erupted or partially erupted teeth (1891). 
facial lines, probably, will be in best harmony with the peculiar facial 
type of the individual. 
"Therefore, it would seem that the term malocclusion of any tooth or 
number of teeth would not only better express the true condition, but 
naturally and constantly suggest the paramount importance of occlusion THE INFLUENCE OF EDWARD 11. ANGLE 
691 
in the study and treatment of these deformities, instead of making it 
secondary or even losing sight of it entirely, as has been too much the 
case in the past. The author has become firmly convinced that occlu- 
sion is the very basis of the science, and that in the treatment of cases, 
unless occlusion is established, the results will be largely of the nature 
of failures. So in the pages that are to follow we will make occlusion 
the central thought, and on it base the classification of 'irregularities' 
as well as the nomenclature; and will define orthodontia as being that 
science which has for its object the correction of malocclusion of the 
teeth. 
"In order to diagnose all cases of malocclusion correctly it is necessary 
to be familiar with, first, the normal or ideal occlusion of the teeth; 
second, the normal facial lines. These must be so fixed in the mind as 
to form the basis from which to reason, and to intelligently note all 
Fig. 391.-Expanding' by the wire-stretching- pliers (1895). 
deviations from the normal; and it must follow that without clear, fixed, 
and definite ideas as to the normal, the limits or boundary lines of the 
abnormal must also be vague and indefinite, and the line of treatment 
the merest empiricism. 
"A knowledge of the occlusion of teeth being the first importance, 
should embrace a knowledge of not only the normal relations of the oc- 
clusal surfaces of both permanent and deciduous teeth, but of their entire 
forms and structures. The growth and normal development of the jaws 
and muscles, together with the development of the teeth and the normal 
periods for taking their positions in the arches, should receive careful 
attention. Our perceptions of the subject would be broadened also by 
a comparative study of the occlusion of the teeth of the lower animals." 
As this article covers some thirty odd pages it will be impossible to 
include it in this historical review and fearing that injustice might be 
done same by reviewing or extracting parts, the author advises that 692 
ORTHODONTICS HISTORICAL REVIEW 
his readers review the article in the above journal or the seventh edition 
of Angle's book. 
There is some slight difference in the wording of the classification as 
will be seen by comparing the one from the Dental Cosmos and the other 
found in the sixth or seventh edition, and therefore both are included 
in this historical resume. (Dental Cosmos, page 264.) 
Class 1. 
Relative position of the dental arches, mesiodistally, normal, with malocclusions 
usually confined to the anterior teeth. 
Class 2. 
Retrusion of the lower jaw, with distal occlusion of the lower teeth. 
Division 1. 
(a) Narrow upper arch, with lengthened and prominent upper incisors; lack of 
nasal and lip function. Mouth-breathers. 
(b) Same as a, but with only one lateral half of the arch involved, the other being 
normal. Mouth-breathers. 
Division 2. 
(a) Slight narrowing of the upper arch; bunching of the upper incisors, with 
overlapping and lingual inclination; normal lip and nasal function. 
(b) Same as a, but with only one lateral half of the arch involved, the other being 
normal; normal lip and mouth function. 
Class 3. 
(a) Protrusion of the lower jaw, with mesial occlusion of the lower teeth; lower 
incisors and cuspids inclined lingually. 
(b) Same as a, but with only one-half of the lateral arch involved, the other 
being normal. 
OUT OF SEVERAL THOUSAND CASES OF MALOCCLUSION EXAMINED THE PROPORTION PER 
THOUSAND BELONGING TO EACH CLASS WAS AS FOLLOWS: 
Class 1 692 
Class 2 
Division 1 90 
Subdivision 1 34 
Division 2 42 
Subdivision 2 100 
Class 3 34 
Subdivision 8 
1000 
(Seventh Edition, page 57.) 
Class 1. Arches in normal mesiodistal relations. 
Class 2. Lower arch distal to normal in its relation to upper arch. 
Division 1. Bilaterally distal, protruding upper incisors. Usually mouth- 
breathers. THE INFLUENCE OF EDWARD H. ANGLE 
693 
Subdivision. Unilaterally distal, protruding upper incisors. Usually mouth- 
breathers. 
Division 2. Bilaterally distal, retruding upper incisors. Normal breathers. 
Subdivision. Unilaterally distal, retruding upper incisors. Normal breathers. 
Class 3. Lower arch mesial to normal in its relations to upper arch. 
Division. Bilaterally mesial. 
Subdivision. Unilaterally mesial. 
"Orthodontia-New Combination of Well-Known Appliance--Forms of 
Appliances," Dental Cosmos, 1899, p. 836. We here find for the first time 
the use of the Friction Sleeve Nut. 
"The expansion arch possesses qualities which will probably always 
keep it easily in the lead of all other regulating appliances. By its use 
we have control over the entire dental arch ; over the teeth individually 
as well as collectively in contradistinction to the vast number of appli- 
ances which have been devised to act locally, principally by reciprocal 
force upon the malposed teeth alone, and by which so acting usually 
effect displacement of others originally in correct position, so that these 
in turn require additional devices for their correction, etc. 
"Again, with the arch we have the greatest control over anchorage, 
being able to employ simple, reinforced, reciprocal, and even a certain 
amount of stationary anchorage, so that it is possible to concentrate upon 
one tooth the combined resistance of all the remaining teeth. 
"Finally, it is an ideal pattern to guide in tooth-movement, and to 
which the dental arch is molded to conform, besides being a temporary 
retainer as well. 
"In the improved form, as here shown, Fig. 392, it is believed that its 
size, proportion, strength, and elasticity, as well as stability of anchorage 
and attachments, are probably very nearly perfect. Fig. 393 is part of 
Fig. 392. 
"Without doubt the greatest improvement which it has received in 
recent years is the substitution of annealed brass wire ligatures, Nos. 26 
and 28, for the long-used fibrous or elastic ligatures, which were un- 
cleanly, admitted of slipping and stretching, and exerted only a moder- 
ate amount of pressure. With a proper quality of wire ligature there 
is no slipping or stretching, and power being direct and positive and the 
maximum amount of force easily exerted. Most valuable of all, these 
ligatures may be tightened without renewal by an additional twist of 
their united ends, thus really adding to the ligature that ideal power, 
the screw. So the range of application and usefulness of the arch has 
been greatly extended, and, as well, the time of treatment with its use has 
been reduced fully one-half. 
"The latest improvement of the arch is the extension flange or fric- 
tion sleeve upon the nut, which fits with great accuracy into the sheath 694 
ORTHODONTICS- HISTORICAL REVIEW 
upon the clamp band D and effectually prevents the annoyance of the 
nut becoming loosened by the friction of tongue or cheek. At the same 
time longer thread and consequent greater strength is gained without 
increase of bulk. 
"In the intelligent use of the arch the teeth may be moved en masse; 
either arch may be widened by moving outward one or both of its lateral 
halves, or either may be lengthened or enlarged in any portion in front 
or on one or both sides thereof. Elevation, depression, or rotation, labial, 
lingual, or mesial movements of individual teeth may be accomplished 
with certainty and under the best control. 
"But for the purpose of shortening the dental arch on one or both 
sides after extraction of a tooth, or the front by the moving inward of 
protruding teeth, or for the distal movement of individual teeth, the 
Fig. 392.-Angle appliance in 1899. 
Fig. 393.-"D" bands and expan- 
sion arch, with friction sleeve nut 
(1899). 
expansion arch by itself is unsuited and should never be employed; not 
that it lacks in power, for this is ample, but for the reason that dis- 
placement of the anchor teeth will follow, their resistance being in- 
sufficient to overcome that of the moving teeth. It is the common ex- 
perience of all that the combined resistance of the molars in simple 
anchorage is not equal to that of the cuspid alone. The molars arc in- 
variably tipped forward and the normal harmony of the occlusal planes, 
so necessary to maintain is destroyed. A careful study of the alveolus 
and of the length of the roots and attachments of the teeth confirms 
common observation and practice on this point. 
''The difficulty of this movement, so frequently necessary, is success- 
fully overcome by a combination of the expansion arch with the author's 
well-known device, the traction screw A and D, Fig. 394. 
"The traction screw is adjusted for retraction of the cuspid first. The THE INFLUENCE OF EDWARD II. ANGLE 
695 
angle of the screw is made to engage a pipe soldered to a band en- 
circling the cuspid, while the shaft of the screw passes backward through 
its sheath, which has been rigidly soldered to a screw-clamp band (No. 
2) firmly clamped in cement upon the first molar. The retraction of the 
Fig'. 394.-Traction screw used in 
combination with the expansion arch 
(1899). 
Fig. 395.-Appliance used in 1889, as in 
Fig. 382. 
No. 1. 
No. 2. 
No. 3. 
No. 4. 
X Band. 
D Band. 
Fig'. 396.-Various "D" and "X" bands. 
Fig'. 397.-Appliance (Fig'. 386) applied to 
the teeth (1890). 
Fig. 398.-Appliances for expansion 
found in the second edition of Doctor 
Angle's book (1890). 
cuspid following tightening of the nut at the posterior end of the long- 
sheath is easily effected, while tipping forward of the crown of the 
anchor tooth is impossible. It must be dragged bodily through the 
alveolus, if moved at all. (This form of anchorage is most efficient and 696 
ORT 11 ODONTI OS 111STORI(' AL REVIEW 
valuable, and is best known as stationary anchorage. It was first sug- 
gested by Dr. Barrett.) 
"By combining the expansion arch with this appliance the movement 
of other teeth is easily carried on at the same time. The end of the arch 
is securely supported by being passed through a short tube previously 
soldered to the anterior end of the long sheath of the traction screw. 
Of course the same combination may be used on both sides if desirable. 
If not, the opposite end of the expansion arch is secured in the usual 
way in the sheath of the clamp-band I). The expansion arch is attached 
Fig'. 399.-Appliances found in the third 
edition of Angle's (18 92). 
Fig'. 400.-Appliances found in the third 
edition of Angle's (1892). 
Fig; 401.-Appliances found in the third 
edition of Angle's (1892). 
Fig. 402.-Appliances found in the third 
edition of Angle's (1892). 
to the teeth to be moved by means of spurred bands and ligatures in the 
usual way. 
"It will be seen by studying this combination that we have reciprocal 
anchorage combined with stationary; in other words, the resistance of 
the force of the moving incisors is reacted to the molars, and helps to 
overcome the resistance of the retracting cuspid. 
"This is a most valuable combination, and with it the most perfect 
control of that very obstinate tooth, the cuspid, is gained. 
"A similar combination is extremely valuable in shortening tbe arch THE INFLUENCE OF EDWARD H. ANGLE 
697 
by retracting cuspids and protruding incisors after extraction of the 
first bicuspids, the force for retracting the incisors being received from 
some form of headgear upon the center of a plain threadless arch (arch 
B), the ends of which rest in tubes soldered to the ends of the long 
sheaths, as shown in Fig. 395, thus combining occipital and stationary 
anchorage. With its use we may shorten the time of treatment of these 
cases nearly one-half, and that, too, without displacement of the molar 
teeth, so important to avoid in all these cases." 
Dr. Angle, in his first Presidential Address before the American Soci- 
ety of Orthodontists, speaking of "Orthodontia as a Separate Science," 
stated: "It is that orthodontia is a great science by itself, with require- 
ments in its study and practice so radically unlike that of other branches 
of dentistry that the two can never be profitably combined, either in 
Fig-. 403.-Angle (1899). 
study or practice. Each seriously handicaps the other and orthodontia 
naturally suffers most for the reason that it is wholly unlike other opera- 
tions in dentistry. It is therefore least understood, least studied, and 
made secondary alike in dental colleges, in practice and in dental soci- 
eties. Hence it is not unlikely to follow that in proportion as a dentist 
is successful in other operations of dentistry he will naturally be less 
successful in those of orthodontia, for in that same proportion he will 
have less inclination, less time, and less energy to devote to it. Few 
would think it advisable to combine the practice of rhinology with that 
of dentistry, and yet we believe the two could be far more easily, prof- 
itably and successfully combined than can orthodontia and dentistry 
proper. The fact is, orthodontia deals almost wholly with different tis- 
sues, principles and art problems from those treated in ordinary dentis- 
try and is extremely exacting in its requirements, necessitating peculiar 
talent, energy, fitness and devotion to certain lines of study which arc 698 
ORTH ODONTIC^ HISTORICAL REVIEW 
as unlike those of other branches of dentistry as are the instruments best 
adapted to the performance of operations in each. 
"Another most important reason is that the science of dentistry has 
grown to such proportions as to embrace in its study so large a field 
that any one who attempts to master it all must be regarded as a mere 
smatterer. In fact it needs no argument to prove that all progress in 
the different branches of dentistry is in reality being made largely by 
those who are specializing. 
"The ultimate separation of orthodontia from dentistry proper is nat- 
ural and inevitable and the sooner it is encouraged and becomes firmly 
established, the better it will be for both and infinitely better for 
humanity at large. Orthodontia offers ample opportunities for the bright- 
est minds. Let each student of dentistry, after having acquired a thor- 
ough knowledge of the fundamental principles of the science, select such 
lines as are best suited to his aptitude and liking and confine his ener- 
gies to his selection and the result cannot fail to be vastly more beneficial 
than the plan now followed. As yet there have been only a few men who 
have had the courage to completely specialize the practice of orthodon- 
tia, but the results of the efforts of even those few have been truly re- 
markable. Orthodontia has been revolutionized, and we would ask those 
who may doubt the practicability of this specialization of orthodontia 
to but reflect on the marvelous advancement which has been made in the 
various branches of medicine through specialization, not to mention the 
growth of nearly every other branch of science and art accomplished 
by the same power. Indeed this is the very age of specialization, and 
was there ever such an age of progress? Wise is he who recognizes the 
natural and resistless power of specialization, and narrow indeed must 
he be who is blind to its demands and attempts to resist its might. 
"To hope that all this may be brought about at once, or even in sev- 
eral years, would be expecting too much. Great and radical changes 
must be wrought slowly. We must remember that each specialty in 
medicine has developed slowly and has become firmly established only 
after a considerable lapse of time and after many trials-ofttimes in 
spite of the keenest opposition-yet we can point with pride to the 
career of the late Dr. Thomas Rumbold of this city, whom several of us 
were proud to have the honor of calling friend. Tie was the father of 
rhinology and lived to see it firmly established as an indispensable spe- 
cialty in medicine." 
"Some Basic Principles in Orthodontia,,'' International Dental Journal, 
page 729, 1903. 
"I shall try this evening to make clear some principles which seem to 
me basic, and on the intelligent comprehension and application of which 
depend the possibilities of successful achievement. THE INFLUENCE OF EDWARD EI. ANGLE 
699 
"First, I shall hope to demonstrate to you that we must consider the 
dental apparatus as a whole in each case, together with the throat and 
nose and facial lines, instead of limiting our attention to local symptoms 
in the form of one or more crooked teeth, as has long been the practice. 
"Secondly, T shall try to impress you from the orthodontist's stand- 
point, with the value of each individual tooth and with the absolute 
necessity of preserving the full complement of teeth, or its equivalent, 
in every case. I shall try to bring conclusive evidence that the sacrifice 
of teeth for either the intended prevention or correction of malocclusion 
is not only wrong practice and fallacious teaching, but most baneful in 
its results. T shall further try to show that the full complement of teeth 
is necessary to establish the most pleasing harmony of the facial lines. 
"Thirdly, I shall try to prove to you that the first molars are the most 
important of the teeth, and that they are the first to be considered, from 
the orthodontist's standpoint, in both diagnosis and treatment; that we 
must first look to their correct adjustment instead of beginning with the 
incisors and ignoring the positions of the molars, or attempting to cor- 
rect them last. 
"Fourthly, it is positively essential that each arch and the teeth of 
each arch shall receive at least equal care in their adjustment, the pref- 
erence, if any, being given to the lower. 
"And lastly, I shall try to show you that fully 90 per cent of the 
regulating appliances represented in our literature are constructed and 
operated upon incorrect principles. 
"I shall not have time to touch upon the etiology of malocclusion, but 
I feel that I should not miss this opportunity to say that I believe it is 
as ignorant as it is cruel to brand as degenerates those suffering from 
malocclusion of the teeth. 
"I hope I shall this evening awaken much interest, and if we do not 
agree on some points it will not be the first time that men have differed 
on the subject of orthodontia, yet I hope and believe that our differences 
will be honest. 
"Normal occlusion is maintained only through the normal relations 
of the inclined planes of the cusps, assisted by the normal influence of 
the muscles externally and internally upon the crowns of the teeth. 
"There are two points of great importance in the occlusion that I also 
wish you to remember. First, the normal relations of the first molars, 
and second, that of the cuspids. The first determines the mesiodistal 
relations of both lateral halves of the arches; the second, the width of 
the arches. If the first molars lock normally, as you see in this picture, 
the mesiobuccal cusp of the upper will occlude in the buccal groove be- 
tween the mesio- and distobuccal cusps of the lower. And if the first 
molars are so locked in their eruption it will make possible the normal 700 
ORTHODONTICS HISTORICAL REVIEW 
eruption of all the teeth both anterior and posterior to them, as has re- 
sulted and is here shown in this beautiful picture. But if the first molars 
lock mesially to normal, or distally to normal, in their eruption, it will 
necessitate the eruption into positions of malocclusion of all the remain- 
ing teeth both anterior and posterior to them, and according as these 
molars erupt and lock in mesial or distal relations, in one of the lateral 
halves of the arches, or both, will be determined certain classes of mal- 
occlusion which will be considered later. 
"Now, if the locking of these molars plays so important a part in the 
eruption and positions of the remaining teeth, can you not see how im- 
portant it is that they be preserved and early attention given to their 
eruption and relations'? Hence the time for beginning treatment of mal- 
occlusion is no longer mythical, but as fixed and well defined as the first 
molars themselves. 
"It must be borne in mind, however, that even with the normal lock- 
ing of the first molars and normal mesiodistal relations of the jaws and 
arches, the normal locking of all the other teeth is by no means assured, 
and malocclusion may involve any or all of the teeth anterior to them, 
but usually is chiefly confined to the narrowing of the arches in the 
region of the cuspid, with bunching of the incisors, similar to the case 
first illustrated, and, as we have said, by far the largest number of cases 
of malocclusion belong to this class, and it is to this great class we will 
first direct our attention. 
"Before leaving this picture let me try to impress you with the impor- 
tance and wonderful relations of the occlusal planes, how they must gain 
their normal relations if we would hope to be successful in maintaining 
them in the positions in which we wish them to remain after correction. 
And what a waste of time to consider one arch without the other, or to 
attempt to ignore the importance that each tooth bears to all other teeth 
in both arches. Or, in other words, this picture of normal occlusion and 
all that it means must actuate and direct all of our efforts from the 
beginning of treatment to the termination of retention. 
"In the treatment of these cases I believe 1 can again prove to you 
that my theory is correct, that extraction is wrong, that the full com- 
plement of the teeth is necessary to the best results, and that each tooth 
shall be made to assume its correct relation with its fellows. In other 
words, if the molars and premolars of the upper dental arch be moved 
distally one-half the width of the cusp of a molar, or premolars of the 
lower arch be tipped forward in their alveoli to the same extent, or one- 
half the width of a cusp of a molar or premolar, there will then be nor- 
mal mesiodistal relations of these teeth, and if the arches in the region 
of the incisors be put in true at the same time, there will be harmony in 
their relations and the best effect will have been produced upon the TILE INFLUENCE OF EDWARD II. ANGLE 
701 
facial lines. In other words, we will have established normal occlusion 
with all its possible benefits. 
"This plan of treatment I have been practicing now but three years, 
and so pleased am T with it in the large number of cases that I have so 
treated that I no longer practice or believe in the plans that I formerly 
advocated, or that of gaining harmony in the sizes of the arches by the 
sacrifice of the two first premolars in the upper arch and retracting the 
cuspids and incisors to close the spaces, or by the plan known as 'jump- 
ing the bite,' first advocated by my friend, Dr. Kingsley, consisting of 
first placing the teeth of each arch in correct alignment and then com- 
pelling closure of the mandible forward the width of one premolar tooth 
on each side, so that all of the teeth were in normal occlusion. That 
both of these plans may have been more or less successfully followed 
there can be no doubt, but I believe them to be far more tedious, more 
difficult of accomplishment, and more uncertain as to satisfactory re- 
sults than the plan I now follow. 
"Now, as to treatment. The upper molars and premolars were moved 
distally and the lowers mesially until they were in normal occlusion, 
as shown in the next picture. You will see that each occlusal plane is 
in normal relation with its opposing occlusal plane, thus locking and 
assisting in its retention, and I assure you that the facial lines were as 
greatly improved as was the occlusion. 
"And how was this accomplished? you will naturally ask, for you 
must justly reason that to move all of the teeth in both arches, as has 
been done, certainly would require a considerable degree of force, and 
that it should be directed in the right direction. 
"I formerly advocated a few combinations of appliances which I have 
now largely abandoned. I believe the headgear and chin retractor were 
valuable. The latter is now entirely obsolete in my practice and the 
former but rarely used, and the same might be said of the traction screw 
and rotating levers. The jackscrew has been and doubtless will long 
continue to be the one form of regulating appliance most used by den- 
tists, for it seems almost impossible to get dentists to study occlusion, 
its bearing upon and importance to orthodontia, but they can and do 
reason only from the basis of the mere symptoms, or 'crooked teeth,' 
as they call them, and they naturally reason that a jackscrew placed 
against a tooth that seems to be 'straight' and made to operate at its 
other end against one that is 'crooked,' to push it into a better position, 
is the one thing needful, but I believe the jackscrew to be one of the 
poorest of regulating appliances, and I say this notwithstanding that I 
am the inventor of what I believe to be the most simple and efficient one 
yet brought out, and one that has more base imitations than any other 
of my inventions. But I now think the principle is wrong with the 702 
ORTHODONTICS HISTORICAL REVIEW 
jackscrew, as it is with all these forms of appliances that are macle to 
act locally, so to speak, or upon only the teeth that seem 'crooked,' in- 
stead of one that should become operative from the basis of occlusion, 
having control of one or of all the teeth of not only one but of both 
arches, if need be. I cannot bring out the point too forcibly that it 
should be our mission to improve the dental apparatus as a whole through 
occlusion, for in this way only can our efforts be fruitful of the best 
results in not only bettering the principal function of the teeth,-masti- 
cation,-but their appearance, as well as giving greater freedom to the 
movements of the tongue, and also making possible the modification of 
the vault of the arch towards the more normal growth and development 
of the nasal tract, and last, but of great importance, a better contour 
of the face with more pleasing lines of facial expression. 
"I am now accomplishing fully 98 per cent of the tooth movements in 
my practice with but a single appliance, and performing them far easier 
and more quickly than I ever did with all the various combinations I 
have ever advocated in the past, which at most were only very few, for 
it has ever been my aim to simplify both the diagnosis and treatment of 
cases in my practice, and all of the cases you will see on this screen to- 
night have been treated with but one appliance,-namely, the expansion 
arch,-and although I believe that I have added some valuable improve- 
ments to it, yet it was known and used before this Republic was. It was 
first used by that greatest of the early dentists, the Frenchman Faiichard. 
"The next picture (Fig. 30) [Fig. 404] shows it as I now use it. In 
temper it contains much spring, sufficient to speedily widen the dental 
arch, if need be, and having self-locking nuts to properly adjust it to 
the demands of expansion. It is round instead of being half-round or 
flat, as used by the older writers, which better prevents the accumula- 
tion of food, as well as making it more compact and less conspicuous. 
My latest improvement to it is a delicate rib on the periphery of the 
inthreaded portion. This is to be notched at desired points to prevent 
the slipping of wire ligatures, this form of ligature being not only a very 
valuable addition to orthodontia, but making this wonderful appliance 
vastly more efficient. I have called it wonderful, and truly it is, and he 
who intelligently experiments with it will grow daily more and more 
impressed with its great possibilities in correcting malocclusion. In my 
opinion there is no tooth movement, be it simple or complicated, that 
cannot be performed more quickly and easily with this than with any 
other device, and I have arrived at this conclusion not hastily, but grad- 
ually, and one by one have abandoned nearly all of the other once favored 
appliances. 
"I wish we might spend much more time on this picture, but I have 
carefully described it in other writings, and must hasten to other pic- THE INFLUENCE OF EDWARD II. ANGLE 
703 
tures, only stopping here to say that in all cases belonging to the first 
class, if we have used this appliance intelligently and have adjusted each 
tooth in each arch, the arches and the occlusal planes will then be in 
harmony, and if the teeth are in distal occlusion, as in the case considered 
but a few moments ago, the lower teeth may be easily shifted mesially 
and the upper teeth distally into harmony of occlusion, it only being 
necessary to use two of the expansion arches, and reciprocating the 
force from one to another, as shown in the next picture (Fig. 31) [Fig. 
405], the force being derived from one or more delicate rubber liga- 
tures made to engage the distal ends of the tubes of the bands on the 
anchor teeth of the lower arch, and sheath-hooks which have been at- 
tached at desired points to the upper expansion arch. By studying this 
picture carefully you will see that force is exerted in the exact direction 
Fig'. 404.-Angle's E expansion arch 
(Ribbed) 1903. 
Fig'. 405.-Use of the intermaxillary 
elastics, Class II. (Angle, 1903.) 
it is needed, and at the same time most inconspicuously and with very 
little inconvenience to the patient. 
"Now, I know that when anything new and valuable is brought out in 
dentistry there is usually that familiar type of individual who will rise 
up and say, 'Why, I have been using that for twenty-five years,' but to 
my mind this savors of 'degeneracy.' The fact is, to the best of my 
knowledge and belief we are indebted to Dr. H. A. Baker1 of Boston, 
for this idea, he having used it in the retraction of the protruding inci- 
sors of his son a number of years ago, and it was from him I received the 
idea. I have hence called it the 'Baker Anchorage,' and it has almost 
revolutionized my daily practice. In its use, however, I would add this 
important improvement,-that the force be directed upon the molars 
first, instead of on the incisors, their positions being, as I believe, merely 
JSince giving the above address I have learned that Dr. Calvin S. Case, of Chicago, 
also employed this form of anchorage, probably at about the same time as Dr. Baker. 
It is reported in the Transactions of the Columbian Dental Congress, 1893. ORTHODONTICS--HISTORICAL REVIEW 
704 
the result of the malpositions of the molars, and we should unravel the 
complexities of these cases by beginning right, that is, with the molars, 
following with the premolars, and lastly adjusting the incisors. And 
using it as here shown the force is directly received upon the first molars, 
pushing the upper distally and pulling the lowers mesially. Of course, 
all the lower teeth, as here shown, will be carried forward, and all the 
force required in their movement will be pitted against the upper first 
molars. As these move distally (the nuts being occasionally tightened), 
more or less space will be noted between them and the second premolars, 
and after the molars have been carried well back into correct positions 
the anchor bands should be removed and similar smaller bands (X-bands) 
Fig'. 406.-Method of retention. (Angle, 1903.) 
placed upon the second premolars and the expansion arch again applied. 
Wire ligatures are also made to engage both first and second premolars 
on each side, and force from the rubber ligatures again exerted. After 
the premolars are well back into position the nuts in front of the tubes 
on the anchor teeth are loosened, or removed entirely, allowing the force 
of the rubber ligatures to be received upon the incisors, through the 
center of the arch. In this way the incisors, if they be prominent, are 
soon retracted. 
"Of course, it is of the utmost importance that the teeth shall be 
mechanically retained in their new positions. The real retaining devices 
arc the inclined occlusal planes, but these must be assisted for a time by 
a mechanical device, or of course the teeth that have been moved will 
speedily revert to their original positions, and the next picture (Fig. 32) 
[Fig. 406] will show you a simple device for holding the teeth that have THE INFLUENCE OF EDWARD II. ANGLE 
705 
been moved mesially in the upper arch in normal relations. I have been 
using this with much success for a long time. At first I used a spur 
cemented into a tooth, but later attached the spurs to accurately fitted 
clamp-bands, the spur being made to close in front of a metal plane at- 
tached to a band upon an opposing tooth, as you now see them. They 
may be used either upon molars or premolars. The bands must be accu- 
rately fitted and carefully cemented, and the plane and spur correctly 
placed. If this be properly done they will last as long as desired. I 
have had them remain in position two years without loosening, but 
unless they are properly adjusted they will give trouble, the one usually 
giving way being the spurred band. 
"The other devices shown in the cut are for the retention of incisors 
and cuspids, and arc so well known that I will not take up your time 
here with an explanation of them. 
Fig; 407.-Use of the intermaxillary elastics, Class III. (Angle, 1903.) 
"The plan of treatment was the same as that described for cases be- 
longing to ('lass II, only, of course, the direction of force was reversed, 
as shown in Fig. 33 [Fig. 407]. 
"In conclusion, let me say I have touched but a few of what seem to 
me the important places in orthodontia. Each class, division, and sub- 
division is ample for a full evening's discussion but if I have awakened 
a higher appreciation of occlusion and convinced you that the first molar 
tooth is not only first in importance but first to correct if in malposi- 
tion, I will have accomplished much but no less than if you have been 
brought to realize that the hasty, ruthless sacrifice of teeth for the cor- 
rection or prevention of malocclusion is as barbarous and unscientific as 
it is disastrous in its results. If 1 have done this I shall always feel that 
my mission to this society has been an enjoyable and fruitful one." 
Before the Fourth Annual Meeting of the American Society of Ortho- 
dontists, 1905, Angle, in speaking of the "Upper First Molar as a Basis 
of Diagnosis in Orthodontia," treated the subject of the importance of 
diagnosis. He states: 
"If, then, diagnosis involves such responsibilities, what extreme care 
should the orthodontist give to it! How eagerly should he grasp every 706 
ORTHODONTICS HISTORICAL REVIEW 
particle of knowledge that can give him light toward correct, intelligent 
diagnosis! 
"Yet, notwithstanding that we still have 'guessers' and 'guessing' and 
'odontocides' linked together, one and inseparable, who juggle terms and 
meanings and furnish lots of evidence which won't bear sifting to ex- 
plain the 'guessing,' with carefully devised loopholes as to meanings 
and dates and assertions, and will doubtless continue to have such with 
us for a long time to come; yet, I say, notwithstanding all this, we do 
have a simple principle to guide us to a correct, intelligent decision in 
diagnosis, which diagnosis is always a sure clue to a correct line of 
treatment, even to retention. A principle, too, which eliminates 'guess- 
ing' is antipodal to both 'guessers' and 'guessing.' It is a principle, too, 
so simple that experts are not needed to understand and interpret it, 
but any sincere student, no matter how humble, with intelligence enough 
to master the English alphabet can understand this principle and apply 
it successfully in diagnosis, and this principle applies to every case of 
malocclusion in existence in a human denture today, or that ever did 
exist. Indeed, every case of malocclusion carries with it this principle 
which is a key to its own solution, its correct diagnosis, and that key is 
the key to occlusion-the first permanent molars, or more particularly, 
as I shall show you later, the upper first permanent molars. I repeat 
that this key is not for the 'guesser' or the would-be improver of God's 
laws, but for the student of occlusion-the interpreter of Nature's great 
law in the human denture. 
"To the members of the new school of orthodontia this key is familiar 
and in daily, yes, hourly, use, and its great value attested, so that to you 
little need be here said. Yet in connection with it there are some points 
which I shall present that may be of interest to you, for, recently, in the 
preparation of the MS. for another edition of my book T have gone over 
the entire subject of orthodontia, reasoning and weighing as carefully 
as I could all the points bearing on its various phases, and I believe 
that I can offer a few additional proofs why the upper first molar is the 
correct basis for diagnosis. 
"Let us study somewhat carefully this kind of teeth which we have 
designated the 'key of occlusion.' Before the first molar erupts it is 
preceded by the completed denture of the child, which has developed 
normally under the most favorable conditions, for the food and habits 
of the child have been very simple and normal, with practically no patho- 
logic conditions sufficiently grave to prevent Nature from carrying out 
her plan of the normal in building the denture. So the deciduous teeth 
almost always erupt into ideal normal occlusion and the child denture 
is not only perfect in form, in part and in whole, but in location with 
the rest of the face and head, so that there is beauty, harmony and the THE INFLUENCE OF EDWARD H. ANGLE 
707 
highest efficiency. Anema has well said in connection with this thought, 
that the reason children's faces are in such perfect balance is because 
their teeth are in normal occlusion. 
"So, when the first molars erupt, they do so under the most favorable 
conditions, unhampered by predecessors or by those teeth anterior or 
posterior to them, the jaws having been lengthening for years for their 
coming, and instead of being in any way hindered in their eruption they 
are, on the contrary, guided into and guarded in normal position by the 
beautiful, normally built child denture anterior to them. 
"The first molars have the largest crowns, best defined cusps, largest 
roots and strongest attachments to the alveolar process of any of the 
permanent teeth, .and owing to their great size and their position in the 
jaws they are chief in the function of mastication. As the first molars 
are planted in the alveolar process long years before the permanent 
teeth, anterior and posterior, shall take their place in the line of occlu- 
sion, they have become very firm of attachment; so by their size and 
strength they can and do act as dictators of these teeth and indirectly 
of all the other permanent teeth as they take their respective positions 
in the line of occlusion at their respective times. They also act as wise 
ruler, determining by their own length the length of bite, and in this 
way, in no small degree, decide the length of the face and the art rela- 
tions, which, in importance, is best illustrated, and in a striking manner, 
by what the face misses in after years when these teeth arc sacrificed, 
allowing the settling together of the jaws and shortening of the face, 
with consequent inharmony of facial lines, always so noticeable, and 
their wise control of the normal mesiodistal relations of the jaws by the 
locking of their well defined cusps is a factor in the growth and devel- 
opment of the face and jaws of mighty importance. 
"Up to the time of the coming of these teeth this important office was 
performed by the locking of the entire number of deciduous teeth, whose 
efficiency has been gradually lessened by the wearing away of their cusps 
and the otherwise weakening of these teeth by the absorption of their 
roots, but after the eruption of the four first permanent molars they 
must be not only the principal supports of the jaws and the controller of 
their lateral as well as mesiodistal relations for years, but on them, also, 
must fall almost wholly the burden of mastication. I wonder how many 
of you comprehend and appreciate the important responsibility that the 
first molars assume in controlling the relation of the jaws, mesially and 
distally, as well as buccally, which has been transferred to them by the 
wearing smooth of the cusps of the deciduous teeth. Little indeed can 
be the assistance given by the permanent incisors during or even after 
their eruption, toward controlling the normal mesiodistal relations of 
the jaws, but if out of their normal positions they may and often do act 708 
ORTHODONTICS HISTORICAL REVIEW 
as hindrances instead of helpmeets. Not until long years after the erup- 
tion of the first molars do they receive support and assistance from their 
weaker brothers, the premolars, and not until they have faithfully borne 
the great burden and responsibility during the most trying period in the 
growth of the denture for six long years do they receive that real sup- 
port from the second molars which it would seem they have so long 
needed; but by this time the great structure is practically completed, 
there only remaining to be added the tardy, erratic and very important 
last members of the family, the third molars. 
"So far in what I have said relating to the first molar, the upper and 
lower have been regarded as of equal importance, as they should be, for 
in function of mastication they are equal, as well as in influence upon 
the rest of the dental apparatus during its growth and development, and 
they should be of equal importance in diagnosis, but only when they 
succeed in locking normally in their mesiodistal relations. But owing 
to the fact that the lower molar is dependent upon the caprices of the 
migratory mandible, it is in consequence less reliable than its sturdy, 
though somewhat smaller, but far more steadfast antagonist. For this 
reason the upper first molar becomes the true basis of diagnosis." 
Tn 1908, Angle, before the Alumni Society of the Angle School of 
Orthodontia, brought forward the question of ''Bone-Growing," Dental 
Cosmos, 1910. In this paper he introduced the "Working Retainer," the 
method that later developed into the "Pin and Tube Appliance." 
"Doubtless you will be surprised at the title of my paper, and you 
will ask what Bone-Growing has to do with orthodontia. My answer is 
that it is probably the most important problem in orthodontic treat- 
ment. Indeed, most of our successes in treatment depend on our success 
in bone-growing, and if the orthodontist does not succeed in growing 
bone he will find, in time, that the teeth he has moved so dextrously and 
satisfactorily have all returned to, or very nearly to, their original posi- 
tions. For this reason the branch of science which Noyes teaches us, 
histology, when it is understood and its relation to orthodontia really 
comprehended, will probably be accepted as the most important of any 
subject in the orthodontic curriculum, because it has so largely to do 
with the science of Bone-Growing. 
"Let us remember that malocclusion of the teeth is always associated 
with a lack in the growth of bone, or the perverted growth of bone, in 
degree corresponding exactly with the degree of malocclusion. Nature 
attempts to build a denture, a face, a skull, and all other parts of the 
anatomy to be in accordance throughout with a type she has designed 
for the individual; but for some reason some of her processes in the 
building of the different parts may have been interfered with. The re- THE INFLUENCE OF EDWARD H. ANGLE 
709 
suit, as we find it, is perversion or arrest in the growth of the alveolar 
process, jaws, and associate hones, and malocclusion." 
THE "WORKING RETAINER" 
"With a view of expediting the treatment of malocclusion by shorten- 
ing the period of retention in these cases, the writer has devised a 
method of retention by which he believes the cells involved in these tis- 
sue changes will be gently stimulated to greater and longer activity, 
with the more speedy and complete development of the tissues. 
"The device has for its purpose not only to support the crowns of the 
teeth in their corrected relations with the line of occlusion, but at the 
same time to exert a very gentle but constant force labially on the roots 
of the incisors. It may be regarded as a ''Working Retainer/ as appro- 
priately named by a former student of the writer, Geo. B. Palmer. 
"The device is made by removing the segment between the threaded 
ends of the expansion arch that had been employed in accomplishing the 
movement of the teeth, and substituting for it a segment, of the same 
length and curve, of very delicate and elastic iridioplatinum, and gold 
wire, twenty-nine thousandths of an inch in diameter, attaching the ends 
of this wire to the threaded ends of the original arch with twenty-two 
karat gold solder. Very small tubes are soldered perpendicularly to 
the labial surfaces of delicate iridioplatinum bands previously very care- 
fully fitted to the crowns of the incisors. These tubes must be parallel 
with each other, their incisal ends resting in contact with the middle 
segment of the arch. 
"Very delicate spurs, of the length and diameter of the bore of the 
tubes, or twenty-two thousandths of an inch, are soldered to the arch at 
points opposite the mouths of the tubes when the arch is in position. 
The ends of the spurs are then gently inclined forward about three 
thirty-seconds of an inch by bending, the arch replaced upon the teeth, 
and the spurs sprung into the tubes. Thus a gentle force from the elas- 
ticity of the spurs and arch combined is given stationary support in all 
directions." 
Again before the Alumni Society of the Angle School of Orthodontia, 
September, 1911, Angle gave to orthodontia his method of "Root Move- 
ment of Teeth." 
"Instead of tipping the crowns of the teeth into the line of occlusion 
and leaving the roots at abnormal angles of inclination, to be adjusted 
by nature during the period of retention, the teeth should be moved 
bodily, as a result of force so gentle and so evenly distributed as to stim- 
ulate normal cellular activity and the growth of bone." This was known 
as the "Pin and Tube Appliance," "Evolution of Orthodontia-Recent 
Developments," Dental Cosmos, page 853, August, 1912. 710 
ORTHODONTICS HISTORICAL REVIEW 
"bonk-growing" and the "working retainer" 
"It then occurred to the writer that the retaining device should, if 
possible, be so constructed as to operate not only for the support of the 
crowns of the teeth in their corrected positions, but also to exert gentle 
pressure outward on their roots, and thus assist nature by stimulating 
the osseous cellular activity to more rapid, complete, and normal devel- 
opment of the bone. 
"The working retainer, which was carefully described and illustrated 
on page 265 of the March, 1910, issue of the Dental Cosmos, and which 
we would request the reader to review carefully, was the result, and so 
successful was this method of retention that it has become an accepted 
practice and is recognized as a factor of much value, as with it far 
quicker and better results are gained in many cases than were possible 
before, especially, as we have said in the article above referred to, in 
those cases where the most active period in the development of bone had 
passed. 
"From this step the writer reasoned that our very plan of treatment 
might be greatly improved; instead of tipping the crowns of the teeth 
into the line of occlusion and leaving the roots at abnormal angles of 
inclination, to be adjusted by nature during the period of retention, the 
teeth should be moved bodily, as a result of force so gentle and so evenly 
distributed as to stimulate normal cellular activity and the growth of bone. 
In other words, the work of the orthodontist should be the intelligent 
assisting of nature in her process of development of bone, thus making 
it possible for her to normally build the denture in its entirety. When 
the proper assistance has been rendered and the normal growth and 
development of the bone and other tissues accomplished, all other con- 
ditions being favorable, the work of the orthodontist should be at an 
end, thus eliminating entirely the usual tedious period of retention, with 
its attendant difficulties and annoyances. 
"That tooth movement is performed more easily, more satisfactorily, 
and with better results when very gentle pressure rather than pro- 
nounced force is employed, has for a number of years been becoming more 
and more apparent to the writer, and the correctness of this belief has 
now been abundantly proved by the recent remarkable research work 
of Dr. Albin Oppenheim of Vienna, in his elaborate experiments in mov- 
ing the teeth of monkeys. These experiments were fully reported in a 
course of lectures by Dr. Oppenheim at the session, just closed, at the 
Angle School of Orthodontia; a report of these investigations will soon 
be published in this country, and should awaken the greatest interest, 
especially among histologists and orthodontists. THE INFLUENCE OF EDWARD II. ANGLE 
711 
AN IMPROVED FORM OF EXPANSION ARCH 
"Experiments made by the writer, covering a period of four years, 
have resulted in the production of appliances for accomplishing tooth 
movement in accordance with the plan above suggested. These appli- 
ances consist of an expansion arch of further modified form, with auxil- 
iaries and attachments. Fig. 408 shows the modified arch. It will be 
seen that it is divided into three parts, a middle section and two end sec- 
tions. The end sections are threaded and provided with friction-sleeve 
nuts. The middle section is smooth, with square ends, which accurately 
telescope for a distance of about one-eighth of an inch in square sock- 
ets in the anterior ends of the threaded sections. One of the advantages 
of this form of arch is that the middle section may be of any length or 
diameter desired, and as a result of many measurements of models, 
three lengths and three diameters of each length are found to amply pro- 
Fig. 408.-Angle (1912). 
vide a most, convenient range of size and strength for all dentures, from 
the smallest to the largest, thus fully meeting all requirements in prac- 
tice. All middle sections, of whatever length or diameter, are accurately 
interchangeable with the threaded sections, which are of the same diam- 
eter as the threaded portions of the writer's standard expansion arch E, 
the friction-sleeve nuts being adapted to the writer's standard D bands. 
"The three diameters of the middle section are forty-five thousandths 
of an inch, thirty-eight thousandths of an inch, and thirty thousandths 
of an inch (.045", .038" and .030"). The arches of heavier diameters, 
that is, .045" and .038", are intended to be used in connection with wire 
ligatures in precisely the same way as the standard expansion arch E, 
which has so long been familiar to all. These heavier sections are made 
in both precious metal and nickel-silver, as are also the threaded sections. 
THE .030" DIAMETER ARCH AND ITS APPLICATION 
"To those already familiar with the expansion arch E, any further 
description of the larger diameters of the middle sections of the new 712 
ORT 11ODONTICS 1IISTORIC AL R EV IEW 
arch in regard to their use in connection with the clamp bands, wire 
ligatures, etc., seems unnecessary; the use of the two forms of appliance 
and the manner of their operation is identical, but the greater conven- 
ience of the new form readily suggests itself. The manner of using the 
delicate arches of .030" diameter, however, is unique, and the plan of 
operation radically different from that for the arches of heavier sizes 
just described, and it is by the use of this delicate arch only that the 
movement of the teeth bodily, i.e., of the roots as well as the crowns 
through the stimulation of bone-growth, is possible. It is made of pre- 
cious metal only, for reasons which will be given later. In its use, wire 
and all other forms of ligature are dispensed with, the attachments of 
the arch to the teeth to be moved being accomplished by means of deli- 
cate pins (Fig. 35) [Fig. 409] soldered directly to the arch, which en- 
gage very delicate tubes (Figs. 35 and 36) [Figs. 409 and 410] soldered 
to bands upon the teeth to be moved, insuring the most firm and com- 
pact attachment with practically no loss of power by stretching or dis- 
placement, and with perfect control over the direction and distribution 
Fig-. 409.-Angle (1912). 
Fig'. 410. 
of force, not only upon the crowns of the teeth to be moved, but simul- 
taneously upon their roots as well. 
''These very delicate pins, tubes, and arches are carefully proportioned 
and most accurately made on special machinery. The pins closely tele- 
scope the delicate tubes, which are of uniform length, diameter, and bore. 
One end of the pin is made in the form of a hook, which accurately fits 
the bevel of the end of the tube when the pin is in place in the tube. It 
is of the greatest importance that this hook shall not be dulled and thus 
rendered ineffective. The orthodontist should study its proper locking 
and unlocking, to avoid injuring it. The other end of the pin has the 
form of a minute fishtail, with a knife-edge crescent for convenience in 
attaching the pin to the arch with solder. A portion of the outer wall 
of some of the tubes is seen in Fig. 35 [Fig. 409], to be cut away in cres- 
cent form. This is not necessary, but will often serve as a convenience 
by giving access to the pin for its bending without wholly removing it 
from the tube. 
"Mode of Applying Arch in a Typical Case Belonging to Class I.-In 
the following we shall describe the adjustment and operation of the new 
appliance for the treatment of a well-defined, typical case belonging to THE INFLUENCE OF EDWARD H. ANGLE 
713 
Class I (writer's classification), a model of the upper jaw of which is 
shown in Fig. 37 [Fig. 411]." 
It will be impossible to describe the adjustment of the appliance in 
this history, on account of the length, but by referring to the original 
article those interested will find a detailed description of same. 
On account of certain defects in the handling of his previous appli- 
ances Angle before the same Society the next year (1912) described a 
better method of adjusting the tubes, etc., in order to bring about root 
movements. "Further Steps in the Progress of Orthodontia," in the 
Dental Cosmos, January, 1913. 
"At our meeting one year ago, as you will recall, I presented a new 
plan of treatment of malocclusion of the teeth, with new forms of appli- 
ances for accomplishing the various tooth movements in accordance with 
this plan, a description of which was published in the Dental Cosmos for 
Fig'. 411.-Angle's "Pin and Tube'' appliance (1912). 
August last. A close study of that description is necessary for a full 
comprehension of what I shall present today. 
"As a result of wider observation, much thought, and careful experi- 
menting, I think I can today not only greatly simplify the technic in 
the adjustment and operation of the appliances then presented, but lead 
you to a more intelligent appreciation of the possibilities and advan- 
tages to be gained by the employment of the new method of treatment." 
Not satisfied with the "Pin and Tube" appliance Angle in 1916 in- 
troduced "Some New Forms- of Orthodontic Mechanism, and the Reasons 
for Their Introduction." [Dental Cosmos, September, 1916, p. 969.] 
"The introduction of the pin and tube appliances undoubtedly marked 
a great step forward in orthodontic treatment, for with it was gained 
not only better control of force for crown movements of teeth, it was 
the first practical mechanism for the proper control and distribution of 
force for the movement of roots of teeth, singly or collectively, and simul- 
taneously with or independently of their crown movements. And, what 
is of still greater importance, with this mechanism the force for the 
movements of either crowns or roots can be applied or 'controlled in a 714 
ORTHODONTICS HISTORICAL REVIEW 
manner that is far more nearly in accord with the requirements of the 
physiology of the tissues involved in tooth movement than with any 
other previously employed. It is well known that more nearly ideal 
results in occlusion and in bone development, as well as in facial de- 
velopment, have been gained by its use than was ever possible before. 
"Its use has become standard with the best orthodontists of this and 
other countries, and it is of course very gratifying to me to know that 
my predictions regarding its value have been verified. Yet it is a humil- 
iating fact that many who are attempting the practice of orthodontia 
seem to be so lacking in judgment and in technical skill as to be unable 
to gain anything nearly like the measure of success that is possible in 
the use of this mechanism, or to appreciate the fact that correct forms 
and proportions and proper material for the construction of the various 
parts, with accuracy and perfection of workmanship in manufacture, 
are essential to its proper efficiency. The principal difficulty with most 
seems to be inability to properly locate the pins and attach them to the 
metal arch, and many indeed h-ave been the modifications of the mech- 
anism and the substitutes devised in order lo overcome this, to them, in- 
surmountable difficulty, and to obviate the necessity for acquiring tech- 
nical skill and accuracy. Tn all instances delicacy and simplicity, and 
to a large extent efficiency, have been sacrificed. Indeed, some of the 
productions are so crude and clumsy as to be mechanical curiosities. 
"Realizing how apparently hopeless to many is the mastery of the 
technic of this appliance, I have, after many months of careful thought 
and experimentation, succeeded in producing another typo of mechanism 
-that which I am about to describe, and which, while retaining much, if 
not all, of the force control of the pin and tube appliance, possesses 
other advantages, besides being far easier to apply and operate. In fact 
it is so simple I think you will agree with me that there is now no neces- 
sity whatever for change of principle or modification of form, even by 
the habitual 'modifier,' that well-known type of practitioner whose great- 
est happiness seems to consist of modification of mere details in mechan- 
ism-nearly always to the detriment of the mechanism. 
"In presenting this new mechanism I fully realize the normal respon- 
sibility I must assume, or that anyone must assume when he attempts 
to add anything to the already very large number and variety of ortho- 
dontic appliances. If the added device be not truly useful and an ad- 
vance beyond what has already been produced, better by far it should 
never appear, for it will not only cause unnecessary inconvenience and 
disappointment to many patients and orthodontists, and further add to 
the confusion of our literature and to the perplexity of the ever-increas- 
ing number who review it, but it will lessen confidence in its author. The 
usual crude modification or mere difference without distinction in prin- THE INFLUENCE OF EDWARD H. ANGLE 
715 
ciple is more often a step backward than forward, but there are reasons 
why, at this time, there should be additions to our orthodontic mechan- 
ism, additions that are real improvements, the wonderful advances that 
have been made in the science of orthodontia in the past very few years 
having made necessary the rearrangement of our entire plan of treat- 
ment, and demanding decided betterment in orthodontic mechanism." 
angle's new devices 
"The forms of mechanism I shall now describe, if not strictly in accord 
with all the ideals set forth, will, I believe, upon careful analysis by com- 
petent judges, at least be found to be measurably nearer these ideals 
than any of the forms hitherto employed. They have not been hastily 
evolved, but are the result of long experience, close and careful observa- 
tion, and the closest consideration of every detail as to the material of 
which they are composed, their size, forms, proportions and relations 
of parts, the mechanical principles on which they are to operate, and the 
physical and physiologic laws that are to govern their use. At the same 
time the object has been to produce an appliance which will be easy to 
understand and so simple as to reduce to the minimum the difficulties and 
exactions of the technic of both its adjustments and operation. This 
mechanism is of course based on that excellent main principle of the 
expansion arch given to us long ago by that great Frenchman, Fauchard, 
whom especially all orthodontists are honored in honoring. Some of the 
devices are but modified forms of my own former, well-known appliance; 
others are radically new. All are harmoniously proportioned, defined, 
and very delicate." 
BRACKET 
"A, Fig. 38 [Fig. 412], shows a delicate block of metal, or bracket, 
actual size, and b, and c show it enlarged to facilitate description. All 
are shown attached to band material. The outer edge of the bracket is 
rounded, as are also its corners and its two ends, its sides being straight 
and parallel. Inwardly, a deep transverse slot extends downward in the 
bracket one-half the length of the bracket, terminating in a concave floor. 
The walls of flic slot are parallel, one of them being formed by the band 
material and the other by the inside of the bracket proper. In the center 
of the latter wall is a delicate square perpendicular groove which passes 
downward and through the floor of the bracket. Its use will be consid- 
ered later. The band material to which the bracket is soldered and which 
forms the inner wall of the slot is thickened at this point which is very 
important, in order to give it the necessary strength. Fig. 413 shows 
several bracketed bands fitted and cemented to the crowns of the incisors 
of an upper dental arch typical of those, especially in Class I, in which 716 
ORTHODONTICS 11ISTORIC AL REVIEW 
the teeth are crowded and the dental arches proportionately diminished in 
size. It will be especially noted that the seams of the bands have been 
formed on the lingual surfaces of the teeth, and that the brackets are 
located at the center of their labial surfaces." 
"Ribbon Expansion Arch, is a very delicate, flat, continuous, or non- 
sectional, expansion arch with parallel sides and rounded edges. It has, 
therefore, the form of a ribbon, and in order to distinguish it from the 
other forms of my expansion arches, I have called it the 'ribbon' ex- 
pansion arch. It is but twenty-two thousandths of an inch (.022") in 
Fig. 412. 
Fig. 413. 
Figs. 412 and 413.-Angle's "Ribbon-Arch" (1916) 
thickness and thirty-six thousandths of an inch (.036") in width. Its 
ends are also flat, but threaded, and are provided with my wOll-known 
friction-lock nuts, which have been greatly reduced in diameter in order 
that they may conform to the delicate proportions of this arch, which is 
used in connection with the usual anchor clamp bands, the sheaths of 
which are also reduced in diameter and possess other novel features 
which will be described later. They are shown on the teeth in Fig. 39" 
[Fig. 413], 
It will not be necessary to describe the application of this appliance, 
the following illustrations explain themselves. THE INFLUENCE OF EDWARD H. ANGLE 
717 
SUMMARY OF ADVANTAGES OF THE NEW DEVICES 
"From the foregoing it will be apparent that the force may be so con- 
trolled as to permit or to prevent the tipping of any tooth or teeth to 
any extent, or to compel the bodily movement of any tooth or teeth in 
either or both arches. 
"It will have been noted that this mechanism is of the greatest sim- 
plicity, of the maximum delicacy of parts, and with all unnecessary ma- 
terial eliminated. Hence it is of the least inconvenience to patients and 
the easiest to keep cleansed. It would seem that the mechanism is nearly 
ideal, not only for securing the necessary static force for anchorage and 
of dynamic force for tooth movement, but for directing and controlling 
Fig. 414. 
Fig'. 415. 
Fig. 41G. 
Fig. 417. 
Fig'. 418. 
Figs. 414-418.-Showing application of brackets and ribbon arch. (Angle, 1915.) 
this force so that all cellular change attendant on tooth movement most 
nearly accords with the laws of physiology. It is also graceful in its 
proportions and not unpleasing in appearance. In a word, the principles 
of mechanics, art, and physiology do not conflict, but are made to har- 
monize beautifully and as was never possible in orthodontic mechanism 
before. It is so simple and easy to apply as greatly to lessen the usual 
work of the orthodontist and the usual number of visits of patients. It 
is not expected that it will wholly supersede the pin and tube mechanism, 
neither will it wholly supplant the expansion arch in its round form with 
ligature attachments. In fact, the ligature attachment will be found to 
be of advantage in connection with the ribbon arch in the movement of 
premolars and of other teeth that may be so pronouncedly misplaced as 
to render impracticable the bending of the ribbon arch to gain bracket at- 718 
ORTHODONTICS HISTORICAL REVIEW 
Fig. 419.-Method of establishing 
normal mesial distal relations of the 
dental arches. (Angle, 1916.) 
Fig. 420. 
Fig. 421.-Improved curve 
sheath D bands. (Angle, 
1916.) 
Fig'. 422.-Application of the old expansion arch. 
(Angle, 1899.) 
Fig. 423.-Chin retractor adjusted. (Angle, 
1895.) 
Fig'. 124.-Occipital anchorage. (Angle 
1895.) THE INFLUENCE OF EDWARD II. ANGLE 
719 
tachment with them until after they have first been moved into more favor- 
able positions by means of ligatures. But in the great majority of cases 
the mechanism herein shown will be found to possess such obvious ad- 
vantages in force control and in ease of application and operation, that 
I believe it will find a permanent place in orthodontia. 
"In concluding the description of this mechanism, let me say that 
I have given such close care and thought to perfecting it in all its de- 
tails, and have been so ably supported by the manufacturers, that I feel 
sure that it cannot be improved by modifications or additions, at least 
not until you give it years of thought and study, as I have. Therefore 
let me earnestly advise that, instead of attempting to modify it, you 
devote your energies to understanding it and its possibilities, and to per- 
fecting your skill in the technic of its application and operation. In 
this way your opportunities for self-improvement will be greatest, and 
you will be able to confer the greatest aihount of good on your patients. 
Apt in this connection is the remark of the great surgeon, Hamilton: 
" 'It is not in the discovery and multiplication of mechanical expedients 
that the surgeon of this day declares his superiority, so much as in skil- 
ful and judicious employment of those which are already invented.' " 
Fig. 422 shows an old type of appliance used by Angle applied to a 
model. Fig. 423 shows Angle's "chincap" and "headgear," and Fig. 
424 is another illustration of Angle's "headgear." CHAPTER XXVII 
VICTOR HUGO JACKSON TO HENRY N. DODGE 
Victor Hugo Jackson, M.A., M.D., D.D.S., (1850- ). In 1887 be- 
fore the New York Odontological Society, Jackson presented a simple wire 
device for the regulation of teeth, which he termed a crib. Although 
he had used other apparatus prior to this time, and appliances similar 
in design had been used, this term is now associated with Dr. Jackson's 
name and that type of appliance has become known as the Jackson crib. 
The "crib" is designed as an anchorage attachment for plates of vari- 
ous kinds, "this anchorage was gained by extending a spring wire on 
the lingual and labial sides of the teeth near the gums, in some cases in- 
cluding all of the teeth, in others only a part of the arch; the spring in 
the labial and lingual sides was connected by passing wires over the 
arch at the junction of the teeth. Later I [Jackson] devised the Jackson 
System. The anchorage is secured by spring-clasp attachments and par- 
tial-clasps, supporting a base-wire, to which any form of spring can be 
added." [Preface to Orthodontia and Orthopaedia of the Face. (1904.)] 
In appearance Jackson's crib resembles the devices of Delabarre, 
Schange, Evans, Lachaise and Atkinson, although these were used prin- 
cipally to open the bite. 
The following are the claims made of the system. 
1. Ease of construction and alteration. 
2. Firm anchorage. 
3. Occupation of little space in the mouth. 
4. Cleanliness. 
Jackson was one of the early advocates of continuous pressure in pref- 
erence to intermittent force as brought forth by Farrar. 
"Some Methods in Regulating," Dental Cosmos, page 372, 1887: 
"It is my custom, before choosing the method to be pursued, to pre- 
pare models of the upper and lower teeth, that their articulation and the 
position of those to be moved can be more fully apprehended and the 
models preserved for future reference. The method that will cause the 
least pain and inconvenience to the patient, the least injury to the teeth 
and surrounding structures, interfere least with articulation and move 
the teeth to the position desired in the shortest time, should be adopted. 
"I believe that as dentists and members of societies we should deal 
more with practical cases, and not speak so much as is common from a 
theoretical standpoint, if we wish best to assist our fellow dentists. With 
720 VICTOR HUGO JACKSON 
721 
this feeling I have brought before you this evening several models illus- 
trating the position of the teeth before and after regulating. The appli- 
ances used in these special cases, both for moving the teeth and to retain 
them in position, are also shown. 
"As the models are examined, it will be seen that the arch was first 
spread by a plate described, and then wooden pins so inserted as to force 
the lateral forward toward the central. Later the pins were so changed 
in position as to send the tooth outward. 
Fig. 425.-Victor Hugo .Tackson. (1850- ) 
''The plate was inserted April 22, and taken out July 10, the teeth 
then being in proper position, although not fully erupted. A retaining 
wire, after the idea suggested, I think in this society, several years ago 
by Dr. Atkinson, was used very successfully, and worn until September 
15, when the patient was discharged. Dr. Atkinson recommended half- 
round wire for retaining. I use round platinum and iridium wire, form- 
ing it upon a plaster model, by starting on the palatal surface of the 
molars, and following the line of the gum; bending the wire sharply, 
with the fingers of the clasp-benders, to such form as will best clasp the 
necks of the teeth. It can be extended around the entire arch to the 
place of beginning, or pass over at any place the articulation will permit. 
Short pieces of the same material can be passed between the teeth or 722 
ORTHODONTI('S 4 11STOR1 (' AL REV 1EW 
over certain cusps to stiffen the appliance and to keep it from riding on 
the gum. These pieces should be soldered with pure gold. If necessary 
to connect between the front teeth to stiffen the remaining wire, slots 
should be punched in the ends of a narrow piece of thin platinum plate 
to receive the wire, and pure gold flowed over all. I have found this a 
most'valuable retaining appliance, and after a little experience it can be 
used in a majority of cases. It can well be called a crib, and used in a 
great variety of forms. It was used successfully to retain a right supe- 
Fig. 426. 
Fig. 4 27. 
Fig. 428. 
Fig. 4 29. 
rior central that had been drawn back from a very prominent position 
where it had overlapped the left central. A crib was made to fit over and 
around the bicuspids on the left side, from which a wire was extended 
along the palatal surface of the teeth to the space between the centrals 
through which the flattened wire passed and hooked around the right 
central. It could be displaced and cleaned by the patient, and there was 
nothing in sight but the slight end of the hook. It takes but a few 
minutes to construct such an appliance. The same method can be used 
for the attachment of cords or rubber rings, where traction is needed 
toward the distal part of the mouth, the crib being made to extend over VICTOR HUGO JACKSON 
723 
two or more teeth as the case requires, and a hook formed at one side at 
any angle desired to make proper tension." 
One of the appliances described by Jackson is shown in Fig. 426, and 
is the retaining wire as applied and worn for several months. 
Before the American Dental Association, 1889, under "Some Methods 
of Regulating Teeth," Jackson goes into greater detail concerning his 
system. Figs. 427, 428, 429, and 430 illustrate the method he then used. 
"Correcting Irregularities of the Teeth" is the title of a paper given 
by Jackson before the International Medical Congress at Berlin, 189'0. 
(Dental Cosmos, 1890, page 877.) "Orthodontia will no doubt eventu- 
ally become a distinct specialty of dentistry, but it is necessary at present 
for the general practitioner to be more or less familiar with the sys- 
tems in use, in order that he may choose that which will bo the most 
effective in a given case and require the least outlay in construction. 
Fig. 430. 
Fig'. 431. 
It is my purpose in this brief paper to describe and demonstrate with 
models and apparatus some methods of applying removable springs with- 
out the use of a plate for regulating teeth, describing methods that I am 
using daily, and with which I have attained good results in a limited 
time, and in passing I desire to express a growing confidence in the use 
of the removable spring in moving teeth. Piano wire is at present the 
best spring for the purpose, although spring gold, silver, and German 
silver are often applicable, especially if the temper is not drawn while 
soldering, and that can be avoided in some cases by keeping the spring 
portion cool or by using soft solder, which is usually preferable." 
The crib as described in this paper was made "for each side of the 
arch, to encircle all of the teeth back of the incisors; a slight separation 
was made by wedging in front of the cuspids, and a round iridioplatinum 
wire was flattened to pass into the space on either side, and extended 
back following the line of the gum and surrounding the cuspid, bicuspids, 
and molars. This was supported and made to more firmly clasp the ORTHODONTIUS-11ISTOK1 ('AL REVIEW 
724 
teeth by making cross-bars to connect the two sides of the crib by pass- 
ing over the articulating surface at the junction of the teeth, serving 
also to keep the crib from pressing on the gum. 
"There was a loop soldered to the crib-wire opposite the palatal sur- 
face of the first molar on each side of the arch, into which loop was 
hooked the end of a piano wire formed like the letter £ and extended 
forward, passing just back of and following the curve of the incisors. 
There were placed on the incisors gold collars with lugs soldered on their 
palatal surfaces, to hold that portion of the spring in position. Fig. 
431 shows the device in place on the four incisors in another completed 
case of the same character. 
"Pressure was made as needed, by straightening the S-loops of the 
spring wire a little at a time. 
Fig. 432. 
Fig. 433. 
"The incisors were moved rapidly, and when sufficiently forward, the 
portion of the crib in front of the cuspids was removed, and a piece of 
piano wire was soldered to the original spring wire, which extended to 
the distal sides of the cuspids, by the application of which they also were 
moved forward. Another spring was then attached by solder to the 
original one, as before, to move the cuspids forward, and at the same 
time one of the cuspids was prepared to be rotated by placing on it a 
collar, with a cylinder soldered to its palatal surface, to hold a spring 
which extended to the opposite side of the arch and hooked into the 
loop in the crib. 
Figs. 432, 433, 434, 435, and 436 illustrate some of the various devices 
shown before that Congress. In a case of protrusion of the mandible 
Jackson presented the following method: 
"A split plate (Fig. 437) was made as described by Dr. W. H. Coffin, 
of England, except that it did not cover the teeth or open the bite. It 
was strongly retained by two wire clasps extending from either side to VICTOR HUGO JACKSON 
725 
clasp a bicuspid and molar. The plate was divided laterally, leaving the 
anterior part sufficiently large to cover the intermaxillary portion of the 
process for the purpose of forcing it forward with the teeth. Collars 
of gold, with lugs on their lingual surfaces, were placed on the incisors, 
and firmly retained the anterior part of the plate. 
"When the incisors were moved as far forward as practicable the ap- 
pliance shown in Fig. 438 was made and adjusted, as seen in Fig. 439." 
Fig. 434. 
Fig. 435. 
Fig. 436. 
Fig-. 43 7. 
"Methods of Regulating Teeth," Cosmos, 1891, page 1067: 
"It is not the present intention to enter into a discussion of the rea- 
sons for advocating early regulating, as that is not the purpose of this 
paper, which leaves the question for consideration at another time. 
"It is, however, the opinion of the writer that each tooth should be 
encouraged to take a correct position in the circle of the arch while 
erupting (or as soon thereafter as practicable), in order to promote the 
proper development of the jaw, for the teeth next to be erupted are 726 
ORTHODONTICS HISTORICAL REVIEW 
thus more likely to do so in proper position and order. Only a portion 
of the alveolar process that forms the sockets for the roots of the teeth 
is developed until the teeth are fully erupted. For this reason a slight 
pressure will change their position. 
"When convinced of the advisability of regulating teeth for young 
patients, several devices have been adopted with partial satisfaction, but 
Fig. 438. 
Fig'. 439. 
none as yet have met all the requirements so perfectly as the 'crib,' 
which is equally applicable to patients of every age. 
"The common and reckless extraction of temporary and permanent 
teeth to relieve crowding should be discouraged, and in preference, when 
necessary, an appliance be made for spreading either the superior or in- 
ferior arch. 
"If there is insufficient room for the free eruption of the permanent VICTOR HUGO JACKSON 
727 
teeth, it is best to begin to expand the arch, if necessary, when the in- 
cisors are erupting, an operation easily accomplished by means of the 
crib appliances. 
"The advantage of using the crib appliance for young patients is 
that it is easily retained, causes no inconvenience, and does not interfere 
with articulation, even when used in the upper and lower arches at the 
same time. 
"By attaching the appliance to a single tooth on each side of the arch 
as an anchor, all of the other teeth tend to support it, and thus, in ordi- 
nary cases, the same object is gained as when more teeth are used as 
anchorages. 
"If the arch is much crowded and some of the teeth too prominent or 
requiring to be rotated while at the same time expanding the arch, an 
appliance like Fig. 440 will often be required, and in addition to the 
appliance described a base wire should be anchored either to the second 
temporary molar, second bicuspid, or first permanent molar on each side 
of the arch, and provided with one or two loops or corrugations, just 
anterior to the crib attachments. The loop-shaped spring is then united 
to the base wire by one of the methods previously described. To expand 
the arch, the loops or corrugations in the base wire are opened slightly 
from time to time, and the loop in the spring over the incisors changed 
to meet the indications. 
"If the lower incisors arc crowded, and especially if they are held 
back by the position of the superior incisors, and their position is such 
as to require the whole or part of the arch to be expanded, an appliance 
like the one shown will, in many cases, meet the requirements. The 
base wire in this instance is made with a loop in the center just posterior 
to the central incisors, and anchored to a tooth on each side of the arch 
as described. A spring is then attached to the base wire just anterior 
to the crib portion on each side in the usual manner, and extended for- 
ward to the lingual surface of the teeth to be moved. A collar with a 
lug is often placed on an incisor or other tooth to steady the spring. 
The pressure is controlled by opening the loop and bending the springs 
outward. Fig. 441 exemplifies the method employed to force into line 
a left superior lateral incisor that was far inside the arch and out of 
proper position. At the same time the arch was to be spread to some 
extent. A crib was formed about the first bicuspid on each side of the 
arch, and to the crib was soldered a base wire that was shaped to the 
curve of the lingual surface of the teeth. A spring was then fastened 
to the base wire near the right bicuspid and extended forward, forming 
a spring which passed beneath a lug soldered to a collar on the lateral. 
The same system was employed to move a central incisor out into line, 728 
ORTHODONTICS HISTORICAL REVIEW 
the crib being attached to the temporary molar. In each case the teeth 
were moved into position in a very limited time. 
"In Fig. 442 it will be seen that the right superior incisor is too promi- 
nent and the left incisor not prominent enough, and is partially rotated. 
The irregularity was corrected by making a crib with which to clasp 
the second right superior temporary molar. A spring extended from the 
crib to the front of the arch, following the labial surface of the teeth 
Fig. 440. 
Fig. 441. 
Fig. 44 2. 
Fig. 443. 
near the gum line, and was formed to pass the right incisor and to 
extend into a tube soldered to a collar placed on the left incisor. 
"Fig. 443 shows a very convenient method of regulating the V-shaped 
arch, by forming a base wire (with or without a loop or corrugation), 
which is shaped to the lingual side of the teeth, and anchored to one or 
more teeth on either side by a crib, to the labial side of which should 
be attached a hook or eyelet to sustain a straight bar of spring wire 
that is sprung over the front of the teeth for the purpose of flattening 
the shape of the arch. The tendency of the wire to straighten itself VICTOR HUGO JACKSON 
729 
exerts a pressure backward on the front teeth, and at the same time 
assists in spreading the arch. 
"Respecting this entire crib and spring wire system, special stress is 
laid on the following facts: (A) The materials-piano wire, Tagger's tin, 
sheet copper, copper wire, tin and soft solder-are inexpensive, and within 
the reach of all. (B) The crib and spring construction is simple and 
quickly done. (C) The clinging grip of the crib on its anchorage is suffi- 
cient to hold the fixture firmly, yet it is easily sprung off for cleansing or 
change. (D) Changes or additions are easily and quickly made. (E) 
The structure is light, cleanly, and occupies the least possible space in 
the mouth. (F) Its action is controllable, and free from risk of over- 
action. (G) It forms a perfect retainer." The following are a few of 
the appliances used by Jackson at the time (Figs. 444 and 445). 
Fig. 444. 
Fig'. 445. 
At the World's Columbia Dental Congress, 1893, the following paper 
was read: "Method of Constructing Spring Appliance for Correcting 
Irregularities of the Teeth." Most of the principles used in this paper 
have already been shown. In conclusion Jackson replied, "Before I 
conclude, let me recapitulate what I consider the indispensable advantages 
of the system I have described: 
"First. It does away with plates covering the roof of the mouth. 
"Second. Although the anchorage is sufficiently firm for all prac- 
tical purposes, the appliance may readily be removed by the patient. 
An aid to cleanliness. 
"Third. The materials, German silver, Tagger's tin, piano and German 
silver wire, and soft solder, are cheap and easily obtained. 
"Fourth. The crib and spring construction is simple and quickly 
prepared, and changes and additions are easily made. 
"Fifth. The appliance requires less attention than those ordinarily 
used, and thus there is a saving of time. 730 
ORTHODONTICS HISTORICAL REVIEW 
"Sixth. Many of the springs described can be utilized to advantage 
in combination with a rubber or metal plate. 
"Seventh. The whole or part of the appliance can be macle of precious 
metals if desired. 
"I freely give the results of my study to the profession. 
"Beyond copyrighting this paper 1 reserve no exclusive rights in the 
system to which I have devoted years of thought and labor. I need not 
rehearse to this audience the perplexities and unforeseen obstacles which 
are at once the bane and the fascination of scientific research. 
"How far I have succeeded in conquering the difficulties in my path 
let others judge. The story of man's contest with the forces of nature 
is as old as the world. No one is more familiar with it than the members 
of our profession, who work to relieve their fellow beings of the con- 
sequences sometimes of misfortune, sometimes of folly. 
"But though no letters patent protect me in the material advantages 
of my method, I am not without a great reward; I shall find it in the 
knowledge that I have in a manner aided the work to which we give 
the best part of our lives: the best product of our knowledge. If my 
professional brothers find the system 1 have outlined a help in their 
practice and a step along the road of progress, I am amply repaid for 
what I have done. 
In 1904 Dr. Jackson brought all of his material that had been pub- 
lished in various journals together and published his book entitled: 
Orthodontia and Orthopaedia of the Face. Under "Bodily Tooth Move- 
ment," page 309, he says: 
"Early in practice I moved the incisor teeth bodily, both anteriorly 
and posteriorly, without changing their angle." [See Dental Cosmos, 
1887, page 385, and 1888, page 512.] "At some future time 1 will 
describe my method of carrying the incisors forward bodily without 
changing their angle." Cosmos, 1887. "I expected to present here 
today a method of carrying front teeth forward and retaining them 
in position. I believe that teeth can be moved bodily without in- 
juring to any great extent their pulps. I have succeeded in carrying 
them to some distance. 1 have caused the death of pulps by carrying 
the teeth too great a distance, and too rapidly, however. We must con- 
sider when the lower arch is much larger than the upper, there has been 
from some cause an arrest of development in the upper. How does this 
upper jaw expand and enlargef It is by the growth of the palatal bones 
from the edges, as well as by the interstitial growth spoken of by Wcdl; 
and if we begin the regulating early in life we encourage that deposit 
which is necessary to enlarge the upper arch to the required size, or com- 
parative size of the lower one." Cosmos, 1888. 
"In but a small percentage of the cases presented for treatment re- VICTOR HUGO JACKSON 
731 
quiring the incisors to be moved outward or inward it is found necessary 
to adapt special apparatus and move them bodily, and again but a few of 
the cases that are so treated meet the full expectations of the operator, 
especially when the operation is performed upon an adult. After the teeth 
and bone have been moved, in the healing process there is always a con- 
traction similar to the contraction of scar tissue after a wound; and if 
an ordinary retainer is applied which does not hold the teeth bodily, this 
condition will force the roots of the teeth towards their original position, 
which gives an unpleasant appearance of their crowns. Moving all of 
the incisors outward at any time by force applied to their crowns carries 
more or less of the alveolar process with them, particularly the outer 
table. With young patients the stretching of the premaxillary bone en- 
courages its development. The suture between the premaxillary and the 
palatal processes of the maxillary bones is not fully united in early 
childhood. Flat bones grow from their edges. The premaxillary may be 
numbered with this class; during its development it can be encouraged 
by pressure to take on a different form, and therefore better results are 
obtained if the change is made while alveolar process and jaws are in this 
active stage of development. In any case, the continued retention of 
the teeth in their new position for a considerable length of time, to permit 
the process to become firm around them, is essential. This is sometimes 
difficult to accomplish while the bones and process are still developing 
and before the bicuspids are fully erupted. Space for the accommoda- 
tion of the permanent cuspids should be constantly preserved. If the 
deciduous cuspids are absent, with insufficient room for the permanent 
ones at about the time of their eruption, the case should be carefully 
examined to determine whether the roots of the lateral incisors are 
sufficiently in front of the incoming cuspids to permit the latter to take a 
correct position. The roots of the lateral incisors are somewhat flattened 
laterally, and they should be located so that the incoming cuspids will 
not rotate them. These precautions are necessary when the anterior 
region of the upper arch is not sufficiently prominent to harmonize the 
features. It is difficult sometimes to determine fully before the tenth or 
twelfth year how the jaws are going to harmonize as to their fullness, 
and when the deformity is not very marked it is usually advisable to 
defer operating until a satisfactory diagnosis can be made. 
"Outward Bodily Movement of Incisors.-The first appliance that I 
devised for moving the teeth bodily outward was made for improving 
the position of four upper incisors. A metal cap of No. 28 gauge, made 
with accurate metal dies, was attached to the incisors. To the lingual 
side of the cap near the gum were soldered two heavy wire arms, ex- 
tending backward and following the inner curve of the arch, one on 732 
ORTHODONTICS-HISTORICAL REVIEW 
either side, near the bicuspids and molars. Holes were made in the 
labial and lingual sides of the cap, in position to accommodate wire 
ligatures passing between the teeth near the margin of the gum. The 
cap was fastened to the teeth by first passing the ligatures between them 
and the holes in the edge of the cap, drying the teeth carefully, and 
setting the cap with cement, hastily drawing the ligatures up firmly and 
twisting their ends. The anchorage for moving the teeth was secured 
by shaping a partial vulcanite plate to the palatine arch, covering the 
arms described. Tn these places the plate was thickened, forming grooves, 
extending from front to back on the lingual side, for the accommodation 
of the arms. 
"The plate was retained with wire-clasps passing around the first 
bicuspids and first molars. Each arm had a small projection or knob 
soldered to the side of it made long enough to project through the sur- 
face of the plate to engage with springs for supplying the force, the 
plate being dressed away in these parts down to the grooves to expose 
the knobs, and to form a short slot in front of them to permit the move- 
ment. Two springs for this purpose, one on either side, were attached to 
the anterior third to the plate, and shaped to the double curve to extend 
back of and engage with the distal side of the knobs on the arms, thus 
giving the desired pressure forward. 
"Several methods of making attachment to the teeth will be described. 
To the incisors a fixed attachment may be made with collars, soldering 
to them a heavy lingual base-wire, with the ends extending backward in 
the form of arms; or by arranging on the inner curve on each side of the 
arch a forked arm, one of the forks being soldered to a broad collar 
previously fitted to the central, and the other soldered to a similar 
collar on the lateral. With the arms forked in this manner, the collars 
are easily adjusted for cementing. The free ends of the arms project 
backward to be supported, and engage with springs in a plate in the 
manner mentioned; or force can be applied from a metal anchorage. To 
make the long arms removable for cleansing, etc., (Fig. 446), solder a 
strong short arm to the lingual side of each of the collars, or to a metal 
cap, the arms pointing backward parallel one with the other, to project 
into strong tubes attached to a lingual base-wire, or to forked arms. The 
tubes, if required, should be a little larger in the mesiodistal diameter 
to allow for any side variation in the line of the posts, and to permit 
of easy removal. This connection can be made in the reverse manner by 
soldering the tubes to the collars, and the arms shaped to project into 
the tubes. The anchorage usually consists of spring-clasp attachments 
to the first bicuspids and first molars, the sides being connected by a 
palatine base-wire. Each end of the base-wire, a tube, and one end of 
a U-shaped spring pointing towards the roof of the mouth, are soldered VICTOR HUGO JACKSON 
733 
to the partial-clasps opposite the molars, the tubes being properly placed 
for the support of the arms. Each arm is provided with a flange to 
engage with the free end of the spring. Force is applied by bending 
the ends of the springs forward. 
"Later the system of attachment of the arms to the teeth was simpli- 
fied by soldering horizontally to the lingual side of each of the collars 
a small loop of flat or round metal to engage with suitably shaped spurs 
projecting downward and forward from the anterior part of a lingual 
base-wire. This attachment is in effect like a hinge that comes to a 
full stop when the distal part of the arm is pressed into place. It holds 
the teeth in the same relationship to the base-wire when force is applied, 
but it is easily unhooked for removal. 
Fig. 446.-Outward bodily movement of the 
incisors. (Jackson, 1904.) 
Fig. 447. 
"This form of attachment is also available for moving the incisors 
bodily inward by reversing the hinged attachment to the base-wire arms, 
having the loops or eyelets near the necks of the teeth. 
"Fig. 447 illustrates another method of making an attachment on this 
principle. To each of the incisors to be moved is cemented a collar with 
a hook-shaped flange on the lingual side nearly as broad as the width 
of the tooth, and bent at a right angle towards the gum to engage with 
spurs projecting downward from a lingual base-wire. 
"'When the incisors arc nearly in a line, cementing to them a swaged 
metal cap, covering all of the teeth to be moved, is sometimes preferable 
to the use of collars (Fig. 448). 
"The base-wire is attached to the cap in an adjustable manner by sol- 
dering one or more loops to the lingual side of the cap to engage with 
spurs on a base-wire. One loop should be placed at the median line, and 
a shelf-like projection near each of the distal ends to support and hold 734 
ORTHODONTICS HISTORICAL REVIEW 
Fig. 44 8. 
Fig. 44 9. 
Fig. 450. 
Fig. 451.-Jackson's modified split plate of vulcanite. 
Fig'. 452.-A device for moving forward a lower or upper molar. VICTOR HUGO JACKSON 
735 
Fig*. 453.-Expanding the posterior region on one side. 
Fig. 454.-Jackson's retaining' appliance. (Plate 34, Jackson's Orthodontia.) 736 
ORTHODONTICS HISTORICAL REVIEW 
the cap and bar in the same relationship as force is applied; or a short 
post may be soldered to the distolingual sides of the cap to engage with 
tubes on the base-wire. 
"Another method of making this connection is illustrated in Fig. 449. 
A large semicircular wire is soldered to the lingual side of the cap near 
the gum, with the end projecting a little. To a lingual base-wire of the 
same curve is attached one or more flanges that project upward and 
curve outward to engage with the upper surface of the semicircular 
wire attached to the cap, the base-wire being removable as described. As 
force is applied, the flanges lock with the semicircular wire on the cap. 
"Several variations from these forms of attachment have been devised. 
One that has proved convenient is made by soldering two horizontal 
planes to the lingual side of a cap, as illustrated in Fig. 450. The 
planes are formed of two pieces of plate-metal cut on a curve, the space 
between the planes being just sufficient to pass either side of the base- 
wire. ' ' 
Dr. Jackson has read various papers before nearly all the prominent 
dental societies of this country and Europe, but as the principles of his 
methods are the same, it will be impossible to review all of them in this 
work, especially as this work extends only to the period of 1900. 
The accompanying illustrations are taken from various papers and 
need no explanations. (Figs. 451, 452, 453 and 454.) 
Arthur E. Matteson (1842-1919), in an article in the Dental Cosmos, 
1888, page 68, entitled "A Regulating Device" introduced his method of 
compound coil and lever spring as follows: 
"In minor operations for the correction of dental irregularities, I have 
found very useful the compound coil and lever spring shown in Fig. 
455. This is made of piano wire, No. 14 or 16, according to the degree 
of expansive power designed to be exerted by it. The diameters of the 
coils and the lengths of the levers are to be determined by the positions 
and relations of the teeth to be moved. So, too, the distance of the 
coils from each other will depend upon the circumstances of the case. 
"Preferably the coils are to be made small and the levers short, in 
order that the device may lie close to the teeth upon which it is intended 
to act. A narrow ribbon is then made of gold or platina plate, as thin 
as No. 40, and of a length sufficient for its special purpose. 
"In the case illustrated, the ribbon bends over the distal side of the 
central, passes behind the lateral, and comes out over the mesial side of 
the cuspid. The free ends of the spring levers are brought towards 
each other, and, by means of fine binding-wire or strong twine passing 
through their loops, are held against the expanding strain of the com- 
pressed coils (see Fig. 456). The bound spring is then to be laid over 
the ribbon ends as they rest on the central and cuspid, and the ribbon VICTOR HUGO JACKSON 
737 
marked where the ends of the spring touch it. The ribbon is removed 
and punched with a plate punch at the marked points, and also at other 
points near these and towards the middle of the ribbon, to provide for 
the taking up of the ribbon as its ends become separated by the distend- 
ing action of the spring during the progress of the operation. The rib- 
bon is again put in place on the teeth; the lever ends inserted in the 
punched holes, and the twine cut or the binding wire untwisted to bring 
the spring into operation." 
In the Dental Review, 1892, page 563, Matteson explains his other 
method of treating irregularities: 
"The appliance used is simple as you will see, and rather after that 
of Dr. Angle's system. After using and turning the screw, the teeth 
were brought forward, they had been worn so short it was necessary to 
Fig. 455. 
Fig. 456. 
Figs. 455 and 456.-Compound coil and lever spring'. (Matteson, 1888.) 
elongate them. All that I did was to use the same appliance by bending 
the wire toward the cutting edge, the spring of it drew the teeth down. 
"The first right molar and the first right bicuspid were banded. On 
the lingual side of the bicuspid was soldered a short tube. One end of 
screw-cut German silver (No. 20 gauge) was soldered to the band on the 
molar-the other end passing through the tube on the bicuspid band. 
(Pig. 457.) 
"On this wire screw between the bands, was placed first a nut then 
a T-tube, and in front of the T-tube and on the band of bicuspid another 
nut. 
"The left central was banded with 'gold platina' plate with a lug on 
the lingual surface. 
"The left second bicuspid was banded and a short tube on the buccal, 
and a long T-tube on the lingual surfaces, was soldered transversely. 
"Schoniacher gold-plated piano wire (No. 16 gauge) was formed, the 738 
ORTHODONTICS HISTORIC AL REVIEW 
ends passing into the openings of the T-tubes and in contact with the 
central incisor above the lugs. 
"This piano wire was supplemented with another (No. 14) and united 
by winding with fine wire and soft solder. The free end of this wire 
(No. 14) forced out the lateral. 
"The second bicuspid was rotated by changing the angle of the piano 
wire where it entered the tube of the left bicuspid. 
"By turning the nut which is back of the loose T-tube forward the 
pressure was brought against the central and lateral. This also permitted 
the adjustment of the expansion of the arch either in the region of the 
molar or bicuspid. The nut in front of the screw was used to draw the 
first bicuspid back. 
"The tube on the buccal surface of the left bicuspid band was to 
lock, when in position with a pin. 
Fig. 457.-Lingual appliance. (Matteson, 1892.) 
"The long tube on the inside of this band was to support it with the 
contingency of cutting a thread on this end of the piano wire, and with 
a nut, form a jackscrew to assist in forcing the incisors, although the 
necessity for this did not arise. This piano wire which I have men- 
tioned is superior to any which 1 have used. It might be improved by 
a heavier plating. It can be obtained larger than I have mentioned but 
I have found No. 16 sufficient to expand the arch of any case so far 
since commencing its use. 
"In regard to making these nuts for irregularity cases, having found 
that cutting them out of solid nickel and German silver plate, to be 
drilled, tapped and squared, a very tedious process, I have simplified the 
method greatly by first drawing tubes of platinized silver (one part plat- 
inum and two parts silver), soldering the joint with 20 carat gold, then 
drawing through a 'square hole' draw plate, inserting piano wire in 
the tube, thus making a square tube with a round hole, then sawing off 
enough for a nut." VICTOR HUGO JACKSON 
739 
In discussing Dr. Jackson's paper before the World's Columbian Den- 
tal Congress, Matteson exhibited the appliance shown in Fig. 458, for 
expanding the dental arch: 
"Fixed bands are constructed with such attachments as are required 
to carry the case forward to completion. On the upper model are the 
bands (cemented on the teeth), with tubes on the buccal and lingual sur- 
faces. Around the labial surface of the teeth extends a threaded gold 
wire ($) No. 22 B and S gauge, passing through and carrying nuts (TV) 
in front and back of the tubes. 
Fig. 458.-Matteson's complicated appliance (1893) 
"The tubes on the lingual surface of the molars are tapped and re- 
ceive a screw-cut rod which extends through the bicuspid tubes, with 
nuts (A) iu front. On those bars are slipped T-tubes (7'), and between 
each and the molar is a nut. 
"The piano-wire spring is formed so as not to interfere with the occlu- 
sion and the comfort of the patient, and the ends bent at right angles, 
and passing into the cross tubes of the T. The nuts back of the T-tubes 
permit the adjustment of the action of the spring, either to the front or 
rear just where the force is required, and also may act as a jackscrew 
forcing out the inlocked lateral. 740 
ORTHODONTICS HISTORICAL REVIEW 
"On the end of the cross tube of the T-tube there is cut a slot or 
recess to receive the piano wire and lock it in position." 
Dental Review, 1895, page 829. "Treatment of Irregularities of the 
Teeth with Cases." 
Fig. 459. 
Fig. 460. 
Fig. 461. 
Fig. 462. 
Fig. 463. 
Figs. 459-463.-Series of appliances devised by Matteson. 
"The successful correction of this case was comparatively simple. The 
appliances were constructed of German silver as follows: 
"Bands in the form of a figure eight were fitted to the first perma- 
nent and second deciduous molar on each side. To these bands on the 
buccal surface, and on the same horizontal plane, tubes were soldered. VICTOR HUGO JACKSON 
741 
The lateral was banded, and on the lingual surface was soldered an open 
(wire) ring. Bands were fitted to the central incisors, embracing them 
as near the incisive edge; on the labial surface of each band was soldered 
a triangular shaped strip of plate %0 of an inch across at its base, and 
the other two sides of an inch in length. To prevent the solder from 
Fig-. 464. 
Fig. 465. 
Fig. 466. 
Types of appliances used by Matteson. 
Fig-. 467. 
flowing the whole width of the band a scale of mica was inserted. The 
points of these strips extended a trifle beyond the gingival margin. The 
mesial edges were placed parallel, for reasons to be explained later. A 
hard drawn wire (No. 20) was formed so as to extend around the labial 
surface of the teeth but not in contact with any but the central incisors 742 
ORTHODONTICS HISTORICAL REVIEW 
at the gingival margins, the ends passing freely into the tubes on each 
side. The ends of this wire were threaded and nuts prepared for them. 
"The place on the wire where the distal edges of the strips crossed it 
was marked, the wire removed and rings of smaller wire slipped to the 
marks and soft soldered without heating enough to draw the temper. 
After electro gilding, the bands were cemented to the teeth and allowed 
twenty-four hours to harden. The wire was inserted into the tubes and 
brought to place. A rubber ligature was looped over the wire, around 
and into the open ring back of the lateral. 
"With pliers-one lip resting on the bases of the triangular strips and 
the other on their opposite points-the strips were curled over the wire. 
This was repeated two or three times a week, or as often as the soreness 
subsided. 
"This shortening of the strips around the wire, which acted as a spring, 
forced the teeth into their sockets; while the wedge formed by the in- 
cline of the distal edges of the strips against the rings on the wire 
brought the mesial surfaces of the centrals together. 
"After the incising edges of the teeth had been brought to their 
proper alignment, the nuts were moved forward on the ends of the wire 
until the centrals were forced back into occlusion with the lower teeth. 
"The same principle may be used to advantage in eases of retarded 
eruption not determined until later in life, by reversing the position of 
the triangular strip on the band against the wire, producing reverse 
action; or it may be used conjointly when one tooth requires subtruding 
and the other extruding, in which case reciprocating force is made 
available. ' ' 
Other appliances as devised by Matteson are shown in Figs. 459 to 467. 
Samuel Julius Shaw (1830-1911), Cosmos. 1888, pages 211 and 215. 
Shaw's first description of Regulating Studs is as follows: 
"Vulcanite and other fixtures for regulating teeth often require the 
attachment or insertion of studs or hooks, from which rubber rings may 
be stretched on to the teeth that are to be put into place. I have made 
such studs of celluloid or hard rubber in form like that shown in Fig. 468, 
drilled and tapped through its center as shown in the section, Fig. 469. 
This stud I readily fix on the plate or bar by means of the screw, and a 
section through the stud, screw, and plate (see Fig. 470) makes evident 
the security of the attachment. In Fig. 471 is seen a plate in place, and 
a rubber ring stretched from the stud to the lateral, which is being pulled 
into position. The size of the stud-shank is such that the ligature will 
not be cut by the strain, and the stud-head is round and smooth, and 
overlaps the ligature, so that the tongue will neither be chafed nor in- 
terfered with to any appreciable degree during the progress of the regu- 
lating operation." VICTOR HUGO JACKSON 
743 
Fig. 468. 
Regulating studs as devised by Shaw (1888). 
Fig. 469. 
Fig. 470. 
Fig. 471. 
Fig. 472. 
Fig. 473. 
Fig. 474. 
Fig. 475. 
Figs. 471-475.-Appliances devised by Shaw (1888). 744 
ORTHODONTICS HISTORICAL REVIEW 
Under Teeth Regulators, page 215, Shaw then explains his method: 
"For drawing outward an erratic incisor, a cross-bar, a screw with 
nut, and a loop or band form an effective combination. In application, 
however, the bar is apt to turn from the horizontal line, and to prevent 
this I solder to a face-plate the screw and a parallel guide-pin (see Fig. 
472)., which with tire screw passes through the bar and keeps it at right 
angles to the face-plate. This plate I attach to the tooth with waxed 
floss silk, and the fixture is thus made to serve for every such case that 
may be presented. For a retaining fixture, I simply solder a bar to a 
face-plate and tie it on with floss silk. 
"The regulation of complicated cases I accomplish by a system of piv- 
oted levers operated by jackscrews. In Fig. 473 it will be seen that the 
lower bicuspids must be moved outward before the cuspids can be 
brought in. For that purpose I made a vulcanite plate fitting over the 
bicuspids and molars. With a narrow, fine saw I cut sections from the 
plate of forms such as I could pivot at points behind the molars, and 
insert two jackscrews opposite the first bicuspids. The illustration shows 
the completed contrivance in position. 
"In another instance, in which for improved occlusion it was desirable 
to push outward the left superior bicuspids, the pivot was placed opposite 
the cuspid, and a metal screw-arm built into the plate opposite the molar 
(Fig. 474). It is apparent that successive turnings of the screw would 
swing the lever outward and carry the bicuspids into place. 
"Fig. 475 exhibits a case in which the superior left central incisor re- 
quires partial rotation, the lateral and both bicuspids an outward dis- 
placement, and the cuspid to be pushed inward. All these movements 
can be simultaneously effected by the compound pivoted levers and screw- 
arm shown. The illustration makes clear the details of the construction 
and operation of the device, which so directs and adjusts the mechanical 
powers brought into action that the turning of the screw against the 
neck of the cuspid will result in pushing it, and bringing the four other 
teeth into symmetrical alignment at one and the same time. 
"It will be understood that in all the cases here illustrated casts show- 
ing the restoration of the teeth to their normal relations and positions 
have been at hand, but the cost of the cuts would be a great addition to 
the already expensive illustrations, and, therefore, as not really neces- 
sary to a complete comprehension of the operations, those casts have not 
been herein represented. 
"I have other exemplifications of both the simple and compound lever 
appliances in models on casts of the cases in which they were employed, 
but the specimens given are deemed sufficient for the purpose of bring- 
ing the devices fairly before the profession." VICTOR HUGO JACKSON 
745 
Levitt E. Custer (1862-1924), in the Ohio Journal of Dental Science, 
1888, under "Intermittent Pressure, Its Delation to Orthodontia," states: 
"To move teeth in the alveoli, we are dependent upon the same funda- 
mental principle of the animal economy as that by which all change of 
shape in osseous structures is accomplished, namely, resorption and depo- 
sition. The theory was once held that there is an actual digestion and 
excavation in one portion, and a new deposition taking place in another. 
During the preparation of the lower jaw for the permanent molars, the 
ramus is carried back, not by an interstitial development, but by a resorp- 
tion anteriorly, and a deposition posteriorly. When lime salts have once 
been deposited as the basis substance of bone, they, by virtue of their 
intense hardness and heterogeneous nature, retain that form until reduced 
by retrograde metamorphosis to the embryonic condition. 
"Resorption, as a physiologic process, takes place under the agency of 
a class of cells which may be understood to have a retrograde function. 
They break down tissue already built, and under accidental conditions re- 
duce foreign substances of animal origin to a condition fit for assimilation 
by osmosis. Such cells, according to where found, have been termed leu- 
cocytes, giant cells, osteoclasts or odontoclasts. 
"The above cells, even though of retrograde function, like all others 
are brought into action by adequate stimuli. Every different cell re- 
quires a special excitation; for the cells of the salivary glands to act, there 
is reflex nervous irritation originating in the gustatory cells; for muscle 
cells, motor impulse; for giant cells, a thrombus, an infarct or foreign 
body; for odontoclasts or osteoclasts, the effort of nature to change the 
size or shape of a preexisting osseous structure. Osteoclasts are also 
stimulated by pressure, and upon the latter do we depend for change of 
shape in the alveolar process for correcting irregularities. When Nature 
has once fashioned the alveolus and the arrangement of the teeth to 
satisfy our own typal demands, we can ask no more of her as a stimulant, 
but must resort to the other method, namely, pressure. All the forms of 
pressure for regulating resolve themselves into either of two classes of 
forces, intermittent, or constant. Under the former may be classed those 
forces which move to a definite distance and there remain stationary, 
such as the screw in all its forms; under the latter, constant force, all 
those which bear with an elastic or continued pressure, such as the spring 
or rubber bands. Intermittent pressure acts intermittently as such be- 
cause the space gained by absorption is not followed up immediately by 
new pressure only as it is applied by the operator. 
"The method by which giant cells, leucocytes, osteoclasts or odonto- 
clasts, cells of retrograde function, reduce substances has been designated 
by Dr. Black as resorptive digestion. We understand these cells to have 
the property of throwing out a digestive fluid which acts as a soluble 746 
ORTHODONTICS HISTORIC AL REVIEW 
ferment analogous to that of ptyaline, pepsin, or trypsin. In each case 
this fluid varies according to the nature of the object to be digested. 
Krause maintains that in absorption of osseous tissue this fluid is lactic 
acid. In order to act, these cells arrange themselves as to be in direct 
apposition with the part to be digested, they become in actual contact. 
Implanted teeth, the roots of which are undergoing absorption, contain 
pits which are lined with odontoclasts. In the formation of sequestra of 
bone, osteoclasts are found at the line of union of the dead with the 
living; ligatures are surrounded and crowded with leucocytes. In sponge- 
graft, granulations are filling up the pores while giant cells are preparing 
the walls for osmosis, and blood clots become organized by the presence 
of connective tissue cells." Dr. Black says, "The osteoclasts are not 
attached to the surface of the bone or tooth by any mechanical means 
whatever; they simply lie against the surface and are detached with the 
least movement. They act only, however, when lying in contact with 
the surface. Any intervening substance whatever will prevent their 
action. 
"From the foregoing it is evident that the action of osteoclasts may 
be lessened or entirely suspended by either of two conditions; dilution 
of the digestive fluid, or separation of the cells from the point of absorp- 
tion. When resorption is produced artificially, and it is agreed that 
pressure is necessary to stimulate osteoclasts, as the result of pressure 
there are associated conditions affecting the action of these cells, which 
vary according to the method used. By one method of pressure the 
digestive fluid may be weakened, or by another the cells may be sepa- 
rated from the seat of absorption by intervening bodies. Any form of 
pressure in orthodontia, if continued long enough and hard enough, will 
produce hyperemia followed by inflammation and possibly suppuration 
or abscess. When hyperemia occurs we have a serous and a corpuscular 
exudate which infiltrate the surrounding tissue. Serum being a liquid 
which in small quantities is taken up by the lymphatics, but when in- 
creased, producing edema, readily comes in contact with the digestive 
fluid of the osteoclasts which is diluted and resorption retarded. On the 
other hand, the blood corpuscles of hyperemia not being liquid insinuate 
themselves between the cells and the point of absorption and become a 
mechanical obstruction to their action. In inflammation we have, as 
well as the serous and corpuscular, an additional one, fibrinous, which 
at first acts mechanically and after liquefaction becomes a menstruum 
for weakening the digestive fluid. The result of mechanical obstruction 
to the action of these cells is no better shown than by the resorption of 
the roots of temporary teeth where the process is stopped by the occur- 
rence of abscess. In this instance the resorptive cells become dissem- 
inated among the pus corpuscles, and not being able to act unless in VICTOR HUGO JACKSON 
747 
contact, the process ceases. Resorption is more marked when the diges- 
tive fluid is undiluted, but when it is disseminated in the serous exudate 
of hyperemia, fibrinous exudate of inflammation or the pus corpuscles of 
abscess, it becomes retarded. Herein lies the problem of the efficiency 
of the different methods-to stimulate retrograde cellular activity with- 
out producing excessive hyperemia or inflammation. 
" Cognizant of the fact that resorption produced by artificial means 
or by external agents is not to be compared with nature's physiologic 
process in that we have to deal with two opposites-to stimulate osteo- 
clasts by pressure and at the same time prevent excessive hyperemia and 
inflammation, the result of pressure-we may yet by a peculiar method 
of pressure produce a process approaching very closely nature's own. 
Such a method of pressure, besides being sufficient to stimulate osteo- 
clasts to action, will allow, first, regain of tone to the blood vessels and 
lymphatics in the region of pressure; and second, it will allow free ex- 
change of pabulum and rapid entrance into the lymphatics of the dis- 
solved bone tissue. Of the first condition, I say there will be regain of 
tone in the vessels, because pressure of any kind tends to paralyze the 
vasomotor nerves in that region and hyperemia will result. Let the 
pressure be continued and the exudates of hyperemia will follow, which 
will retard the action of the osteoclasts in the two ways that have been 
shown. On the other hand, let there be an intermittent pressure, and 
the room gained by the osteoclasts while under pressure will allow re- 
gain of tone to the vessels during that period which some have denom- 
inated 'rest.' 
"The osteoclast, like all other cells, has three properties, ingesta, 
assimilation, and excreta; it also ceases to act when this excreta is not 
removed-. Since the lymphatics under pressure cannot so readily absorb 
the waste products of the body, and since under continued pressure we 
have continued stimulation and continued action of osteoclasts, as a 
result, we have a continued formation of excreta in the most unfavorable 
conditions for its removal; but let this pressure be such that it will ex- 
pand to a definite distance and there remain stationary, then the space 
gained by active work of the osteoclasts before their action is stopped 
by the excreta or dissolved lime salts will allow their escape by the 
lymphatics which have regained tone. Under continued pressure there 
is not a free exchange of fluids; mechanical resistance keeps back pab- 
ulum, and the osteoclasts become surrounded by their own debris. 
"Besides the peculiar fitness and adaptation of intermittent pressure 
in the above two fundamental conditions for a physiologic performance 
of resorption, there are other minor qualities which render it still more 
desirable as a system of pressure to be used in orthodontia. More force 
may be applied by this method than by the other, and the teeth acting 748 
ORTHODONTICS 1LISTORICAL REVIEW 
as a lever will under this increased force produce enough pressure, not 
on the edge alone, but in the body of the alveolus to stimulate osteo- 
clasts in that portion. Were elastic pressure applied even to inflamma- 
tion, this would not be strong enough to produce resorption at any 
other point than directly opposite the tooth. I think there is more in 
this than we are willing to admit. To produce any other resorption 
than opposite the tooth by elastic force the peridental membrane would 
run high in inflammation. This is an easy thing to accomplish with 
intermittent force since wc are able to apply many times the amount of 
pressure with less danger of inflammation. 
"It is a positive method, and distance gained by its use is definite; it 
may be measured with mathematical precision; also holds what has been 
gained. 
"It needs no renewing; once in place it may be used, as a general 
thing, until the end is accomplished. As a result the new depositions of 
osseous materials are not interfered with as they would be when the 
tooth is drawn back by the fibers of the peridental membrane during the 
change of apparatus; the death of pulps has been attributed to break- 
ing or changing of appliances. 
"Under intermittent pressure we have a work almost painlessly per- 
formed, because more nearly a physiologic process. According as are 
all either constructive or retrograde processes physiologically performed 
are they painless, and as they approach the pathologic do they become 
painful. We have a work more progressive, because of continued action 
under natural laws-not an action that is half inflammatory; and a work 
that is more effective, because produced by causes which work more in 
harmony with nature, which allows regain of tone, free exchange of 
pabulum, and more favorable conditions for contact of resorber with 
resorbed, and an undiluted action of the digestive fluid." 
J. H. Magruder, in the September Dental Cosmos, 1 889, introduced 
A New Regulating Device.-"The appliance consists of a strip of gold 
plate, 26 gauge, three-sixteenths of an inch wide and about two and a 
half inches long. At intervals corresponding to the width of the upper 
oral teeth, holes the size of a No. 3 bur are drilled through the strip, and 
at each end, opposite each other, two smaller holes are to be made, Two 
pieces of gold wire, say 20 gauge, are then soldered to the strip near its 
end and so placed that the wires will overlay the holes and the free ends 
nearly meet in the middle of the strip, as at A in the illustration (Fig. 
476). It will be observed that each wire is soldered only at one of its 
ends. Suitable rubber bands are then slipped over the wire, a piece of 
floss silk passed through each band, the ends of the silk put together and 
pushed through the holes and appear as shown at B. The number of 
bands will, of course, depend on the number of teeth to be moved. The VICTOR HUGO JACKSON 
749 
appliance as illustrated may be adopted to the drawing or pushing of 
irregular oral teeth into line, but it is preferable to form the strip upon 
a cast of the case so the holes may be drilled at points corresponding to 
the anchorage teeth and to the positions into which the other teeth are 
to be brought. Ligatures through the end-holes will serve to secure the 
plate to the bicuspids or other anchorage teeth. The bands should be 
as thick as may be to act in separating as well as drawing the teeth. 
By suitably bending the plate it may be made to bear on the tooth or 
teeth which are to be moved inward, and thus the plate will both push 
and pull in effecting the regulation. 
"For holding the teeth until firmly set in their new positions, I employ 
a gold wire very carefully fitted and tied to each tooth with sterilized 
silk ligatures. 
"The appliance described is simple, effective, and occupies the least 
possible space between the teeth and the lips, which are not liable to be 
Fig. 476. 
chafed by the plate because the bands or ligatures lie very close upon 
the plate over the wires, as is made obvious by the illustration." 
Edward Augustus Bogue, M.D., D.D.S. (1834-1921).-"The correction 
of irregularities of the temporary teeth for very young children is the 
most important work of modern dentistry. I hope to show that the best 
of our constructive dentistry must be done by the time the child is six 
years old, that such work before the age of six facilitates the develop- 
ment of the child's whole body as it cannot do at any other age; that 
it enables Nature to do for the child in the most advantageous manner, 
much that we have sought to do at a later age, and with great trouble; 
that such dentistry can be done easily, quickly and practically without 
pain; that the cooperation of the child and its parents may be enlisted; 
and that the results are permanent in a degree which is not always true 
of the work done at a later age. 
"As the years go by I feel more like saying that if the child has com- 
petent professional care up to the age of six, he can be almost guaranteed 
against serious oral troubles during life, and a well developed head, nose 
and chest, with at least satisfactory physical vigor will result. These 750 
ORTHODONTICS HISTORICAL REVIEW 
are the greatest guarantees of health, intelligence and efficiency that 
can be given any human being." 
Bogue was among the first to recommend and practice early treatment 
and correction of the deciduous set of teeth and has for over forty-five 
years consistently dwelt on this early phase of orthodontic treatment. 
In 1889 before the New York Odontological Society (Dental Cosmos, 
August, 1889, pages 581 to 596) Dr. Bogue presented his first paper on 
"A Study of the Visible Changes that Take Place During the Develop- 
ment of Human Teeth and Their Alveoli." He states: "I present for 
Fig. 477.-Edward Augustus Bogue (1834-1921) 
your consideration this evening a study of the visible changes which 
take place during the development of the permanent human teeth and 
their alveoli. In saying visible, I refer to those changes that any prac- 
titioner may see if ho will but take casts of the mouths that come before 
him and carefully preserve them for a series of years. In giving atten- 
tion to the changes which take place during this development, my pur- 
pose is to find out what Nature has to tell us. Nature is our best teacher. 
If we can get her mind as to what constitutes a perfect denture and the 
basis of it, we shall be. prepared in any case of imperfection to unite our 
efforts with hers to produce a normal condition, and that with large 
prospects of success. VICTOR HUGO JACKSON 
751 
"The diagrams exhibited are intended to illustrate certain well-known 
anatomic facts, so as to open the way to some important and practical 
inferences. 
"The facts are: 
"(1) That the jaw continues to grow from infancy to adult age. 
"(2) That its elongation is mostly from the second temporary molar 
backward. 
"(3) That its elongation depends largely upon the growth of the per- 
manent teeth. 
"(4) That the growth of the alveolus is also dependent on that of the 
permanent teeth. 
"From these facts it will be inferred that the removal of permanent 
teeth will prevent the natural development of the jaw, the growth of the 
alveolus, and the attainment of the height of the normal bite. These 
inferences, I think, will be sustained by the diagrams. 
"From these various facts it seems evident that the extraction of 
teeth during the period of their development results in preventing the 
normal enlargement, causing irregularity among the teeth, and shorten- 
ing the bite of the jaws, diminishing thereby the height of the features, 
impairing their strength, and injuring their contour." 
Before the Pan-American Medical Congress, Bogue discussed the Prin- 
ciples Underlying the Regulation of the Human Teeth (Dental Cosmos, 
1893, page 1222). 
"In the great majority of cases, irregularities in the position of the 
teeth arise from the dental arch being too small. The causes which pro- 
duce this diminution of size are often obscure. We say heredity; we 
see the roots of pulpless deciduous teeth remaining too long in their 
places, and deflecting the crowns of permanent teeth away from their 
proper positions. This deflection is generally, though not always, inward 
toward the center of the mouth. 
"We guess that the failure to masticate properly may in some way, 
as yet unknown to us, produce these results, as we see them most fre- 
quently in those classes where the food is carefully prepared by cooking 
and made fine for eating. 
"But be the causes what they may, the effects are certainly present, 
and the problem before us is so to correct irregularities in the position 
of the teeth as to produce the nearest approach to the normal arch, which 
will through its own perfection remain where it is put. 
"It is only through obedience to the laws governing the growth and 
development of the child that we can hope to obtain permanence in our 
results. 
"Allow me, in closing, to recapitulate these six laws. 752 
ORTHODONTICS-HISTORICAL REVIEW 
"1st. The child continues to grow up to eighteen years of age, or the 
time for the development of the third molars. 
"2nd. The crowns of permanent teeth are as large in circumference 
at six years of age as they ever will be, and they are packed away in 
their alveoli with regular irregularity, the central incisors lying in front 
of the laterals and the cuspids almost over them. 
"3rd. The cuspids are the firmest and least movable of all the teeth 
in the mouth, so that all the other teeth incline toward them. 
"4th. The lower molars incline inward, the upper molars outward. 
"5th. Each class of lower teeth develops before the corresponding- 
upper teeth, and thus guides, or ought to guide, the upper teeth into a 
right position. 
"6th. The lower incisors normally lean forward to form an arch with 
the cuspids, and so support the arch of upper incisors, which, closing 
outside of the lower ones, are constantly drawn toward them by the 
action of the lips." 
In the Dental Cosmos, pages 1213 to 1239, December, 1899, we find a 
paper read by Bogue before the National Dental Association, on "Results 
that Follow the Extraction of Permanent Teeth." 
"For the sake of clearness I will give in the first place a list, probably 
not complete, of the results that follow extraction, and then will explain 
those results one after the other, lest there should be some to whom 
occasionally they might not be familiar. 
"First, then, it diminshes the size of the dental arches. 
"Second, it straightens some of the lines in those arches so that the 
arch in certain directions is scarcely perceptible. This straightening 
becomes very evident at times when one has tried ineffectually to place 
a rubber-dam in one of these straightened arches where the teeth lean 
forward. 
"Third, it diminishes the size of the arch of the palate. 
"Fourth, it shortens the bite. That is, it causes the nose and chin to 
approximate more than would be normal had there been no extraction. 
"Fifth, it often causes separation of the upper incisor teeth. 
"Sixth, it causes exposure of the gums wherever the triturating or 
cutting ends of the teeth are not in contact. 
"Seventh, it prevents thorough mastication. First, because hard bits 
of food strike the gum where spaces exist, giving pain or inconvenience; 
second, because the occluding surfaces of the teeth do not mesh. 
"Eighth, it causes undue wearing down of the cusps of the teeth. 
"Ninth, it tends later on in life to fractures of the teeth at points of 
malocclusion. 
"Tenth, it gives greater liability to the deposit of tartar. 
"Eleventh, it withdraws the normal support of the teeth, each against VICTOR HUGO JACKSON 
753 
the other, which originally constituted the arch, resulting in a weaken- 
ing of the powers of mastication or crushing of hard food. 
11 Twelfth, it causes as surely undue crowding between the teeth that 
remain and touch at their grinding edges as it gives space in the places 
left by extraction. 
" Thirteenth, it causes a rotation upon their own axes of the teeth, 
which lean forward after extraction so that their contact with the ad- 
joining teeth, if contact comes, is awkward, and is conducive to undue 
deposits both of food and tartar. 
"Fourteenth, it diminishes the needed room for the tongue, so that 
speech frequently becomes less distinct than it would otherwise have 
been; and sometimes it leaves so little room that the patient complains 
of being cramped in tongue movement. 
"Fifteenth, finally, if the extraction has been early in life the devel- 
opment of the palatine arch is so much interfered with that it becomes 
impossible to develop first-class vocalization. Patti would never have 
been heard of had she lost her first permanent molars at the age of 
eleven or twelve. 
"I am sure that if my professional brethren will study the results of 
extraction as I have been compelled to study them, from the failures 
that have resulted from extraction, their practices can certainly be made 
so conservative that they will never extract unless the good to be gained 
will surely and greatly overbalance the injury that is sure to be done." 
Below are enumerated a few of the papers presented by Bogue: 
"Observations on Some Recent Cases of Orthodontia," International 
Dental Journal, 1902, page 869. 
"Some of the Causes of Irregular Teeth, with Suggestions as to Preven- 
tive Treatment or Early Cure," International Dental Journal, 1903, page 
40. 
"The Principal Molar in Man, and Its Relation to and Bearings upon 
the Other Teeth," Dental Cosmos, August, 1903, page 605. 
"The Influence, on Development, of Arranging Irregularly Placed Teeth 
into Normal Positions," International Dental Journal, 1905, page 761. 
"The Relations of the Dental Arches to Pathologic Affections of the 
Nasopharynx and Adjacent Parts," Dental Digest, 1907, page 1374. 
"Theories Made Facts," Journal of Allied Dental Society, 1907, page 
180. 
"During four or five years I have advanced the opinion that the posi- 
tion of the deciduous teeth affects the permanent teeth, and that there- 
fore any irregularities in the deciduous teeth should be corrected in 
order to prepare the way for the permanent teeth. 
"If the deciduous teeth arc brought to occupy a normal position, the 754 
ORTHODONTICS HISTORICAL REVIEW 
crowns of the underlying permanent teeth will naturally take a correct 
position and their roots will be formed in harmony. 
" These results have been obtained by means of very simple apparatus. 
But they are highly instructive to those who are interested in ortho- 
dontia." 
"Appliance for Expanding the Dental Arch, Thereby Increasing the 
Size of the Nasal Passages and Superjacent Bones," Items of Interest, 
1907, page 619 {American Society of Orthodontists). 
"Some Results from Orthodontia on the Deciduous Teeth," Journal of 
the American Medical Association, 1, 1908, page 267. 
"Some Reasons for Orthodontia on the Deciduous Teeth, with, Descrip- 
tion of an Appliance," Journal of the Allied Dental Society. 
"Prevention of Dental Deformities," British Dental Journal, 1911, 
page 1121. 
"Orthodontia of the Deciduous Teeth," eleven papers published in the 
Dental Digest for 1912, continued in the Dental Digest, 1918. These 
papers are also published in two pamphlets, 81 and 28 pages. 
In summarizing the articles Bogue states: 
(1) "The regulation of the temporary teeth is the most important 
feature in modern Orthodontia. 
(2) "The prevention of dental deformities requires the retention of 
the deciduous teeth in their proper positions, and proper relations to 
each other until the permanent teeth are ready to erupt. 
(3) "Adenoids arc a cause of dental, nasal, facial and thoracic de- 
formities. 
(4) "Hypertrophied adenoids may be discovered at a very early age 
by the parents through the presence of snuffles, ear trouble, paroxysmal 
cough or mouth breathing. The adenoids may generally be removed 
during the first year of life without an anesthetic, and with very little 
hemorrhage or pain. 
(5) "The early discovery and removal of adenoids and thorough per- 
formance of the functions of mastication and breathing are the surest 
preventives of irregularities among the temporary teeth. We find an 
intimate relation between the irregular temporary teeth and the whole 
category of children's diseases. 
(6) "Irregularities among temporary teeth are as frequent as among 
permanent teeth. 
(7) "The surest preventive of dental deformities, as well as of the 
contagious diseases, which are acquired through mouth breathing, is to 
spread the arches of temporary teeth, when too narrow, and to correct 
malpositions. 
(8) "Underdeveloped dental arches are evidence of lack of vigor. 
Nature, unaided, cannot spread them. Almost all irregularities indicate VICTOR HUGO JACKSON 
755 
an arrest in the general development of the child. Protrusion of the 
front teeth indicates a narrowed arch which is another symptom of ar- 
rest in development. 
(9) 11 Spreading the arches of temporary teeth enlarges the nasal pas- 
sages and allows the mouth to close, thus preventing the entrance di- 
rectly into the lung of the air-borne microbes of contagious diseases, and 
forcing them to pass through the filter of the nose. 
(10) "The relation existing between the temporary incisors and the 
permanent ones can, by measuring the width of the upper, temporary 
incisors, be ascertained with sufficient accuracy to furnish a working- 
basis for the calculation of the size of the permanent arches. 
(11) "A standard relation between the width of the permanent upper 
central incisors and the proper width of the dental arches has been 
demonstrated, so that one may be calculated from the other. 
(12) "The correction of dental deformities before the sixth year, not 
only assures fairly correct arches of permanent teeth, but aids in correc- 
tion of nasal stenosis, due to deflections of the septum, or to too narrow 
nasal space and aids in the correction of curvatures of the spine, which 
carry with them the ribs, an irregular breastbone, and stooping shoulders. 
(13) "The child's brain at six years of age is within 40 gm. of its 
weight at nineteen years of age; hence it is most important that all 
irregularities of the nose, face or teeth should be corrected before the 
sixth year while growth is at its maximum. 
(14) "Perfectly close and regular teeth after five years of age con- 
stitute a marked deformity, and are an absolutely sure indication of a 
crowded condition in the permanent teeth beneath. 
(15) "The normal arch of temporary teeth at five and a half years of 
age, its front teeth being spread apart normally, should correspond in 
size to the arch of the ten front teeth of the permanent set at the date 
of their eruption. 
(16) "The conditions which most call for the attention of the ortho- 
dontists at this early age (four to six years) are two: prognathism of 
the lower arch and the continuance too close together of the temporary 
teeth, especially the six front ones, up to this age. At four years of age 
these arches can generally be spread at small expenditure of time or 
money, and without pain if the child has been well brought up and has 
not been frightened. At five years of age it may take months to accom- 
plish the same result, and at six years of age one can never be sure of 
results under two years, although the actual movement may have been 
made in two months. A retainer is necessary in all cases until the tem- 
porary teeth fall out. 
(17) "Narrow arches of teeth are an indication of lack of vigor. If 
they are less than 28 mm. broad at lingual gum margins of second tern- 756 
ORTHODONTICS HISTORICAL REVIEW 
porary molars at five years of age, it is wise to assume that they will 
not broaden without assistance. 
"We of course must take the cases as we find them. Preliminary to 
any operation, we should determine what has caused the defects that we 
are undertaking to correct. There may be defects in enamel, defects in 
structure, shape or contour of the teeth, or defects in their position or 
relations to each other. 
"From 75 per cent to 95 per cent of the dental arches are narrowed 
by some systemic weakness. This same weakness is indicated by the flat- 
tening of the proximal sides of the bicuspids and molars, thus diminish- 
ing the possibility of self-cleansing. The same weakness has prevented 
a perfect union of the enamel coatings of the teeth. 
"The defective spots should be filled before appliances are fitted; if 
there are approximal cavities, insert fillings and contour them, to make 
their contact points rounded. 
"Regulate misplaced teeth until the lines of occlusion of upper teeth 
with lower ones are normal, both on grinding and approximal surfaces, 
and teach proper mastication to insure self-cleansing to a physiologic 
degree. Teach also what food to eat and what to avoid. Teach deep 
breathing and correct enunciation. 
"While we specialize as orthodontists, let us not fall short in seeing 
to it, that all that can be done, is done, toward putting our patient in good 
order to enjoy, yes, enjoy good health, for more than three score years 
and ten, and so justify the confidence that has been reposed in us in 
placing the patient in our hands. 
"Finally, see the end from the beginning. Have a clear idea of the 
steps to be taken to accomplish that end. I do not mean that no changes 
should be made as changing circumstances or accidents demand, but that 
the main course of procedure shall be mapped out beforehand. Let us 
have a definite reason leading from cause to effect every time. 
" 'Remove the cause,' is one of the axioms of the healing art, and 
orthodontia of the deciduous teeth is treating causes; it is the recogni- 
tion of conditions causing malposed permanent teeth and underdeveloped 
jaws; and the correction of those conditions prevents irregularities of 
permanent teeth with their attendant evils. 
"The time and annoyance saved, not to mention the benefit of the 
health and development of the little patient whose deciduous teeth were 
used as the means to procure the space necessary for the permanent 
teeth, is hard to estimate, but is considerable, as any one interested in 
the normal development of the child will realize." 
Meissen Siegfried, in the Deutsche MonatsSchrift filr Zahnheilkunde, 
1.889, page. 184, explains his Methods of Correcting Irregularities of the Teeth 
by the use of the Coiled Springs. Figs. 478 to 483 illustrate this prin- VICTOR HUGO JACKSON 
757 
ciple. Again in the Dental Cosmos, 1896, page 497, Siegfried's appliances 
are described by R. Runschenbach. 
"To Draw Receding Teeth into Position.-A nicely made band is fitted 
to the irregular tooth. This done, a piece of wire is cut and soldered to 
the band, and the end of it bent up so as to form a hook, see Fig. 484. 
The prepared band is now firmly cemented to the tooth. After this, 
separate the two wings of the spring, slip the spiral on the hook h, and 
finally the end of it is bent over, so the spring of it is prevented from 
slipping off. 
Fig. 478. 
Fig. 479. 
Fig. 480. 
Fig. 481. 
Figs. 478-481.■-Siegfried's coiled springs (1889) 
"Retraction of a Tooth.-As will be seen, this is a case where a forward 
growing cuspid is to be pressed backward. Here we have as a driving 
force only one wing of the spring. 
"The band is fitted to the second bicuspid, and as shown in Fig. 485, c, 
a piece of half-round wire is soldered to the band on the lingual surface, 
starting from the first molar and ending at the first bicuspid. By this 
arrangement the spring is supported by three teeth. On the labial sur- 
face two wires, bent at right angles, are soldered, Fig. 485, d, e. 
"Thus prepared, the apparatus is cemented to the second bicuspid. 
The spring is then placed on the bent wire d, and the end of the wire e 
is bent over again to firmly hold the spring. The wing f of the spring 
exerts its power against the cuspid. ORTHODONTICS HISTORICAL REVIEW 
758 
"To Rotate One Tooth in Its Alveolus.-In this case (Fig. 486), we use 
both wings as a driving force. This apparatus has much likeness to 
that just described, as it also consists of a band with a support soldered 
on the labial surface. 
Fig. 482. 
Fig. 483. 
Figs. 482 and 483.-Siegfried (1889) 
Fig. 484. 
Fig. 485. 
Fig. 486. 
Fig'. 487. 
Figs. 484, 485, 486 and 487.-Siegfried (1896) 
"After this device is fastened with cement on the first bicuspid, we 
at first turn the wings of the spring over one hundred and eighty de- 
grees. Now we put the spiral on the hook h, so the wing, i, will press on 
the distal side of the tooth to be regulated, and operate in the direction 
of the screw, x, Fig. 486. VICTOR HUGO JACKSON 
759 
"A silk ligature is now attached to the tooth, and the knot made on the 
labial surface. One end of the spring is drawn through the eye of the 
wing k and fastened with the other end of the string to another knot, 
and the wing k will draw the tooth in the direction of the arrow y, Fig. 
486. In this way the tooth is turned with perfect equality of action on 
both wings of the spring. 
"To Turn the Teeth at the Same Time.-Among the many forms of 
dental irregularities the following cut, Fig. 487, represents one which 
is very common; the central incisors being situated more or loss at right 
angles at the line of the arch. Both teeth are encircled by a well-fitting 
band. A hook is soldered on a little back of the space between the 
central and lateral incisors. 
"Now the bands are fastened with cement, and we only have to put 
the regulating spring into use. The wire ends are to be turned over again. 
The arrows in Fig. 487 show the action of the spring." 
Sir J. F. Colyer. "Some General Considerations on the Treatment of 
Irregularities." 
"Irregularity has been defined as a departure from the normal type. 
"That irregularities are on the increase is undoubted, and with the 
increase we have, also, that of the badly nourished teeth. It is this latter 
which causes the Dental Surgeon the utmost perplexity in giving an 
opinion, and in the following remarks wo propose to consider some gen- 
eral points which claim our attention when deciding upon a course of 
treatment. 
"Like many other troubles, irregularities can often be avoided by pay- 
ing careful attention to the mouth during the period of eruption of the 
second dentition, judicious filling of the temporary teeth, and extraction 
of them at the proper period being important factors in this prophylactic 
treatment. 
"By carefully filling the temporary molars, their premature extraction 
is often avoided, and the first permanent molars prevented from moving 
forward, so causing crowding of the erupting teeth. 
"Judicious extraction is also important, for undue persistence of the 
temporary teeth in many cases retards eruption, or causes irregularity. 
"A good rule is that temporary teeth should not be retained after the 
time has arrived when they should in the ordinary sequence of events be 
'shed.' 
"When deciding upon a line of treatment, several points will require 
careful consideration, and it is an excellent plan to make models, for a 
careful study of these will often elucidate points which would be missed 
by simply examining the mouth. 
"One of the first points to be considered will be the age of the patient, 
for an extensive operation undertaken at an early age might tax to a ORTHODONTICS HISTORICAL REVIEW 
760 
great extent the vital powers, while, if delayed to a later period, health 
and strength being greater, it might be undertaken with better results. 
"On the other hand, too long delay may bring about more complica- 
tions and difficulties. 
"Roughly speaking twelve to fourteen is about the best time to regu- 
late, but naturally, no hard nor fast rule can be drawn. 
"After age, the sex of the patient should not be lost sight of, for cer- 
tain lines of treatment which are sometimes admissible in a boy, are not 
always so in a girl,--appearance in the latter being the greatest im- 
portance. 
"The temperament of the patient must be taken into consideration; 
some children submitting to the inconvenience of plate, etc., others not. 
"The patient's position in life, whether well-to-do or otherwise; the 
distance to travel for each visit, must both effect our decision. 
"The facial expression and features must also be considered; for in- 
stance, many good-looking people, especially women, have contracted 
mouths which are in harmony with the rest of their features; in such 
cases an operation like expansion, could not fail to mar the beauty of 
their expression. 
"Turning to the teeth themselves, their character as to whether weak 
or strong, should certainly weigh with us; as mechanical treatment in 
the one may lead to worse results, in the way of caries, than the leaving 
of the irregularity. 
"The question as to whether the deformity is hereditary or acquired, 
must also be taken into account, the former being much less amenable 
to treatment. 
"Lastly, with reference to the teeth, we must examine the 'bit'; the 
importance of this proceeding will be subsequently referred to. 
"The question of Extraction or Expansion in crowded mouths may with 
benefit be alluded to at this part. Without doubt there is no condition 
of the teeth which requires more careful consideration, in order to dis- 
cover the correct line of treatment, than this class of case. 
"With reference to expansion it is an excellent way of gaining room, 
but it must generally be confined to those cases which arc of the acquired 
form. As to what happens in expansion is not quite known, and it is 
an excellent subject for some careful and accurate observations. 
"Extraction on the other hand, is in its place an excellent method of 
gaining room, and should be adopted in those cases where the teeth are 
weak in structure, and where there is the slightest tendency to inter- 
stitial caries. Extraction in these cases is conservative treatment. 
"Expansion is naturally best adopted when we have fairly strong 
teeth, and can often be combined with extraction to advantage." VICTOR HUGO JACKSON 
761 
James Frank Colyer in the Transactions of the Odontological Society, 
1896-97, on "Open Bite." 
"From a practical point of view 'open bite' may be considered under 
two headings: 
" (1) Cases where the bicuspids and the molars occlude, but the cutting 
edges of the upper and lower anterior teeth are separated from one an- 
other by a space more or less oval in shape. 
"(2) Cases where not only the anterior teeth, but the majority of the 
posterior teeth, fail to occlude. 
"Etiology.-The causes producing 'open bite' are, in the majority of 
cases, by no means definitely understood and arc invariably the result 
of some acquired habit, such as thumb or finger sucking. 
"A by no means uncommon cause of this form of 'open bite' is to be 
found in the various artificial teats and similar articles which are given 
to troublesome children to pacify them. 
"In cases coming under my second heading, the etiology is frequently 
obscure. In a few instances the use of regulation plates can be traced 
as to the cause of. the mischief, the back teeth being left uncovered, and 
so permitted to elongate. 
"Treatment.-For the treatment of 'open bite' it is impossible to lay 
down any hard and fast rules, as each case must be treated on its own 
merits. 
"To deal first with class i, namely cases where the posterior teeth 
occlude in a proper manner, the deformity being limited to the anterior 
teeth. 
"The treatment of cases coming under class it, may be considered 
under the following headings. (1) Removal of adenoids and enlarged 
tonsils; (2) the use of the skull and chincap; (3) the removal of teeth; 
(4) cutting in the bite; (5) a combination of the above. 
"Cutting in the Bite.-This method is extremely satisfactory, and may 
be used alone, in combination with extraction, or the skull and chincap. 
The treatment consists in grinding down the teeth until the bicuspids 
and the molars articulate. The idea is by no means new, but is one 
which might be more extensively adopted in these troublesome cases. 
It possesses the advantage of (i) giving the patient a good surface for 
mastication; (ii) being permanent; with teeth forced down by the skull 
and chincap, there is a tendency for them to rise again directly the 
apparatus is thrown aside; (iii) the patient is not put through a long 
and tedious line of treatment." 
Henry Baldwin on "Open Bite" states: 
"In the late number of the Zahnartzliches Wochenblatt, Herr Schmidt 
states that in most cases of open bite which he has observed, the patient 
has been of a strumous constitution, and.this has caused an enlargement 762 
ORTHODONTICS--HISTORICAL REVIEW 
of tonsils and a generally increased thickening of mucous membrane of 
both nose and fauces. Thus the difficulty of breathing through the nose 
is explained, and also there is presented a reason for an additional diffi- 
culty of breathing through the mouth. The result of this is that the 
mouth has been held open, the tongue has been held down to the floor of 
the mouth, and the tongue's tip has been pressed against the back of 
the front part of the lower jaw and teeth in a downward and forward 
direction. This, operating on the yielding bone of a strumous person, 
has caused the alteration of the angle at which the body of the lower 
jaw is set to the ascending ramus, so that the deformity of open bite is 
produced. He also suggests that the impact of the column of inspired 
air upon the roof of the mouth is a cause of the abnormal vaulting of 
the palate in these cases; this appears to be a rather unlikely cause for 
the modification in shape of the bone, and I should rather suggest it is 
due to the bending in of the alveolar processes by the constant slight 
pressure exerted by the cheeks, which results from the mouth being more 
or less in a condition of extension. 
"Carl Sauer (1835-1892) has written in the December number of the 
Deutsche Monatsschrift fur Zahnheilkunde on the subject of open bite. lie 
mentions several cases in which section by surgical operation was performed 
for the remedy of this deformity. He then proceeds to describe a method 
of his own, whereby he claims to secure the desired result in the best 
way yet invented, and without surgical operation. His method consists 
in adapting a metal plate to the lower teeth, capping them all, and se- 
cured by means of screws, the points of which screw into the intervals 
between the necks of the bicuspids and molars, after the manner of 
Herbst. To the front part of the plate, near its lower edge is soldered 
an inclined plane of sheet metal which projects upwards and forwards, 
is nearly three quarters of an inch in depth (judging from the wood- 
cut), and extends round from about lower canine to lower canine in- 
clusive. 
"This inclined plane is so placed that the upper teeth impinge upon 
its inner surface in mastication. Strips of metal arc soldered on to the 
plate when it caps the end molars, and so the bite is raised. It is claimed 
that, by gradually raising the bite at the same time by gradually bend- 
ing the inclined plane in and in, the deformity of open bite is at length 
abolished. Professor Sauer's paper is illustrated by several woodcuts 
showing the models of the particular case on which he bases his opinion 
and the apparatus employed." 
Alfred Sternfeld (1857-1904), in 1891, exactly forty-four years after 
Carabelli's, a book on the same subject was published by Sternfeld, 
"Bissarten and, Bissanomalien" (forms of bite and anomalies of bite) ; VICTOR HUGO JACKSON 
763 
and in 1891 the same author published in Handbuch der Z ahnheilkunde 
an article on " Anomalien der Zaline." 
In the last-named article Sternfeld introduces a nomenclature which 
has for its basis terms employed in anthropology. He recognizes two 
classes of occlusion-a physiologic or ethnologic, and a pathologic. 
"The first class, the ethnologic, comprises the following named species: 
(1) Orthognathia dentalis: Normal bite. (2) Prognathia ethnologic 
Prognathism. The same condition exists here as in (1), with the differ- 
ence that here the maxillary teeth have a forward direction. (3) Ortho- 
geneia: Edge-to-edge bite. (4) Progeneia ethnologica: Protrusion of 
Ihe mandible. 
"Under the pathologic forms of occlusion Sternfeld ranges the follow- 
ing: (1) Prognathia pathologica: Protrusion of the maxilla. (2) Ortho- 
geneia pathologica: Pathologic edge-to-edge bite-which he says is very 
rare. (3) Orthognathia pathologica: Pathologic normal bite-which is 
also seldom met with. (4) Progeneia pathologia: Pathologic protrusion 
of the lower jaw; not rare. (5) Opisthogeneia: Retrusion of the man- 
dible. (6) Opisthognathia: Retrusion of the maxilla. 
By combining two distinct forms of the anomalies, expression can be 
given to certain sub-forms, e.g., a retrusion of the maxilla (opisthog- 
nathia) with a protrusion of the lower (progenia), i.e., progeneic opis- 
thognathism." 
In general, Sternfeld applies the term "gnathia" for the upper and 
"geneia" for the lower jaw, and uses the prefixes "ortho-," "opistho-, " 
and "pro(s)-" to indicate the position of the teeth, whether straight, 
backward, or forward. 
Sternfeld cites as an example of ethnologic progeneia the ancient 
Frisians, and gives this on the authority of Virchow, who in his "Beitrage 
zur physischen Anthropoligie der Deutschen mit Besonderer Bcrucksich- 
tigung der Friezen" (Contribution to the physical anthropology of the 
Germans, with special reference to the Frisians), 1877, claims for the 
ancient Frisians protrusion of the lower jaw as a racial characteristic, 
and in support of his conclusions gives a few drawings of ancient skulls. 
In the text, however, we find some passages which make it extremely 
doubtful whether the conclusions of Virchow are correct. 
Edward Cameron Kirk (1856- ), page 907, Cosmos, 1891, "A New 
Regulating Device." The following contribution to the list of devices 
for correcting one of the more frequently occurring forms of dental ir- 
regularities may be found useful. I have obtained very satisfactory 
results with it in the two cases where I have used it. The object to be 
accomplished in both of these was to move the incisors outward for the 
purpose, in the first instance, of increasing the size of the upper arch, ORTHODONTICS HISTORICAL REVIEW 
764 
and in the second instance, where the upper central incisors closed inside 
of the lower incisors, of correcting this defect. 
"The appliance (Fig. 488), is constructed as follows: A broad clasp 
of platinized gold is thrown around each of the sixth-year molars, the 
opening of the clasp being at the distal buccal angle of the tooth or on 
its distal approximal surface. These clasps are yoked together by a 
narrow silver plate simply to give solidity to the fixture and cause the 
two molars to act as a single abutment. Upon the buccal aspects of each 
molar clasp is soldered a section of gold tubing about three-eighths of an 
inch in length; the tubing used is the hinge-tubing of watch-case makers. 
The distal end of each tube is closed with a drop of gold solder. When 
the appliance is thus far completed, it is placed upon the model and a 
section of piano wire bent to conform to the arch, impinging upon the 
buccal aspect of the teeth about the middle of their crowns. The length 
Fig. 488.-Plate, band and bar appliance. (Kirk, 1891.) 
of the piano-wire spring and the relation to its curvature to the labial 
aspects of the incisors is made such that its form will be that which the 
arch of the anterior teeth is to take and permanently retain, or, in other 
words, the wire is to be bent to the form of the arch which it is desired 
the teeth shall form when the correction is completed. 
"The wire will now be approximately a U shape. The three extremi- 
ties of the wire are to be cut to the proper length, so that when intro- 
duced into the tube-sockets with the fixture in position in the mouth the 
arch of the U will stand nearly one-quarter of an inch anterior to the 
incisors and about the middle of their crowns. After the fixture is ad- 
justed in the mouth, the teeth to be moved outward are to be firmly 
ligated to the piano wire by means of fine gilling-twine or silk. The 
especial advantages of this fixture are that it is cleanly and easily remov- 
able for readjustment or cleansing. The traction force is exerted directly 
outward in the median line, or if desired its direction may be modified by VICTOR HUGO JACKSON 
765 
tying the ligature to the wire on cither side of the tooth to be moved. 
The amount of force exerted is absolutely under control, and may be 
modified at any time by changing the length of the legs of the U-shaped 
wire, or by using a wire of small diameter, or by the method of tying 
the ligature to the wire. 
"Not the least important advantage of the appliance as described is, 
that by having proper regard for the curve of the spring and length of 
its sides in relation to the curvature of the corrected arch, the fixture 
becomes practically automatic from the fact that the limit of resilience 
of the spring is reached at the moment the irregularity is corrected. 
Consequently, when the work of correction is done, the spring ceases to 
act. I have found much satisfaction in the use of electro-gilded piano 
wire not only in the cases described, but wherever I have occasion to use 
piano wire in regulating teeth. The deposit of gold is amply sufficient 
to protect the wire from oxidation during a reasonable time while in 
use in the mouth, and the unsightly staining of the teeth by iron salts 
is thus avoided. The gold surface is also an advantage when it becomes 
necessary to unite lugs, loops, or other fixtures to it by means of solder." 
Henry N. Dodge, Cosmos, 1891, page 1045, "Reciprocating Tooth Move- 
ment." 
"It is now necessary to protect the tooth from contact with the lower 
incisors, for the diameter of the root where they touched it was much 
greater than the corresponding thickness of the upper left central. To 
keep the jaws asunder, therefore, an old upper plate which has been 
made for this case but discarded was now hastily cut down so as to cover 
the upper molars only, and as it was impossible to make it hold fast, two 
gold screw-eyes-convenient things to have at hand-were inserted into 
it, one near each angle of the mouth. The angles of the mouth were 
protected from abrasion by a bit of rubber tubing slipped upon the shank 
of each screw-eye; an elastic ring was put in the eye of each screw, and 
a ribbon fastened to each elastic; these two ribbons, tied at the occiput, 
held the plate in position. This plate is shown in Fig. 489. As soon as 
practicable this fixture, somewhat uncomfortable during mastication, was 
replaced by a lower plate, covering the molars, passing across the lingual 
surfaces of the lower oral teeth and reinforced by a half-round wire of 
platinized gold passing across the labial surfaces of the incisors and 
cuspids. The upper surface of this plate articulated with the upper 
molars, rendering mastication comfortable. The next problem in the 
case was to devise some appliance sufficiently powerful to force this con- 
spicuously elongated tooth back again into its place. It was useless to 
rely on any fixture attached to the molars; they were even too short to 
support any appliance controlled by an occipital bandage. An occipital 
bandage attached to the tooth alone seemed to me crude, and ungovern- 766 
ORTHODONTICS HISTORICAL REVIEW 
able, and likely to result in injury to the tooth by displacement or irregu- 
larity and lack of delicacy in its action. Dr. Herbst's method of secur- 
ing an implanted tooth by a strip of rubber-dam covering the crown of 
the tooth in question, perforated and slipped over the adjoining teeth 
and tied to their crevices, occurred to me; but these incisors had no 
crevices, and were too short to afford any such fastening. In this dilemma 
I concluded to make gold caps fitting the three unbroken incisors and 
cement them fast to the teeth, having first connected the three caps by 
gold wires passing across in front and back of the mended tooth, leaving 
Fig'. 489.-Method as adopted by Dodge (1891) 
an intervening' space around it. Upon each of these wires were soldered 
three gold buttons, as shown in Fig. 490. 
"After allowing a few hours for the cement to harden, the patient re- 
turned and a strap of elastic rubber was made with three small holes 
punched in each end. These holes were slipped over the buttons at the 
front and back of the tooth, so that the elasticity of the rubber might 
force the tooth into place. The stretching of the rubber at the button- 
holes, however, made the appliance unsatisfactory, and several modifica- 
tions resulted finally in the powerful combination of rubber strap and 
screw. 
"The strap could be readily removed for cleansing and replaced in a 
moment, and by means of the key the nut could be turned as directed at VICTOR HUGO JACKSON 
767 
the patient's home. The operation of this appliance is shown in Fig 
491." 
Again in 1898 in the Dental Cosmos under "Reciprocating Tooth Move- 
ment: A Sequel," Dodge wrote: 
Fig. 490. 
Fig. 491. 
Figs. 490 and 491.-Modification of Herbst's method by Dodge (1891) 
Fig. 492. 
Fig. 493. 
Fig's. 492, 493 and 494.-Reciprocating' tooth movement. (Dodge, 1898.) 
Fig. 494. 
"I now present to the Odontological Society, at the request of its 
honored secretary, a sequel or appendix to the article previously pub- 
lished in the Cosmos. 
"The left incisor has indeed grown, but not so much as was expected, 
the length of the teeth of the patient's parents being the criterion. 
"I herewith present for examination two regulating appliances which 
have been used for the correction of the position of the mended incisor 
since the publication of my report of the case in 1891. Figs. 492 and 768 
ORTHODONTICS HISTORICAL REVIEW 
494, of which two views are shown, proved to be very powerful for the 
purpose of pushing up the incisor when the cuspids and bicuspids had 
grown enough to afford a fastening for the appliance. Fig. 493 was used 
for the rotation of the incisor back to its normal position, and its opera- 
tion was faultless. The appliances will explain themselves on exami- 
nation. ' ' 
J. A. Osmun in the Dental Cosmos, 1891, "Correcting an Under-Bite." 
"Where the lower front teeth bite too high on the palatine surfaces of 
the upper teeth, thereby throwing the upper out, to crown or cap one 
or two molars on each side, will allow the other teeth to elongate and 
bring about a better occlusion. Then remove the caps on crowns." CHAPTER XXVIII 
CALVIN S. CASE TO CLARK L. GODDARD 
Calvin Suveril Case, M.D., D.D.S. (1847-1923).-The writings of many 
men who attained national and international prominence have been 
recorded in this historical resume, but few in the pursuit of their pro- 
fessional activities have written more on the subject of orthodontia than 
Case. 
Before the Columbia Dental Congress in 1893, Case presented one of his 
first papers on "The Esthetic Correction of Facial Contour." Like 
Farrar's this paper was practically forgotten until Angle in 1911 reintro- 
duced the subject of "Foot Movement." Eighteen years elapsed before 
men in the practice of orthodontia began to pay a great deal of attention 
to this important phase of their work. 
In this paper Case not only showed the possibility and advisability of 
changing the position of the malposed teeth in regulating but also of 
applying force in such manner, when necessary, as to produce anatomic 
changes in the bony tissue adjoining the teeth, thus bringing the parts 
into harmonious and esthetic relations with the other features. 
To do this he said, "It would be necessary to move the roots of the 
teeth as well as the crowns so that any overfulness or deficiency in the 
root region would be changed to a condition of normality and harmony." 
This root movement, either labially or lingually, he accomplished by 
devising a method of applying force well up opposite the roots of the 
teeth which served the same purpose as though the roots themselves were 
operated upon directly by the mechanism. This was accomplished by 
soldering short stiff bars to the bands upon the teeth to be moved and 
having these bars extend upwards outside of the gum to a point midway 
of the roots. Force exerted in a lingual direction by means of an arch 
wire passing over these bars near their free ends and operating through 
a tube attached to the molar anchor bands would compel lingual move- 
ment of roots, whereas force applied in the opposite direction, by having 
the arch wire press against the under sides of the rigid bars, would force 
the roots in a labial direction. In either case the moving roots would 
carry with them the surrounding alveolar tissue producing the anatomic 
changes desired. 
The paper was accompanied by models showing how such movements 
had been accomplished in actual cases in practice. A paper of similar 
purport had been read by him before the Chicago Dental Society, in 
769 770 
ORTHODONTICS HISTORICAL REVIEW 
February of the same year, describing a case operated along these lines 
during the previous year. 
Beside the root movements in this first case the entire mandible needed 
retracting and this was accomplished, or at least aided, by the use of 
intermaxillary elastics operating between buttons attached to the upper 
and lower appliances. 
It will be noticed that although both Dr. Baker and Dr. Case employed 
intermaxillary elastics at nearly the same time, there was this slight 
difference in the two procedures; Dr. Baker employed the elastics for the 
Fig. 495.-Dr. Calvin Suveril Case (1847-1923). 
sole purpose of protruding the mandible and effecting a normal occlusion, 
while Dr. Case employed them to retract the mandible and as an auxiliary 
to an operation for the labial movement of the upper incisors, teeth and 
roots. 
Although Dr. Case started to write for dental journals in 1881, his first 
paper pertaining to orthodontia was read before the Michigan State 
Dental Society in 1888, {Ohio Dental Journal in 1888) and was on the 
question of "The First Permanent Molar." In 1890 in the Dental Cosmos, 
page 908, we find a paper entitled "The Angle System in Orthodontia." 
In this he describes the important features of this system, as well as a CALVIN S. CASE 
771 
"Jacket and Traction Screw." "Orthodontia-A Practical Case," Dental 
Review, page 531, 1892, lie states: 
"The only apparatus that was used to overcome the prognathous posi- 
tion of the teeth and jaw was a simple band extending from the molars 
around the front teeth; the ends of the band were soldered to German 
silver wire bars (No. 19 E. s. g.), which were threaded and passed through 
long tubes, or pipes, attached to the buccal surfaces of the banded first 
molars. The first bicuspids were banded and carried short pipes in 
which the bars loosely rested, to aid in giving greater stability to the 
anchorage by preventing the molars from tipping forward. 
"The centrals were also banded and possessed lugs for holding the 
traction band in position. 
Fig. 496.-Appliance as used by Case (1888). 
"Fig. 496 represents a model made from an impression taken during 
an intermediate stage of the operation with the traction apparatus in 
position. The interproximal spaces are closed and also the space nearly 
closed where a bicuspid had been removed. The left second bicuspid 
was also removed about this time. The plate that was worn is laid upon 
the model. 
"The nuts were never turned so as to give a painfid tension to the 
traction band, and the apparatus was worn from the beginning to the 
end of the operation with comparative comfort and so little mental and 
physical derangement that school duties were never interrupted ou this 
account. 
"This I consider one of the most important factors in correcting every 
case of mabposed teeth, compared to which time is a matter of every ORTHODONTICS-HISTORICAL REVIEW 
772 
consequence. If there is anything distasteful to me it is to hear the 
much vaunted expressions relative to ease and shortness of time in which 
certain skillful operations were or can be performed; and especially a 
case in orthodontia, the treatment of which should always be kept sub- 
servient to the physiologic demands of nature, regardless of time." 
Before reading his paper at the Columbia Dental Congress on "Root 
Movement" Case published an article on "The Application and Influence 
of Force in Orthodontia," Dental Review, August, 1892. It is in this 
treatise that Case first mentioned Root Movement. He says: 
"To those, therefore, who hope to be eminently successful in this de- 
partment I wish to emphasize the importance of thorough training in the 
foundation principles. Know well the possibilities presented by nature; 
the principle of force and its proper application and management; then 
if you will adopt some system in the main whereby the appliances may be 
constructed under your immediate supervision-permitting a freedom of 
ingenuity not possible in an attempt to use some particular set already 
in the market-a far more perfect treatment of malposed teeth will be 
given, suited to the needs of particular cases in hand. 
"In the short time allotted to a paper I shall attempt to give only a 
few thoughts relative to the principles of force in the correction of ir- 
regularities of the teeth, dwelling more particularly upon the influence 
which different ways of attaching the appliance have in the production 
of certain movements-on the one hand to obtain all the advantage which 
the force employed affords in producing the greatest amount of move- 
ment, and on the other, of so distributing or managing the anchorage 
force that little or no movement of other teeth is produced. 
"In correcting the positions of malposed teeth, it should never be 
forgotten that the important and indispensable part of the operation is 
to so regulate the force that the normal functions and healthful con- 
ditions of the teeth and surrounding tissues are preserved, and that 
nature will permit their movement, physiologically, only so rapid as she 
is able to take care of the broken down tissue of retrogressive meta- 
morphosis, caused by pressure of the tooth upon the walls of the alveolar 
socket. The rapidity of the movement will be influenced largely by the 
age of the patient, and differ as other things differ with people. 
"The point which interests us under the caption of this paper relative 
to the application of force may be stated as follows: as soon as the ap- 
plied force overreaches the possibilities of natural (and I may say physio- 
logic) change-the surplus is liable to spend itself in producing some 
undesired and unlooked for condition. In other words, Nature can only 
work so rapidly, and any attempt to force her beyond her natural powers 
will result-if not in disaster-certainly in a misdirection, and transferal 
of the force to other parts which should not, and would not, otherwise CALVIN S. CASE 
773 
be disturbed. For instance, it is not always possible to move the apices 
of the roots of teeth in the same direction that we are able to move the 
crowns and it is usually quite important to avoid moving them in an 
opposite one. 
"On account of the relatively hard surface layer of alveolar process, 
there is always a tendency for it to act as a fulcrum over which the 
tooth is tipped; but fortunately the apical region of bone in which the 
roots are embedded usually presents sufficient resistance for it to remain 
as the true and immovable fulcrum of the lever so long as force is not 
increased beyond the powers of absorption in other portions of the socket. 
The moment this does occur, however, the peripheral surface of the 
alveolus becomes the fulcrum while the load is delivered to the end of 
the root in the opposite direction, and in exact proportion to the sur- 
plus force. If we admit that the apical portion of the socket-blending 
as it often does with the cortical layers of true bone-presents greater 
resistance to changing the positions of that portion of the root, there 
can be but one conclusion; viz.: So long as the pressure is kept within 
physiologic bounds, it makes little difference in regard to the length of 
the arm of the lever, or, in other words, whether the force is applied near 
the occluding surface of the teeth or at the cervix, provided always that 
it is not restricted in its action by the method of attaching the ap- 
pliances." 
"Some Principles Governing the Development of Facial Contours in 
the Practice of Orthodontia," Columbia Dental Congress, 1893, vol. ii, page 
727. This was the first published presentation of bodily movement of 
the teeth, as well as the use of the intermaxillary force. 
"The practice of correcting irregularities of the teeth has advanced so 
rapidly under the influence of modern methods of constructing regulating 
appliances, that it bears today little relation to dentistry proper, and in 
its most advanced practice may justly claim a distinct field in art and 
mechanics. Nor is the prophecy a wild one, that the science of ortho- 
dontia is destined to cover a still wider and more peculiarly distinct field 
-that we are at the beginning of a renaissance in this department which 
will not rest or be satisfied with the mere correction of malposed teeth, 
but will include as an indispensable part of its repertoire the correction 
of all facial deformities which have resulted from irregularities of the 
teeth and jaws, and, in fact, the development of every esthetic contour 
of the face that can be accomplished by a scientific application of force 
to the underlying bony structure through the medium of the teeth. 
"In the ordinary dental practice of correcting irregularities of the 
teeth, not enough attention has been given to facial effects; the principle 
aim having been to bring the teeth to a more perfect position and oc- 
clusion. While this has usually resulted in an improvement in the ap- 774 
ORTHODONTICS HISTORICAL REVIEW 
pearance of the face even when the features were in repose, the develop- 
ment of facial contours from an esthetic standpoint seems rather to have 
been a result than one of the principal aims of the operator. I refer 
particularly to those cases that have been discharged as satisfactorily 
finished when the crowns of the teeth have been brought to a more per- 
fect alignment, with little or no regard to the movement of the roots and 
the bony structure in which they were embedded. In many instances, 
too, had this latter movement been accomplished, as would not have been 
difficult with our present possibilities, there would have been a vast 
improvement in the general form and contour of the face; and this 
higher esthetic attainment would have been considered the most impor- 
tant part of the whole operation, producing a satisfaction and pleasure 
unequaled by few things in orthopedic surgery. 
Farrar, in the two volumes which were published of his valuable 
work on Irregularities of the Teeth and Their Correction, gives very little 
space to this branch of his subject; and then in reference only to the 
movement of the entire tooth in a lateral direction. On page 647 he says: 
"The lateral movement of the entire tooth has always been regarded 
as difficult; and (in referring to successes claimed by the author) Dr. 
Guilford has even gone so far as to state in some remarks he made at 
a meeting in 1888, that he had always been 'inclined to doubt' the ac- 
complishment of the operation. Not only have I performed the opera- 
tion several times, but I have advised its performance by others who have 
found it to be fully successful." 
"It can be seen by these remarks that the movement of the roots of 
teeth is a rare and somewhat modern accomplishment, and doubtless an 
operation which never would have been possible under the old regime 
of regulating plates and their numerous force contrivances. 
"He further very perfectly states the following axiom, the only method 
by which a movement of the roots in the direction of the force is pos- 
sible : 'The secret of effecting a lateral movement of the roots of the 
teeth lies in relatively fixing the antagonizing ends of the crowns while 
the force is being applied at their necks.' In another place he restates 
the same proposition thus: 'For the lateral movement of roots the 
power should be applied between the fulcrum and the point of resistance, 
or weight.' Then he follows this by a beautiful illustration of this 
principle of force with a number of ingenious contrivances by which a 
lateral movement of the roots of the teeth has been effected. 
"The purpose of this paper is to show how, with our present possi- 
bilities in the construction of regulating appliances, this principle of force 
may be also applied to the movement of the roots of the teeth in any 
direction, and to illustrate also the importance of this possibility when 
it is observed in the operation where the teeth are moved in phalanx, CALVIN S. CASE 
775 
that the bones of youth do not remain stationary to be plowed through 
by the roots in a process of retrogression migtamorphosis, but that a con- 
siderable portion of the bone in which the teeth are embedded is carried 
with the roots in proportion as they are changed in position, thus en- 
abling one to regulate many imperfections of the face by changing the 
shape and surface contour of the frame which supports and gives char- 
acter to the features over all that portion which can be affected by a 
movement of the bones contiguous to the roots of the teeth. 
"I shall be able to show by models to your perfect satisfaction, 1 think, 
that this movement of the roots and adjoining bony structure may be 
made to influence a far greater area in shaping the features of the face 
than would at first seem possible; and especially is this time over that 
part of the face contiguous to the roots of the anterior superior teeth, 
even to the changing of the shape of the nose. 
"I am now able to correct, with perfect certainty of success, any 
marked depression or protrusion of the upper lip which is mainly due to 
a malposition of the roots of the incisor teeth. Instances are often ob- 
served among the youth who demand our professional services, which 
show a comparatively perfect alignment and occlusion of the teeth, and 
yet because of the position of the roots with a consequent abnormal de- 
pression or protrusion of the adjoining bone, considerable imperfection 
of features and external contour of the face is produced. These de- 
formities are peculiar and not common, but have rarely engaged attention 
with a view of orthopedic treatment directed to the development of a 
more esthetic facial form. In the instance of a marked depression of the 
upper lip, as in Classes 1 and 2, they are often mistaken for a prog- 
nathous lower jaw, because of the lack of proper fullness in the central 
features of the face, which frequently affects the shape of the nose and 
deepens the lines on either side. For the same reason the cheek bones 
will appear at times abnormally prominent, giving to the face a broad 
and flattened appearance, especially if the cuspids being retarded in their 
eruption for the want of room take a more lateral and prominent posi- 
tion. If the lower teeth are in proper relative position and the deformity 
caused, as is most common, by the lower incisors occluding in front of 
the upper, every change desirable may be effected by an appliance at- 
tached to the superior teeth alone. 
"On the other hand, if the entire superior dental arch is narrow and 
contracted with a high palatal dome, the teeth long, uncrowded and not 
materially affected in position by occlusion, the face will usually be long 
and narrow, the nose prominent, thin and of Roman type. In these 
cases the entire dental arch and alveolus should be expanded, and the 
force so applied and controlled as to retain the teeth in an upright posi- 
tion, especially in the process of carrying the anterior teeth forward, 776 
ORT II ODONTICS 11 IST( )R IC AL REV IEW 
which is of vital importance in the restoration of the features of the face. 
The principal force, therefore, should be exerted upon the anterior 
superior teeth; and this force may be reciprocated by rubber bands ex- 
tending from the posterior part of the upper appliance to the anterior 
part of an appliance that is attached firmly to all the lower teeth. These 
bands can be made to exert almost any desired force, according to the 
heft of the tubing from which they are cut; and their positions being 
such as to not interfere with mastication, they can be worn continuously. 
"If the inferior dental arch is large, with the teeth occluding outside 
of the alignment of the superiors, it may be reduced in size by the ex- 
traction of a bicuspid on either side and the anterior teeth forced back 
to fill the space. If, however, the chin is abnormally prominent below 
the incisive fossae, teeth should not be extracted from the lower jaw, the 
principal change to correct the facial deformity should be accomplished 
on the upper jaw, as in Case 5. 
"I have abandoned all attempts to reduce a prognathous lower jaw by 
external pressure upon the chin, never having derived the same satis- 
faction from this operation that others claim. I find, however, that the 
rubber bands, before mentioned, extending from the upper and lower 
appliances can be made to exert all the force the patient can stand at 
the glenoid fossae, and doubtless this influence tends to force the lower 
jaw to a more posterior position. 
"On the other hand, with equal facility, I am able now to reduce a 
protrusion of the upper lip at that point where it merges into the nasal 
septum and orifices, when due to a malposition of the roots of incisor 
teeth alone, causing an abnormal prominence of the anterior nasal spine 
and incisive fossae. This position of the roots of the superior incisors 
is not uncommon, even when the antagonizing ends are in perfect posi- 
tion; and often with the production of quite a marked facial deformity. 
As an illustration of this, I call your attention to the models of Case 6. 
"In like manner, I am able to force the anterior inferior teeth bodily 
forward, with the entire alveolar ridge in which they are embedded. In- 
stances are not rare where the point of the chin, the upper lip, and the 
anterior superior teeth arc relatively in proper position, but with in- 
ferior teeth, from various causes, so posteriorly placed as to produce an 
abnormally deep depression or curve, in that portion of the lower lip 
along the line of the incisive fossae. By forcing the anterior superior 
teeth forward, with the alveolus in which they are embedded, a more 
esthetic shape will be given to the chin; and this change, though slight 
according to measurement, will often produce an improvement in the 
general appearance of the face that is quite remarkable. The same is 
true, also, in a posterior movement of the inferior incisor teeth and ('ALVIN S. CASE 
777 
alveolus, when they are so anteriorly placed in relation to the point of 
the chin as to obliterate the graceful curve of the lower lip. 
"I believe that all who have made a study of this particular line of 
work will agree with me that a large proportion of all facial imperfec- 
tions-whicn in many instances amount to actual deformities-are due 
to an inartistic relation of those features of the face whose form and 
contour are governed by the position of the teeth and the peripheral 
surface of the bone in which the roots are embedded. If, therefore, it 
is a fact that by force appliances attached to the crowns of the teeth of 
young persons the roots of the alveolus can be forced outward and in- 
ward to any desired extent, a new field will be opened to the prac- 
titioner in orthodontia, a principal feature of which will be the correc- 
tion of many deformities of the face that have heretofore been considered 
beyond the reach of orthopedic surgery. 
"In a large proportion of these deformities which seem to be due to 
protrusion or recession of the chin, it will be found upon a careful study 
of the face that the chin is not far from its proper position to the fore- 
head, the upper portion of the nose, and malar prominences, and that the 
deformity in the main is due to the relatively imperfect position of the 
middle features of the face, governed by the anterior superior teeth and 
the adjoining bone in which they are embedded. 
"If now, by ordinary methods, the crowns of these teeth are forced 
backward or forward to a more perfect alignment with the lowers, the 
facial defect is only partially remedied and the real deformity far from 
being removed, if not increased, as it may be, by the tendency of the 
roots to tip in an opposite direction. But if, on the other hand, the teeth 
are firmly and substantially grasped by appliances which are so con- 
structed. that the force can be applied directly to the roots while the 
antagonizing ends of the crowns are fixed or controlled in their move- 
ment-as Dr. Farrar has outlined for the lateral movement of the entire 
tooth-it will be found upon trial that the roots as well as the immedi- 
ately surrounding bone will be removed, and can be made to take a 
position which will give a far more pleasing appearance to the face. 
"The peculiar apparatus which I use for applying force to the roots 
of the anterior teeth in facial contouring was first put into practical use 
December 2'4, 1892, and described in connection with a paper I read 
before the Chicago Dental Society the following February, which was 
published in the March, 1893, number of the Denial Review. 
"Before describing the peculiar construction of the contouring appa- 
ratus I use in these cases, I wish to say - that I endeavor to have all 
regulating appliances made as substantially and finished as perfectly as 
a piece of jewelry. The bands are fitted to the natural teeth with as 
much perfection-especially where they extend under the free margins 778 
ORTHODONTICS HISTORICAL REVIEW 
of the gum-as a band for a crown. I use German silver principally, 
and heavily gold plate the apparatus before attachment. 
"Too much praise cannot be given Dr. Angle for introducing to our 
notice the value of German silver for this purpose, and also for many 
original ideas in the construction of regulating appliances. 
"In constructing an apparatus for forcing the roots and adjoining 
bone of the anterior teeth forward, wide German silver banding material 
for the teeth should be selected, that is, five or six thousandths of an 
inch in thickness. This should be fitted to the crowns of the anterior 
teeth near the margins of the gum, perhaps extending beneath the mar- 
gins on the proximal sides. Then bars of No. 18, E. S. G. wire, slightly 
flattened, should be soldered to each of the bands in an upright position, 
Fig. 497.-Case's original appliance for "root movement" (1892) 
and bent so as to lie along the anterior surface of the crowns from the 
apex to where the bars join the band; here they should take a direction 
somewhat parallel to the gum; but free from the surface to about one- 
sixteenth of an inch above its margin, at which point they should be 
flattened or thinned so as to be more easily bent forward, and firmly 
clasped around a rigid bar which is made to extend from anchorage tubes 
attached to the posterior teeth. (See Fig. 497.) 
"This bar, which should be very rigid, is drawn without annealing 
from a No. 12 extra hard German silver wire to No. 18 (E. S. G.). The 
ends are threaded in the No. 4 hole of the Martin screw plate, and the 
central portion is slightly flattened in the rollers. Then it should be bent 
so as to rest when in proper position in the unclasped ends of the upright 
bars that have been left open to receive it. Before placing it in position, 
the nuts should be screwed on to work at the anterior ends of the tubes. 
"This apparatus can be made to exert an exceedingly powerful force, CALVIN S. CASE 
779 
but if put into practical use as it now stands, the ends of the roots and 
the adjoining bony structure would not be forced forward, notwith- 
standing the fact that the power is applied directly to the roots some- 
what above the crevices. The crowns and the body of the roots, with a 
portion of the alveolus only, would be moved forward. 
"To complete the apparatus, therefore, the fulcrum should be removed 
from the anterior alveolar plate and placed so that the power can be 
applied between it and the ends of the roots to be moved. In other 
words, the crowns should be restricted or controlled in movement so 
that the applied force may be directed to the roots alone. 
"I accomplished this by a second bar much smaller and thinner than 
the first, but proportionately rigid, which rests in depressions in the up- 
right pieces along the occluding ends of the teeth. The ends of the 
Fig'. 498.-Modern contouring appliance adopted later by Case 
fulcrum bar are threaded and passed through tubes that are soldered 
to the anchorage bands on each side below the power bar tubes, with 
nuts which work posteriorly to the tubes. 
"An apparatus for reducing a prominence of the features by exerting 
a posterior force upon the roots of the alveolus of the anterior teeth, is 
constructed in a similar manner to the one just described, with the fol- 
lowing exceptions: (1) The bands should be fitted to the crowns of the 
incisors near their occluding ends, for the purpose of obtaining a more 
rigid bearing in the changed application of force. (2) The lower ends 
also of the upright pieces should be made to clasp the fulcrum bar. (3) 
The nuts should be reversed in their relative positions to the tubes (which 
goes without saying). (4) The most difficult and equally important part 
of our task will now consist in moving the roots of the cuspids, if they 
are prominent, but their position is such if much force is applied with 
the present arrangement of the apparatus, the bars will slip through the 780 
ORTHODONTICS HISTORICAL REVIEW 
clasps at the ends of the upright pieces. Therefore some provision should 
be made to prevent this, which may be accomplished by short sections of 
pipe clasped around and soft soldered to the bars. 
"In considering the mechanical qualities of the contouring apparatus 
I have outlined, I wish to direct attention to the fact that the force ex- 
pended at the anchorage attachments is largely neutralized by the recip- 
rocating influence of the two forces, and this reciprocation is always 
equal to the power used on the fulcrum bar in preventing a movement 
on the occluding ends of the crowns. The balance of the power, which 
may be considerable in the general movement of the parts, must be 
sustained by the anchorage teeth, if not further neutralized by other 
auxiliaries. 
"When the central features of the face are depressed with anterior 
superior teeth occluding posteriorly to the lowers, accompanied with the 
usual real or apparent prognathous lower jaw, great reciprocating force 
may be beneficially obtained from the rubber bands before mentioned. 
Rubber rings are cut from a three-eighths inch rubber regulating tube 
of good heft, and passed over the projecting ends of the anchorage 
tubes or buttons, on the upper appliance to buttons on a lower appliance 
opposite the first bicuspids. (See A. A., Fig. 497.) The latter appliance 
may be so constructed that the force will be distributed to all the in- 
ferior teeth, and indirectly to the jaw, forcing it to a more posterior 
position. Or it may be that the first bicuspids have been extracted, for 
the purpose of forcing the six anterior teeth back. Tn either case the 
elastic force of the rubber bands can be made to do effective work to 
the full extent of the power on both the upper and lower jaw, neutral- 
izing force which otherwise would be expended upon a static anchorage. 
"They are useful also as an auxiliary in the reduction of a prognathous 
upper jaw by reversing their attachments. In these cases I also make 
use of the occipital force, largely for the advantage I obtain in forcing 
the anterior teeth further into their sockets. Cases of prognathous upper 
jaw with protruding teeth are rare in which there is not an abnormal 
prominence at the base of the nose. When force is applied to the crowns 
alone of the anterior teeth, this prominence may become more pro- 
nounced, even though the position and appearance of the teeth and the 
face are improved by the operation. 
"In these cases, therefore, I consider it quite as important to move 
the roots as well as the crowns of the anterior teeth, when by so doing 
I find I am able to remove the entire deformity and greatly improve the 
general form of the face. 
"I wish to say right here that time is a matter of little importance to 
me compared to the possibility of accomplishing the desired result with- 
out harm to the teeth or special local or systemic disturbance." CALVIN S. CASE 
781 
"Abnormal Lateral Bite," Dental Review, 1895, page 538, Case states: 
"One of the most difficult, and for a time, discouraging cases of irregu- 
larity of the teeth I have ever treated was that of a girl about fifteen 
years old, whose masticating occlusion carried the chin so far to one side 
of the median line when the jaws were closed that it produced a marked 
facial deformity which was far more noticeable because of the natural 
perfection and delicate chiseling of her features. 
"In this and other cases of a similar character 1 have since treated, 
the extent of the abnormal closure was not caused wholly by jumping 
the cusps laterally, but was partly due to the general tipping of the 
teeth to more nearly approach perfect occlusion. That is, the upper teeth 
were all tipped in the direction that the lower jaw was carried, while the 
lower were tipped in the opposite direction to more or less fairly meet 
their occlusal surfaces. Nor was this peculiar attitude confined to the 
posterior teeth; the anterior teeth also partook of the same general 
posture. 
"Now it will be seen at once that to correct such a deformity all the 
teeth must be tipped back to their sockets to assume their natural up- 
right positions, and their occlusion so adjusted that the abnormal pos- 
ture of the lower jaw will not be necessary for mastication. 
"The advantage of this principle has been practically demonstrated 
by the inclined plane since the dawn of regulating teeth, but beyond this 
infernal machine its various possibilities seem to have been lost sight of. 
"The extending of rubber bands from the extreme buccal endings of 
an appliance attached to all the upper or the lower teeth to points upon 
the occluding set opposite the first bicuspids has become a common one 
in my practice in nearly all cases where there is an abnormal anteropos- 
terior relation of the upper and lower anterior teeth. 
"In Fig. 499, a is a traction screw bar which is attached to the right 
cuspid at one ■end and at the other to the left bicuspids. Upon this bar 
is a sliding tube b. Against a spur soldered to one end of this tube rests 
a jackscrew c which exerts its power against the left cuspid. At the 
other end of the tube b rests another jackscrew d which exerts its power 
against the right bicuspids. 
"A moment's thought will convince one that with this apparatus the 
bicuspids must be moved to the right, while the cuspids are moved to 
the left. Its important possibility, moreover, as an object lesson, lies 
in the fact that the operator has complete control and direction of his 
power. For instance, if it should be found, as probably will occur, that 
the right cuspid takes its proper place before the left, it may be held 
back by the tube b being forced against it by the jackscrew c; the trac- 
tion bar now extending all its power against the left cuspid. This force 
against the left cuspid can be augmented at any time by the jackscrew 782 
ORTHODONTICS HISTORICAL REVIEW 
d exerting its power against the right bicuspids. Or the right bicuspids 
can be made to receive all the force exerted upon the left cuspid." 
"The Esthetic Correction of Facial Contours in the Practice of Dental 
Orthopedia," Dental Cosmos, 1895, page 905. 
"In answer to numerous inquiries, I have decided, in this connection, 
to describe and fully illustrate some of the important features of the 
latest methods I have adopted in the construction and application of the 
contouring apparatus. 
"I do this with the hope that some of the difficulties I encountered in 
my first cases may be avoided by you, and which were partly due to the 
comparative crude construction and application of the apparatus I used 
then and published in my early writings upon this subject. 
Fig. 499.-Case (1895). 
"The limited area upon which force can be applied to a tooth, com- 
pared to that portion covered by the gum and embedded in a bony socket, 
has made it next to impossible, with all ordinary methods, to move the 
apex of the roots in the direction of the applied force; nor could this 
ever be accomplished with force exerted in the usual way at one point 
upon the crown, however near the margin of the gum it be applied, for 
the opposing margin of the alveolar socket must receive the magnitude 
of this direct force, and in proportion to its resistance it will become a 
fulcrum, exerting a tendency to move the apex of the root in the op- 
posite direction. 
"But if in the construction of the apparatus a static fulcrum is created, 
independent of the alveolus, at a point near the occluding portion of the CALVIN S. CASE 
783 
crown, while the power is applied at a point as far upon the root as the 
mechanical and other opportunities of the case will permit, the appa- 
ratus becomes a lever of the third kind, the power being directed to a 
movement of the entire root in the direction of the applied force. 
"This proposition is made plain by reference to the diagrams. In Fig. 
501 let A be a point upon a central incisor, at which force is applied 
in the direction indicated by the arrow, then will the opposite wall, B, 
of the alveolar socket, near its margin, receive nearly all of the directed 
force, and in proportion to its resistance will there be a tendency to move 
Fig. 500.-A, represents original position of central ; B, the present. 
Fig. 501. 
Fig. 502. 
the root on the opposite direction. This proposition will also hold good 
even if we apply the force at A, Fig. 502, or so far upon the root as may 
be permitted, by attaching a rigid upright bar, C, to the anterior sur- 
face of the crown; the only difference being that we distribute the direct 
force over a greater area. But if, as in Fig. 503, we attach to the lower 
end of C a traction-wire or bar, F, and further enforce the mechanical 
principles of our machine by uniting its posterior attachment to the 
anchorage of the power bar P, we will have neutralized our anchorage 
force materially and created an independent static fulcrum at D. Our 
apparatus now will distribute its force over the entire root, and give us 
complete direction and control of whatever power we put to it. 784 
ORTHODONTICS HISTORICAL REVIEW 
"The entire tooth can be carried forward bodily, or either end can be 
made to move the more rapidly. The force thus directed to the ends 
of the roots will have an increased tendency to move the more or less 
yielding cartilaginous bone in which they are embedded. 
"The construction of the anchorage attachment which now remains 
to be described is of the greatest importance to the ease and accuracy 
of its application and its subsequent usefulness. 
"Two molars, or the first molar and a bicuspid, and sometimes all 
three, should be selected for the anchorage teeth. When these are ac- 
curately fitted with wide bands, an impression in compound, of one side 
at a time, including the cuspids, should be taken. The bands should 
then be removed from the teeth without bending, and carefully placed 
in their proper position in the impression, which should be filled with 
Teague's or other investing compounds. You now have the bands upon 
a small model that will hold them firmly in their proper relative positions 
during all the soldering process. 
"As the position and mechanical perfection of the power tube (Pt, 
Fig. 503) is of paramount importance, it should receive first attention. 
"Select a strong tube one-half to three-fourths of an inch in length, 
that loosely fits the threaded end of the bar. Its anterior end should be 
placed so that the nut will work freely upon the bar without impinge- 
ment upon the band, tooth or gum, and it should take a direction that 
points exactly to that place upon the cuspid over which the power bar 
is to extend. In order to strictly observe this important direction, it 
usually becomes necessary to raise one or the other end of the tube from 
the bands by the intervention of lifts. It is often convenient to rest its 
posterior end upon the lever tube, its sharp projecting edges being 
rounded so as not to irritate the cheek. 
"The lever tube (Ft, Fig. 503) should also loosely fit its bar or wire, 
and be soldered directly to the bands, which it firmly unites, and thus 
serves to give statical strength to the anchorage. Their direction is not 
as material as that of the power tubes, because of the smallness and 
flexibility of the lever wire. Their posterior ends should project suffi- 
ciently free from the other parts to admit of the working of the nut. 
And in those instances where reciprocating rubber bands are to extend 
to a lower appliance-the advantage of which has been explained else- 
where-I allow these tubes to project for that purpose, finding them 
much more convenient than the buttons which I formerly used. 
"The tubes now being fitted with their joints turned toward the bands, 
they are attached with an abundance of silver solder, the bands also 
being united along their approximal surfaces. 
"With the anchorage appliance and power band in place, the bands 
for the anterior teeth may now be fitted and cemented, allowing the CALVIN S. CASE 
785 
upper ends of the upright bars to rest in front of the power bar. Finally, 
the lever bar is laced and the contouring apparatus is ready to com- 
mence the application of force at the next sitting. 
"An apparatus for moving the anterior teeth in the posterior direc- 
tion is in the main constructed cpiite similarly. (See Fig. 504.) The 
power bar is now being used for traction force, the same rigidity is not 
as necessary as in the other apparatus. I find, therefore, that a No. 16 
wire, not flattened in front, is of sufficient size. 
"The other, or lever bar, the force of which acts in the opposite direc- 
tion to prevent the occluding ends of the teeth from being drawn back, 
should be as large as No. 18. It should be flattened in the same manner 
described for the power bar. The upper ends of the upright bars are 
Fig. 503. 
Fig'. 504. 
grooved on their anterior surfaces to form a rest for the power bar; 
while a shoulder is filed on the posterior surface of the lower ends, which 
forms a slot, when in place, for the flattened lever bar to rest. 
"It being understood with this apparatus that the power bar nuts 
work at the posterior ends of the tubes, while those of the lever bar work 
at the anterior ends, proper provisions for this arrangement should be 
made when constructing the anchorage appliances." 
''Principles of Force and Anchorage in the Movement of Teeth," in the 
Transactions of the American Dental Association, 1897, page 89, Case 
states the following: 
"While the teeth differ in shape from each other and from the post- 
lever I have described, and while their alveolar surroundings do not 
present a uniformity of resistance to their movement and therefore while 786 
ORT 11ODONTICS 11TSTORI ('AL REVIEW 
we cannot calculate force and motion with mathematical accuracy, still 
the fact that they are embedded one-half their length in a yielding sub- 
stance and subject to the frequent application of force for the correction 
of irregularities, the only way by which we can approach an exact science 
in the application of power for their movement is to consider them as 
levers propelled by a machine doing work on the tissues in which they 
are embedded. 
"When power is applied at one point to the crown of a tooth at right 
angles to its long axis, it becomes a lever with combined qualities of the 
first and second kinds; it is one more than the other in proportion to the 
relative difference in the resistance between cervical and apical portions. 
And while the relative proportion of movement at these points will be 
governed largely by the stability of their bony surroundings, it may be 
influenced considerably, as with the post-lever, by the position upon the 
crown at which power is applied. For instance, in the construction of 
an appliance for the retrusion or retraction of the incisors with a trac- 
tion wire extending from molar anchorages, if wo wish the least move- 
ment possible of the roots in the opposite direction, the wire should rest 
upon the incisors as near to the gingival margins as the gums will per- 
mit. I usually solder to the bands upright bars which extend to the 
highest points of the exposed faces of the crowns. Grooves or rests are 
cut at the upper ends of these for the wire, enabling it to span the inter- 
proximate gingivae. (See Figs. 505 and 506.) I frequently extend these 
bars above the gum margins, as shown in Fig. 507, in order to apply 
power that is equivalent to direct force upon the roots at points above 
the margins of the alveoli, and I wish to say that I find these procedures 
of the greatest importance in arriving at results for which they are 
designed." 
Dr. Case, then reviews the paper above reported as a further descrip- 
tion of his method. 
"When great immobility of a single anchorage tooth is required, use 
for banding material German silver or platinized gold, No. 30 gauge, and 
as wide as the tooth will permit. When these are encountered and fitted, 
solder the power tube at the gingival margin. (See Fig. 508.) This 
should be sufficiently long to permit reinforcing it at either end with 
solder to the full width of the teeth, and large enough to carry a power 
rod that will be inflexible. Where it is possible, the power tube may rest 
above the gingival margin, soldered to an extension plate that is fitted 
or swaged to the surface of the crown and so shaped as to freely clear 
the gum. 
"If the power tube is extended forward to the first bicuspid and its 
anterior end allowed to rest upon a narrow projection soldered to the 
bicuspid band, it will add greatly to the stability of the anchorage. CALVIN S. CASE 
787 
"It will be seen that any tendency of the molar to tip forward will 
carry the anterior end of the tube almost directly toward the root of 
the bicuspid, the movement being prevented by the rest. (See Fig. 509.) 
Nor will such a device offer any special obstruction to the movement of 
the bicuspid, the rest sliding along the tube. 
"It is often more convenient to sustain the anchorage with a flattened 
bar soldered to the lingual aspect of the molar band which extends to 
and engages with rests upon the bicuspids. This is especially applicable 
where it is desired to reduce an anterior protrusion with a small flexible 
traction wire encircling the teeth. Frequently the lower cuspids are 
anteriorly prominent, the incisors are crowded, irregular, and somewhat 
Fig. 505. 
Fig. 50 6. 
Fig. 507. 
Fig. 508. 
Fig. 509. 
extruded, but not protruded,-in fact, they are frequently retruded, pre- 
senting one of those cases where the extraction of a bicuspid is indicated, 
were it not for the fact that the first molar on one or both sides is miss- 
ing. Here the anchorage for forcing back the cuspids with a buccal 
bar may be sustained with a tube, instead of a flattened bar, which ex- 
tends along the lingual aspect of the bicuspids, but not supported upon 
rests. An inflexible rod is fitted into these tubes (one on each side), and 
engages with hooks soldered to the incisor bands. (See Fig. 510.) If 
the incisors are retruded, the ends of the bar may be threaded for nuts 
at the anterior ends of the tubes to force the incisors forward, the two 
forces being reciprocatory. It will be seen that any forward tipping of 
the molars will be prevented by the incisors sustaining the anchorage 
support, the force tending to intrude the incisors." 788 
ORTHODONTICS HISTORICAL REVIEW 
"New Methods and Appliances in Orthodontia," Dental Review, 1898, 
page 573, Case states: 
"The demands of a practice that is limited to dental orthopedy and 
the construction of artificial vela has led to the invention and practical 
application of so many ways and methods that are distinctively individ- 
ual, that I am able to say today that everything in my practice covering 
every variety of movement of malposed teeth from the very beginning, 
where the material and implements to the final retaining appliances, is 
characterized by personal ways and means. 
"I do not wish to be understood as implying by this that I have not 
been dependent upon the thought and skill of other men to whom I shall 
always feel grateful-for that foundation which has enabled me to build 
this system of practice. To Dr. Edward H. Angle I am principally in- 
debted. In fact, it was by following his method, at first, of constructing 
regulating implements and finally seeing the almost unlimited oppor- 
Fig-. 510. 
trinities presented by building a regulating apparatus upon bands ce- 
mented to the teeth, that led me to specialize my practice to this branch 
of dentistry. 
"To Dr. Norman W. Kingsley I am indebted for the foundation to my 
system of constructing artificial vela. 
"While this expander will probably always hold an important place 
in my practice, I have been using of late another form which is quite 
as effective in most cases and much easier to construct. (See Fig. 511.) 
"A German silver wire should be selected for the lingual bow of suffi- 
cient size (B. and S.g. No. 14) to perform its work at the distal ends 
without bending. That portion which rests back of the incisors is filed 
flat to about one-third or one-fourth of its diameter in thickness. 
"In the process of soldering the rests for the jackscrew as shown in 
Fig. 511, the temper is removed from the flattened portion so that it 
can be easily bent. It will be seen that the expansion of the anterior 
portions of the arch will be in proportion to the amount of curvature CALVIN S. CASE 
789 
given to the flattened part. For instance, when the flattened part has 
come to a straight line by the outward pressure of the jack, or has been 
made straight in the first place, as shown by A, Fig. 511, no further ex- 
pansion can occur between these points. The entire power will then be 
directed to the expansion of the distal portion of the arms. 
"Class 2. One of tin' most common forms of irregularity is in those 
cases where the proper eruption of the cuspids has been retarded or 
prevented for the want of room. When this is due to the premature ex- 
traction of the deciduous cuspids the space will frequently be entirely 
closed by the adjoining permanent teeth. An apparatus that is ad- 
mirably adapted for the correction of this form of irregularity is shown 
in Fig. 512. 
Fig. 511. 
Fig. 512. 
"The object to be obtained is to force the bicuspids and incisors back 
to their proper relative positions sufficiently to give room for the cuspid 
and at the same time produce a symmetrical arch." 
In the Dental Cosmos, 1904, page 345, is an article "Origin, Use and 
Misuse of the Intermaxillary Force, and Its Relations to Occipital and 
Other Anchorage Forces," giving correspondence, etc.; as well as dates 
as to the priority in the use of intermaxillary elastics, and force. 
In 1908 Case brought out his book entitled Dental Orthopedia, while 
the second edition, A Practical Treatise on the Technic and Principles of 
Dental Orthopedia and Prosthetic Correction of Cleft Palate, appeared in 
1921. 
Dr. Case's contributions to orthodontia are numerous, so that it will 
be impossible to review them all at this time. 
Case's classification is interesting in so far as to the complication of 790 
ORTHODONTICS HISTORICAL REVIEW 
same. He has divided this into two sections, one on page 194, according to 
group, the other on page 260, according to classes. The combined classi- 
fication embraces twenty-six divisions. The idea of the second grouping 
was to illustrate the type of appliance to be used in each class. 
"In the author's opinion it is unscientific to place in one class mal- 
positions which, though similar in occlusion, produce widely different 
facial deformities and consequently demand widely different methods of 
treatment. 
"In this work therefore irregularities are divided into two general 
divisions. In the first division are placed conditions that are not sus- 
ceptible of classification. These are named Simple and Complex Irregu- 
larities. They are divided into six groups. In the second, or classified, 
divison, are placed distinct types whose correction is dependent upon the 
effect they produce or are destined to produce upon the physiognomy. 
These are named Dentofacial Irregularities. They are divided into seven 
classes. ' ' 
TABLE OF GROUPS 
Group 1. Intrusion and Extrusion. 
Group 2. Malalignments. 
Group 3. Malturned Teeth. 
Group 4. Contracted and Expanded Arches. 
Group 5. Abnormal Interproximate Spaces. 
Group 6. Impacted Teeth. 
CLASSES OF DENTOFACIAL IRREGULARITIES 
Class I. Maleruption of Cuspids-Three Types. 
Class II. Protrusion of the Upper Teeth with Lower Normal- 
Five Types. 
Class III. Retrusion of the Lower Teeth with Upper Normal, 
and Upper Protruded-Four Types. 
Class IV. Retrusion of the Upper Teeth with Lower Normal, 
and Lower Protruded-Five Types. 
Class V. Bimaxillary Protrusion. 
Class VI. Bimaxillary Retrusion. 
Class VII. Open Bite Malocclusion. 
Otto Zsigmondy (1860-1917). "The Alteration of the Dental Arch by 
the Second Dentition/' The writer points out that the opinions of in- 
vestigators are different and contradictory. This, he believes, to be in 
part due to the measurements being taken on macerated specimens, also 
to the difference between the child's and the adult's jaw being but small, 
and because the forms of the bones in different individuals are not 
the same, a poorly developed permanent dental arch would give a smaller CALVIN S. CASE 
791 
curve than that of a well-developed arch formed by the milk teeth. He 
points out that Bell proposed, but did not carry out, measuring the same 
jaw at different ages. This Zsigmondy has done. He took plaster casts 
of the upper and lower jaws at different ages and made accurate meas- 
urements in two directions. Firstly, from the most prominent point of 
the distal surface of the second mdk tooth, and its successor the second 
permanent premolar, to the middle line between the central incisors; 
and, secondly, between the first mentioned points of opposite sides. He 
took the average of three cases. For the upper jaw he found the first 
line measured 32.2 mm. in the milk set, and 33.0 mm. in the permanent. 
The second line measured 42.2 mm. for the milk teeth and 45.3 mm. for the 
permanent. For the lower jaw the following measurements: First line, 
milk teeth, 30.3 mm., permanent teeth, 29.8 mm.; second line, milk teeth, 
40.7 mm., permanent teeth, 41.9 mm. So that while the first measure- 
ments showed an increase of only 0.8 mm. for the permanent teeth of 
the upper jaw, and a diminution of 0.5 mm. for the lower; the second 
measurement was 3.1 mm. increase for the upper, and 1.2 mm. for the 
lower jaw. Thus while the permanent upper teeth increased but slightly 
in prominence as compared with the temporary, (the lower actually de- 
creased) the width of the jaws, as shown by the second measurements, 
increased, but more in the upper than in the lower. Zsigmondy also 
gives the results of taking a series of models of upper and lower jaws at 
different periods between the sixth and seventeenth years. He found 
that whereas at the sixth year the temporary central incisors were in 
contact, by the eighth year they wore 1 mm. apart, and four months 
later were lost. The space between the lateral incisors increased by 
5 mm. between the seventh to the ninth years. The lower incisors also 
moved apart, but not at the same extent as the upper. 
H. F. Hamilton, in the June, 1892, International Dental Journal, 
''Throwing the Lower Jaw Forward." 
"The case I present is a common one, but the treatment is, I think, 
new. The lower jaw was receding, and the upper front teeth were so 
prominent as to prevent the easy closing of the lips, giving the face the 
weak expression characteristic of those cases. 
"Pulling in the upper front teeth would only improve the facial ap- 
pearance slightly, so I determined to try throwing the whole lower jaw 
foiward the diameter of a bicuspid. 
"You will understand what was done by noticing the articulation. In 
No. 1 the superior second bicuspid strikes in front of the inferior sec- 
ond bicuspid. In No. 2, you will notice, it strikes behind. The same 
change is, of course, shown with all the other bicuspids and molars." 
"The method used was simply a rubber plate fitting the roof of the 
mouth and over the bicuspids and first molars, where it was made thick, 792 
ORT 11 (>1X )NTU'S 111STORI (' AL REV IEW 
and with depressions to receive the cusps ot the lower teeth. But these 
depressions, instead of being directly over the cusps, were slightly in 
front, so as to throw the lower jaw forward when closed, by the action, 
as it were, of a series of inclined planes. 
"A plate was made also for the lower jaw on the same plan, and 
worn alternately to keep the teeth in place, and to avoid the injury 
likely to come from long and continuous wearing of plates. 
''At the end of four months the second molars, not being covered by 
the plates, had grown together so as to articulate when the plate was 
in place, and the result of this change was that the patient could not 
close the teeth in the original manner. The changed position was the 
only comfortable one. 
"The plates were worn but little after this, nor were stay plates of 
any kind necessary. In the four months' time, three or four plates 
wore made. The upper and lower plates were worn alternately." 
E. Henry Neall (1838-1900), Cosmos, 1892, page 975, "Protrusion of 
the Inferior Maxilla: A Case in Practice": 
"The first and oidy appliance for the lower jaw (Fig. 513) was placed 
in position December 15, 1890, and consisted of a frame of platinized 
gold, having hooks soldered to the inner part and setting well back of 
the teeth, being held in position by vulcanite attachments surrounding 
and covering the molar teeth on each side, which also served to open the 
bite. These were cut away on the occluding surface from time to time, 
as the changes produced in the articulation rendered necessary. Rub- 
ber bands cut from French tubing were then placed around each of the 
protruding teeth and attached to the hooks on the frame. Pressure was 
also brought to bear upon the body of the. maxilla by a cap-bandage, 
worn day and night, and only removed for a short time at intervals. 
The patient was instructed to press the jaw upward and backward with 
the hand. Heroic treatment, ably seconded by the patient, was used 
from the start. 
"On the commencement of the fifth week, January 16, 1891, an appli- 
ance was made for the upper jaw (Fig. 514) consisting of a platinized 
gold frame (with two hooks over the cuspids) extending outside the teeth 
and cemented by oxyphosphate of zinc to the molar teeth. This was 
worn just two weeks, and was used to pull forward the cuspids. With 
this exception, no pressure was used on the upper teeth, as the jaw was 
normal and did not need to be changed. 
"To the question, What was accomplished? 1 answer, several changes 
took place. First, the lower teeth were brought inward and close to- 
gether; second, a change was undoubtedly made in the articulation of 
the condyle of the inferior maxilla with the temporal bone; and, third, 
I believe a shortening of the angle of the jaw took place." CALVIN S. CASE 
793 
Otto Walkhoff (1860-1921), Die Unregelmassigkeiten in der Zahnstel- 
lung und Hire Behandlung. This book of 180 pages treats of irregu- 
larities of the teeth and their correction. Walkhoff describes the method 
of his coworkers then in use and his own methods of handling these 
complex conditions. He himself contributed little that was new. 
Fig. 513. 
Figs. 513 and 514.-Neall (1892). 
Fig'. 514. 
Lyman Curtis Bryan (1852-1918), Dental Deview, 1892, page 859, under 
"Surgical Treatment of Irregularities," states, "The treatment which I 
have finally adopted is to inject cocaine and either partially cut away 
the thick intervening alveolus with drills and long fissure burs, or, when 
the alveolus is thin, bodily wedge the outer alveolar wall away with a 
half-round, wedge-shaped chisel, by inserting the point of the instrument 
between the tooth crown and the bone, and forcing it up along the root 
until enough space is secured for the tooth to be brought out into place 
outside the lower tooth. This latter 1 formerly accomplished by press- 794 
ORTHODONTICS-11ISTORIC AL REVIEW 
ing the above wedge-shaped instrument or the inner beak of a suitably 
formed forceps up along the palatal surface of the tooth until the crown 
was forced outward sufficiently to be firmly grasped. It was then brought 
gradually out into place, and secured with a small plate, or ligatures. 
My present method of operating on these cases is much simplified by the 
forceps and fulcrum which are herewith presented (Fig. 515). 
"This pair, you will see, has lobster claw-formed jaws, or more resem- 
bles the tapir's jaws with round drooping proboscis and the short reced- 
ing lower jaw. 
"This curved long round serrated jaw rests on a fulcrum fitted to 
the arch of the maxillary to be operated on, and the short beak pushes 
against the palatal aspects of the tooth to be brought out into line. I 
Fig. 515.-Bryan (1892). 
consider it absolutely necessary to lift the outer alveolar plate before 
attempting regulation on account of the great danger of accident to the 
pulp if the alveolar margin including the solid septa between the teeth 
is not broken up. The outer alveolar plate must be broken up nearly as 
far as the apex, that the apex shall not be moved in its position, other- 
wise the nerve will be cut off by any considerable lateral movement of 
the point of the root." 
Frank French, before the First and Second District Dental Societies, 
New York, Cosmos, 1893, page 116, read a paper entitled "Orthodontia." 
"Congenital orthodontia is much harder to treat than acquired, as the 
forces of nature arc all against us, and the teeth are more liable to 
return to their former positon. 
"The kind of appliances to be used must be determined by the judg- 
ment of the operator, and fortunately we have quite a list to choose from; 
but whether we choose levers, jackscrews, rubber plates and ligatures, CALVIN S. CASE 
795 
piano wire, any or all of these, we will often find our skill and ingenuity 
taxed to the utmost to accomplish the desired result." 
"I removed the band from the bicuspid and molar, and lengthened it 
so as to take in the second molar, and again attached my ligatures; this 
time they all moved, that is, the bicuspid and first and second molars 
moved, but the cuspid did not stir. Now, here was my error. The points 
from which the force was delivered were not so strong as the point of 
resistance; still, I think that almost any one would have made a similar 
mistake, as three teeth ought to have greater powers of resistance than 
one. I then made a rubber plate, with gold clasps around the bicuspids 
and molars on both sides, as they were in position and T did not wish to 
move them, and attached a spring of piano wire with a single coil, start- 
ing from the posterior surface of the right cuspid, passing back of the 
incisors, and ending with a loop at the point T wished the left cuspid 
to occupy. I then attached with a silk ligature the wire loop to the eye 
on the cuspid, drawing it as tight as possible, and this time something 
moved, and it was the cuspid. I soon found, however, that this was 
drawing it in too much, and not moving it backward as far as necessary. 
"I then made another rubber plate, but with a long spring extending 
from the right sixth-year molar to the left one, but without any coil, 
and ending in a loop. I attached this loop to the loop on the cuspid by 
a silk ligature drawn tightly, so as to give tension to the spring, and the 
tooth was drawn into place without any further trouble. I used silk 
ligatures instead of rubber, because the wire spring gave it all the 
tension necessary. I placed small pin-heads on the plate, on both labial 
and lingual surfaces, at proper points, and attached rubber ligatures 
from lingual to labial pins, passing between the teeth, and the incisors 
and right cuspid were readily moved into position. The rubber plate 
extended in front of the lower teeth as well as in the rear, but is not 
shown in the diagram. The lower teeth being now in position, I swaged 
a thin plate of gold, covering the cutting-edges and extending down- 
ward on labial and lingual surfaces about one-eighth of an inch from 
bicuspid to bicuspid, including both, and cemented it firmly in position 
(Fig. 516). 
"I then extracted the first bicuspids on both sides of the superior 
arch, for as all the teeth were equally good, there was no choice in that 
respect, and it gave one less to be moved on either side. Then an accu- 
rate impression of the first molar on either side was obtained, and a 
platinum band swaged so as to fit closely and coming up over the grind- 
ing surfaces a little {A,A, Fig. 517). On the buccal surfaces of each, 
and running at right angles to the long axis of the tooth, was soldered 
a gold tube about one-half inch in length (see B,B, Fig. 517), and the 
band fastened firmly to the tooth with cement. A piece of gold wire, 796 
ORTHODONTICS HISTORICAL REVIEW 
No. 18, long enough to reach around from second molar to second molar, 
was bent so as to form an arch of the shape desired for the teeth when 
in position, and fitted accurately to slide in the tubes on the molars and 
yet move easily {C,C, Fig. 517). At a point just in front of the bicuspid 
a narrow tube of gold was soldered on the gold wire (D,D, Fig. 517). 
A narrow band of platinum was swaged to fit each of the centrals, and 
a small groove of the same material was soldered to each band at right 
angles, a very little removed from the median line (E,E, Fig. 517). 
This was to prevent the gold, wire from slipping up and down, and also 
to hold another part of the appliance in position. 
Fig'. 516. 
Fig. 517. 
Figs. 516 and 517.-French (1893). 
"The wire was then placed in position as seen in Fig. 517. A piece of 
heavier gold wire was then bent so as to conform somewhat to the 
shape of the mouth when closed, extending a little beyond the corners of 
the mouth and ending in a hook at right angles to the face. Exactly in 
the center, and at right angles, a piece of gold wire was soldered in the 
center, and at right angles, a piece of gold wire was soldered with a 
groove at the farther end to fit the arched wire already in the month, 
and of sufficient length to allow the lips to close readily when this was 
placed against the tooth. A silk traveling cap was adjusted to the back 
part of the head, two pieces of elastic braid were fastened to each side, 
one above and one below the ear, so that when brought together at the 
angle of the mouth the tension would be equal, and a small eyelet fas- 
tened in the end of each. A short rubber was looped around the regu- CALVIN S. CASE 
797 
lating bar, just in front of the small tube, brought back and hooked over 
the end of the bar at this point (F, F, Fig. 517). The pressure from 
this rubber was not great, but was sufficient to retain what space may 
have been gained. The front bar was then placed against the regulating 
bar, the saddle resting against it at the median line, the elastic bands 
from the cap hooked to each end of it, and I had something, that worked 
nights and Sundays. 
"The pressure from this appliance was so great and got up so much 
inflammatory action that she was instructed to wear it only at night, the 
rubbers at each end retaining what had been gained. 
"A retaining appliance was fitted; and now a word about retaining 
appliances. I believe that they should be made as light as possible, and 
retain the necessary strength. I also believe that they should be made 
nonremovable as a rule, for I think they do the work better. Wherever 
I can, I use a small gold wire swaged so as to fit as closely as possible 
Fig. 518.-French's retainer (1893). 
to the labial surface of the teeth. A piece of platinum is then swaged 
to fit the first or second molars as in Fig. 517, whichever may be used. 
In this case, bands were also fitted to the two centrals; then all the 
bands were soldered to wire (see diagram, Fig. 518) and cemented to 
the teeth, and worn without removal for a year; after that, worn nights 
for six months to insure safety. 
"This kind of a retainer is not inconvenient for the patient, does not 
look badly, and is cleanly. 1 use round wire instead of half-round, be- 
cause there is less substance in contact with the teeth, and it is more 
easily kept clean." 
H. Lindenberger, Cosmos, 1893, page 500: "A band is fitted to each 
of the central incisors and the two second bicuspids or first molars; the 
central bands are soldered together, at the same time attaching a small 
strip of plate, which upon being bent upward, forms a support for the 
center of the curved wire. Upon the palatal surfaces of the posterior 
band is soldered a section of split tubing, which forms a trough against 
which the extremities of the wire rest. When the appliance is thus far 798 
ORTHODONTICS HISTORICAL REVIEW 
completed it is placed upon the model, and a piece of piano wire of 
sufficient length is bent to conform to the inner surface of the arch 
(assuming somewhat of a U shape). This wire, as will be noticed, is not 
attached to the other parts, hence admits of easy removal, either for 
cleansing, readjusting, or to substitute a larger or smaller wire, to pro- 
duce greater or less pressure as the case demands (Fig. 519). 
"A. slight modification of this appliance may be made to include an- 
other class of irregularities, viz., protruding centrals. 
"In such cases the first bicuspids, or possibly the cuspids, should be 
banded, instead of second bicuspids or first molars; then, proceeding as 
before, both retraction of centrals and expansion of arch can be accom- 
plished simultaneously. 
Fig'. 519.-Lindenberger (1 893). 
"Should a tooth be inside the-arch, by shaping the wire to strike this 
tooth it may be forced into proper position. A tooth outside the arch 
may also be brought back by attaching it by ligature to the wire. 
"Thus while teeth may be brought into proper position in the arch, 
the process of expansion may proceed at the same time, if desired. This 
process is applicable with equal facility and effectiveness to either the 
upper or lower teeth. 
"The simplicity of this appliance is not its only recommendation, as I 
feel sure that a trial will prove it to be of value for the purposes 
designed." 
Richard Wilder, Cosmos, 1894, page 831, before the Midwinter Dental 
Congress, read a paper on "Describing a Novel Appliance-Orthodontia'': 
"The outer bands, constructed of spring gold, are divided in the mid- 
dle and arranged with a suitable slide, so that the outer circle or band 
can be expanded or contracted, and fastened, making it capable of adjust- CALVIN S. CASE 
799 
ment to any mouth. The posterior teeth arc used for anchorage always, 
and both expansion and contraction can be accomplished. In expand- 
ing, to prevent these teeth from collapsing a gold spring wire is used 
around the palatal surfaces and connected to the anchored teeth. The 
ball-and-socket attachment gives greater resisting power where the an- 
chorage is not sufficient, and by its use the posterior teeth can be locked, 
and the lower made to move the upper teeth, and vice versa, without 
interfering with the labial movements. Teeth can be moved upward or 
down, backward or forward, outward or inward, or rotated without 
the use of bands, all the movements being produced with grass line or 
rubber tubing (Fig. 520). 
Fig'. 520.-Wilder (1894). 
Clark LeMotte Goddard, A.M., D.D.S. (1849-1905). Goddard spent 
considerable time studying odontology and succeeded in gathering to- 
gether a large variety of skulls and teeth. He was particularly inter- 
ested in the study of the cingulum and cusps of human teeth, with a view 
as to their evolution. 
His first paper on irregularities of the teeth was read at the Ninth 
International Medical Congress, Washington, in 1887. Before the World's 
Columbian Dental Congress, 1893, he brought up the question of "Sepa- 
ration of the Sicperior Maxilla at the Symphysis." In this paper Goddard 
explained his method of accomplishing this task by using a combination 
of appliances, first using the jackscrew. He had found that only two 
cases of forcible separation of the maxillae at the median line had been 
reported, one by W. B. Kingsbury and the other by E. C. Angell. 
"In Dr. Farrar's book the possibility of such a separation is men- 
tioned, also the fact that it sometimes happens, and plans are given for 
preventing such an occurrence (p. 182). No pain or discomfort accom- 
panied or followed the case Goddard described. He kept the arch spread, 
thinking that a deposit of osseous material in the suture would help to 
retain the extra width of arch that he had gained and give the room 800 
ORTHODONTICS HISTORICAL REVIEW 
needed for correcting the irregularity of the incisors. The centrals were 
rotated and the laterals drawn forward till they assumed their proper 
positions. 
"To correct the irregularity an appliance was inserted with a jack- 
screw for spreading the arch. The nut of the screw was turned twice 
daily and the arch spread without pain till in about three weeks the 
teeth presented the appearance shown in the model. 
"By measuring from the buccal surfaces of the first bicuspid it is seen 
that the arch is spread exactly one quarter of an inch. You will notice 
Fig. 521.-Clark L. Goddard (1849-1905). 
that the appliance is attached to the first bicuspid and the first molar on 
each side, but does not come in contact with any of the six anterior 
teeth. Now comes the surprising part, that the spreading is not con- 
fined to those teeth only to which the appliance is attached, for the cen- 
tral incisors which previously overlapped are now separated by a decided 
space. Upon making accurate measurements we find that the cus- 
pids have spread apart %2 of an inch, and that the centrals, measuring 
from distal to distal surfaces, have separated at least one-sixteenth of an 
inch. How can this be accounted for since the appliance did not touch 
any teeth anterior to the bicuspids? 1 can only account for it by the 
supposition that the two halves of the superior maxilla have separated CALVIN s. CASE 
801 
in the median line. It' the casts be examined a depression will be plainly 
seen in the gum above the space between the central incisors, while there 
is no depression in the corresponding position in the first cast. 
"I have quoted thus freely on account of an opinion often expressed 
and formerly firmly believed by myself that a separation would be much 
more likely to take place in the line of the suture between the inter- 
maxillary bone and the superior maxilla of either side. The fact that 
congenital fissure of the hard palate extends from the soft palate in the 
median line as far as the intermaxillary bone, then deviates to the right 
or left or follows both directions in the line of the suture between the 
intermaxillary and superior maxillary bones would lead us to expect 
any separation of the superior maxillae in the same lines. 
Fig-. 522.-Goddard's method to separate the suture (1893) 
"Appliances for Spreading the Arch.-The combination which I used 
for spreading the arch has worked so well in this and many other cases, 
that I think a description will not come amiss. 
"You will notice that T call it a 'combination' and at first sight its 
general features will seem so familiar that you will say that it is noth- 
ing new. Its various parts are old, but the exact combination new. I 
use the Magill bands, with Angle's tubes soldered to the buccal surfaces 
of two of them. Instead of soldering a tube to the lingual surface of each 
band, and extending a wire through the two tubes as recommended by 
Dr. Angle, I solder a flat bar about an eighth of an inch wide or less, 
and thick as number 24 plate U. S. G. to the lingual surfaces of the 
bands on each side, thus uniting the band of the bicuspid to that of the 
molar, or the band of the cuspid to that of a second bicuspid. In this 
bar are punched holes at short intervals. In opposite holes, across the 
arch, are placed the ends of an Angle jackscrew, or a Talbot spring. I 
prefer the spring because it can be bent to lie almost in contact with the 
arch of the plate, and be out of the way of the tongue much more than 802 
ORTI FODONTICS HISTORICAL REVIEW 
the jackscrew. The spring or jackscrew can be placed in any position 
along the bar, whenever the force is needed, and will stay in place, not 
sliding forward or backward, the ends being retained in the holes. If 
necessary, two springs or two jackscrews can be used, one at each end 
of the bars, but 1 have found one to be sufficient. The bar is easily sol- 
dered to the bands as follows: Fit the bands on the teeth or on the cast, 
as preferred, melt a little solder on the lingual surface of each band, 
place the bands on the teeth of the cast, which is better for the purpose 
if made of equal parts of plaster or marble dust or sand, although plas- 
ter alone will answer the purpose. Having fitted the bar and punched 
the holes in it with a plate punch, tip the cast so the bar will lie in place 
and apply the blowpipe flame. The bar, being free, will be heated first, 
and the solder already on the bands will easily unite with it, without 
heating the whole cast to a high heat. 
"If it is desired to move four teeth on each side, viz., two cuspids, bi- 
cuspids and molar, the bands may be placed on the cuspid and second 
bicuspid on each side and the bar extended beyond the second bicuspid 
along the molar, or the bands may be placed on the first bicuspid and 
molar on each side and the bar extended forward around the cuspid, in 
which case the end of the bar should be made narrower and extend 
slightly between the cuspid and the lateral incisor. If it merely rests on 
the inclined surface of the cuspid as force is applied, it may move along 
this inclined plane and force the bicuspids slightly out of their sockets, 
or the cuspid into its socket without moving it out as desired. 
"After the arch has been spread a bowspring of wire can be placed 
around the anterior teeth and held in place by inserting the end in the 
tubes on the buccal surfaces of two bands (Fig. 523). This bowspring 
can be used for attaching rubber bands for drawing incisors forward or 
rotating them. To prevent the ends sliding too far through the tubes, 
a bayonet may be bent in each end of the bowspring, or the ends may be 
threaded and nuts put on to keep it in place. If the latter plan is fol- 
lowed, the size of the bowspring may be increased or diminished by 
moving the bowspring backward or forward. If it is desired to move 
several incisors forward at once, the bow may be ligated firmly to these 
teeth and moved forward by turning the nuts at the ends. If the case 
is a V-shaped arch, the prominence may be reduced by first spreading 
the arch, then inserting the bowspring, putting the nuts behind the 
tubes. By turning those nuts the bow may be drawn back and thus move 
the incisors with it. 
"The arch may be retained after spreading by substituting a V-shaped 
wire for the Talbot spring, or if the bowspring be used outside it may be 
stiff enough to keep the arch spread. 
"An inner bow may be used to advantage for keeping the arch spread CALVIN S. CASE 
803 
and reducing V-shaped or prominent incisors, by extending rubber bands 
from it to the offending teeth. This appliance may be made of German 
silver, but I prefer platinum for the bands, clasp gold for the bar and 
bowspring and gold plate for the tube. 
"Movement of the Teeth.-There is a question which needs our atten- 
tion and which I would very much like to hear discussed, that is: What 
changes take place in the surrounding tissues when teeth are moved? 
The common answer is: 'Absorption of tissues in front of the moving 
teeth and building up behind.' This answer has not fully satisfied me, 
for in many cases where several teeth are moved at once and in the same 
direction, I have observed a movement of the alveolar process itself. I 
noticed this first in 1883, and have taught it to my class ever since. I 
saw no notice of it in print before that time, and have seen it mentioned 
but twice since. 
Fig-. 523.-Goddard (1893). 
''In the first volume of Dr. Farrar's book on irregularities, page 142, 
he speaks of this movement as a 'bending of the alveolar tissue.' The 
term is a good one, and I am surprised that such a bending or move- 
ment is not more widely recognized. It was first brought to my atten- 
tion in a case in which I was retracting incisors by means of rubber 
bands attached to a plate in the roof of the mouth, which plate was 
clasped to the molars. After a few weeks, as the incisors moved in, I 
noticed that the plate did not fit the roof of the mouth as before, and 
upon examination found the palatine portion of the alveolar ridge, pos- 
terior to the incisors, much fuller than before, so much so as to prevent 
the plate going back to its former position. 
"I have noticed the same bending of the ridges when the four (4) 
incisors were moved outward, and in cases of spreading the arch, yet I 
have never known or heard of such a result. The outer plate of the 
process at least must move with the teeth. We might in that case ex- 
pect to find the ridge much thicker after the teeth are moved, from filling 804 
ORT 11ODONTI ('S 111STORI (' A L KEVIEW 
up the sockets behind the teeth, but such is rarely the case. When the 
arch is spread there is more room in the roof of the mouth. The whole 
ridge has moved or been bent on its base as if the process were semi- 
plastic. When prominent incisors are reduced, if the ridge did not bend 
we would expect the teeth to move without removing the prominence of 
the labial portion of the gums and ridge, we would expect the ridge to 
remain prominent till sufficient absorption had taken place to reduce it 
to a normal thickness. Yet as the incisors are moved, you will find the 
gums and ridge over their roots no thicker at one time than at another, 
and when the teeth have reached their new location the outer plate of 
the process will be found to have arrived at the same time. 
1 ' When single teeth are moved along the ridge or outward or inward, 
there is without doubt an absorption in front and building up behind, 
as well as a compression of the cells of the process, but when several 
teeth are moved in one direction I have no doubt that there is, as Dr. 
Farrar expressed, it, a 'bending of the alveolar tissue.' 
"Making Doom for an Inlocked Incisor.--I have found an easy and 
simple way of making room and moving forward an incisor. A few 
years ago Dr. Matteson gave a method, as illustrated in the Dental Cos- 
mos, by placing a spring in front of the overlapping teeth and attaching 
a thread or narrow platinum band to the two (2) ends of the spring in 
such a manner that it passed the teeth on which the spring rested and 
behind the inlocked tooth. By the tension of the spring this thread or 
thin band, tending to straighten, would push apart the overlapping teeth 
and move forward the inlocked ones. While the appliance seemed sim- 
ple and very efficient in theory, 1 found in practice that it did not work 
so well. The thread or band would slip up or down and infringe on the 
gum, or slide off the cutting edge of the tooth. It was very difficult to 
keep it in place. Even when it kept in place it would spread the over- 
lapping teeth too far apart before the inlocked tooth could move forward 
in position. I found the same trouble with Dr. Farrar's appliance, in 
which a similar platinum band was used, and the ends of it attached to a 
screw for straightening it. 
"I was not wholly satisfied with this appliance because the teeth on 
one side tended to return when the straight wire was substituted for the 
spring. I therefore substituted a cut wire for the spring, placing two (2) 
nuts on it. (See Fig. 524.) These nuts can be placed next the tubes on 
each side, and as they are turned will force the teeth apart, while a rub- 
ber band extended from the screw over the offending tooth will draw it 
forward (Fig. 524). This rubber band may well be applied as soon as 
lateral movement is begun with the overlapping teeth, that is, as soon 
as any room is gained. An additional advantage of this plan is that the 
rubber binds the teeth together, so as to prevent the side teeth from CALVIN S. CASE 
805 
being crowded out of the line of the arch. If the irregularity mentioned 
is on one side only, the line between the centrals will not usually cor- 
respond to the median line of the face but by means of such an appliance 
as described, force is exerted so as to move the teeth towards the median 
line so that the two (2) will correspond. 
"Instruction in Orthodontia.-The teaching of orthodontia in colleges 
has become of great importance in the last few years. It should be 
Fig. 524.-Goddard (1893). 
Fig. 525.-Goddard (1897) 
taught practically as well as didactically. I have found the following a 
good plan, and it is the gradual result of eleven (11) years' teaching: 
"Instruction is begun in the junior year and continued through the 
senior year. The didactic instruction consists of lectures and quizzes il- 
lustrated by means of drawings, the blackboard and the lantern. By 
means of an opaque attachment casts and appliances can be projected on 
the screen as transparent slides. Cuts from books and journals can also 
be thrown on the screen by the same lantern. They are easily arranged 
and add very much to our means of illustration. Junior students are re- 806 
ORTHODONTICS HISTORICAL REVIEW 
quired to devote at least one hour a week to making appliances. Each 
student is required to provide files, pliers, draw plate, screw plate, etc. 
He is furnished with large German silver wire and heavy plate. He is 
required to draw the wire down to the various sizes needed and to roll 
the plate out to various numbers needed; to cut screw heads and wire, 
make nuts, taps, draw tubing, and construct various characteristic ap- 
pliances, such as Magill bands, jack and drag screws, Talbot springs, 
appliances for rotating, retracting, spreading, etc. A list of these re- 
quirements is given to each student and he is required to work under the 
instruction of a competent demonstrator of orthodontia technic. 
''The senior students are required to work practical cases, which the 
infirmary has provided in great numbers. A patient is assigned to each 
student, or if there are not enough for that, one case is assigned to two 
(2) students who work together and each receives as much benefit as 
though he had a case alone. He is first required to take impressions for 
casts and to fill out the following blank: 
UNIVERSITY OF CALIFORNIA-COLLEGE OF DENTISTRY 
Orthodontia for Seniors 
Name of Operator No 
Name of Patient 189 
Sex of Patient Age Nativity 
Nativity of Father Nativity of Mother 
Regularity of Father's teeth 
Regularity of Mother's teeth 
Habits. (A) Mouth Breathing 
(B) Thumb Sucking 
(C) Lip Sucking 
Enlarged tonsils 
Median line 
Occlusion, Normal, Prognathous, or Sup. Protrusion 
Mastication 
1. No. of teeth out of normal line 
2. No. of teeth within normal line 
3. No. of teeth rotated 
4. No. of teeth long or short 
V-Shaped arch 
Width of arch between first molars inches 
Height of Palate High Medium Low 
No. of teeth decayed 
Structure of teeth, Hard Medium Soft 
General description of case 
Drawing 
Treatment 
Result CALVIN S. CASE 
807 
"Clinical lectures are then delivered over these cases. The patient is 
seated in an operating chair near a blackboard. The student, or students, 
in charge have the blank and cast ready for inspection. While the class 
is examining the patient, a drawing is made on the board representing 
the irregularity. The case is then described and attention called to its 
peculiarities, and the treatment prescribed. The proposed appliance is 
drawn on the board with colored chalk, and its action explained. 
"The student is instructed to make such appliance, and bring the pa- 
tient to the next clinic, with the appliance in position. Having already 
made appliances in his junior year he is competent to make whatever 
is prescribed. These clinics are held once a week, and several patients 
can be examined at each. The students are required to present the pa- 
tient at these clinics at frequent intervals, so that progress may be noted, 
mistakes prevented or corrected, etc. 
"For similar cases different appliances are prescribed, in order that 
the efficiency may be tested, and the students thus have an opportunity 
of serving their workings. Thus, the screw is used in one case for spread- 
ing the arch, and the spring in another. On one side of the mouth a drag 
screw is used for retracting the cuspid and on the other elastic bands, 
etc., etc. 
"When a case is complete, retaining appliances are inserted, and the 
patient instructed to be present at intervals for inspection. 
"Casts are required of each case, showing the beginning and end of 
the case, and any instructive intermediate stages. These casts, with the 
regulating appliances in position, are stored in the museum, for reference 
and future use in illustrating lectures and clinics. 
"These clinics have proved very interesting and instructive to all con- 
cerned, and the students have, as a rule, eagerly availed themselves of 
the opportunities presented, often bringing patients for the purpose. 
When cleft-palate cases can be obtained they are shown at the clinic 
and appliances constructed for their relief." 
In the Items of Interest, 1897, page 119, Goddard states the following 
propositions: 
"Proposition 1.-If the deformity is due principally to the lower jaw, 
I would first try to jump the bite and force the lower jaw forward with 
a plate in the upper arch, having an inclined plane posterior to the supe- 
rior incisors on which the inferior incisors could occlude, as shown by 
Dr. Kingsley in 'Oral Deformities/ 
"The superior incisors could be drawn slightly backward then, by 
rubber bands attached to the plate. 
"A more effective appliance would consist of metal crowns for the 
superior molars with lugs projecting down behind the inferior molars, so 808 
ORTHODONTICS HISTORICAL REVIEW 
that the teeth could not be occluded without throwing the lower jaw 
forward. 
"To the buccal surfaces of these crowns I would solder tubes for the 
insertion of the screw cut ends of a labial bow, the anterior part of which 
would rest in notches cut in bands cemented to the superior central in- 
cisors. By means of nuts behind the tubes, force could be brought on 
the superior incisors to reduce slightly their protrusion, and close the 
space between the centrals. This bow should be of stiff gold wire, and 
wider than the arch, so that the superior bicuspids could be moved 
Fig. 526. 
Fig. 527.--Goddard. 
buccally by means of rubber bands or ligatures. The bow would bind 
the superior teeth together so that the strain put on the lugs in jumping 
the bite would be borne by all the teeth instead of by the molars alone. 
"Proposition 2.-If the profile of the face indicated that the deformity 
could be corrected by operating upon the superior arch alone, I would 
extract the superior first bicuspids and cement on the first molars broad 
bands with buccal tubes, in which I would insert a labial bow, as de- 
scribed above, and shown in Fig. 525. 
''Behind these tubes I would apply nuts for tightening the bow. These 
would be merely for retention, as, in the majority of such cases, the first CALVIN S. CASE 
809 
molar and second bicuspid on each side-four teeth oidy-would not 
afford sufficient anchorage for moving the six anterior teeth. 
"For moving the anterior teeth, and thus reducing the protrusions, I 
would use the cap and bit shown in Figs. 526 and 527. The vulcanite bit 
should be made on a cast formed in an impression taken with the bow 
in place, so as to fit over it, and should not be allowed to project between 
the central incisors. The cap and bit could be worn at night only, or 
at such times as the patient is not at school or at meals. The nuts on the 
end of the bow should be tightened every morning just enough to take 
up the slack caused by the movement or the anterior teeth during the 
night. The rubber cord from the cap to the bit should be so applied as 
Fig. 528.-Depressing lower incisors. (Goddard.) 
Fig-. 529. 
Fig-. 530. 
to draw upward as well as backward and force the superior teeth some- 
what into their sockets (See Kingsley, p. 134, Fig. 66). This is to pre- 
vent the inferior incisors impinging on the lingual surface of the superior 
as they move back. If reduction of the length of the superior incisor is 
not desirable, the inferior might perhaps be forced into their sockets by 
a bit and chin piece as shown in Fig. 528, or the bit might be opened 
by means of gold crowns on the inferior molars; the bicuspid could 
then be forcibly erupted by rubber bands extending to the superior 
teeth as shown in Figs. 529 and 530." 
In the American Text Rook of Operative Dentistry, first edition, 1897, 
Goddard wrote the chapter on "Orthodontia Exclusively as an Operative 
Procedure." He states: 810 
ORTHODONTICS HISTORICAL REVIEW 
"The Normal Arch.-As the study of physiology is necessary before 
the study of pathology, so is a study of the normal arrangement of the 
teeth necessary before the treatment of their irregularities should be 
undertaken. 
"The face from the hair to the chin measures three-fourths of the 
whole height of the head. The forehead to the root of the nose meas- 
Fig. 531. 
Fig. 532. 
Fig. 533. 
Fig. 534. 
Fig. 535. 
Fig'. 536. 
ures one-fourth, the nose one-fourth and the mouth and chin one-fourth. 
The distance vertically from the root of the nose to its lower border is 
equal to the distance from this point to the bottom of the chin. Of this 
latter distance one-half is occupied by the lips and one-half by the chin. 
The nose, then, equals in length the lips and chin. 
"The Normal Occlusion of the Teeth.-The six upper anterior teeth 
close over the six lower from a third to a half of the length of the latter. 
The lower second bicuspid occludes between the cusps of the two upper CALVIN S. CASE 
811 
bicuspids; this is a point easily remembered. Each bicuspid and molar 
is antagonized by two of the teeth of the opposite jaw. The buccal cusps 
of the lower teeth close between the buccal and lingual of the upper, and 
the lingual cusps of the upper close between the lingual and the buccal 
cusps of the lower. 
"As the lower moves laterally during mastication the cusps of the 
bicuspids and molars grind upon each other, while the six anterior teeth, 
Fig. 537.-Plate with gutta 
percha extremities. 
Fig'. 538. 
Fig. 539. 
Fig. 540. 
overlapping but not touching, pass by each other and escape wear. In 
order to touch the cutting edges of the upper and lower incisors upon 
each other the lowei* jaw is protruded, and at such a time the masticating 
teeth do not occlude. 
"In examining the upper six anterior teeth from the labial aspect it 
will be seen that they touch each other at one point only, about one- 
fourth of the distance from the cutting edge to the gum, and that the 
long axes of the teeth are not parallel but the crowns slant towards the 
median line. Of the six upper anterior teeth the central incisors are 
the longest, the laterals next, and the cuspids shortest, though properly 812 
ORTHODONTICS HISTORICAL REVIEW 
Fig. 542. 
Fig. 541. 
Fig. 543. 
Fig. 544. 
Fig. 545. 
Fig. 54 6. CALVIN' S. CASE 
813 
the cuspid is thought to be the longest tooth because of its prominence 
and the length of its cusps. It will be noticed that the gum line is 
higher on the cuspid, thus adding to its apparent length. 
"A line connecting the cutting edges and cusps of half the upper teeth 
forms a double curve, highest at the third molar and lowest at the cen- 
tral incisor, the line of beauty, while such a line on the lower teeth forms 
but one curve, highest at its ends. 
"While the aim of the student of orthodontia will be to correct all ir- 
regularities, and reduce the abnormal to the normal, it will be possible 
in many cases to do this only in degree. The normal may always be ap- 
proached, but not always attained. 
"The following Classification of Irregularities was suggested in the 
above book. 
"Aberrations from the normal arch are almost numberless, but may 
be grouped into classes as follows: 
"1. Lingual displacement: a tooth inside the normal arch. 
"2. Labial displacement: a tooth outside the normal arch. 
"3. A tooth rotated. 
"4. A tooth extruded. 
"5. A tooth partially erupted. 
"6. Several teeth in any or all of these positions. 
"7. Prominent cuspids and depressed laterals. 
"8. Pointed arch. (V-shaped.) 
"9. Upper protrusion. 
"10. Double protrusion. 
"11. Constricted arch. (Saddle-shaped.) 
"12. Lower protrusion, or prognathism. 
"13. Lack of anterior occlusion. 
"14. Excessive overbite. 
"15. Separation in the median line." 
Figs. 531 to 546 are taken from Goddard's article and will describe 
themselves. CHAPTER XXIX 
W. S. DAVENPORT TO GEORGE C. AINSWORTH 
William Slocum Davenport, (1868- ). Tn the International Dental 
Journal, 189'3, W. S. Davenport contributed an article entitled "Twisted 
Wire for Regulating Teeth." Fig. 547 shows the method employed before 
the American Dental Society of Europe, August 5, 1895. 
"The first means employed towards correcting the irregularity was 
to push forward the lower incisors by the use of linen tapes, acting as 
wedges between these teeth and a corresponding edge of a plate which 
was fitted over the molars and bicuspids. 
"When this was accomplished a simple rubber retaining-plate was 
inserted, and the patient left Paris for the winter. 
"It was my intention, upon the patient's return, to spread the upper 
arch and attempt to jump the bite, but it was finally deemed more 
practicable in the present case to draw the upper teeth backward, and, 
to obtain the necessary space, the two superior first bicuspids were ex- 
tracted. An appliance was then made, consisting of a rubber plate, 
which covered the upper back teeth. Into the right side of the plate 
was vulcanized one end of a half-round platinum wire, which was passed 
around in front of the incisors and terminated in a loop at the free end. 
Two little hooks were soldered to the front of the band in such a way 
as to catch over the ends of the centrals when the plate was in the 
mouth, and prevent the wire slipping up against the gums. Into the 
left side of the plate a staple was vulcanized. 
"When the plate was in position a copper wire was passed through 
both the loop and staple, and had its ends brought together and twisted, 
thus producing pressure upon the centrals, laterals, and cuspids. 
"From time to time another twist was given to the copper wire, until, 
at the end of seven weeks, the teeth were in the desired position." 
In the Dental Review, February, 1896, "Lifting Lower Teeth and Re- 
tracting Front Teeth." 
"The lower arch is very much curved downward with the incisors 
biting into the gums above. The facial expression was very unpleasant, 
as the protruding teeth caused an upward roll of the lip. The patient 
was the only sufferer from this cause in her family, and she had none 
of the habits to which similar cases are attributed. The first means em- 
ployed toward correcting the irregularity was to insert a bridge appli- 
ance, which was fastened by the use of gold caps to the two second 
814 W. S. DAVENPORT TO GEORGE C. AINSWORTH 
815 
molars, and brought forward a few lines above the molars and bicuspids, 
resting with a gold saddle on the six front teeth. 
"In two weeks the arch was spread and the teeth were drawn up to 
a normal position by the use of ligatures which were fastened at the 
lingual surface, then tied to the masticating surface of the bridge above 
(Fig. 547). 
"The ligatures were removed in about one week. The teeth remained 
firmly in this position, and the patient ate on the bridge for three months; 
then removed the bridge, spread the upper arch and there was ample 
space to draw the protruding teeth to their position. This was accom- 
plished by the force obtained of twisting wires as already described." 
Fig\ 547.-W. S. Davenport (1893). 
In the International Dental Journal, 1898, "Spring Levers for Regu- 
lating Teeth." 
"A band in position, with a tube soldered to one side. A piano-wire 
spring lever was so bent that when one end was passed through the tube 
P, power was obtained by pressing tightly against the neighboring canine. 
''The tube W represents the weight; the point F becomes the fulcrum 
by touching the outer edge of the tooth to be rotated. With this simple 
appliance a tooth becomes practically self-rotating. 
"Case II.-A cap was made with a post soldered to one corner; the 
lever was slipped over the post and the end sprung up against the neck 
of the molar, giving a force as obtained in a lever of the second class. 
See P, W, and F. 
"Case III.-A double gold band with a flattened tube attached was 
cemented to the two central incisors. Through the tube was sprung the ORTHODONTICS-HISTORICAL REVIEW 
816 
double spring lever, which brought force to bear on the two laterals, 
the position of which was thus corrected. 
"Every day or two the springs were removed and bent a little more, 
which gave renewed power to continue their action." 
Morton Smale, M.R.C.S., L.S.A., L.D.S,. and J. F. Colyer, L.R.C.P., 
M.R.C.S., L.D.S., "Diseases and Injuries of the Teeth," including Path- 
ology and Treatment, 1893; under Chapter TI, Abnormalities and Diseases 
of the Temporary Teeth, we find the following classification: "(a) ab- 
normalities in size; (b) abnormalities in number; (c) abnormalities in 
position; (d) abnormalities in structure. 
"(a) Abnormalities in size.-By abnormality in size is meant a varia- 
tion from the normal, as, for instance, when one or more teeth are com- 
paratively larger or smaller than the rest of the set. 
"(b) Abnormalities in number.-By abnormalities in number it is to 
be understood either any excess or deficiency in the number of teeth 
found in the temporary dentition. 
"(c) Abnormalities in position.-Abnormalities in position are of two 
varieties-those relating to malposition of individual teeth, and those 
that have to do with the relative position of the maxilla to the mandible. 
The only form of irregularity of the first variety which has come under 
the authors' notice is a slight crowding which leads to overlapping and 
twisting of the incisor teeth. Tn the second variety there are three more 
or less common conditions-(1) Protrusion of the lower jaw. (2) Edge 
to edge bite. (3) Lack of anterior occlusion (open bite). 
"(1) Protrusion of the lower jaw is occasioned when one ramus is 
developed out of proportion to the other. 
"(2) Edge to edge bite is probably clue to causes similar to those 
which produce the preceding abnormality. 
"(3) Lack of anterior occlusion, or open bite may be caused in sev- 
eral ways-by thumb, finger, lip or tongue sucking, or may be due to 
want of development of the ascending ramus, and it might, in some in- 
stances, be due to a partial arrest of development of the intermaxillary 
bone. 
"(d) Abnormalities in structure.-Additional cusps and variations in 
the number of the roots are more rarely found in the temporary than 
the permanent dentition. 
ABNORMALITIES OF THE PERMANENT TEETH 
"Abnormalities of the permanent teeth can be divided into those of 
(1) Size; (2) Number; (3) Position; (4) Structure. W. S. DAVENPORT TO GEORGE C. AINSWORTH 
817 
(1 ) ABNORMALITIES IN SIZE 
"There is no standard by which we can compare the relative sizes of 
teeth. It is possible to have the whole series composed of teeth of an 
abnormally large or small character. The upper central teeth are most 
frequently developed to an abnormally large size, but it should be dif- 
ferentiated from a central that has become germinated with a supernu- 
merary lateral incisor. The second lower bicuspid is also frequently ab- 
normally large, approaching somewhat in character to the molar. The 
second lower molar is also occasionally affected in the same way. The lat- 
eral incisors in the upper, on the other hand, are often diminutive and 
modified in their shape, and in extreme cases are little more than simple 
cases; occasionally, however, they may be abnormally large. The upper 
third molar, like the lateral, is often dwarfed and modified in its shape. 
(2) ABNORMALITIES IN NUMBER 
"Variations from the normal number of teeth may be classified-(a) 
Excess in number; (b) Deficiency in number. 
"(a) Excess in number.-Any tooth in addition to the normal number 
is known as a supernumerary tooth. They may be divided into two 
distinct groups-first, those resembling normal teeth in shape and char- 
acter (called by some authors supplemental) ; second, those abnormal in 
form. 
(3) ABNORMALITIES IN POSITION 
"This section of abnormalities brings us to perhaps one of the most 
difficult subjects that comes under the care of the dental surgeon. The 
vagaries of nature are so frequent, and the accidental causes that may 
give rise to various forms of irregularities so numerous, that it is impos- 
sible in a manual of dental surgery, where only a few pages can be de- 
voted to the subject, to treat exhaustively of all the manifestations and 
varieties which occur. It is proposed, therefore, to deal rather with those 
that are more commonly met with in practice, and to consider them on 
general principles. 
"The causes giving rise to abnormalities in position may be divided 
into general and local. 
"General Causes.-Heredity, and Neurotic Tendencies. 
"Local Causes.-Undue Persistence of the Temporary Teeth, Too Early 
Extraction of the Deciduous Teeth, the Extraction of the First Permanent 
Molar, Supernumerary Teeth, Thumb, Lip, Tongue, and Toe Sucking, 
Alveolar Abscess, Mouth Breathing, Cicatrices, the result of injury, espe- 
cially after burns, lead in some cases to serious deformities. Hypertrophy 
of the Gums, Exostoses of the Bones, and other Tumors, such as the vari- 
ous Epulides, etc., also act as a local cause of irregularity. 818 
ORTHODONTICS HISTORICAL REVIEW 
"Classification.-It is not possible to give any general classification of 
irregularities which will include every variety met with, but for con- 
venience the following will be found useful and practical in considering 
the subject: 
"(1) Irregularity in the position of individual teeth. 
"(2) General crowding. This condition is often seen when bicuspids 
and molars are in good position, and may be produced by the 
following causes: 
"(a) Too early extraction of temporary teeth. 
"(b) Arrest in the development of the maxilla. 
"(c) Excessive development in size. 
"(d) Excessive development in number (presence of supernumerary 
teeth). 
"(e) Eruption of wisdom teeth. 
"(3) Contracted arch (a) The U-shaped arch; (b) the V-shaped arch; 
(c) the saddle-shaped arch. 
"(4) Anterior protrusion of the upper teeth. 
"(5) Protrusion of the lower teeth, 'Underhung bite,' 'Edge to edge 
bite.' 
"(6) Nonocclusion of front teeth. Eack of anterior occlusion, 'Open 
bite.' 
"Before proceeding to deal with the above classification in detail, it 
will be advisable to consider some general principles that should guide 
the dental surgeon in dealing with these cases. 
(4) ABNORMALITIES IN FORM 
"Among abnormal teeth are included all alterations in form, shape, 
or structure which have resulted from acquired, congenital, or hereditary 
causes. They will be considered under the following heads: 
"(1) Alterations produced by constitutional disturbances-(A) syph- 
ilis; (B) rachitis; (C) exanthemata; (D) disturbances of nutri- 
tion; (E) use of mercury; (F) gout. 
"(2') Alteration produced by local disturbances. 
"(3) Gemination. 
"(4) Dilaceration. 
"(5) Enamel nodules. 
"(6) Abnormalities in the number of cusps." 
Louis Jack (1832-1914). In the July issue of the International Dental 
Journal, 1893, "Aligning the Teeth," he says he has used the following 
appliance for several years with great satisfaction. W. S. DAVENPORT TO GEORGE 0. AINSWORTH 
819 
"In reference to the alignment of teeth, carrying them in when they 
are too far out and bringing them out when they are too far in, he uses 
this plate almost invariably. It is composed of two pieces of vulcanite 
joined by a band of gold. (Fig. 548.) 
"The posterior teeth are made the base of resistance by covering the 
second bicuspid and the molars of both sides by two separate shoes of 
vulcanite, which extend at either side of the teeth but a few lines be- 
yond the margin of the gum. To give these shoes strength and to enable 
the patients to masticate upon them, they are surfaced with gold swaged 
to the form of the ends of the teeth. These gold facings are vulcanized 
to the shoes in their proper places. 
"Some preliminary preparation of the cast is required to enable these 
shoes to hold firmly their position. They should go on with a little 
springiness. The cast is trimmed with a suitable instrument to take a 
Fig. 548.-Louis Jack (1893) 
shaving from the teeth at the neck, and also a shallow groove should in 
most instances be made in the plaster, at the gingival margin. The 
proper amount of cutting is quickly gained by experience. 
"These bases of support for the movement of the teeth are connected 
by a narrow band of springy gold, one end of the bar being secured to 
one of the shoes, and the other end being attached to the opposite shoe 
by a male screw fitting in a screw-cut tube or, with proper precautions, 
vulcanized into a projection on the outer plate of the shoe. 
"The reason for this plan is that by turning the free end of the appli- 
ance the bar may be reduced or increased in length. If in any given 
arch a tooth or more is projecting and others are depressed, the bar is 
brought into contact with the most prominent tooth, and a piece of elas- 
tic rubber is placed between this point of contact; at the same time a 
rubber ring is carried over each of the teeth which arc within the arch 
and is drawn through a hole opposite the tooth and extended to a button. 820 
ORTHODONTICS HISTORICAL REVIEW 
On the next day the bar is screwed up enough to be again in contact, 
when a new pressure may be made or the tooth is rested, as the con- 
ditions require. If the depressed teeth are sore, they may be rested by 
tying through the same channel as the ring has passed. Remove these 
plates daily, each time making a gain in the progress. It is important 
to make this daily change for the sake of cleanliness, the patient brush- 
ing the teeth while the further preparations are being made. 
"As before intimated, all the front teeth may be moved at the same 
time either outward or inward. 
"Rotation may also be conducted by the various attachments made 
for that purpose by connecting the rubber band to the attachment, and 
many modifications of this simple description will occur to meet the 
exigencies connected with the alignment of the teeth. 
"It is also needless to state that the impression of the teeth should 
be taken with plaster. 
"This method may be made useful in the treatment of cases at a dis- 
tance whenever either of the parents of the child has the intelligence to 
comprehend the mode of operation of the plate and is capable of apply- 
ing the required instruction. Tn this connection he has conducted the 
correction of a great protrusion of the upper teeth and concurrent de- 
pression of the lower arch for a patient living a thousand miles from me, 
the mother each day making the necessary changes of the plate or liga- 
ture. The upper teeth were forced backward in the manner described, 
and when their position was corrected, a similar plate was placed on the 
lower teeth, when they were gradually brought outward into correct 
relation with the upper arch. This necessitated but three periods of 
attention on my part. 
"The only originality in connection with this appliance is the division 
of the old form of upper plate which was used to separate interlocked 
arches and to connect these by the screw at one end of the bar. Tic pre- 
sents this method as comprising many advantages for the purpose for 
which it is intended, and in this purpose is included the greater number 
of irregularities we have to treat." 
Francis Jean in the June Odontologie and January Revue Internationale 
D'odontologie, Paris, January, 1893, states: 
APPARATUS TO ENLARGE THE ARCH 
"It is an ingenious plate, constructed as follows: Two metallic square 
rods of one millimeter and a half thick are placed in a parallel direction, 
each penetrating in a sheath made of the same metal. At the extremity, 
enclosed in the rubber plate, a piece of metal wire is soldered to each 
sheath, so as to hold it firm in the plate. W. S. DAVENPORT TO GEORGE 0. AINSWORTH 
821 
"This little apparatus, when finished, represents, when the plate has 
been divided in two in the median line, a rod and a sheath fixed each 
side on the palatine surface. 
"The point at which this rod and sheath are to be placed is chosen 
according to the direction in which the displacement of the arch is to 
take place. If one wishes to act on the whole palatine surface, or roof 
of the mouth, from the central incisors to the last molars must be cov- 
ered by the plate. The extremity of one rod and of one sheath must 
then be fixed in the center of each half of the plate in wax, and a line 
drawn in the direction which is to be followed by the saw, in dividing 
the plate when vulcanized. Now the important part is the mode of 
action of the plate, which is to separate gradually and mathematically 
the lateral parts of the apparatus, and to maintain them in that position. 
"To do this, the two halves of the plate must be separated one from 
the other, and a platinum wire half a millimeter thick is placed around 
the part of the rod where it comes out of the rubber. This will prevent, 
when the two halves will be joined together again, the rod penetrating 
to its full extent into the sheath, so that the two halves of the plate will 
be separated by a space equal to the thickness of the wire. Every three 
or four days another turn of a wire is added, and the separation of the 
plate will be so much increased. This is continued until the desired 
effect is obtained. 
"If only a few teeth, say the bicuspid, are to be pushed out, the plate 
can be made much smaller, and only large enough to press upon these 
particular teeth. If to correct the deformity, in addition to the expan- 
sion of the arch, one desires to obtain a pressing backwards of the an- 
terior teeth or incisors, a very narrow metallic band is passed in front 
of these last, the extremities of which band are fixed in the check side 
of the apparatus on a level with the bicuspids. In this case the crown 
of the back teeth is to be covered with rubber, so as to be able to fix 
the band on the outside." 
Safford Goodwin Perry (1844-1911), in speaking of Aligning the Teeth, 
International Dental Journal, July, 1893, states: 
"Cap the bicuspids, and sometimes the first molars, with a simple rub- 
ber plate, which is made with a little ridge rising over the bicuspids. 
Through this ridge a very small hole is drilled and countersunk on the 
distal side, and then the thinnest saw procurable is passed through the 
rubber into this hole. A knot is then tied at each end of a very thin 
piece of elastic, such as is used in place of wrapping-twine for boxes, 
parcels, paper, etc., and the ends slipped through the cuts into the holes. 
The knots drop into the countersunk ends of the holes, and so are safe 
from the danger of chafing the overlying lips. The pressure is varied, 
of course, by tying the knots closer together or farther apart, as the ease ORTHODONTICS HISTORICAL REVIEW 
822 
may be. "When the plate is in place, the elastic is drawn over the front 
teeth, and if care is taken in drilling the holes in the ridge on the plate 
at just the right place, the elastic will not ride up against the gum or 
slip off from the front teeth. This device is the closest fitting and the 
most comfortably worn of any I have ever used." 
Norman S. Essig, in speaking of "A Regulating Case Involving Cor- 
rection of the Position of the Median Line of the Arch," Dental Cosmos, 
June, 1893, states: 
"This case, which was that of a boy of fourteen years of age, presents 
some interesting features. First, as will be seen, the cuspid was com- 
pletely out of the arch, the lateral incisor and bicuspid being in contact. 
Secondly, the central teeth were so much to the right of the median line 
as to constitute a deformity. 
"The two objects to be accomplished, therefore, were to correct the 
center line and bring the cuspid into its proper position in the dental 
arch. To accomplish this it was necessary to take out the first bicuspid 
Figs. 549 and 550.-N. S. Essig (1893 ) 
on the opposite side of the mouth, thus leaving a space which, if the 
median Line were moved to its normal position, was usually occupied by the 
lateral incisor. After the bicuspid on the right side of the mouth was 
extracted, an impression was carefully taken, and the model or cast 
thoroughly dried and well soaked with sandarac varnish. An excavator 
was then passed around the teeth, cutting away the plaster representing 
the gum margin, so as to allow the caps to extend a little under the free 
margin of the gum when the piece was put in the mouth. After this 
was done, the caps were made for the bicuspid and the lateral incisor, as 
shown in Fig. 549. These were made of twenty-two carat gold, of about 
No. 30 thickness, and fitted snugly to the plaster, and in the case of the 
bicuspid the gold was carried up and just a little over the cusps, as 
shown in Fig. 550. 
"The cap for the lateral incisor was provided with a socket on the 
labial surface, into which the bar was fitted, allowing of some movement 
while the teeth were being pushed toward the median line. This cap W. S. DAVENPORT TO GEORGE 0. AINSWORTH 
823 
was also provided with a small arm or lug, which bore against the ad- 
joining tooth in such a manner as to prevent the capped tooth from being 
pushed out of line while the space between them was being enlarged, 
and insure the movement of all the teeth bodily toward the left. The 
nut, which was given one or two turns each day by means of a small 
wrench, was placed next to the cap on the bicuspid, which was provided 
with a cylindrical attachment through which the screw passed. The 
pressure caused by the tightening of the nut lengthened the screw, and 
thus widened the space for the reception of the cuspid. 
"A suitable wrench may be made from a discarded excavator; of 
course it is understood that no thread is needed inside the cylindrical 
attachment on the bicuspid cap, as it is desired that the screw as it is 
passed through should be free to respond to the pressure of the nut. The 
cuspid came down into place as the distance between the bicuspid and 
the lateral was widened, and when it was fully erupted a collar of gold 
was made which fitted up closely to the neck of the tooth, and a small loop 
of gold was soldered to the labial surface, to which was attached a rubber 
ligature, which helped to draw the cuspid into place more quickly. The 
ligature was attached to a little gold button on a small rubber plate. 
11 After the space was enlarged to receive the cuspid it moved very 
rapidly, and in its downward course came in contact with the bar or 
screw which was then removed and a curved one substituted, which al- 
lowed the cuspid to pass inside, thus allowing it to continue on down- 
ward into the space prepared for it. The most remarkable feature of 
this operation was the quickness with which all the teeth responded to 
the pressure as soon as the force was brought to bear on the lateral in- 
cisor. When the median line was brought to its normal position and the 
teeth on their proper place, the fixture was allowed to remain as a 
retaining piece for about three months. 
"This case was finished about two years ago, and since that time there 
has been absolutely no change in the position of the teeth, and their 
regularity is one of the noticeable features of the mouth." 
In the April Cosmos, he says, "Moving Cuspids": 
"The case selected to illustrate the efficiency of the screw in moving 
irregular teeth is a cuspid that was not only greatly out of its normal 
place in the arch, but much turned upon its axis. Here it was necessary 
to draw it back so that it might be made to assume its place between the 
lateral and second bicuspid, and at the same time to turn upon its axis. 
This was accomplished by hooking the bar into a staple soldered well 
around on that part of the cap covering the labial surface of the tooth. 
"An excavator was passed around the molar at that position on the 
model representing the free margin of the gum, cutting away the plaster 824 
ORTHODONTICS HISTORICAL REVIEW 
from around the neck of the tooth, exposing what would correspond to 
that portion of the tooth or root just above the enamel. 
"No. 30 gold, about twenty-two carat, is used and burnished down, 
forming a cap which fits the tooth perfectly, following the line where the 
excavator has cut away the plaster. 
"If such a band is to be placed upon an incisor or lateral, the face of 
the cap may be cut out, thqs avoiding too much of a display of gold. 
Thin platinum may also be used, about the thickness of writing paper, 
and pure gold flowed over the surface after the piece is invested, but it 
is rather difficult to get the gold evenly distributed over the platinum. 
"The first molar, on account of its being provided with three roots, 
is usually the best tooth to select for the point of resistance, for being 
reinforced by the cuspids, it makes it pretty certain that it will not 
move when the screw is in operation. 
"The gold is brought just over the edges of the cusps, and burnished 
to conform to the contour of the crown; the bar is then put in position, 
and the loop or rings by which it is attached to the caps, cemented on 
with hard wax. It is then invested in sand or marble-dust and plaster, 
and the rings soldered on. 
"In making the caps it is better to have them a little loose, as the 
oxyphosphate with which the piece is cemented in will fill up between 
the gap and tooth, thus preventing moisture from creeping in under the 
gold. 
"Platinized gold should be used for the bar, as the thread is not so 
likely to strip, and it can be made of thinner wire. 
"When the piece is finished we have a fixture which will exert a force 
in a given direction sufficiently strong to move any tooth in the mouth; 
and while the force is not a persistent one it is positive and certain, and 
unaccompanied by any inflammation or soreness. 
"Some members of the profession, who saw this piece before it was 
put in the mouth, expressed the opinion that the molar to which the 
fixture was fastened as a point of resistance, and also the bicuspid, would 
move before the cuspid did. The result showed, however, that this was 
not the case. The cuspid was not only brought back, but turned on 
its axis." 
B. H. Catching (1848-99), "Regulating Appliances," Catching's Com- 
pendium of Practical Dentistry, 1893, page 191. 
"This represents cases frequently seen, including superior lateral in- 
cisors. The cut is of the teeth of a robust young man, strong and firmly 
planted in the jaw. Without extraction the appliance moved the ad- 
joining teeth laterally and brought the malposed tooth into position in 
two weeks. The same appliance was used as a retainer. No plate or 
caps were used to separate the jaws so as to allow the malposed tooth W. S. DAVENPORT TO GEORGE C. AINSWORTH 
825 
and its antagonist to pass. The patient operated the appliance by using 
a wrench, and had instructions to tighten the screw to his bearing capac- 
ity just before retiring at night. In this way, when the cutting edges of 
the opposing teeth came together, the upper was easily thrown outside 
the lower. 
"Material used, German silver wire, solid and hollow. A thin band 
is made to pass behind the malposed lateral and between the two ad- 
joining teeth; to the end of this, resting on the cuspid, as shown in cut, 
a piece of hollow wire is soldered, in which threads are cut to accom- 
modate the screw; on the other end, resting on the central incisor, a 
piece of hollow wire, with the outer end closed, is soldered; this acted 
as a socket into which the end of the screw without threads entered. 
A piece of hollow wire, as shown right over the malposed tooth, is sol- 
dered to the screw bar and filed square, so as to engage the wrench. 
When the screw became exhausted, the band under the malposed tooth 
was cut, lapped and soldered." 
Rodrigues Ottolengui (1861- ), Dental Cosmos, November, 1893, be- 
fore the New Jersey Dental Society, read the following: 
"Ever since I first entered upon the practice of dentistry, I have 
heard, ever and anon, the cry go up against the rapid regulation of 
teeth. 'Move teeth slowly, and avoid the danger of destroying the 
vitality of a pulp,' has been the warning. By some, and I believe by 
many, this danger to the pulp has been claimed to be greatest when tor- 
sion of a tooth is the movement attempted. It is this idea I shall en- 
deavor to disprove. 
"The death of a pulp is probably caused, when it occurs during regu- 
lation of teeth, by the production of a pericementitis in the vicinity of 
the foramen, which impairs the nutrient supply of the pulp which in turn 
results in inflammation of pulpitis, followed by its death. The peri- 
cementitis is occasioned by a pressure in one direction, which causes an 
absorption of the impeding tissues more rapid than the progress of 
repair of the tissues from which the tooth is receding. The idea of 
rapidity, as affecting this result, can have but one connection with this 
process, and that is as it applies to the distance to which the tooth is 
moved. This is evident, for the shorter the distance through which the 
tooth is moved, the less can one logically complain of the rapidity with 
which the tooth is moved, the less can one logically complain of the 
rapidity with which it is accomplished. For example, a tooth is moved 
when a silk is pressed between two contiguous teeth, yet it would be 
folly to claim that to pass a silk rapidly would be more dangerous than 
to do it slowly. I cite so extreme a case to reduce the proposition to 
the ridiculous, the reductio ad absurdum method of mathematics. 
"Hence it follows that it is dangerous to move teeth rapidly only 826 
ORTHODONTICS HISTORICAL REVIEW 
when they are to be moved a considerable distance. Before passing from 
this, I will say, parenthetically, that the foregoing is not the only way 
by which a tooth-pulp may be made to die during the regulation of 
teeth, but it is probably the explanation of devitalization resulting from 
the too rapid movement of teeth, which is the subject under consideration. 
"If it be true that the danger of rapid movement is in proportion to 
the amount of movement, I have but to show that in the act of torsion 
a tooth is but slightly moved, in order to support my theory that teeth 
may be twisted rapidly with little if any danger. And when it is remem- 
bered, as it should ever be, that any regulation of the teeth which covers 
a long period of time becomes a distinct strain upon the nervous system 
of the child, one sees at a glance that, where it can be done safely, the 
most rapid movement of teeth is the best and only method which should 
be adopted. 
"It is my intention to show you a typical example of the several con- 
ditions wherein torsion is required, and to point out the amount and 
direction of the movement. But first I will call your attention to my 
methods. 
"It is well known that to rotate a tooth in its socket, it is necessary, 
in some way, to produce a pressure which will act upon one corner in 
one direction, or else upon both corners in opposite directions. Numer- 
ous devices for this purpose have been employed. 
"My method is to band the teeth with gold, having one or more 
hooks upon the band, as may be required for the individual case. This 
band is made very easily. I use pure gold plate of 28 gauge. Having 
cut a strip as narrow as possible for my purpose, I bent it approximately 
to shape with the ends turned up at right angles. This loose open band 
is slipped over the tooth, and not carried much beyond the cutting-edge. 
The ends are then caught with the serrated beaks of a pair of pliers, and 
drawn tightly together, which produces a tight-fitting band, except that 
as the palatal surface of the central incisor is concave, the band will 
pass straight across that surface, leaving a space. Later, however, when 
the band is set with cement, and pressed farther up, so that it impinges 
upon the bulbous part of the tooth, it becomes more accurately adapted; 
the loose ends are united with a tiny bit of solder, and then turned down 
to form the hook. 'When I need two hooks, I begin with two strips 
soldered together, and when the loose ends are united, I bend extensions 
to form my two hooks. The bands are cemented to the teeth, and so are 
permanently fixed until the rotation is completed. With a central in- 
cisor banded in this fashion, if a rubber ligature be thrown over the hook 
at the anterior labial corner, carried backward and attached to some 
fixture within the mouth, the anterior corner of the tooth will be carried 
in. If, however, the ligature attached to the same hook be carried W. S. DAVENPORT TO GEORGE C. AINSWORTH 
827 
around the palatal side of the tooth, and outward around the posterior 
corner, to be attached to a fixture outside of the arch, the result will be 
a rotation which will carry the anterior corner inward and the posterior 
corner outward at the same time. A similar result obtains when the 
ligature is hooked on the posterior palatal hook, then carried around the 
labial surface and inward around the anterior corner, to be attached to 
a hook within the mouth. The selection of either of these methods would 
depend upon the class of fixture used, that is, whether there be an ex- 
ternal band or not. Next, the posterior corner alone may be affected, by 
carrying the ligature from the posterior palatal hook outward to a band, 
carrying the corner out by its action. 
"The cuspid is probably the most difficult tooth to twist, yet it can 
be accomplished. I make a gold cap for this tooth, upon which I have 
my hooks for attachment of rubbers. This cap, like the band for the 
centrals or laterals, is made at the chair, without recourse to dies or 
models. I cut my gold into a shape similar to an hour-glass. When 
doubled by bending across its shortest diameter, we already have an ap- 
proximate cap. This is slipped over the tooth, and burnished to it, after 
which the open edges are soldered together. An accurately fitting cap 
can be made in this manner in a few minutes without going to the lab- 
oratory. The hooks are formed of a round wire, the ends being pelted 
to form knobs, and then soldered across the cap. This allows all the 
variation of attachment of ligatures and direction of rotation described 
in connection with the incisors. 
"I pass now to the consideration of specific conditions. I may say 
that all forms of irregularity may be classified as belonging to three 
groups. First, where the anterior corner alone must be moved; second, 
where the posterior corner only needs change; and third, where both 
corners are in abnormal position." 
R. Ottolengui further explained his method and appliances for regu- 
lating teeth, and illustrated, by means of movable diagrams, the gradual 
movement of the teeth in the operation of regulating. These explana- 
tory remarks would be but imperfectly understood in the absence of the 
diagrams, and are therefore omitted. 
Dr. C. L. Boyd, (Ohio Dental Journal, July, 1894) states: 
"The writer takes the position that lack of development of the maxillae 
is the first potent factor in crowded condition of the teeth. He says 
a system of mouth massage will accomplish much in enlarging the arches, 
and suggests that mothers and nurses be instructed in gentle and per- 
sistent rubbing of the inside of the infantile jaws." 
Dr. H. E. Cutter, (International Dental Journal, June, 1894) on "Draw- 
ing the Lower Jaw Forward," states: 
"The patient was a girl eleven years of age. The upper arch was nar- 828 
ORTHODONTICS HISTORICAL REVIEW 
row and pointed, with the front teeth very prominent. The lower arch 
was regular, but the front teeth were elongated in comparison with the 
bicuspids, so that their cutting-edges almost touched the gum behind the 
upper incisors. The upper centrals projected fully a quarter of an inch 
beyond the lower teeth. The upper and lower cuspids, however, almost 
touched each other. When the mouth was at rest, the lips did not cover 
the front teeth so that the face had an unpleasant expression. The pro- 
file was even more uncomely, for, besides the projecting teeth, the chin 
was receding, and seriously marred what would otherwise have been 
a fine face. 
"It is important to make a careful study of the general outline of a 
patient's face, as well as of the teeth, before beginning any corrective 
treatment. And we should take into consideration the teeth and facial 
expression of the parents of the patient, in order that we may know 
what is likely to be the natural development in the child. If this were 
more frequently done, we should have more satisfactory results. By 
recognizing a family tendency to a deformity at an early age, a simple 
method can often be successfully employed to prevent its development. 
Another patient might have a set of teeth very similar to the one before 
us, and yet an entirely different treatment is required. In the one case 
the deformity might be due to a receding lower jaw, but in the other to 
a projecting upper jaw. The first and most important question in cases 
of this kind is to decide at the outset whether it is the upper or lower 
jaw which requires treatment, for upon this success or failure largely 
depends. 
"Before undertaking a case of this character, one should first satisfy 
himself that the patient is one who will willingly undergo some un- 
pleasant requirements. For there is occasionally a person who is very 
anxious to undergo treatment, and for a time he faithfully follows the 
instructions given: but gradually he becomes indifferent and careless, 
and the treatment of the patient has to be abandoned. 
"In the case before us it was evident that the lower jaw could not be 
carried forward without first expanding the upper arch. This was done 
by means of a thin rubber plate, into which was vulcanized a German 
silver jackscrew. To hold the width which was thus gained, and at the 
same time to flatten the arch, another plate was made. A spring German 
silver wire was bent around close to the outside of the teeth, with its 
ends embedded in the plate at the sides. From time to time the wire 
was bent so as to bear hard on the mesial edges of the centrals, and thus 
the arch was gradually flattened. 
"This being done, the next step was a more difficult one, which was 
to lengthen the bite and at the same time draw the lower jaw forward. 
"This plate was made thick over the bicuspids and the first molars W. S. DAVENPORT TO GEORGE C. AINSWORTH 
829 
and behind the front teeth. Deep depressions were made in the plate 
a little forward of the places where the cusps of the lower teeth would 
naturally touch the plate. The result was that the patient began to 
carry the lower jaw forward a little, so that the teeth would enter these 
depressions. 
"It was found, however, that a plate which covered the bicuspids 
and first molars prevented these teeth, both in the upper and lower jaws, 
from elongating and forming a now articulation to correspond with the 
lengthened bite. Therefore another plate was made for the upper arch. 
This one was thickened only behind the front teeth, where depressions 
were made to receive the points of the lower incisors. No other teeth 
of the lower jaw were allowed to touch any part of the plate. This plate 
was held firmly in place by wire clasps encircling the first molars. There 
was also attached to this plate a wire which passed around the outside 
of the front teeth to keep them in the flattened position which they had 
assumed. 
"In making this plate much care was required to have the depressions 
in just the right places, and of exactly the proper depth. 
"A wax and paraffin base-plate was fitted to the plaster model of the 
upper arch. To the part where the plate was to be thickened soft yellow 
wax was then added. While the wax was soft the base-plate was in- 
serted in the mouth, and the patient told to throw the lower jaw forward 
and bite into the wax, thus determining how much the jaw was then to 
be carried forward and the bite lengthened. This was an important 
question, for a slight variation at this point might have produced an un- 
fortunate result. Several plates of this character were made, as the 
amount to be gained had to be gradually accomplished. 
"When the case was begun but one second molar had begun to ap- 
pear; when the work was completed, all four of these molars had erupted 
and interlocked with each other. The result was that the patient could 
comfortably bring her jaws together only as they had been newly related. 
"All that then remained was for the bicuspids and first molars to 
complete their articulation, which they are doing. 
"It was necessary to carry the lower jaw forward while the second 
molars were erupting, as the retaining of the jaw in the new position 
depended entirely on the articulating of these teeth. Unless the opera- 
tion had been undertaken at just this time, it is doubtful if it could have 
been accomplished. It would not have been possible to secure the re- 
taining of the jaws in the relation they now are, had the attempt been 
made at an earlier or a later time." 
Theodore Francis Chupein (1830-1901), {Dental Office and Laboratory, 
July, 1894), "Attaching Regulating Appliances." 
"Sometimes, in making a vulcanite crib or covering over the bicuspids 830 
ORTHODONTICS HISTORICAL REVIEW 
and molars to be used as a buttress or point of resistance for the jack- 
screw to press against, this crib drops off or loosens, thus defeating the 
object. We have found that they may be made to hold securely by 
lining the entire surface with moderately thin oxyphosphate cements, 
wiping the tooth dry and forcing the crib in place. After it has set 
hard the pressure on the jackscrew niay be applied with no fear of its 
coming off or getting loose." 
DRAWING DOWN AN UPPER CENTRAL 
In the case of Drawing Down an Upper Central he reported a case of 
a superior central incisor broken off, but left long enough to be brought 
down in regular order with the other teeth. 
"A cap of gold was made to fit the broken tooth. For the two ad- 
joining teeth, saddle caps were made. A bar extending from one to the 
other of these caps was soldered to the ends of them, a hole was drilled 
in it over the end of the fractured tooth, to admit a screw post, which 
was adjusted and soldered to the cap of the fractured tooth. The ap- 
pliance was set with cement, and a tap was placed on the screw post, 
which, on being turned, traded the short tooth. The elongation was 
accomplished in about five days. As a retainer, thin caps were made 
for the three teeth; to them was soldered a bar on the labial surfaces; 
these were cemented in position." 
Again in the September number of the same Journal we find in speak- 
ing of "Protrusion of the Upper Teeth Regulated": 
" Deformities of this kind produce a great disfigurement of the counte- 
nance, and when unsightliness is rectified so as fo produce a harmony, 
the aid of all parents should be enlisted in the work. 
"A correct impression of the upper and lower teeth is taken, with 
modeling compound, to serve as a history of the case, and the two models 
made from these are placed together to show the natural articulation. 
A plaster of Paris impression is taken of the two central incisors, and 
after the sides of this are luted, crown, or low melting fusible metal is 
poured into this impression. This gives a correct die of the front teeth, 
over which a gold cap may be accurately fitted, by burnishing pure gold 
of No. 30 or 32 gauge, to it, after having first made a thin lead pattern 
of the cap. 
"The cap made, two little hooks or headed platinum pins, such as 
may be made by breaking an old vulcanite tooth and using the pins from 
it, are soldered to it on each distolabial edge. 
"We next proceed to bend, in the mouth, around the first molars, two 
thin German silver bands. This is done by passing the metal, which 
should be about one-eighth of an inch wide, around these teeth, and 
drawing it tightly against the tooth by seizing the ends with a pair of W. S. DAVENPORT TO GEORGE C. AINSWORTH 
831 
flat-nose pliers. The band thus formed is carefully removed from the 
tooth and heated red hot while held by the pliers. By doing this, when 
the pliers release their hold of the ends of the band, the metal being 
changed by the heat, will not spring away, and they can then be ac- 
curately soldered together. The band thus formed may be placed on a 
wooden stick or tapering mandril, and the ends which have been soldered 
may be filed, or the soldered ends may be bent backward so as to form 
a hook. 
" These preliminaries accomplished, the cap is cemented to the two 
front teeth with phosphate cement, and the bands also cemented to the 
molar teeth. It may be a valuable precaution regarding these molar 
bands to solder a small tick, at some suitable point, to them, and when 
they are cemented to the teeth to bend the tick over the masticating 
surface to prevent the band working up to the neck of the teeth, burying 
itself in this tissue, and causing intolerable pain. 
"The bands and caps being adjusted, as shown in Fig. 551, elastic 
bands are hooked over the pins or hooks of the caps and stretched back 
and hooked over the molar bands. 
"We omitted to say that in order to obtain room for the backward 
traction of these teeth, the first bicuspids were extracted. 
"It might be found that the elastic bands, after having been worn a 
week, lose their strength or elasticity, in which ease they should be 
changed weekly or oftener. The progress is slow, but as the appliances 
give little discomfort, is therefore no impediment to mastication, or to 
the proper cleansing or brushing of the teeth; the time consumed is not 
of much moment. 
"Should the elastic bands slip down and bury themselves into the 
gum, this may be rectified by placing a little hook over the eye-teeth, 
which will lift it from the gum, and hold it in position by the resilience 
of the rubber. Such a hook is formed of a piece of plate, snipped by the 
shears so as to make two ends on one side, and a single end on the other; 
to the single end the hook is bent, while the two extensions are pressed 
over, in order to let the point of the eye-tooth protrude." 
It is not my desire, nor intention, to settle in this history, questions 
of priority, especially the much debatable subject of the origin and use 
of the intermaxillary elastics. Both Baker and Case in 1893, suggested 
the use of clastics, though it appears each had in mind a different pur- 
pose. Baker mentioned the possibility of protruding the mandible, as 
in Class II (Angle) cases and thus establishing normal occlusion, while 
Case endeavored to retract the mandible and as an auxiliary anchorage 
to an operation for the labial movement of the upper incisors. For 
some unknown reason the importance of either of these methods was 832 
ORTHODONTICS HISTORICAL REVIEW 
lost sight of, until about 1904 when Angle applied the term of "Baker 
Anchorage." It has always been a mystery to me why Farrar in his 
second volume, published in 1897, fails to mention either of the above 
suggestions or such use of elastics. 
Henry Albert Baker (1848- ). In the International Dental Journal, 
1894, p. 263, H. A. Baker on "Orthodontia." "Mr. President and Gen- 
tlemen: Dr. Ainsworth and I do not claim to bring anything new before 
this meeting. We merely show a method by which regulating is. made 
easy. We believe this method to be adapted to a greater variety of 
cases than any other with which we are familiar. It has to do with bands, 
a spread-plate, and retaining spurs. 
"The band is, in many ways, orignal with Dr. Ainsworth. He has 
already brought it before this Society. I have of late adopted it in most 
cases. 
Fig. 551.-Chupein (1894). 
"The spread-plate differs from others in this respect, that the screw 
is made of German silver and the nuts are vulcanized into the rubber. 
With this appliance you can push the teeth on one side more than on 
the other by properly slanting the screw; this can be done although the 
plate is split equally on both sides. Dr. Ainsworth, I think, claims the 
originality of this arrangement. 
"The spur I believe to be the original with myself, and is adapted to 
the retention of a great many cases, after having been regulated. In 
many instances no other retainer need be used. It consists of a little 
spur or pin projecting from a cavity in one tooth, and resting on the 
adjacent tooth, thus holding the teeth in position. It is particularly use- 
ful in holding a tooth after being rotated, or in holding one or more teeth 
in line. Many cases have been retained by these spurs alone, without 
other appliances. I have here the models of a few cases, which I will 
show. W. S. DAVENPORT TO GEORGE C. AINSWORTH 
833 
"Nearly all these cases have been regulated by means of Dr. Ains- 
worth's band. This ease has a right central turned a quarter way round, 
and a right cuspid placed outside of the arch. The irregular teeth are 
now in good line, and held in position by spurs. Here is another case, 
which is very much out of line, both as regards the upper and under 
teeth; the upper ones only have been regulated, and are now held in 
place by retaining spurs. Here is another case, in which the right cus- 
pid is very much out of line, and the arch contracted. In this case I 
used the band in the connection with the spur as a retainer. This case 
shows a separation of the front teeth. The under teeth seemed to throw 
the upper ones out, making a space of about one-sixteenth of an inch 
between the incisors. This condition was corrected by the use of the 
band, which threw back the front teeth, both upper and lower. These 
teeth were retained in position by a wire hook passing around the upper 
centrals. I do not claim that they will remain in place. There is a 
cause for the separation of these teeth, and I do not know whether or 
not there is any remedy for it. I have here a bad case of protruding 
upper jaw, or a much receding lower one. This case is my own family, 
and no one wishes it corrected more than I do. My plan of treatment 
is to put in place bands on both upper and lower teeth, and spread the 
arches by tying to the bands, all the teeth in front of the molars. Then to 
take four square nuts, and solder a hook to each, and screw them onto the 
bands. Elastics are to be slipped over these hooks. The child is to 
wear the appliance constantly. You will see that the tendency of this 
arrangement will be to draw the upper jaw back and the lower one out, 
and so jump the bite. The right central and right lateral are both 
twisted. The right central was turned to place, and a spur put in the 
mesial surface of the right lateral, the spur holding the central in place. 
After twisting the right lateral to place, it was retained by drilling' into 
the distal side of the right lateral, and putting in a spur which rested 
on the cuspid. Another spur in the mesial surface of the right central 
rested on the palatal surface of the left central. 
"George C. Ainsworth.-The apparatus used in the correction of the 
cases which I present tonight is the same which I brought before the Acad- 
emy about a year ago, and as to the details of this apparatus, I believe I 
may claim some originality. It was in use by me two or three years before 
I brought it before this society. The apparatus is a modification of the 
Patrick band, from which I failed to get satisfaction. After discarding 
this, I tried a band having its ends soldered to the anchor bands which 
were about the molars. But the heating of the band necessary to this 
operation removed its spring temper, a most important quality. Tn 
seeking a way to overcome this difficulty, I devised this method. The 
ends of the band were provided with a thread and nuts, and were al- 834 
ORTHODONTICS -HISTORICAL REVIEW 
lowed to pass through tubes about a quarter of an inch in length, which 
were soldered to the sides of the anchor bands, these bands being placed 
upon the molars. Here is a case where the upper front teeth protrude 
very much, the arch being contracted at the bicuspids. The lower teeth 
strike one space too far back. My first step was to spread the upper arch 
so as to make a fair occlusion when the under teeth were closed one space 
further forward. After spreading the arch, I put the nuts at the rear 
ends of the tubes, and drew the front teeth in until the upper arch was 
in proper shape. I then instructed the patient to project the under jaw 
in closing the mouth, and relied upon her intelligence to accomplish the 
desired result. In this way the bite was successfully jumped. At first, 
('specially at night, she found it difficult to keep her mouth closed in the 
new way. In the morning the occlusion would be more natural in the 
old way. She has entirely overcome that now. Had I used Dr. Baker's 
spurs on the laterals, they would have been held more positively, but the 
result is not satisfactory as it is. I use German silver for my bands, 
but I know of no objection to using platinized gold. There is no one 
system of regulating which is invariably better than another. I believe 
the best system of regulating is that to which the operator is most ac- 
customed. There is comparatively little trouble in moving teeth into 
proper position, but it is a great problem to hold them there. Here is a 
case of very prominent upper teeth, and it was very difficult to hold 
them in place after regulation, because the child did not appreciate 
what was being done for her." 
Baker, in the International Dental Journal, 1904, page 344: "Treat- 
ment of Protruding and Receding Jaws by the Use of the Intermaxillary 
Elastics." 
"To my mind, of all the authors who have written upon the subject 
of Orthodontia, no one has given the term irregularities of the teeth so 
correct a definition as Edward H. Angle when he defined the term as 
malocclusion, for wherever you find irregular teeth you will find mal- 
occlusion. With perfect occlusion you will invariably find regular teeth. 
"Not only do 1 give him the credit of giving the most correct defini- 
tion, but I also believe he has given to the profession the best appliance 
for its correction, although he disclaims the originality of it, his only 
claim being a modification of an old method. 
"The arches can be expanded or contracted, protrusion or recession 
of the jaws corrected, bringing into line in- and outstanding teeth, cor- 
recting lack of anterior occlusion by elongation of the teeth, and by the 
same means bringing into position partially erupted teeth; also rotation 
in all its forms and combinations can be accomplished to advantage 
with it, which practically covers all varieties of malocclusion. W. S. DAVENPORT TO GEORGE C. AINSWORTH 
835 
"Another advantage of this appliance and its modifications is the great 
amount of resistance that can be obtained, not only from the anchor teeth, 
but from all teeth of the jaw which can be brought to bear on those that 
are to be moved, thus diminishing the danger of displacing or tipping, 
the anchor teeth, which is apt to occur unless the operator is very skil- 
ful. I wish to go a step farther and say that the teeth of the opposite 
jaw from which the appliance is fixed will serve as resistance by the 
principle of inclined plane, a force that is of great importance in regu- 
lating, both to help or retard the work, according to whether the oper- 
ator uses the force to work with him or ignores it, in which case it is 
very liable to work against him, and he wonders why he fails. Still 
another advantage is that if one or more of the teeth need more force 
applied, simply ligate them firmer or oftener than the others, or, if 
they are moving too rapidly, reverse the process and give them rest; thus 
the appliance is well under control. 
"We will endeavor to show how it is especially adapted to correct the 
class of cases that come under the title of this paper,-namely, protrud- 
ing and receding jaws, which affect the expression of the face more than 
any other class. To be successful in correcting them, one should always 
have an ideal in mind and endeavor to approach it. 
"As we all very well know, the common device for correcting protru- 
sion is the head-cap and the bit, which in the first place is very unsightly 
as well as uncomfortable; and secondly, my experience is that the pa- 
tients object to it more than any other device connected with orthodon- 
tia. Because so many patients refuse to undergo the treatment with 
such an appliance, I have given the above question considerable study. 
"My youngest son was afflicted with a very pronounced case of pro- 
trusion and recession of the jaws, for which I studied out a course of 
treatment which I thought would be effective. 
"I brought my study model before the American Academy of Dental 
Science (189?) and explained my method, after which I proceeded as I 
explained and carried the case through without a false step, if you will 
permit me to say so. 
"Case 1.-When my youngest son was an infant of six weeks, condi- 
tions were such that we were obliged to bring him up by artificial means, 
and he acquired the habit, so common among children, of keeping the 
rubber nipple in his mouth almost constantly. As a result, the gentle 
pressure of the soft rubber caused the deformity in his delicate jaws 
before being discovered, and after his permanent teeth had been erupted 
presented the appearance as shown. Carefully considering the case, I 
decided to wait until just before the lower twelfth-year molars erupted. 
"While studying these models, by sliding the lower jaw forward so 
that the sixth-year molars would be in a normal occlusion I found that 836 
ORTHODONTICS-HISTORICAL REVIEW 
with a very little spreading of the arches and slightly retracting the 
upper incisors I would get the proper occlusion. By close observation 
we notice the deformity is confined to more of a recession of the lower 
jaw than protrusion of the upper. As the correction requires very little 
tooth movement and considerable forward bodily motion of the lower 
jaw, it was a great problem to me what force to apply to produce this 
result. I studied the case long and carefully, and it occurred to me that 
by using the Angle appliances in combination with elastic pressure ap- 
plied in such a way as to obtain what we might call reciprocal anchor- 
age, that is, to retract the superior incisors and at the same time bring 
the lower jaw forward to its normal position, we could obtain the desired 
results. To apply this theory I attached a moderately heavy elastic to 
each side of the lower appliance by slipping them over the ends of the 
tubes of the anchor bands, stretching them forward, and fastening to 
the superior expansion arch between the cuspids and laterals. (Being a 
case I could constantly watch, I decided to make the trial.) I took my 
models before the American Academy of Dental Science and explained 
my method of procedure, requesting it to be put on record as a new 
device for correcting protruding and receding jaws. I commenced the 
case in the spring of 1893. I was astonished with the result. In two 
months' time the teeth were occluding in a normal position; but for 
fear that they might return to their former position, I reduced the size 
and strength of the elastics and kept them in that way several months, 
longer, and by so doing they settled into perfect occlusion. 
"The next step was to retain them. My experience with rubber retain- 
ing plates festooned around the teeth was so unsatisfactory that I thought 
out a method of retaining which I hoped would be more satisfactory. 
The features of this device are, first, the extremely small amount of con- 
tact between the retainer and the enamel of the teeth, therefore improv- 
ing the sanitary conditions which reduces the liability of causing decay 
to a minimum. The second feature of advantage is the amount of free- 
dom that is allowed the teeth, permitting them to settle into proper 
occlusion, as well as the range of adjustment that is allowed by the 
alterations of the metallic spurs. 
"The retainer consists of a vulcanite suction-plate covering enough 
of the vault to insure its stability. From the plate radiate platinized 
gold spurs bearing at a single point against the cuspids, bicuspids, and 
molars. The incisors are held in their intended position by a wire of the 
same material passing around their labial surfaces and entering the 
palatal surface of the plate by being adjusted between the laterals and 
cuspids, care being taken not to interfere with the occlusion, either by 
the striking of the lower teeth or by separating the cuspid and lateral. 
"The lower retainer was made on the same general principle as the W. S. DAVENPORT TO GEORGE C. AINSWORTH 
837 
superior, excepting that suction was out of the question for holding the 
appliance in place. For this purpose I arranged a snap device similar 
to those used in coin purses. We see that the first bicuspids are 
banded, and to these bands solder was flowed to thicken them, into 
which deep notches were filed for the purpose of holding spurs project- 
ing from the plate. These spurs snap into the notches in the same man- 
ner that the snap fastener of a coin purse works. The plate is further 
prevented from sinking into the soft tissue of the floor of the mouth 
by uprights from the heel of the plate hooking over the crevices of the 
molars. To prevent backward movement of the plate, spurs were ex- 
tended from it on either side, resting on the mesial surface of the sixth- 
year molars. It is readily seen that both of these retainers can be re- 
moved by the patient for cleansing purposes, which I consider a great 
feature. " 
Grant Mitchell, Ohio Dental Journal, February, 1895, "Enameling De- 
taining Appliance": 
"After the teeth have been regulated, making the retaining bands of 
platinum plate of suitable gauge, solder with pure gold, coat the labial 
surface with properly shaded enamel, and bake." 
George Cunningham (1851-1919), Dental Record, London, 1895, "Luxa- 
tion or the Immediate Method of Treating Irregular Teeth." 
"Many interesting cases treated by the author after this manner are 
illustrated. His modus operandi is as follows: 
"AH the teeth should be thoroughly scaled, cavities filled, and an alco- 
holic saccharine wash used several times a day before operation. 
"On the day of operation. Brushing the teeth and bathing them with 
saccharine wash-better with H2O2 than H2O for dilution-same wash 
after the operation and frequently next few days. 
"It is well, except in the simplest cases, to have studied a model, mak- 
ing the rearrangement of the teeth on a duplicate model. If a splint 
can be prepared from this, ready for use immediately after the operation, 
so much the better. 
"All being ready, cut the alveolus with a thin circular saw, % inch to 
1% inch in diameter, not thicker than thin note paper, into such sections 
as are necessary. This is quickly done, and can be borne quite frequently 
without any anesthetic. Forceps, elevator, or other instrument is used 
for pushing, pulling, or rotating the tooth sections into place. Forceps 
should have the beaks guarded. I use copper sheaths molded and sol- 
dered so as to fit the beaks fairly tightly. Rubber sheaths, soft or hard, 
will also do. Dr. Bryan's special forceps with curved support for bring- 
ing a tooth inside the arch into line seems well adapted for this purpose. 
Moving teeth backward or rotating teeth out of line into the arch is 
much facilitated when a badly carious neighboring tooth is extracted. 838 
ORTHODONTICS -HISTORICAL REVIEW 
This extraction may be clone at the time, but possibly better two clays 
or so previously, as the local postoperative inflammation facilitates the 
bending and movements of the alveolus. Tn such cases the sectionizing 
of the tooth and its alveolus may be clone with a pair of surgical bone 
cutters, or even with Physick forceps. The wedge-shaped beaks of the 
latter are extremely useful when it is necessary to push the teeth back- 
wards. The movement of the tooth or teeth into the desired position 
may be very easy, but often requires great strength carefully applied. 
One to six teeth have been so moved. The chief point in the operation 
is to move each tooth with its socket entire as far as that may be possible. 
"The teeth when in position should be ligated with silk or thin sil- 
vered steel wire, preferably the latter, or fixed in a splint. Thin German 
silver or platinum bands soldered together make a good splint. 
"Care must be taken in closing the teeth, as the articulation is almost 
certain to require adjustment by disking, etc. Carborundum wheels work 
quickest. 
"When finished, syringe thoroughly with peroxide, saccharine wash, 
especially any pockets or spaces marking the previous positions of the 
moved teeth. Paint all the bleeding or cut surfaces with Richardson's 
styptic colloid. To a saturated solution of tannic acid in alcohol and 
ether (equal parts) pyroxylin (gun-cotton) is added, as the liquid will 
dissolve (tannin collodion preparation). The pain has usually subsided 
by this time and the patient feels fairly comfortable. The patient should 
be seen next day in case the teeth have moved-syringing, styptic and 
cleansing, as before. If possible, continue this treatment for the next 
few days, the patient always using the wash after meals. In a few cases 
new ligatures may be unnecessary; ligatures should be renewed or dis- 
pensed with as required by the indications. A period of three or four 
weeks is usually ample time for retention by ligatures or splints." 
J. E. Grevers, before the Odontological Society of Great Britain, 
1897, on "Notes on Various Forms of the Articulation of the Upper and 
Lower Teeth," reviewed the classification of Carabelli, 1884; Sternfeld, 
1888, and Iszlai, 1881, criticising them but added nothing of value nor a 
substitute classification. 
In the Items of Interest for 1897 we find a series of articles on "Theory 
and Practice." The cases under discussion were where prognathism had 
to be overcome. The most interesting one was that presented by William 
Jar vie. 
"This case was commenced by making an apparatus after the Jackson 
method. It consisted of a crib of piano wire upon both sides of the 
upper jaw, which embraced the two bicuspids and molars as supports. 
"These cribs were connected with a wire passing in front of, and in 
close contact with the incisor teeth. Instead of being in a straight line W. S. DAVENPORT TO GEORGE C. AINSWORTH 
839 
from bicuspid to bicuspid, the connecting wire was bent, between the 
cuspids and first bicuspids, in the form of an inverted letter U, and to 
this connecting wire were soldered hooks which turned over and rested 
against the cutting edges of the four incisors. 
''This apparatus was inserted about December 1st, 1893, and the move- 
ment of the teeth was induced by bending towards each other the sides 
of the loops, two or three times each week, thus forcing the incisors in- 
wards, while the hooks over the cutting edges prevented the elongation 
of the teeth. The incisor teeth were in proper position by April 1st, 1894, 
when the arch was widened by straightening somewhat the supporting 
wire across the roof of the mouth. 
"May 1st, 1894, a retaining crib of gold and platinum wire was made, 
passing in front of the incisor teeth with hooks attached and arranged 
as in the regulating apparatus. 
"November 15, 1894, an apparatus was inserted in the lower jaw sim- 
ilar to the one made for the upper, a strong supporting wire passing 
behind and near to the incisors. A little straightening of this wire 
caused the spreading of the lower arch. From the crib on either side was 
a small connecting wire passing in front of and in close contact to the 
incisors. To this were attached hooks, one resting upon the cutting edge 
of each of the four incisors. These hooks were bent two or three times 
each week, and thus these teeth were forced into their sockets, making 
them shorter and relieving their occlusion upon the lingual surface of 
the upper teeth. 
"If I had written this report at the time the retaining plates were 
inserted, I could truthfully have said that the result had been a great 
success, but, as we sometimes learn as much from unfortunate termina- 
tions as we do from successes, I will report the sequel. 
"March 1st, 1895, everything indicated a permanent and happy result 
of this case. The lad, though delicate and of nervous temperament, had 
improved in physique during the operation and he had regular teeth and 
a greatly improved physiognomy. But in the following autumn there 
was the commencement of decay in many of his teeth. In spite of all 
my care and the care customarily given by a boy of thirteen, cavity after 
cavity developed. The presence of the retaining plates, which were sup- 
posed to be removed several times each day for cleansing, seemed to 
accelerate decomposition and fermentation, and in the spring of 1896 
decay progressed so rapidly and cavities became so numerous that al- 
though I realized the retaining plates should be worn longer, I deter- 
mined that unless the conditions were made more favorable decay would 
destroy all the teeth, and it would be wiser to remove all the plates and 
take whatever chances there might be for a return to the original posi- 840 
ORTHODONTICS HISTORICAL REVIEW 
tions of the teeth. The sanitary position of the mouth is much improved, 
but the teeth have partially resumed their old position." 
Wilhelm Sachs considered the treatment of prognathism and describes 
his method as follows: 
"I will report a typical case, from my practice, which may be of in- 
terest to those occupied with the correction of irregularities, because it 
facilitates progress, by simplifying the usually lengthy progress of treat- 
ment. 
"One of the most disfiguring anomalies is a prominence of the anterior 
superior teeth. Many writers have explained this malposition as a con- 
sequence of thumb-sucking. This may account for some cases, but in 
many others the condition is the result of heredity. From a purely prac- 
tical standpoint, we may ignore the etiologic aspect of the subject, be- 
cause, whether acquired or congenital, the treatment must be the same. 
Tt is the dentist's more important duty to find the surest method of re- 
storing the teeth to a normal position. Cosmetic considerations, as well 
as the preservation of the teeth themselves demand this. 
"In prognathism of the upper jaw we find the lower teeth occluding 
with the slanted palatal surfaces of their antagonists at or near their 
necks, and in more pronounced cases the lower incisors strike against 
the gum tissue of the upper jaw. Pressure during mastication is in such 
a direction that a leverage is exerted, the tendency of which is to throw 
the upper teeth further outward, the teeth spreading fan-shaped, slowly 
elongating, and finally loosening, until removal is necessary later in life. 
This theory contradicts the prevailing notion that regulation of teeth 
is apart from their preservation. I further believe that not only a 
prominence of the teeth, but other abnormal positions, whether of a 
single tooth or the entire set, may lead to premature loss. Teeth which 
overlap or stand crowded together afford lodgment for food and invite 
caries. Orthodontia therefore preserves, as well as rearranges teeth. 
"If pressure be brought to bear upon teeth in a protruded position, 
the force being exerted solely upon the labial surfaces, the result, when 
they are finally brought into proper place, will be an elongation of the 
teeth, either apparent or real. To prevent this, in the Kingsley appa- 
ratus, the mouth appliance covers the cutting edges of the teeth, and 
the elastic bands extend back to the skullcap in an upwardly oblique 
direction, the result being that the teeth are driven up into their sockets 
as they are carried backward. 
"The Kingsley appliance serves its purpose, but very few patients 
can be persuaded to wear such a cumbersome and disfiguring apparatus. 
"My method obviates the necessity for the skullcap, as well as the 
protruding arms of the mouth fixture, yet acts so as to prevent elonga- 
tion of the teeth. An appliance of clasp-gold wire was constructed to fit W. S. DAVENPORT TO GEORGE C. AINSWORTH 
841 
closely the labial surfaces of the incisors, extending over the cutting 
edges. A silver plate was fitted to the roof of the mouth, not reaching 
the incisor teeth, a space of three quarters of an inch being left to 
permit the backward movement. As the occlusion of the posterior region 
was very accurate, leaving no room for the passage of clasps, the plate 
itself was extended over the cutting edges of the molars and bicuspids. 
"To this plate, opposite the bicuspids, was soldered a stout extension, 
as shown in the illustration, in the free end of which a slot was cut for 
the reception of the rubber ligature. The two parts of the appliance 
being in position, and united by a rubber ligature from the extension in 
the bicuspid region, to the fixture over the incisors, it is seen that the 
pressure exerted, while backward, is slantingly upward, which would 
obviate any elongation. The patient herself renewed the ligatures two 
or three times a week, using smaller rings as the case progressed. 
"The retainer was worn for eighteen months, by which time the teeth 
had become firmly rooted in their new position. The retainer was also 
of silver, swaged to fit the roof of the mouth, and extending fully over 
the molars and bicuspids, but only engaging the cutting edges of the 
anterior teeth sufficiently to hold them in position, without showing too 
much metal. 
"The method here described has the advantage of not disfiguring the 
patient during the regulation of the teeth, and does not annoy the 
wearer after the first two or three days. The further fact that the 
chief care of the plate may be attended by the patient is especially ad- 
vantageous where the child lives out of the city. A rubber plate may 
be used in place of the metal, but is less satisfactory, since it must be 
thicker to avoid breakage. I have utilized this apparatus in ten cases 
with the greatest success, and heartily recommend it to my colleagues." 
Rodrigues Ottolengui describes a similar apparatus: 
"The above article, forwarded from across the ocean, is abundant evi- 
dence that all that is original of dental science does not necessarily come 
from America. Yet it is noteworthy that dentistry has reached such a 
plane, and so many are working along similar lines, dealing with similar 
problems, that an absolutely original method or device is very rarely 
recorded. The method described by Dr. Sachs, and more especially the 
illustrations accompanying it, is practically a description of a method 
which I had supposed entirely peculiar to myself, and it may be of in- 
terest to have both instruments described and illustrated together. 
"Dr. Sachs has constructed his appliance in recognition of the possi- 
bility of elongation of the incisors in progress of the backward move- 
ment, but his carrying of the plate over the masticating edges of the 
teeth seems to have had no special motive beyond the convenience of so 842 
ORTHODONTICS HISTORICAL REVIEW 
doing, because the occlusion prevented his reaching the buccal portion 
of the mouth, for his arm, which was to hold one end of the ligature. 
"My old appliance was evolved on opposite lines. It is usually be- 
lieved that if a band is placed around a molar, and used for resistance 
in moving an anterior tooth, that the full resistance to the force includes 
the bicuspids as well as the banded tooth. Long ago I concluded that 
this is only partially true, and that it is possible to cause an elongation 
of a single tooth thus used for a resistance, despite the fact that the 
arch may be filled with teeth. Where I have feared such a result, I have 
used pure gold plate, about 29 g., and struck up a continuous cap, cov- 
ering the molars and bicuspids, and partly lapping the gum at that 
palatal aspect. To this continuous cap 1 have soldered such wires, hooks 
or other attachments as would be required. This gold cap was then 
Fig. 552. 
Fig. 553. 
Fig. 552 and 553.-Ottolengui (1894). 
firmly cemented to the teeth, binding them all together, and thus assuring 
me that I might depend upon them all as a single anchorage. These 
caps are made of pure gold, as with that pliable metal they have a 
wider range of usefulness, it being possible thus to cap shorter teeth 
than were a more resistant metal used. When placed in position the 
gold is burnished tightly to the buccal and palatal surfaces of the teeth, 
and with a small egg-shaped burnisher and gentle taps with the mallet 
is forced between the teeth, thus getting a hold not attainable with 
silver, German silver, or even with platinum. 
"Having used these continuous caps for years, it was but natural in 
dealing with a patient who declined to wear the skullcap, that I should 
construct the appliance shown in the accompanying illustrations. In 
this instance the patient was but nine years of age, and it was necessary, 
as a primary step in the correction, to retract the two central incisors. W. S. DAVENPORT TO GEOROE C. AINSWORTH 
843 
A cap of pure gold was constructed by swaging, and this, having a wire 
soldered across the labial surfaces, forming two loops, was then cemented 
to the two teeth. Continuous caps for the molars (both temporary 
molars on each side being still in place) were then made in the usual 
manner, except that the metal was extended to cover the gum at the 
buccal aspect, extending high up under the lip opposite the site of the 
first bicuspids (had they been present). The upper edge of this plate 
was made rigid and comfortable by soldering a wire along the edge. At 
the highest point, in the bicuspid region, a hook was fashioned, and an- 
other opposite the molar. These caps were also held in place with 
cement. At the outset the rubber ligatures were attached, stretching 
from the corners of the incisors to the first and highest hooks on the 
back pieces. Later, as more pressure became endurable the ligatures 
passed over these hooks, and back to the hooks opposite the molars. In 
either arrangement the ligatures exert pressure upward as well as back- 
ward, and in this particular my method is identical with that of Dr. 
Sachs. 
"Fig. 552 shows the buccal aspects of the apparatus, with the ligature 
in position. Fig. 553 shows the roof of the mouth, and the general shape 
of the various pieces cemented.to the teeth." 
Ottolengui in the Dental Cosmos, 1899, page 1116, "Extraction and 
Delayed versus Expansion and Early Interference in the Treatment of 
Prognathism." 
"I desire to present for your consideration the histories of two cases 
from practice which taken singly and separately might not justify my 
intrusion upon the society, but studied together I believe they so well 
illustrate the mischievousness of certain methods of procedure hereto- 
fore considered sound by many of our best men that a description of the 
two cases in detail will merit your attention. 
"The chief purposes of this paper may be summarized as follows: 
"First. That by early interference and expansion in cases of protru- 
sion the upper jaw may be made large enough to receive the unerupted 
teeth, thus in the end not only attaining correct occlusion and beautiful 
external symmetry, but retaining all the dental organs. If such a case 
has been reported before, it has escaped my notice. 
"Second. The theory of removing the first permanent molars in cases 
of upper protrusion, with the idea that the jaws will fall back, is a false 
one, attended by many evils, not the least of which is the fact that 
subsequent regulation is made doubly difficult because at the age when 
it would be attempted, in accordance with the plan of delay, such wait- 
ing having proved to be in vain, the second permanent molars, which 
must serve as anchorage, would be as little developed as were the first 
permanent molars when the latter were extracted. But the main diffi- 844 
ORTHODONTICS HISTORICAL REVIEW 
culty with this plan is the unnecessary loss of the two important organs, 
for it must be remembered that I am speaking of the extraction of per- 
fectly sound teeth. 
"Third. That with the use of proper fixtures, made of pure metals 
where they enter the mouth, perfect oral prophylaxis may be assured, 
even extensive regulation being possible without the least danger of in- 
ducing caries; and this is especially true if the fixtures are removable 
and can be boiled, and if such fixtures are not retained during meals, 
by which precaution it is certain that food cannot be lodged upon them. 
"Fourth. That the eruption of tardy teeth may be facilitated by oper- 
ative measures." 
0. W. Bedell, Items of Interest, 1897, p. 598, "A Simple Appliance for 
Moving Single Teeth." 
Fig\ 554.-Bedell (1897). 
"I tried the following little appliance with most satisfactory results: 
"A band is made for either the second bicuspid or first molars, de- 
pending on the number of teeth to be moved, and the relative amount of 
force necessary to accomplish the movement. These bands are made of 
German silver or other suitable material, and either have adjusting nuts 
or made to measure as a driving fit. A large size wire 8, 10 or 12 gauge 
depending on the strength required, is then flattened by passing through 
the rolls until sufficiently thin to make a neat appliance, but still not so 
thin as to bend or spring too easily. This is then formed into an ideal 
arch extending from the bands on either side of the mouth and soldered 
securely to them. Holes are then drilled in the band exactly in front 
of the teeth to be moved, these openings being sufficiently large to allow 
the passage of a small-sized threaded wire. The teeth to be moved are 
banded with thin banding material, allowing the two ends to project W. S. DAVENPORT TO GEORGE C. AINSWORTH 
845 
towards the front, these ends being pressed tightly together by means 
of pliers. A short piece of threaded wire is split with a fine saw far 
enough to take in the projecting ends of the band. A perfect adjust- 
ment is made and the parts soldered, care being taken not to allow the 
band to extend beyond the edges of the threaded wire so as to prevent 
a nut being turned down against the band. 
"These bands with projecting threaded wires are firmly cemented to 
the teeth to be moved, the wires passed through the opening in the heavy 
arch band, and the entire appliance cemented in position. A nut is 
then turned down over the projecting ends until it rests tightly against 
the arched band, and all the surplus is cut away. The patients are sup- 
plied with a wrench and instructed to turn the nut up as fast as the 
tooth will move without soreness or discomfort, until the correct posi- 
tion is obtained, and to call occasionally to have the surplus of wire 
which would project beyond the nut and irritate the lip, cut away. 
(Fig. 554.) 
"Rotation on the axis of the tooth may also be arranged for when 
required, by simply cementing the bands to the teeth to be moved in 
such a way that the attached threaded wire comes closest to the edge 
requiring the most movement. 
"These little appliances have given splendid results in several cases; 
one being a case in which five teeth were moved forward fully a quarter 
of an inch, and all at the same time. The advantages which I have found, 
have been freedom from the pain and discomfort usually accompanying 
the use of rubber bands or ligatures; the firmness and accuracy with 
which the tooth could be moved, and the slight trouble to operator as the 
patients did most of the regulating themselves." 
George S. Monson in the Dental Cosmos, 1898, page 9T4, on "Con- 
stricted Vaults." 
"These deformities are usually classed under the head of V- and saddle- 
shaped arches. The term 'constricted vault' is here used for the reason 
that more is involved in this deformity than the mere malposition of 
the teeth. 
"The predisposing causes of this class of deformities have been a 
matter of careful study for some time, but still no satisfactory reason 
has been given for the arrest of development in the palatine process of 
the superior maxillary bone, which to all appearances seems to be the 
primary cause, and the crowding of the teeth, with the giving way of 
the tables of process, as secondary. 
"I will not take up any more of the reader's time in discussing the 
different appliances, but will at once describe one that has been used 
in my practice with great success. 
"The majority of appliances devised for this purpose, as I have said 846 
ORTHODONTICS HISTORICAL REVIEW 
before, exert their force on the teeth, and very little on the lingual por- 
tion of the bone. 
"In the construction of the appliance I am about to describe it is 
necessary to take an impression of the teeth and adjacent parts. The 
impression is poured in the usual manner and a model obtained. A die 
and counter-die are then made, using zinc and lead. With these a plate 
of German silver, .5 millimeter in thickness, is swaged to fit the vault 
of the mouth. When this is done, a piece of tubing is soldered in the 
highest portion of the vault transversely, so as to have the greatest 
force close to the greatest resistance. The plate is then cut antero- 
posteriorly in the median lino, as in Fig. 555. There are many modi- 
fications of this form which can be used to great advantage in the cor- 
rection of minor irregularity. 
Fig'. 555.-Monson (1898). 
"The tubing is also cut in the median line and a segment removed 
sufficient to allow a nut to be placed on the screw-rod which is run in 
from a hole cut through the plate on the palatal portion, opposite the 
tube. By tightening the nut on the side through which the hole is cut, 
the lateral diameter will be increased. The reason the long tube is used 
in this manner and afterward cut is to insure that the lateral sides of 
the plate shall separate on even lines, giving more even pressure to 
process and teeth. 
"Now that the jack-plate is finished, let us turn our attention to an 
appliance that will maintain the crowns of the teeth, and also the plate 
in position, until such time as the highest portion of the vault is widened. 
"A plaster model of the case is cut down to the gingival line, forming 
a type to be used for printing on paper, using printers' ink and pad. 
The line drawn lingually will represent the paper pattern. This pattern 
is reproduced in German silver, using plate 1.5 millimeters in thickness. W. S. DAVENPORT TO GEORGE C. AINSWORTH 
847 
This plate should be about 3 millimeters in thickness. This plate should 
be about 3 millimeters in width on the sides, but slightly broader in 
front where the stress is greater, as the force from the jack in the vault 
is increased. 
"At the interdental points on this plate, opposite the bicuspids and 
molars, it is sawed in about 1 millimeter; into these cuts folded bands 
are forced and soldered, soft solder being sufficient to hold them in 
position. These bands pass through the interdental spaces, and on the 
ends of them are soldered loops and screw-rods in such a manner as to 
allow them to be tightened around the respective teeth. I might say 
here that the loops and screws are fastened with silver solder to the 
bands before they are attached to the plate with soft solder. You 
will notice that this plate for retention is not cut in the median 
line, but is solid throughout its length, thus giving to us a greater 
line of resistance than that of the palatine process; the latter, 
being the lesser, will yield first, thereby widening the top of the vault 
and the floor of the nasal cavity, avoiding the tipping of the crowns of 
the teeth out and the roots in (see note), as the cut I have produced 
does not show, and in this manner diminishing the top of the vault in- 
stead of widening it as is so frequently done with those appliances which 
press the teeth at their neck. It will be noticed that this plate serves 
in a double capacity in that it holds the crowns of the teeth in position 
and prevents the plate that is exerting in force on the palatine portion 
of the bone from being displaced until the upper part of the vault carry- 
ing the roots of the teeth is sufficiently expanded. When this is accom- 
plished, the bands may be relaxed or removed, and bands without the 
plate put on the teeth to prevent the jack-plate from being displaced 
until such time as the tooth arch is enlarged. 
"The plates, bands, and other appliances may be made of any metal 
preferred; in my practice I employ eighteen to twenty per cent Ger- 
man silver, as indicated in my paper, not only because I have found it 
to sustain the necessary strain of the screw better than any other I have 
used, with the possible exception of the alloy of platinum and gold, sold 
under the name of clasp metal, but also, and more especially, because I 
have found the danger of softening of the enamel under the bands 
greatly lessened, if not wholly avoided, and I consider the temporary 
annoyance of the slight discoloration of the appliance more than com- 
pensated by the permanent disfigurement of a filling should decay follow 
the use of the bands made of other metals. 
"Note.-When force is applied to a tooth from the lingual side at 
the gingival line the tooth acts as a lever, and the buccal portion of the 
process in which it is set serves as a fulcrum, thus giving the apex of 
the tooth a radius which would be determined by the rigidity of the can- 
cellous portion of the bone." 848 
ORTHODONTICS HISTORICAL REVIEW 
J. H. Hanning' in the 1899 Items of Interest, page 562, states: 
"It gives me pleasure to bring to the notice of the profession this un- 
usual case as an example of the advantage of cooperation between sur- 
geon and dentist, at a time when the patient and her parents are with- 
out hope. 
"The patient was healthy and strong until two years of age, when 
she was attacked by scarlet fever. The early history of the case is not 
so clear as desirable. As near as can be ascertained, the fever left her 
in feeble condition, and abscesses appeared on both sides along the bor- 
der of the lower maxilla. The family physician, after treating for some 
time, resorted to mercury, which increased the trouble. 
"The case was finally abandoned by him, and a surgeon called in by 
the father of the patient. The surgeon diagnosed necrosis of the body 
and of the jaw (both sides), and advised removal to save life. 
"The necrotic bone was removed, leaving two thirds of the rami and 
chin. Seven anterior teeth were saved. The chin collapsed, having 
nothing but the tongue to support it. The periosteum deposited new 
bone, forming a new body on each side. At the age of twelve the family 
dentist told the mother that the patient's condition could not be im- 
proved. 
"The patient was fourteen years of age when I first saw her. Upon 
examination I found the lower jaw undeveloped, with a receding chin, 
and cicatrices, broad and depressed on each side at lower border of the 
jaw. The upper jaw was quite narrow, with great protrusion in incisor 
region. She had been under treatment by a throat specialist for over a 
year without relief, and used the mouth almost exclusively for breathing. 
T assured the parents and patient that an improvement could be made 
by plastic operation and regulation of teeth. 
"I asked and obtained permission to present patient at the 'Dwindle 
Clinic' for consultation. 
"None would express an opinion. 
"Left to my own resources I consulted Dr. Robert II. M. Dawbarn. 
"When Dr. Dawbarn made an examination he discovered the pharynx 
occluded with adenoids, which he decided must be removed before opera- 
tion on face or teeth. 
"On June 9, 1897, adenoids and tonsils were removed, at the patient's 
residence, from which operation she recovered quickly. 
"On June 16, 1897, at the French Hospital, the scar tissue of face and 
neck was dissected out and flaps raised from the bone. The incision 
extended from ear to ear along the lower border of the jaw. On left 
side a fistula was found which had discharged from time to time. Trac- 
ing this the surgeon found embedded in a bone a sac containing a molar 
lying at right angles to body of jaw, the crown toward tongue. This W. S. DAVENPORT TO GEORGE C. AINSWORTH 
849 
tooth was removed through wound, and abscess curetted. The edges 
of wound were brought together evenly and sutured, leaving a small 
opening on each side, through which sterilized vaseline was injected until 
face showed proper contour. The remaining aperture was closed, and a 
dressing applied. The wound did not heal readily (owing to vaseline), 
and left too broad a cicatrix. 
"A second operation on face was performed on November 1, 1897. 
"On making the incision surgeon found that vaseline was almost com- 
pletely absorbed, connective tissue filling its place. This time a rapid 
recovery ensued, the scar being narrow and depression eliminated except 
a small place on left side. 
"An examination of the mouth showed that there were no teeth strong 
enough to serve as anchors in retracting the anterior portion of the jaw. 
The cuspids were just presenting with barely enough room and a little 
outside of line of bicuspids. The first molar on the left side had been 
Fig-. 556.-Hanning, (1897). 
extracted by order of former family dentist, who told the mother that 
the incisors would fall back when this room was made. It will be seen 
that the teeth did move some on that side, but only to increase deformity. 
He also assured the mother that nothing more could be done except to 
make a plate to supply the missing molars and bicuspids of lower jaw. 
"I extracted the first bicuspids and retracted incisors with a cap and 
bit, which were worn at night only. During the day a retaining plate 
was worn. This plate was of vulcanite, covering the palate, with gold 
wire clasps and retaining wires anchored on each side of plate at space 
where first bicuspids were extracted, the free ends extending across the 
labial surface of teeth to cuspids on opposite sides. The clasps embraced 
molar on one side and bicuspid on the other. As the teeth moved back 
the anterior border of plate was trimmed and retaining wires bent back. 
"The first bit covered the four incisors. (Fig. 556 a.) 
"When regulation was about half finished the cuspids were forced out 
of alignment and considerably turned. Small gold caps (Fig. 556 &&) 
were swaged to fit cuspids. On the buccal surface of caps, tubes with ORTHODONTICS HISTORICAL REVIEW 
850 
posterior ends closed were soldered horizontally. These caps were held 
in place with cement. 
"The second bit (Fig. 556 cc) was made of German silver wire, the 
ends of which fitted the tubes. When bit was in place the central portion 
pressed upon incisors, forcing them back, while the ends in the tubes 
turned and retracted the cuspids, bringing all six anterior teeth into 
position. 
"When the regulating of the upper jaw was finished an apparatus for 
jumping the bite was introduced, and is still in use." 
E. S. Fuller, in the 1899 Items of Interest, page 17, "A Mechanism for 
Retracting and Retaining the Side Teeth." 
"Make German silver bands about 32 gauge and wide enough to reach 
from the gums to the occlusal surfaces, for the two molars. Burnish 
closely around the teeth and take a plaster impression with the bands in 
place. Make a model of any good investment compound. Solder the 
bands together. Thread a piece of fulling one-quarter inch long with a 
tap fitting the No. 3 hole in the Martin screw plate. Place it in align- 
ment with the teeth to be moved by passing through it a piece of iron 
wire and resting it against the cuspid at the proper place; solder it to 
the anterior band on its buccal surface. Make a short heavy right angle 
hook and solder it to the lingual surface of the band opposite the tube. 
Make three headed bolts and thread in the No. 3 hole in screw plate. 
The heads should fit the No. 4 watch key. They should be made from 
wire drawn down through one or two holes only, to insure its being uni- 
form in size, and to avoid too much spring. It should not be annealed. 
"The bolts should reach from the mesiobuccal angle of the cuspid, first 
bicuspid and second bicuspid, respectively, to the anchor tube on the 
molars. Roll down a piece of stiff, heavy wire to about 32 or 35 gauge 
and about one-eighth inch wide. Cut from it five ribbons, two for each 
of the bicuspids and one for the cuspid. Each should be reinforced at 
one end with a piece of ribbon one-half inch long. Punch a hole in the 
reinforced end of the cuspid ribbon to fit loosely the hook on the anchor 
bands; bring it forward and around the cuspid to its central axis and 
solder a short piece of smooth-bore tubing to it at that point. One of 
the two ribbons for each of the bicuspids should carry a threaded tube 
instead of a smooth bore, and should be about one-quarter inch shorter 
than its fellow. The parts should now be heavily gold-plated and polished 
and the anchor bands cemented to the teeth and allowed to set fully. 
To catch the second bicuspid ribbon with the smooth tube on the hook, 
carry it forward and around the tooth and pass the short bolt through 
the tube into the anchor tube. Give the patient a key and instruct him 
to tighten the screw until pressure is felt. This is to be repeated two or W. S. DAVENPORT TO GEORGE 0. AINSWORTH 
851 
three times a day until the tooth is in the desired position. Replace the 
ribbon with one having a threaded tube. (Fig. 557.) 
"Select the smooth-tubed ribbon for the first bicuspid and hook it on 
the anchor hook also. Pass the next size bolt through it and also through 
the threaded tube on the second bicuspid and into the anchor tube. 
"It may be necessary to exert a little pressure on the bolt to recover 
any retrograde movement of the tooth occasioned by the appliance hav- 
ing been removed. Retract the first bicuspid as you did the second 
and substitute the smooth tube on the first bicuspid for the threaded one. 
Place the cuspid ribbon in place and pass the long bolt through its loose 
tube and through the two other threaded ones and finally into the anchor 
tube (Fig. 557) and retract as before. The cuspid will move posteriorly, 
but the bicuspid will remain stationary, the appliance acting both as a 
Fig-. 557.-Fuller (1899). 
power machine and a retainer at the same time. The positive action of 
a screw is secured. The teeth are held so rigidly that little soreness is 
produced. 
"Gfum guards are not necessary and there will be no danger of the 
teeth rotating while being moved. A single bolt is used as a power bar 
and can be made as heavy as required. There are no nuts to loosen. 
<fIt can be easily and quickly removed and cleaned. Advantage can 
be taken to receive the best possible anchorage the case affords. It may 
be applied to a sagged arch, or anchored to a single molar if necessary 
with lessened liability to tipping, by soldering extension bars to the 
bands." 
Myland A. Knapp in the Dental Cosmos, 1899, page 762: "An Example 
in Teeth Regulating." 
"With reference to the illustrations it is to be said that the descrip- 
tive matter will be clarified by a citation of the numerical designations 852 
ORTHODONTICS HISTORICAL REVIEW 
of the devices employed and a list of these will be found in my pub- 
lished work on the subject of teeth regulation. 
"No. 35, Fig. 558, is a threaded arch bar on which are six clutch nuts, 
No. 22. The No. 8 is a molar double-socket clutch band; the No. 13 are 
single-socket clutch bands, while No. 45 is a double-socket screw clutch 
band. 
Fig. 558.-Knapp's System (1899). 
Fig. 559. 
Figs. 559 and 5 60.-Knapp (1899). 
Fig. 560. 
"In Fig. 559 is shown No. 8 fitted, wired, and cemented upon an upper 
right first molar. No. 13 is likewise fixed upon the upper right cuspid, 
and there is also secured on the upper left cuspid another button band, 
No. 13. Upon the upper left first molar a screw clutch band, No. 45, is 
cemented and screw clamped. 
"Upon the arch bar No. 3'5 six Nos. 22 have first been screwed into 
the positions shown in Fig. 558, and two bar end caps, No. 34, fixed on 
the ends of the bar. W. S. DAVENPORT TO GEORGE C. AINSWORTH 
853 
"This is then ready to be bent, placed, and adjusted in the position 
shown in Fig. 559. The open sockets of the bands are specially desig- 
nated to make easy the passing of the bar through the slots into the 
sockets, wherein it is then screwed by means of the peculiar shaped nuts 
No. 22. A magnified cut of the nut and the socket is seen in Fig. 560. 
It will be observed that the rounded or annular portion 3 of the nut 2 
will telescope and fractionally fit in the corresponding socket or sheath 
Fig-. 561. 
Fig. 562. 
Fig. 563. 
Figs. 561, 562 and 563.-Application of Knapp's principle (1899) 
C of the slotted tube B, which is soldered to the band A. The primary 
function of this construction is to provide for the lateral entrance of a 
screw bar through the slot D into the tube or sleeve B, in the telescoping 
or clutching socket C of which the nut 22 is screwed to frictionally hold 
and lock the screw bar, because of the telescoping portion 3 of the nut 
is thicker than the slot D. Consequently in placing or removing the bar 
the nut or nuts remain on the bar; obviating the hitherto very trouble- 
some necessity of pushing the bar into the tube and screwing the nut 854 
ORTHODONTICS HISTORICAL REVIEW 
onto the bar-encl located beyond the tube, which is fixed upon the tooth 
within the mouth. 
"In the present instance, illustrated in Fig. 559, the arch bar is shown 
to have been readily placed in the socketed tubes of the molar and cuspid 
bands, and operatively secured therein by turning the nuts with the wrench 
No. 29. Manifestly the turning of the distal nuts of the anchor teeth 
bands will drag the cuspids both inward and rearward, and the turning 
of the medial nuts will also force the cuspids backward. Simultaneous 
pressure on the rubber or wood block will press the right central in- 
ward with a rotative action. 
"Independent traction of the right lateral and left first bicuspid may 
be effected by means of the wire ligatures, the twisted ends of which may 
with pliers be given operatively torsional strain. The engagement of the 
wires with the screw threads affords means for giving any desired lateral 
direction to the drag. Locating the twisting stress on an outside contact 
with the bar will be more effective than the inside positions chosen for 
clearness of illustration. 
"The grouping of these several modes of arch bar regulation in this 
Fig. 559 briefly presents for selection any one, or all, of them to meet 
the requirements of a similar case in hand." 
William H. Mitchell, Dental Cosmos, 1899, page 764, "Three N.ew Regu- 
lating Devices." 
"The positive action of the screw in regulating teeth has become so 
universal that any device that will render these powerful little instru- 
ments more useful and adapt them to a more extended use will be ap- 
preciated. Therefore I present some of the later ones I have in use as 
a supplement to those that have previously been illustrated in the Dental 
Cosmos; not that I claim anything new in them, but the combination of 
those in use will add to their adaptability and produce results hereto- 
fore unattained by this method. 
"In the figure the 'pull-back' screw and push screws are combined 
in one stationary nut-post vulcanized in the plate, and are so close that 
they both operate on the same tooth. This is very positive in rotating 
centrals and laterals; for with it you work both ways on the tooth at 
once, or you are able to hold one side in exactly the same position and 
use either side as may be desired. The illustration shows it so well that 
further description is unnecessary. Change screws to reverse the motions. 
"Fig. 2 is an angle arrangement suggested by what bell hangers call 
a 'crank,' and serves to change the line of the direction of the power 
applied, and yet the pull of the tooth will be in the line that the operator 
desires. This is also vulcanized into the plate, and is used in connection 
with a Littig-Lee-Bennett 'pull-back,' found in the depots. 
"Owing to the peculiar position of the teeth in some cases, it is im- W. S. DAVENPORT TO GEORGE C. AINSWORTH 
855 
possible to place the 'pull-back' where it would do its work. Here the 
angle-post can be placed, and the 'pull-back' wired to it can be placed 
in a favorable position to exert its full power, yet be out of the way. 
"Fig. 3 shows the angle used with a push and a pull plate; A shows 
the angle with the pull-back drawing the tooth to the left; B the jack 
pushing outward, and C shows the resultant direction of the movement 
of the tooth. 
"Fig. 4 shows the nut-post with threads cut so that the screws can 
be used at right angles. Frequently useful to move two teeth at once. 
With this nut both screws can push. Two pull-backs can be used, or 
they can be used in combination." 
Although this history treats mainly with the orthodontic literature 
prior to 1900, a few exceptions have been made so as to make same 
complete. Ainsworth devised a system which later became known as the 
Ainsworth appliance and even to this day is referred to as such, for that 
reason we thought it advisable to incorporate the following article. 
George C. Ainsworth (1852- ) in the International Dental Journal, 
1904, page 481, "Some Thoughts Regarding Methods, and a New Appli- 
ance for Moving Dislocated Teeth into Position." 
"It is my purpose, this evening, to place before you three appliances, 
all of which I have been using for some time with much satisfaction, 
and while the principles involved are not now, the manner of applying 
them is, so far as I have been able to learn. The first is a self-acting, 
spreading appliance, the second is an inclined plane for jumping the 
bite and adjusting the occlusion, while the third is a simple retaining 
appliance. 
"It also seems to be the opinion of those best able to judge, that this 
work should be largely done by the specialist. Certain it is that the 
successful orthodontist must be a man of large resource,-in art, in me- 
chanics, and in patience,-for there is no hard and fast rule for the solu- 
tion of all cases, and while we may classify them in general terms, there 
still remains an individuality which necessitates an independent solution 
of the case in hand according to its merits. 
"We should study to simplify methods and appliances, to minimize 
pain, and to economize time. Along these lines I have expended much 
time and thought to produce something that should be self-acting, re- 
quiring little attention, and which should interfere as little as possible 
with the ordinary functions of the teeth and mouth, not forgetting 
cleanliness, which presupposes simplicity and a due regard for one's 
appearance. 
"Teeth are made irregular by pressure, of one sort or another, and 
without pain. Why, then, should we not expect to make them regular 
by pressure without pain1? In the first instance, the pressure is against 856 
ORTHODONTICS 11ISTORICAL REVIEW 
nature, while in the second it is in accordance, with her design. It seems, 
then, to be a question of applying the necessary force to move them in 
a proper way. 
"We have two kinds of force at our command,-the intermittent, as 
applied by the screw, and the constant, as applied by the spring, the 
lever, the ligature, and the elastic. 
"The claim has been made in favor of the screw pressure, that force 
thus applied was attended with less soreness and consequent discomfort; 
that there should be periods of rest between the periods of movement 
such as might be obtained by turning the screw each day; that the 
force having spent itself, the tooth rested until the next turn of the 
screw. That claim, it seems to me, is not borne out by facts; and while 
it undoubtedly is true that force applied by an elastic band or rubber 
wedge is attended with more soreness and consequent pain, it seems to 
be owing to the peculiar quality of elastic force as applied by rubber, 
and which differs from force as applied by a spring. What seems to be 
tolerated most kindly is a firm, gentle pressure, be it intermittent or 
otherwise. When a tooth first starts it is usually attended with slight 
tenderness, which, as a rule, quickly subsides without a letting up of 
that force; then, if the force is continued in a reasonable way, all goes 
well. 
"Again where teeth are moved slowly they are less liable to be drawn 
out of, or away from, their tissue environment,-a matter of much im- 
portance, particularly when elongating teeth. 
"We come now to a consideration of the self-acting spreading ap- 
pliance, which may have a double action, i.e., it can be so adjusted as 
to spread the arch and, when desirable, retract the incisors at the same 
time, or, by the addition of ligatures, the front teeth may be moved 
forward or elongated. In accomplishing the first two, it is entirely self- 
acting and requires very little attention, allowing the absence of the 
patient two, four, or even eight weeks at a time, yet its action is under 
the control of the patient at all times. 
"In the second instance, where ligatures are employed it requires 
closer attention, but where wire ligatures are used, even those allow the 
absence of the patient for some days. Yet I find many occasions to use 
silk ligatures, even though they require more constant attention, for 
the sake of cleanliness. 
"This appliance, in its simplest form, is composed of three members 
(Fig. 564),-two anchors and a wire spring, while the compound form 
has two springs. Each anchor is made up of three pieces,-a piece of 
seamless tubing, with 30-gauge walls, of suitable size and length to be 
fitted to the tooth chosen for anchorage, after the manner of forming 
a band for a gold crown. To this is soldered, on the palatal side at W. S. DAVENPORT TO GEORGE C. AINSWORTH 
857 
right angles with the band, a piece of 16-gaugc wire running along the 
border of the arch, with a bearing on and of sufficient length to engage 
all of the teeth to be moved on that side; while on the buccal side of 
the anchor band is soldered a short piece of 16-gauge seandess tubing 
running parallel with the band, to receive the end of the spring-wire,- 
Fig. 564. 
Fig. 565. 
the active principle of the appliance. These anchors, when completed, 
are adjusted to the teeth selected, and cemented firmly into place (Fig. 
564)-one on either side of the arch, after which the two ends of the 
spring wire, bent at right angles to itself, are sprung into the tubes pro- 
vided for them (Fig. 567). The inside bar is designed to move the bi- 
cuspids and molars as a unit without the aid of ligatures. ORTHODONTICS -HISTORICAL REVIEW 
858 
"This case seems to be an unusually favorable one for this appliance, 
which in its operation has a double action. The sides of the arch are 
to be equally expanded and the incisors moved in. The teeth to be 
moved out include the cuspids, the bicuspids, and the first molars. The 
spring, being adjusted to bear firmly on the labial surface of the in- 
cisors, presses those teeth in as the side teeth move out. The teeth 
chosen for attaching the anchor bands should be midway between the two 
points of resistance, and this perhaps more often fails on the first bi 
cuspid than otherwise, though sometimes it may be the second bicuspid, 
or even the first molar. * * * 
"I have been asked to explain why I commenced work on the upper 
teeth instead of the lower. It is not always easy to give a lucid explana- 
tion of the reason for doing a certain thing, although one follows the 
dictates of his judgment-instinct, perhaps. It is true, nature begins 
her work in the adjustment of her masticatory apparatus by the develop- 
ment of the lower teeth first, but the conditions under which she does 
it are different from those presented to us for correction. She moves 
the teeth upward and downward on a line with the axes of the tooth, 
while we are called upon to move them sidewise. Again, the lower 
teeth are inferior in size and stability to the upper, which, fully de- 
veloped, have a larger controlling influence, and it seems to me as a rule 
easier to expand the larger arch first after which the smaller is more 
easily adjusted to it, especially as the upper jaw is stationary, while the 
lower is not. In other words, there are limitations to the possibilities 
of movement or adjustment in the upper jaw that do not obtain in 
the lower. 
"Fig. 565 represents the teeth of a lady from forty-five to fifty years 
of age, and introduces the addition of another spring-wire and its at- 
tachment to the simple appliance, making a compound, self-acting ap- 
pliance which is applicable to those cases where much pressure is re- 
quired at both the cuspid and molar region. The longer spring, acting 
on the molars, may be adjusted high up under the lip entirely out of 
sight, while the shorter one, acting on the cuspids, may be adjusted 
lower down at the pleasure of the operator. 
"You will observe that the tubes on the molars run high up opposite 
the ends of the roots. This was for the purpose of applying the expand- 
ing pressure in such a way as to move the roots and process at that point, 
the long ends of the spring-wire being bent out at such an angle as to 
apply force there when inserted in the tubes. It is also perfectly prac- 
ticable to insert the wire on the other way, i.e., at the top of the tubes, 
and thus apply the force high up, overcoming the tipping tendency some- 
times met with in other appliances. W. S. DAVENPORT TO GEORGE 0. AINSWORTH 
859 
"Thus you will see that this appliance offers the possibility of many 
variations through additions and modifications, which unfold every day 
in our experience, to solve the problems as they are presented. 
"Other figures show a case where the inside bar is used in connection 
with the ordinary arch band. The cuspids and bicuspids are to be 
moved out a little, while the front teeth are to be elongated and 
brought in. 
"The objection to the self-acting appliance here is the limited down- 
ward pressure obtainable with the spring-wire attached to the first bi- 
cuspids, besides the possibility of moving those teeth forward while in 
the act of pressing the front teeth in. If we anchor to the molars we 
shall not spread the arch at the cuspids and bicuspids without the addi- 
tion of several ligatures around those teeth. The same objection applies 
to the ordinary arch band, anchored to the molars with nuts at the dis- 
tal ends of the tubes, but by combining the inside bar with this appliance 
we do away with all such ligatures, substituting one between the cuspid 
and the first bicuspid on either side connecting the inside bar with the 
spring of the outside band. This will move those teeth out and not 
materially interfere with the downward spring of the arch band. 
"The inside bar soldered to the anchor band around the molar coun- 
teracts the tendency to the tipping of that tooth, which might be ex- 
perienced by raising the arch band up and ligating to the front teeth. 
ADVANTAGES 
"In summing up the advantages of this appliance, its simplicity 
seems to stand out as a keynote far and above everything heretofore in 
use. Being simple, it is cleanly, doing away largely with ligatures, 
ALWAYS PAINFUL TO APPLY AND UNCOMFORTABLE TO WEAR. 
"It is effective, because it is worn twenty-four hours every day, and 
the power is applied directly to the teeth to be moved. It interferes as 
little as possible with the ordinary functions of the teeth and mouth, 
besides minimizing the deleterious effect sometimes noticed from wearing 
a more complicated appliance. 
It is automatic in its work, and may be adjusted so as to have a 
double, or, by the addition of ligatures, a triple action, i.e., it will spread 
the arch, move the front teeth in, and elongate at the same time. 
"As it is automatic in its action, it requires less attention, and con- 
sequently produces less inconvenience and pain, which should lend value 
to our services. 
"It is equally applicable to the upper or lower teeth and may be used 
on both simultaneously. 
"It is conveniently adjusted to bring pressure to bear on the roots 860 
ORTHODONTICS HISTORICAL REVIEW 
and alveolus, and thus has a tendency to overcome the outward tipping 
of the anchor teeth sometimes encountered in spreading the arch. 
"And lastly, it is not unsightly, since it admits the greater cleanliness. 
INCLINED PLANE 
"The next appliance shown is an inclined plane fixed to the teeth, for 
' jumping the bite' and adjusting the occlusion. 
"It sometimes happens in regulating teeth that the lower jaw is all at 
sea as regards an occlusion of the teeth. It is equally bad in two or 
three different positions. It becomes then a question of compelling one, 
and only one, closure in order to give the teeth a chance to adjust them- 
selves to each other after nature's design. 
"It is particularly applicable where there is excessive overbite of the 
front teeth, such as usually accompanies a case of thumb-sucking. 
"An attempt was made to establish a correct occlusion by construct- 
ing gold crowns for the upper six-year molars with grinding surfaces 
corresponding to those on the lower teeth when in correct relation, thus 
allowing the twelfth-year molars, which were just beginning to show 
through the gum, to erupt into their proper relation. Thus far every- 
thing seemed satisfactory, but the gold crowns being removed, observe 
what happened. The patient instead of adopting the correct occlusion, 
found the one now on the screen more agreeable and effective, thus de- 
feating the attempt to correct the overbite. 
"The obvious objections to an inclined plane in connection with a 
plate led to the application of the same principle involved in a plane 
soldered to bands encircling the upper centrals and to lugs engaging 
the cutting edges of the laterals, to prevent undue depression of the 
centrals. This resulted in establishing the correct occlusion. 
"This was the first appliance of the kind I made. I now have them 
made with a round wire lug to rest over the end of the lateral, as more 
cleanly and less likely to injure the tooth, and for the same reason have 
the gold dressed away from the palatal side of the laterals as much as 
possible to avoid contact. The bands on the centrals cover nearly the 
whole palatal surface and are firmly cemented on. The inclined plane 
surface is made from a fairly heavy piece of platinized gold plate. 
"Some of the teeth to be lengthened in the first case were banded with 
thin gold, pin-heads being soldered to the bands in such a way that an 
intermaxillary elastic band could be attached at night and produce an 
elongating pull, but this was soon abandoned as unnecessary. 
"The inclined plane need not, as a rule, be as wide as the one shown, 
and may be reduced as the work progresses. This appliance sometimes 
facilitates the work of the automatic spreading appliance, and may be 
worn in conjunction with one of those appliances on the lower teeth. W. S. DAVENPORT TO GEORGE C. AINSWORTH 
861 
It may also be incorporated with a retainer for the upper teeth such 
as shown in Fig. 566. 
"The advantages of this appliance are, first, its simplicity-no liga- 
tures or rubbers required. It is cleanly and effective, automatic in its 
action, and requires no attention from either patient or operator after 
it is adjusted. It is not painful, and the patient makes less complaint 
than the parent. 
RETAINING APPLIANCE 
"The next, and last, appliance to be shown is a simple retaining appli- 
ance, designed to securely hold the teeth after regulating until they 
have become fixed in their new position. 
"The requirements in such an appliance are security, cleanliness, 
COMFORT, APPEARANCE. 
The appliance here shown (Fig. 566) combines all these to a marked 
Fig. 566. 
Fig-. 567. 
degree. Like the self-acting expanding appliance (which is an out- 
growth from the retaining appliance), it is composed of anchor bands 
with small tubes attached to the buccal sides, into which are inserted 
the ends of a labial wire, bent at right angles to itself. The inside wire 
differs from that of the self-acting appliance in that it is continuous 
around the arch, thus holding all the teeth that may have been moved 
out, while the labial wire holds the front teeth in. 
"This appliance is securely cemented into place and worn without 
discomfort. 
"The labial wire is usually smaller than in the self-acting appliance. 
"Additions may be made to this appliance, as, for instance, when a 
tooth has been rotated, it may be banded and the band soldered to the 
inside wire, thus becoming a part of the retaining appliance. 
"And again, when it is desired to tip a front tooth or teeth inward, 
moving the apex of the root outward, spuds may be soldered to the in- 
side wire at right angles to it in such a way as to rest on the palatal 
or lingual surface of the root high up under the gum, exerting, when 862 
ORT 11ODONTICS HISTORICAL REVIEW 
adjusted, an outward pressure, while the labial spring-wire is adjusted 
to bear hard on those teeth well down towards the cutting edge. The 
result is obvious. 
"This completes what I have to show this evening, and while it may 
not all be new to you, I hope some of it is. It has been my desire to 
make the subject clear. If I have not, I shall be glad to do so later. 
And if any of you can derive the satisfaction from the use of these appli- 
ances that I have, it will be an added source of pleasure to me." CHAPTER XXX 
JOHN NUTTING FARRAR (1875- )* 
JOHN NUTTING FARRAR (1839-1913) Father of Modern Orthodontia. 
At just what age Farrar became interested in orthodontia, histo- 
rians have failed to enlighten us. From the following lines, written by 
this great pioneer himself, we presume it must have been very early in 
youth for he says, "The first regulating operation performed by the 
author was upon one of his own upper central incisors, when he was a 
Fig. 568.-John Nutting Farrar (1839-1913). 
small boy. This outstanding tooth was moved into line by pressing his 
finger upon it several times a day for several weeks." It matters little 
whether this was the beginning, or the cases reported in 1872-3, we 
nevertheless find the year 1875 the turning point in his professional 
career for at that time he began to publish the results of his experiences 
and experiments. From a crude beginning we find later evolved the 
first, of the many, systems in Orthodontia. 
*This chapter properly belongs after page 544. 
863 864 
ORTHODONTICS HISTORICAL REVIEW 
Before the Brooklyn Dental Society, April 12, 1875, Farrar read the 
first of his many papers, the title of which was An Inquiry into the 
Physiological and Pathological Changes in Animal Tissues in Regulating 
Teeth. This series of articles, some thirty-eight in number, he later pub- 
lished under the title of Regulation of the Teeth Made Easy by the 
Positive System. 
These are to be found principally in the Dental Cosmos and were 
sharply criticised by his fellow-copractitioners. However, in time those 
who were the most prone to condemn, were his staunchest friends. 
This first distinct "system" of regulating teeth was based upon the 
screw as a motive force. His ideas were far in advance of his age, most 
of his papers "were constructed to serve a double purpose; namely, to set 
forth some esthetic or theoretic principle and to illustrate the applica- 
tion of the same to practice." The underlying principle of his work is 
found in the preliminary chapter, vol. I, page 13, of his work. 
"One of the cardinal principles, especially advocated in this work, is 
the importance of the observance of the physiologic law which gov- 
erns tissues, during a movement of the teeth (by means of art), the 
object being to prevent pain. To insure this result (exemption from 
pain), the pressure by which the movement is to be effected should be 
under the control of the patient, a requirement which implies the use of 
instruments capable of being operated and adjusted at will. By this 
maximum rate at which it is possible to move teeth painlessly can be 
ascertained. But while the system expressly advocates the use of 'con- 
trollable' mechanism, and of intermittent force, when practicable, the 
assertion made by hostile critics, that the use of continuous force, is 
wholly disapproved of, under all circumstances, is untrue. 
"The idea of taking advantage of the functional laws of the tissues to 
prevent pain, appeared to me (at the time of its conception) novel, and 
yet so rational that, when fully appreciated, it would be available in 
general surgery as well as in dentistry. To determine this rate and test 
its value, I made a series of experiments which extended over a period 
of several years. The results were made known to several professional 
gentlemen in 1873; and in February, 1874, this topic was the subject of 
my graduating thesis at Jefferson Medical College, and afterward read 
in the main before the Brooklyn Dental Society, April 12th, 1875, and 
published in the Dental Cosmos, January, 1876." 
Farrar was the originator of the broad theory of Intermittent Force in 
regulating teeth, this being considered not only the proper method physi- 
ologically but also proving the most effective one. 
In 1888 Farrar, after fifteen years of conscientious labor, gave to the 
profession what was undoubtedly, and still is, the greatest work ever 
issued on orthodontia. Too much honor can never be bestowed on him JOHN NUTTING FARRAR 
865 
for these two volumes, the third never having been published. His 
Treatise on Irregularities of the Teeth and Their Correction contains over 
fourteen hundred pen and ink sketches, drawn by the author himself, and 
has some fifteen hundred and seventy pages. These volumes are a ver- 
itable mine of orthodontic knowledge, epoch making in character and 
more than profitable reading to those engaged in this specialty. This 
great work was founded upon the results of active experience carefully 
recorded from 1863 to the publication of the work. 
The author's aim in these volumes was to make every appliance self- 
acting, at the same time the dynamics being such that the patient would 
be practically unconscious that "regularity was taking the place of ir- 
regularity in the mouth." In regard to the force he adopted in his 
"system" Farrar says, "When I first made the broad statement that the 
screw was capable of being used in more forms than that of the screw 
jack, and that the screw might be made to play an important part in 
the correction of nearly all conditions of irregularity, the assertion was 
said, by many, to be absurd. Even the screw jack now admitted to be 
adaptable to many conditions with wonderful results, was then thought 
to be capable of very limited service." 
In regard to the effect of forces, Farrar says, Vol. II, p. 758, 
"Teeth will move in any direction by force continuously maintained, 
or frequently repeated for a sufficient length of time. The force may be 
within the tissues of the jaws, as exemplified in cases where liberty, by 
extraction of an interfering tooth, is followed by natural adjustment of 
the obstructed tooth, but perhaps it is more satisfactorily shown in cases 
where the force is furnished by the finger, or is obtained from a ma- 
chine. The first aim, however, in any operation for the movement of a 
tooth is to cause slight looseness, by more or less decalcification of its 
socket-tissues, a condition that results from pressure of the tooth upon 
these tissues. This softening of the socket breaks the fixedness or rigidity 
of the tooth, leaving it comparatively easy to be moved either by ab- 
sorption of the tissues or by bending of the alveolar process, or by both. 
"The proper correction of teeth by machines lies in applying the force 
in the right direction and in a philosophical way. To elevate teeth in 
their sockets, the direction of force applied is similar to that for extract- 
ing them, the difference in results depending upon the amount of force 
applied in a given time. For movements in other directions, philosophy 
is also the basis. Teeth can be moved in any direction by brute force 
simply, but to move them in the best way depends very much upon a 
high quality of intelligence behind the hand. 
"If these facts are clearly understood, it will be seen that to move a 
tooth, all depends upon applying a proper degree of force; and to suc- 
cessfully regulate a tooth, by any of the various plans, depends not only 866 
ORTHODONTICS HISTORICAL REVIEW 
upon furnishing force, but upon applying the engine of force so that it 
will bear or draw upon the right place. If the object is simply to elevate 
the tooth, all that is necessary is to cause the force to act in the line of 
its long axis, and in the direction of the end of the crown; but if the 
object is to move the crown posteriorly or anteriorly, the force should 
be applied so as to act at right angles (or nearly so) to the long axis 
of the tooth. 
' ' Thus far we have gone along the lines of general principles; but 
there are several related factors that cause deviations from these gen- 
eral lines in operations upon the front teeth (especially the upper), that 
should be taken into consideration. These deviations are caused by the 
socket resistance acting upon these teeth (being moved) like fulcrums; 
that is, some of these teeth tilt upon places somewhere within the middle 
third of their long diameter. [Page 765.] To move both the crown and 
the root bodily forward (sometimes necessary in elongating the dental 
arch) requires the application of forces that will act in opposite direc- 
tions; or, perhaps more clearly expressed, the mechanism must be so con- 
structed that the crown can be held firmly and given gradual liberty to 
move forward, as the root is made to move forward. 
"Brief of Author's Theory.-Teeth are moved through absorption of 
the socket-tissue, or by bending of the alveolar ridge, or both. This 
absorption, or this bending, may take place by the tissue alterations being 
carried on within their physiologic functions, or outside of these healthy 
functions and in the pathologic. If the tissue-changes can be conducted 
within the physiologic functions, the operation of moving a tooth will 
be painless; but if the rate of changes be pushed beyond this condition, 
into the pathologic, there will be more or less pain. 
"Any regulating mechanism that can be controlled so as to confine 
the tissue-changes within the healthy line is therefore superior to those 
that can not. Mechanisms that operate by elastic rubber or by metallic 
springs, if the power is not so great as to force the changes to exceed 
healthy action, will be comparatively painless; but to control elastic 
materials so that they will not cause pain is generally difficult and often 
impossible. 
"This is not the case when mechanisms operated by screws can be 
used, because by the screw exactness can be secured, and precisely the 
proper degree of force can be given. Especially is this true when the 
management of the mechanism is left to the patient, who knows better 
than the operator when the greatest degree of force can be given without 
causing pain. This desideratum is assured by the screw making it pos- 
sible to take advantage of the law of labor and rest, which applies to 
this kind of tissue-action as well as to all other tissue-energies." JOHN NUTTING FARRAR 
867 
At a banquet given him by his friends in 1908, Farrar explained his 
position as to specialties in dentistry, in a way worthy of remembrance. 
He said, "I regard tlie profession of dentistry as equal to any profes- 
sion in the world. Is there any profession or any branch of medicine 
that can relieve the amount of pain and suffering that we do? I think 
not. I have always made my study of the profession as a whole, and am 
an all-around dentist today, have practiced every part with equal knowl- 
edge. I have no specialty, unless all the branches are specialties and 
altogether amount to a great specialty called dentistry. I cannot under- 
stand how anyone can undertake to be a specialist in dentistry who is 
not an all-around dentist. ... I advise young men to learn all 
branches of dentistry equally well, and never give up the other branches 
to follow a specialty. If a dentist thinks he can follow a certain line 
better than any other, lie can get a reputation as a specialist, but no man 
can treat a particular branch successfully unless he is a master of every 
branch of the profession beforehand." 
The following prophecy from the pen of Dr. Farrar in the Dental 
Cosmos, January 20, 1878, has been more than fulfilled and illustrates 
the farsightedness of this great thinker. 
"Although the simplification of regulation has been a great desideratum 
for many years, it has for some time been evident to me (though by most 
people thought to be impracticable) that the time will come when the 
regulating process and the necessary apparatus will be so systematized 
and simplified that the latter will actually be kept in stock, in parts and 
wholes, at dental depots, in readiness for the profession at large, so that 
it may be ordered by catalogued numbers to suit the needs of any case. 
So that by a few moments work at the blow-pipe in the laboratory the 
dentist may be able, by uniting the parts, to produce any apparatus, of 
any size desired, at minimum cost of time and money." The importance 
of this prediction was not readily grasped at that time, but today we are 
fully aware of the results of this standardization of orthodontic appliances. 
Farrar also realized the necessity of bringing about a new arrangement 
of the two dental arches so that normal articulation would result. His 
devices were far too numerous and the complication of their character 
undoubtedly prevented their general adoption. 
Under An Inquiry into Physiological and Pathological Changes in Ani- 
mal Tissues in Regulating Teeth, Dental Cosmos, 1876, page 13, we find, 
"In some cases the correction is easy and simple, producing little or no 
pain or inflammation; in others the operation is difficult and tedious, ac- 
companied by pain and inflammation. Are these differences owing en- 
tirely to a difference in the constitutions of different people? or do they 
mainly lie in the manner the operations are performed? 868 
ORTHODONTICS HISTORICAL REVIEW 
"This led me to consider various well-known operations in surgery and 
it appeared evident that all of them which depend upon pressure, such 
as dilating strictures, ligation of tumors, and regulating teeth, involve 
and are subject to much the same physiologic laws. To illustrate the 
operation of these laws in one class will explain my idea of all. 
"The treatment for regulating teeth was instituted for correcting a 
defect where the eruption had taken place in a crowded, irregular man- 
ner in the arch, producing deformity of the features, incorrect articu- 
lation of speech, lisping, imperfect mastication, etc. 
"In moving teeth, the slight inflammation of the alveolar process at 
the point in the socket in the rear of the departing teeth, causes in the 
same way (so far as we are able to judge) a deposit of cartilage material 
in the space left. 
"It will be seen that in this act or movement of a tooth a double 
physiologic operation is going on,-absorption on one side and deposit on 
the other. Exactly how this absorption takes place is not well under- 
stood. First, pressure is a primary cause, and absorption the result. 
These are facts we all can see. 
"As it is so common to theorize, I may be pardoned if I give here 
my views. The pressure of the tooth upon the soft alveolar process, or 
socket, causes more or less devitalization of the contiguous cells, which 
are broken down and carried off by the absorbents, which possibly are 
somewhat stimulated by the slight inflammation acting upon them through 
sympathy from contiguity and continuity, while the advancing tooth, in- 
terfering with the blood nutrition, prevents new cells taking the place of 
old ones. Thus the tooth moves as fast as the cells give way before it. 
Tn other words, the tooth advances by 'displacement.' 
"On the opposite side of the tooth the reverse of absorption is going 
on. The tissues are constantly separating, and the space between the de- 
parting tooth and the socket-wall is filling with new cells, formed from 
the exuding plasma. 
"In the treatment for regulating teeth, the operator meets many ob- 
stacles, especially in the construction of apparatus to obtain desired re- 
sults. The great desideratum in his mind has been to move the teeth, 
without much regard to physiologic laws. 
"Teeth may be moved in any direction from one-fourth to one-half inch, 
and in some cases even more. Generally they are moved laterally, but 
may be depressed or raised in their sockets. The principal apparatus, 
except those on the inclined-plane principle, is, and always has been (since 
this branch of the profession has been vigorously prosecuted), made of 
rubber, so secured to the teeth by ligatures and metallic bands as to keep 
up a constant tension on the tooth to be moved. This constant traction, 
after a day or two, starts the tooth from its old home a very short distance. JOHN NUTTING FARRAR 
869 
It continues to move slowly from clay to clay, from week to week, as long 
as the tension is maintained, the apex remaining comparatively stationary 
as the crown advances. 
"It is found that the unfavorable cases are those in which the tooth has 
been moved a considerable distance, the operation having been accom- 
panied by much inflammation and pain, as before mentioned, while those 
moved but slightly have caused little or no pain or inflammation, requir- 
ing but short treatment. Therefore the difference must arise from the 
degree of tension, or length of time, or both. 
Fig'. 569.-One of Farrar's first cases, treated by the rubber plan (1876) 
Fig. 570.-Represents the first step for treatment with the gold band and screw applied 
(1876). 
"From these considerations, it will be seen that undue pressure upon 
the tissues will, if allowed to remain too long, produce inflammation, and 
will also modify or arrest the action of the absorbents, and all together 
produce unhealthy changes in the parts involved. On the other hand, 
tissues can receive a moderate amount of pressure, causing absorption, 
and yet not passing beyond healthy action. Therefore there must be a 
dividing line within which we may operate successfully, and beyond which 
we cannot." 870 
ORTHODONTICS HISTORICAL REVIEW 
One of the first cases Farrar treated is shown in Fig. 569 and represents 
a specimen in his cabinet, treated by the rubber plan; a represents posi- 
tion of the left central incisor under the gum, erupting six years after the 
mate; a," gold band; 5, rubber ring, under tension; the ligatured tooth 
is a left lateral incisor in contact with one right central incisor. 
A very thin gold band was fitted around the cuspid (Fig. 570) and ex- 
tended back along the lingual surface and around the first molar tooth, 
leaving a space between the ends of the gold strap on the buccal surface 
of about six-eighths of an inch. On each extremity of this strap of gold, 
at right angles, was soldered a nut, through one of which was cut a 
screw-thread. Through these nuts passed a screw one inch in length, 
having sixty threads; the screw being fitted at the anterior or mesial ex- 
tremity for a watch-key. (Fig. 571.) This simple apparatus having been 
applied, the screw was turned so as to cause a slight sense of tightness, or 
pressure, but not enough to produce pain. This sense of tightness passed 
away after about an hour, leaving no unpleasant feeling whatever. Even 
the instrument caused little or no inconvenience. The screw was turned 
Fig. 571.-Represents the simple band and screw with a key applied (1876). 
one-half of a revolution morning and evening,-thus advancing it one-hall 
of a thread, or %26 an inch by each operation, or %20 an bich per 
day. 
"It should be borne in mind that the gold band had but one screw; con- 
sequently, when it was advanced %2o an inch, the tooth only moved 
half that distance, or %40 of an inch, at each operation, and, as the opera- 
tion was performed twice each day the tooth moved %4o of an inch, or 
%20 °f an incb Per day- 
"From these experiments we deduce the following conclusions: 
"1st. That in regulating teeth, the traction must be intermittent, and 
must not exceed certain fixed limits. 
"2d. That while the system of moving teeth by elastic rubber ap- 
paratus is unscientific, leads to pain and inflammation, and is dangerous 
to the future usefulness of the teeth operated upon, a properly constructed 
metallic apparatus, operated by screws and nuts, produces happy results, 
without pain or nervous exhaustion. 
"3d. That if teeth are moved through the gums and alveolar process 
about y>4o of an inch every morning, and the same in the evening, no 
pain or nervous exhaustion follows. JOHN NUTTING FARRAR 
871 
"4th. That while these tissues will allow an advancement of a tooth at 
this rate (%4o of an inch) twice in twenty-four hours, the change is physio- 
logic, yet, if a much greater pressure be made, the tissue-changes will 
become pathologic. 
"The Law. In regulating teeth, the dividing line between the produc- 
tion. of physiologic and pathologic changes in the tissues of the jaw is 
found to lie within a movement of the teeth acted upon-allowing a varia- 
tion which will cover all cases-not exceeding %40 or of an inch every 
twelve hours." 
In the Dental Cosmos, 1877, page 519, under Rotating Teeth in Tlieir 
Sockets in the Process of Their Regulation, Farrar stated: 
"The main points necessary in the successful regulation of teeth are, 
firmness of application of the instruments and minuteness of the ap- 
paratus, in order to facilitate management and secure the ease and com- 
fort of the patient. 
Fig'. 572.-Method of rotating- teeth (1877) 
"Clumsiness of apparatus is a great stumblingblock to the success of 
operations as well as the reputation of dentists. The idea of a wrench 
application is not new, though original with me. Dr. Atkinson has used 
something of this sort, made after the shape of an old-fashioned, long- 
handle dipper, fitted over the tooth, with the handle used as a lever; but 
this device lacked firmness of attachment,-a defect that is fully over- 
come by my plan. 
"Fig. 572 represents one of the forms of these devices, and the ordinary 
methods of tlieir application to the teeth. 
"The apparatus should be made of eighteen-carat gold, unless it be the 
screw, which is often more durable if made of brass. ' ' 
Under Regulation of Teeth Made Easy in the Dental Cosmos, 1878, page 
18, we find the following: 
"My object is to show the advantages of a system founded upon prin- 872 
ORTHODONTICS HISTORICAL REVIEW 
ciples, and at the same time illustrate the typical forms of apparatus 
necessary to show that this hitherto most difficult branch of our business 
may be made not only easier, but more scientific, by what may be called a 
positive system of mechanism, conducted in harmony with physiologic 
laws. This system may be successfully practiced by any patient dentist 
of ordinary ability, who clearly understands the laws of mechanics in- 
volved, and the laws governing physiologic and pathologic changes of 
animal tissues while under pressure, in order that the line between the 
two conditions may not be overstepped. The pressure upon the tissues 
should be intermittent, and only carried so far in degree as to be within 
the area of physiologic or healthy action, and not beyond and into that 
condition called pathologic; by the careful avoidance of which any move- 
ment of the teeth may be made without producing inflammation, and with 
little or no pain." 
Fig. 573.-Appliance used in 1878. 
"It is not claimed that the pursuance of any one system under all 
circumstances is a guarantee against difficulties, as these are liable under 
any system, and it may be necessary to resort to other methods to gain 
some points. 
"An inventive mind will suggest various ways and means to accomplish 
this point, but the accompanying illustration (Fig. 573) will be sufficient 
to meet the difficulty in most cases. 
"The clamp or box-wrench (Fig. 573) having been firmly secured to 
the tooth, according to explanations, and the side-draught apparatus ap- 
plied, a counter-action is produced by securing a clamp, C," around some 
distant tooth, 0 for anchorage; and having connected the two devices by 
means of a thin metallic (gold or platinum) band, B," with one end first 
secured to the anchor-clamp around the distant tooth by means of a bolt, JOHN NUTTING FARRAR 
873 
Q, through a smooth nut soldered to it, and the other punched end caught 
over a pin S, soldered on the band of the clamp C, a corresponding offset 
force can be made by tightening the screw Q, which will cause the band 
to draw upon the box-wrench or band C, as illustrated in the diagram, 
which at the same time assists in the rotary motion of the tooth, care being 
taken always not to tighten this (as likewise with all regulating apparatus 
on the screw principle) more than will be comfortable to the patient. Just 
enough to feel comfortably snug, will, I have found, be about the right 
degree of pressure to be in accordance with the above law. 
"Two of the greatest advantages recommending the positive system are 
firmness of the apparatus in the mouth, and the fact that, with a little 
instruction the patient is enabled, by the use of a properly made key for 
turning the nuts (night and morning), to do a large part of the regulat- 
ing work at home; thus rendering it unnecessary to go to the dentist 
oftener than once or twice per week, and sometimes not oftener than 
once in a week or two. 
"Page 80. There are three principal forms of irregularity,-those with- 
out the esthetic line of the arch, those within this line, and the mixed 
Fig'. 574.-Represents a simple little rotating- apparatus that sometimes may be 
made of great service. The nut T, when tightened, draws the nut through the bar 
U, and being attached to the band-clamp V on the opposite side of the tooth causes 
the tooth to rotate, and at the same time drag backwards if desired. Should, however, 
this latter movement be undesirable, it may be prevented by a little screw, W, passing 
through a threaded hole in the bar U, which, impinging against some point (or nut) 
as shown, holds the tooth in position (1878). 
forms, covering both the former. Leaving the two latter for future con- 
sideration, we will confine ourselves in this paper to the first. The third 
class, or the mixed variety, is the most difficult of regulation; the other 
two, though generally requiring about the same time, are more easily 
managed; and, though the apparatus may require considerable skill, the 
working of it is exceedingly simple. 
"The entire practice of regulating teeth may be summed up under the 
following aphorisms or fundamental rules for constructing and operating 
mechanical appliances for such regulation, and which, it seems to me, will 
be self-evident to those who understand the philosophy of the positive 
system in theory and practice: 
"1st. All mechanical appliances for regulating teeth should, if pos- 
sible, be constructed upon the principle of the screw or inclined plane. 
"2d. All apparatus for regulating teeth should be constructed with the 
view of being worn inside the mouth. 874 
ORTHODONTICS-HISTORICAL REVIEW 
"3d. All mechanical appliances should be so constructed as to cause as 
little pain and inconvenience to the patient in speech and eating as pos- 
sible. 
"4th. All apparatus should be constructed as minute and as delicately 
as possible, and be capable of doing its work with certainty and effect. 
"5th. All appliances should be so constructed as to relieve the patient 
as much as possible of the necessity of going to the dentist to have it ad- 
justed; in other words, so that the patient can, with a little instruction, 
do most of the work, by means of keys to turn the screws and nuts. 
"6th. Forces for the movement of the teeth should be applied once in 
about twelve hours, and as powerfully as possible, short of causing pain,- 
a point which may be best determined by the patient. 
Fig; 575.-Method of retracting anterior teeth (1878) 
"I take an impression of the jaw and teeth (generally in wax), and 
having made a cast, sketch it npon paper, and, with the cast and patient 
before me, and a knowledge of the median line and lateral sway (if any), 
I indicate by arrows on the diagram, the line of direction in which the 
tooth should be moved, which serves as a guide in the construction of the 
regulating mechanism; after which the apparatus is made up. 
"Having determined upon one or more posterior teeth (molars or bi- 
cuspids) on each side of the jaw to be used as anchorages, a band clamp 
(Fig. 575) (A) made of very thin (like paper) gold or platinum, about 
one-tenth of an inch wide, is constructed to fit around them firmly, by 
means of a bolt (B), passing through nuts, C, C' (one plain and the other 
threaded), which are soldered, one to each end of the band (A), as repre- 
sented in the cut. To prevent these clamps from working down and im- 
pinging upon the gums, they should be cut from plate wide enough to 
make one or two ears (Zt) in suitable places, which, when bent over and JOHN NUTTING FARRAR 
875 
into the convolutions of the grinding surface, act as stays to prevent 
undesirable movement. Should the teeth be short, the bands may be made 
to hold firmly to the teeth by soldering on the inside clamp a small pin- 
like point, X, which will fit a small hole drilled into the tooth. 
"Connected with these anchor-clamps by means of a little hook and ring 
(not shown in the diagram) or by solder, is a slim swaged platinum U- 
shaped plate, about one-quarter to one-half of an inch wide, which ex- 
tends forward along the inner wall of the dental arch to within about 
half an inch of the protruding teeth, and which lies flat and snug to the 
gum and roof of the mouth. 
"On the front margin, and in line of the forces to be given, are punc- 
tured ears (H), bent at right angles with the plate, or as many smooth- 
bored nuts (not shown in the cut) as there are teeth to be moved, through 
each of which passes a small bolt (E), having on the threaded end a nut 
(F). On the dental extremity of these bolts or screws are soldered loosely, 
in the eye of each a small ring (not shown in the cut), each of which 
bolt-rings is connected by solder or hook to little metallic clamp-bands 
secured firmly around their respective teeth. Sometimes, when it is found 
that the bulk of the rings or screws would require that the lower incisors 
be cut away too much in order to prevent contact, it is an excellent plan 
to solder a small piece of thin (clamp) plate between the clamp and the 
screw, which will take up but little room, and will be as pliable as any 
ring-joint. 
"When the teeth are fully regulated they should be retained in position 
for at least a year, perhaps longer. This may be done by a delicate ap- 
paratus made of narrow bands and strips of gold around the teeth, and 
secured to a delicate rim of plate work or plate wire connected with the 
bicuspids; or they may sometimes be retained by wearing a simple suc- 
tion plate, having gold fingers passing between the teeth and bent nearly 
at right angles in front. Whatever the apparatus be, it should be kept 
clean and free from collections of food." 
Page 307: "In the February number of the Dental Cosmos was ex- 
plained one form of apparatus for regulating protruded upper front 
teeth separately." 
"Fig. 576 illustrates a different modification of the apparatus for ac- 
complishing the same object collectively. The apparatus is made to 
draw upon the outstanding teeth by the tightening of the nuts (a) similar 
to that device explained in Fig. 575, but differs from it in construction in 
applying the forces to the teeth by a bar or plate (5) extending across all 
of the teeth to be moved. 
"In all the accompanying figures, the arrows indicate the direction of 
the movement of the teeth operated upon. 876 
ORTHODONTICS HISTORICAL REVIEW 
"Fig. 577 illustrates another form of apparatus which acts upon the 
teeth collectively, also by means of a band (m) extending along the outer 
surfaces, and which is made to force against the teeth to be moved by 
tightening of bolts which pass through smooth-bored nuts (i, i) soldered 
to the ends of the band (m), and which enter threaded nuts soldered to 
anchor-bands (h, c) secured around the back teeth as shown. The bar 
1) of Fig. 576 and band m of Fig. 577 should be prevented from imping- 
ing on the front gum by passing through the eye of a clamp-band o, 
Fig. 576. 
Fig. 577. 
Fig. 579.-Retaining apparatus in 
position (1878). 
Fig. 578.-Elevating a cuspid (1878). 
secured to a front tooth, or, better still, by having a T soldered to the 
inside, so that the top of the T shall rest on the lingual surfaces of the 
central incisors." 
Page 74, Dental. Cosmos, 1879, "Bands.-All fixtures of this sort should 
be as delicate as possible, consistent with the necessary strength. The 
general tendency is to make apparatus too clumsy. On delicacy and ac- 
curacy of fit everything depends. One of the most important points to 
hold in mind is proper thickness of material. While the anchor-bars (not 
bands) may be of considerable thickness, those straps which reach from JOHN NUTTING FARRAR 
877 
the anchorage to the teeth to be moved should generally be thinner, espe- 
cially those portions which are intended to slip around the teeth when 
tightened by the bolts. A disregard of this point may lead to failure. 
"The thickness of bars for molar teeth to which anchor-bands are 
secured (Fig. 580) should be about Nos. 22 or 23; for bicuspid teeth 
about No. 34 or 35, and in breadth not greater than is absolutely necessary 
for strength and firmness, say from %2 1° %2 an inch." 
Page 607. "We will pass on to consider another plan of accomplishing 
the same purpose, which, although also old in principle, is worthy of men- 
tion,-the use of pieces of plate bent from time to time, so as to maintain 
sufficient temporary force against the teeth. (I do not include that class 
of appliances which are so constructed as to maintain continued pres- 
sure.) This plan is practical with variously constructed fixtures, from a 
size less than that of the smallest tooth to that of the roof of the mouth; 
but, as a rule, small fixtures of this variety give the best results. First, 
for instance, a small piece of thick plate, an eighth of an inch or more 
wide, and half an inch or more in length, bent somewhat into the form 
of the letter U, can be made by being opened more and more, from day 
Fig-. 580.-Anchor band (1879). 
to day, to spread teeth sufficiently apart to insert an artificial one. By 
the use of longer bars or narrow plate, constructed on the same principle, 
extending across the mouth, secured to teeth in pits or by binders for 
anchorage, they may be made to successfully move teeth into line which 
have erupted in the posterior position on the opposite side of the mouth. 
"Irregular and protruding front teeth may be drawn into position by 
the same plan, by occasionally bending metallic fingers extending from 
a plate secured inside of the mouth, and passing between or over the 
cutting edges of the teeth. This variety of fixture, although old and well 
known, is a favorite with many dentists. 
"Besides the lateral movement of teeth, rotation may be accomplished 
to a certain degree, in some cases, by occasional bending of these metallic 
fingers. 
"It may be thought that a nut facing towards the back of the mouth, as 
suggested in some of my previous illustrations (Fig. 575) may be difficult 
to manage; but it is as easily operated as in any other case by properly 
made keys. While most of my fixtures are worked by the straight and 
curved 'box-keys,' flat, open wrenches, or by pointed levers, which fit into 
holes, I have a right angle key (Fig. 581) made to work on bevel-gearing 878 
ORTHODONTICS HISTORICAL REVIEW 
similar to that used for right angle drill attachments to the dental engine; 
which enables a patient to operate the screws and nuts of any fixture, in 
any part of the mouth, as easily as lie could wind his watch." 
Page 302, 1881. "Reasons of Success and Failure of Mechanisms De- 
pending upon Unaided Impingement, Arising from Position and Shape 
of Teeth. 
' ' There are two means of retaining regulating devices in position: By 
impingement against the teeth, perhaps more or less assisted by the un- 
Fig. 581.-Key to allow patient to operate the screws and nuts. 
evenness of their surfaces. 2d. By binding with strings, wire, or perhaps 
by lodgment on surplus plugs in cavities. 
"First Proposition. In order to obtain scientific accuracy in regulating 
teeth by impingement, the direction of applied forces should be made on 
the plane of the shortest line, between the opposite points of impingement, 
by the mechanism across the jaw. 
Fig. 582.-Enlargement of the arch (1882). 
"Second Proposition. Position and shape of teeth govern the applica- 
bility of the principles of the first proposition/' 
Page 76, 1882. "Enlargement of the Arch. A different device, made 
of gold, which could be bound to the teeth so that it could not slip off was 
used. It consisted of a system of jack-screws capable when used entire of 
acting upon twelve teeth at the same time, as shown in Fig. 582. 
"In this case, however, only a part of it was applied at first, the re- 
maining portion being added at a later period in the operation. The 
portion used consisted of a double yoke jack-screw, with a bar extending JOHN NUTTING FARRAR 
879 
against the first molars, which was firmly bound to the bicuspids by means 
of screws and nuts. 
"The use of this portion of the apparatus was to force still further 
outward these six side teeth-four bicuspids and two first molars. Dur- 
ing the latter portion of the time that this fixture was being used sep- 
arately, a cylindrical spindle jack-screw was placed across the mouth, the 
points of which were set in little artificial pits, made in the lingual 
surfaces of the cuspids, for the purpose of forcing them directly out- 
ward before being carried forward. 
"When it was convenient for the patient to visit me the retaining plate 
was removed, and the yoke jack-screw, which as before said was a por- 
tion of a larger apparatus was reinserted in its former place, not only 
to hold the four bicuspids and first two molars in position, but to serve 
as foundation to support the other portion of the compound system of 
jackscrews above alluded to, for the purpose of forcing outwardly the 
six front teeth. This portion consisted of six spindle-pointed jackscrews 
Fig. 583.-Appliance used for lateral movement of roots and "righting-up" of crowns. 
attached by rivets or sockets to a body, U, as shown in Fig. 582, which 
was fixed to tlie larger and more powerful yoke jackscrew on the side 
teeth. These six screws radiated from the body, U, like the sticks of a 
spread fan. The radiating principle used in the fan portion of this 
machine, which for a long time I supposed was entirely original with 
me, I am happy to acknowledge I subsequently learned from Garret- 
son's Oral Surgery had previously been used in a somewhat similar way, 
though I think in a rather primitive degree of development, by Dr. A. 
Westcott. With this apparatus resting upon the firm yoke jack-screw 
in the rear, and the points of the spindle jackscrews firmly set in gold 
sockets tied to the four front teeth, as illustrated, these teeth in exactly 
one month were carried into the desired positions." 
Page 186, 1882. "Straggling Teeth.-Lateral Movement of Boots and 
'Righting-Up' of Crowns: 
"The secret of the lateral movement of roots lies in firmly fixing the 
articulating ends of the crowns of the teeth to be acted upon while force 
is being maintained at their necks. 880 
ORTHODONTICS HISTORICAL REVIEW 
"There are two reasons for attempting a change in the condition of 
straggling teeth; the first is for the purpose of making room for others 
that are in process of development; the other is purely a matter of 
esthetics. 
"A knowledge of the position of the apices of the roots of teeth is one 
of the first requisites to a clear comprehension in all cases, in order to 
proper treatment; for upon this depends the question of the highest 
esthetic possibilities. This vital point is often overlooked by young 
operators, and sometimes by older ones. 
"As is well known, the direction of motion and degree of power neces- 
sary in mechanical leverage depend not only upon the length of the lever 
but upon the position of the fulcrum and the distance between it and the 
points of power and resistance. In the simple movement of the crowns 
of teeth the apical extremities of the roots of which are already in their 
proper position, the operation is always based upon that law of mechanics 
which places the fulcrum between the points where the power is applied 
and that of the resistance. (See Z, Fig. 584.) But, on the contrary, in 
an operation for the lateral movement of roots of teeth the power should 
be placed between the fulcrum and the point of resistance. (See Z, Fig. 
585.) 
"Fig. 583 illustrates the front portion of the upper jaw in this and sim- 
ilar cases as they appeared when the apparatus was first applied, and also 
beautifully shows how it is sometimes possible that the same power from 
the same device, when continued to be used at the same points throughout 
the entire operation can be made to act very differently upon different 
portions of the teeth and sockets at different stages of the operation, by 
an automatic shifting of the place of the fulcrum so that the direction of 
the force by the leverage becomes reversed. 
"In the treatment of such cases (Fig. 583) where the roots as well as 
the crowns are out of their proper position, it may become necessary at 
different stages to adopt the principles of both rules of leverage philos- 
ophy. To make the matter plain let us refer to four ideal figures, 584, 
585, 586, 587, which diagrammatically illustrate four successive stages in 
such treatment. Let B represent the alveolar process; R, R, central in- 
cisors straggled; P, gold clamp-bands operated with a screw; F, F, 
fulcrum, or places of the fulcral bearings; C, C, X, X, places where the 
teeth have separated from the socket-walls, the arrows indicating the 
direction of the movement of the different portions of the teeth at dif- 
ferent stages in the operation that caused the 'spaces,' and we shall soon 
see how simple it all is. Now, if the septum, B (Fig. 584), which acts 
in a measure as a fulcrum, be hard and unyielding, and the alveolus about 
the apices of the roots be soft, the force of the clamp-band about the 
necks, as shown, would cause the apices of the roots, R, R (if not fully JOHN NUTTING FARRAR 
881 
formed and calcified), to move in the direction of 8, 8, causing separa- 
tions from the socket-walls at the opposite sides, A, A. 
"It should, however, be remembered that, in actual practice, instead of 
the septum being a positively unyielding substance, it undergoes more or 
less absorption, and possibly some condensation, especially if the applied 
force should be greater than is required to cause absorption. The effect 
of this reduction of the fulcrum (septum) under the pressure of the 
dental lever is to reduce materially the degree of inclination of the crowns 
Fig. 584. 
Fig. 585. 
Figs. 584 and 585.-First stage of the operation, 
Fig. 586. 
Fig. 587. 
Figs. 586 and 587.-Second stage of the operation 
referred to. The real attitude of the teeth, after such alveolar changes, 
is approximately shown by Fig. 585. 
"Under such circumstances any force applied to the crowns of the 
teeth that would be sufficient to draw them in contact at the point 0 (Fig. 
585) would cause separations between the necks of the teeth and socket- 
walls at the points C, C, on one side and the opposite movement of the 
apical portions of the roots (if calcified) would, through this play of the 
different arms of the lever, cause other separations on the opposite sides 
of the sockets at X, X; both of which 'spaces' would increase, as the case 
would advance, until the crowns were brought in contact, as shown. 
"The first stage in the operation is now completed, and the time for the 882 
ORTHODONTICS HISTORICAL REVIEW 
next has arrived. The object of this second stage is to produce approxi- 
mate parallelism of the teeth, by causing the apical portions of the roots 
to approach each other. At this point the curious change, before referred 
to, takes place in the play between cause and effect, for, by the same 
power from the same apparatus, the forces act upon the apices of the 
roots to cause them to return and travel in exactly the opposite direction. 
(See E, E, Fig. 585, and A, A, Fig. 586.) 
"This change in the direction of movement of the apical extremities of 
the roots is brought about from the fact that the moment the crowns are 
brought in contact at the point 0,-at that same moment, if the power of 
the clamp-band be continued, the fulcrum automatically shifts from the 
position about B in the septum to the point of contact of the crowns at 0. 
This shifting of the fulcrum changes materially the philosophy of the 
leverage, by placing the power between the fulcrum and the point of 
resistance, instead of outside of it. (See Z, Z, Figs. 584, 585.) 
"Fig 586 illustrates the relative changes in position between the teeth 
and sockets at a little later period in the operation, and Fig. 587 the ap- 
pearance at its close. The spaces formed by separation of the teeth from 
their sockets fill in with new, but soft tissue formations as fast as the 
teeth move. The yielding nature of this new deposit of tissue is the 
reason why regulated teeth are loose for a considerable length of time 
afterward, and suggests the reason why they should be kept steady until 
sufficient time shall have elapsed for calcification. The mechanism which 
I use in such an operation, as shown by Fig. 583, is made up of two parts; 
a clamp band, to draw the teeth together, and a lock portion, to hold sta- 
tionary the cutting edges of the teeth; but while the crowns of the teeth 
are being drawn together, only the band portion need be used. ' ' 
Before the First District Dental Society, New York, Dental Cosmos, 
page 153, 1886, Farrar discussed among various orthodontic problems, the 
question of Shortening the Dental Arch and showed many devices to ac- 
complish his purpose, saying, 
Page 159: "In constructing devices for regulating teeth, especially 
for large operations, five points should be considered: First, simplicity; 
second, practicability; third, painlessness; fourth, convenience; fifth, 
cleanliness. That which is practicable, so far as the mechanism is con- 
cerned, may be extremely inconvenient, if not painful. For various 
operations, including this, Magitot mentions in his work the use of hard 
rubber plates, with wooden pegs set in holes. The plate is formed so as 
to extend outside of the front teeth, through which at different points are 
daily driven more and more the wooden pegs, which impinge against and 
move the teeth. In place of these wooden pegs Dr. Gaine, of England, has 
used screws." JOHN NUTTING FARRAR 
883 
Page 162: "I now have much better and more convenient forms made 
as follows:-To each anchor clamp-band there is soldered on the lingual 
side a smooth staple or a hook to fix other parts to. Through or to these 
anchors are fixed the legs of a small U-shaped wire, threaded about one 
inch from the ends. This wire is bent to lie close to the gum alongside the 
lingual walls of the bicuspids. There are various other ways this might 
be attained, but they are objectionable. 
" When this apparatus is ready for use and the anchor clamp-bands are 
in position, the teeth to be moved may be attached by a front bar, or bet- 
ter, by a small individual band, placed around each tooth, and connected 
independently with the front part of the U drag-wire by a string or wire. 
They may also be connected by small flat-rolled wire, by hook, ferrule or 
solder. The legs of the U wire are passed through the smooth anchor sta- 
ples and held in place by hooded nuts, as shown here, or by ferrules." 
Page 165: "Outside Apparatus for Drawing in Protruding Teeth.- 
The outside apparatus for drawing in front teeth consists of two clamp- 
bands for anchorages fitted around the posterior teeth, to which is at- 
tached, by a screw, a long band extending from one anchorage-band 
around the front of the arch to the opposite anchor-band." 
Page 405: "Caution to Be Observed in Correcting Protruding Front 
Teeth.-The correction of deformity caused by abnormal protrusion of 
the six upper front teeth, however, requires a greater degree of anchorage 
than the posterior teeth afford, thus requiring great judgment and care; 
for, as the condition of the alveolar process varies at different ages and in 
different people of the same age, it necessarily follows that the value of 
posterior teeth as anchorage must also vary. In other words, the anchor- 
age resistance of teeth has a limit inside of which oral apparatus may be 
used with great success; outside of which, caution, at least, is necessary. 
This limit, however, depends somewhat upon the point of attachment of 
the apparatus; for, when the draught is made from the necks of the 
teeth the degree of anchorage resistance is greater than when from near 
the grinding surfaces; as in the latter position the crown acts as a lever 
upon the socket tissues. 
"Fig. 588 is an outside view of Farrar's bridle apparatus for correcting 
deformities caused by protruding front teeth. 
"According to my experience the degree of anchorage resistance of 
bicuspids and molars may be approximately stated as follows: 
"Relative Anchorage Resistance of Teeth. 
"1st. The anchorage resistance of two bicuspids is sufficient to move 
one cuspid; but as the resistance of both is nearly equal, they are equally 
affected, and in approaching each other by means of a clamp-band will 
meet about half way. 884 
ORTHODONTICS HISTORICAL REVIEW 
"2d. The anchorage resistance of one molar is sufficient to move the 
first biscuspid into the place of a missing second bicuspid. 
"3d. The anchorage resistance of one bicuspid and one molar is suffi- 
cient to move one cuspid and one lateral incisor. 
"4th. Assuming that the first bicuspid is extracted to make room, the 
anchorage resistance of the second bicuspid and two molars (fully devel- 
oped) is generally sufficient to move the cuspid back against the second 
bicuspid, and is sufficient afterward to draw back the contiguous incisor 
and one central about one-eighth of an inch, sometimes more; but this 
cannot be relied upon. 
"By the above it will be seen that, in order to correct the deformities 
under consideration by means of inside apparatus, the operation should 
Fig. 588.-Head gear as used by Farrar in 1886. 
not be commenced until the patient is about the age of twelve or thirteen 
years; for at an earlier age the anchorage resistance is liable to be insuffi- 
cient, and these posterior teeth will be liable to move forward and meet 
the front teeth moving in the opposite direction before they have reached 
the desired position, thus rendering the completion of the operation with 
apparatus depending solely upon bicuspids and molars for anchorage 
difficult if not impossible. 
"Should the anchor teeth, through carelessness, or lack of experience, 
be tilted or moved forward too much, the further use of such teeth for 
anchorage should be postponed for several months, perhaps a year, when 
they will generally become sufficiently reset to complete the operation, if 
conducted with care. Instead of postponement, I prefer, however, to 
make such cases exceptions to the rule and push the operation on to com- 
pletion by the aid of the same apparatus modified, making the back of the .JOHN NUTTING FARRAR 
885 
head the place of anchorage, and using the portion on the posterior teeth 
as a retaining fixture only, as illustrated by Fig. 588. 
"By this apparatus (which I shall presently explain) the advancement 
so far made by the teeth may be retained, as the case progresses, by taking 
up the slack in the inside apparatus from day to day, thus insuring the 
case against accidents such as would occur should the outside portion of 
the apparatus slip off or get out of order. This combination also permits 
the safe removal of the outside portion and the temporary suspension of 
the operation during school hours. 
"Bridle Apparatus for Correcting Protruding Front Teeth.-P. 409: 
The details of construction of this apparatus are as follows: A gold 
strap made of rolled wire, having a smooth nut on each end, is bent to 
conform with the anterior surfaces of the four or six front teeth, and 
Fig. 589.-Inside view of Farrar's "Bridle apparatus" (1886). 
fastened by means of screws to clamp-bands on the posterior teeth, as 
shown in Fig. 589. To prevent this front band from slipping upward to 
the gum, troughs have been tried, but they collect food and injure the 
teeth. I use one or more T pieces, made to fit between the teeth, soldered 
to the band or to ferrules sliding on the band, as used on some of my sim- 
ilar band apparatus of ten years ago (see Fig. 589), or broad plate hooks. 
Another plan of attaining this end is by the use of a round wire resting 
upon the lingual surfaces of the teeth, connected in the same way to the 
front band. The nearer the cutting edges of the teeth these front wires 
rest, the less power it requires to move the teeth. 
"The front band is connected with the outside apparatus by means of 
cylindrical or angular ferrules or staples soldered to it at points opposite 
the space between the laterals and cuspids. Through these ferrules or 
staples, which are at a sufficient distance from the corners of the mouth 
to prevent drooling, are hooked bent cheek-wires, C, C, C (about No. 12), 886 
ORTHODONTICS HISTORICAL REVIEW 
which project forward and outward, thence pointing toward the ears on 
a line with the front band (Fig. 589). To prevent the falling over of 
this curved cheek-wire one side of the ferrule portion may be filed flat, 
and the ferrule shaped to correspond by a blow of the hammer; but this 
is seldom necessary. 
"When the apparatus is in position the friends of the patient are in- 
structed to tighten the posterior bands or to turn the nuts within the 
smaller rings daily. The patient is advised to call at the office once or 
twice per week, when, if the position of the teeth has changed sufficiently 
to render the front band liable to slip off, the direction of the draught 
should be changed by raising the nut-ring from a lower hook on the ear- 
ring to one higher. 
"Since devising this apparatus T have been able to regulate protruding 
front teeth in all cases, before as well as after the development of the 
second molar; and if it is made properly and delicately it operates easily, 
accurately, and is neither uncomfortable nor very unsightly. 
"This apparatus resembles somewhat a fixture described by Dr. Kingsley, 
but differs widely in the object, philosophy of construction, and the charac- 
ter of force. The latter has for its object to depress protruding teeth in 
their sockets ; the former to move teeth posteriorly. One is constructed with 
a leather skullcap and elastics for continued force on a line from the cut- 
ting edges of the front teeth to the crown of the head, or nearly in line 
of the long axis of the teeth ; the other is a skeleton bridle constructed of 
woven inelastic material, connected with the teeth by means of screws, 
for the purpose of intermittent pressure on a line at right angles with the 
long axis of the front teeth, directed towards the back portion of the head. 
"My methods of retaining such teeth in their new position consists in 
fastening gold wire into cavities in the bicuspids and molars with amal- 
gam, as shown. As amalgam hardens slowly, the wires should first be 
set with phosphate of zinc, replacing only one or two plugs with the amal- 
gam at each subsequent sitting until all are changed." 
Before the section of Dental and Oral Surgery, at the Ninth Inter- 
national Medical Congress in a discussion of the paper of E. II. Angle, 
after reviewing informally, at considerable length, Ihe papers on Etiology 
of the Teeth, J. N. Farrar spoke concerning the reason for correcting 
irregularities of the teeth by intermittent force: 
"To differentiate more clearly, I will reiterate in brief that, while the 
old plans of constructing regulating apparatus only recognized one thing 
as essential, force, a view based upon the belief that 'force is force,' no 
matter of what character or as one essayist puts it, 'it matters little 
whether the pressure be continuous or intermittent, since the results are 
the same,'-implying that the results are the same, and not even taking 
info account the almost necessary concomitant of such devices, filthiness,- JOHN NUTTING FARRAR 
887 
I claim that the character of force can govern tlie question of pain, that 
the tissues will always painlessly tolerate a proper degree of intermittent 
force if not too frequently repeated, and that any cleanly mechanical 
apparatus which can be controlled at will so as to attain these ends, when 
based upon and operated with these functions in view, embodies the main 
principles of a system that I consider the most scientific. 
"This being my opinion, it goes without saying that regulating appara- 
tus constructed substantially as here shown by the essayist preceding me, 
must be, in the main, in accordance with my views; but when the essayist 
attempts to assert that this is a new system of regulation and retention, 
1 think he is assuming that which cannot be accepted by readers of the 
dental journals. So far as the mechanical devices are concerned, it would 
be easy to mention the journals which contain descriptions and illustra- 
tions, substantially, of every one of them. But this is not the time or 
Fig. 590.-Machine for enlarging the upper dental arch (1887) 
place to do so; indeed, it is unnecessary, as they must already be familiar 
to all. 
"Mechanisms for regulating teeth are now numbered by the hundred; 
some are simple, others complicated; both kinds are equally valuable in 
their place. Of the many fixtures that I have devised and published from 
time to time, probably the simplest is a metallic clamp-band made of a 
ribbon of rolled gold wire, on each end of which is soldered a nut, which 
in turn is connected by a screw. 
"The clamp-bands as well as the splice-bands may be prevented from 
working down upon the gum by having ears made upon them to rest in 
the sulci of the teeth, or by gum guard-rings having lugs for the bands 
to rest on. 
" Clamp-bands are excellent anchorages for jackscrews, which may be 
made to push or to draw teeth in nearly every direction. This combina- 888 
ORTHODONTICS-HISTOR1 CAL REVIEW 
tion may be simple or complex, depending upon the number of parts and 
pieces used. 
"The more complicated fixtures in connection with the clamp-bands I 
generally improvise from various elementary devices selected from what 
I denominate the 'universal set.' This consists of different sizes of anchor- 
bands, push-jacks, E; draw-jacks, anchor-jacks, J; rings, R, T's; N; fer- 
rules, T, etc., samples of the most of which are represented in Fig. 590. 
"To return to our case, the upper jaw received the principal share of 
the attention, the lower teeth being reduced only sufficient to better fit the 
needs of the upper arch when it should be properly enlarged. While the 
upper jaw was too small1 to be in proportion with the other parts of the 
face, the lower jaw was not, and only required slight alteration. The 
lower arch was somewhat crowded in the region of the cuspid teeth, which 
Fig. 591.-Appliance used by Farrar (1887) and described before the Ninth Interna 
tional Medical Congress. 
were inclined forward, lapping and partially hiding the front of the 
lateral incisors. The bicuspids also had not sufficiently erupted to be on 
a plane with the antagonizing surface of the others. To regulate the 
lower arch one of the bicuspids on each side was extracted, and the cus- 
pids drawn back by means of gold clamp-bands extending around the 
molar teeth for anchorage; the bands being operated by screws and a key. 
"The third and main step, the spreading of the upper arch, the most 
interesting portion of the operation in the case of this patient, was success- 
fully accomplished in stages, intermitted by periods of rest. The first step 
of the operation upon the upper jaw was the partial outward movement 
of the bicuspids and the first molars. The apparatus consisted of a system 
of jackscrews capable, when used entire, of acting at the same time, as 
shown in Fig. 592. 
"Only a part of the device, however, was applied at first; this consisted 
of a double-yoke jackscrew with a bar extending against the first molars, JOHN NUTTING FARRAR 
889 
which was firmly bound to the bicuspids by means of screws and nuts as 
shown. 
"The use of this portion of the apparatus was to force outwards these 
six side teeth. At this stage a cylindrical spindle screw-jack was placed 
across the arch for the purpose of forcing the cuspids directly outward 
before being carried forward. 
"Fig. 591 represents the appearance of the upper jaw at this time, with 
the six side teeth nearly in position. These instruments had, in eleven weeks 
carried the side teeth sufficiently outward to be directly over the lower 
arch. At this point the masticating functions of the teeth being perfect, 
these appliances were exchanged for a simple hard rubber plate, and the 
treatment suspended for several months, for rest. The cuspids and four 
incisors required to be forced radially forward, over, and in advance of 
the under teeth. 
Fig. 592.-Appliance used by Farrar (1887) and described before the Ninth Interna- 
tional Medical Congress. 
"The retaining plate was finally removed and the jackscrew reinserted 
to hold the four bicuspids and two first molars in position, and to serve 
as a foundation to support the other portion of the compound system of 
jackscrews, for the purpose of forcing outward the six front teeth. Fig. 
592 shows the appearance of the case at the completion of the operation 
and before the apparatus was removed." 
In 1888 Farrar published the first volume of A Treatise on the Irregu- 
larities of the Teeth and Their Correction, containing 757 pages and 695 
illustrations. This volume was based upon the articles already reviewed 
and therefore will not be taken up in greater detail. Under Chapter 
XLVI and XLVII, pages 487-498, Antagonism of the Teeth, Theoretical 
and Actual-Different Kinds of Occlusion, the following will, no doubt, 
be of interest to the readers of this historical review: 
"The division of the dental arch into sections, constituting what are 
denominated teeth, together with the peridental pocket (cushion), in 890 
ORTHODONTICS HISTORICAL REVIEW 
which each of them rests, allows greater elasticity of movement than would 
be the case if all the teeth were massed into one. This independence of 
action not only renders them less liable to wear away, but also enables 
them to move about by the antagonism of their inclined surfaces until 
they fit themselves to each other. If one section becomes disabled, so that 
it is necessary to extract it, the remainder are held comparatively undis- 
turbed. The theory of this independent movement of the teeth in most 
cases is proved by the worn and highly polished facets that are plainly 
noticeable on the approximate surfaces of teeth in aboriginal skulls, which 
can be seen in museums. 
"Tn the art of correcting irregularities, a perfect understanding of 
antagonism, and of the influence of lateral pressure of adjacent teeth, is 
still more important to insure the permanence of the new relations after 
correction; for it should be remembered that success in regulating teeth 
depends not only upon adjusting them so that they will have sufficient 
room to stand freely, but also upon holding them in place by the inter- 
locking of some of the cusps. Indeed, without this knowledge, no one 
should expect permanent success in his operations. In some cases, it is 
even more difficult to fix the teeth so that they will remain in their new 
positions than it is to move them into line. 
"There are, however, some aspects of this question that should be ob- 
served ; for instance, if the line of continuity of the arch is broken by the 
loss of some of the teeth, and some of the remaning teeth antagonize 
obliquely, a greater or lesser number, adjacent to the gap, will probably 
move away from their neighbors along the open territory; or, if the 
obliquity is in the opposite direction, toward a portion of the mouth 
which is already overcrowded, not only may the deformity become more 
striking, but, at the points of contact, necrosis of the enamel may occur. 
In such cases, the enamel in time breaks down in decay. Thus it will be 
seen that the locking of teeth has its advantages as well as disadvantages." 
"Perfection Not Attainable.-Perfect antagonism, such as is found in 
the highest order of human development, is a condition that cannot be 
attained in all cases, but must be regarded rather as a point to be aimed 
at and reached so far as practicable. An attempt to secure more would 
not only be found impracticable in many cases, but (if possible) it might 
also be at the sacrifice of esthetic results. To reiterate, although, theo- 
retically, perfection of antagonism is desirable, it is in practice not only 
often impossible to attain, but in some cases it would also be injudicious 
to attempt it, as it might increase facial deformity. 
"In cases where the upper alveolar ridge is too small to accommodate 
the teeth, which are consequently overcrowded and jumbled, while at the 
same time the jaw and upper part of the face correspond in size with the 
lower, it is evident that if we proceed to enlarge the upper arch suffi- JOHN NUTTING FARRAR 
891 
ciently to accommodate all the teeth in line, we would not only destroy 
the antagonism, but would also cause, as has been implied, protrusion of 
the lips. To avoid this result, extraction of one or more teeth is the only 
alternative, in order to bring about the arrangement which best combines 
usefulness with improvement of the face. In some cases, antagonism 
should be regarded as second in importance. That is to say, the aim of 
the operator should be to reach the highest possibilities, taking all things 
into consideration. To avoid deforming the face, while securing the best 
antagonism possible under the circumstances, is more desirable than to 
gain antagonism by the sacrifice of appearance. Let us try to increase 
usefulness by improving antagonism and mastication as far as possible, 
but let us not, in order to effect these, permit tlie faces of our patients to 
assume the appearance of apes." 
In 1895 before the Odontological Society of New York, Farrar, in dis- 
cussing a paper read by Calvin S. Case on the Bodily Movement of Teeth, 
published in the Transactions of the Odontological Society, page 69, 
Replied: 
"This society should congratulate itself upon having such an interesting 
presentation of this subject as the essayist has given us this evening. Now, 
to his question, do we 'believe that the bones around about the roots of 
the teeth were bent?' I will say I think they were; but just how far they 
were bent, or just what and where all the parts were altered, of course 
can only be inferred from the outward appearances. If we could take 
the flesh off the bones before the operation, and then take a cast of the 
bone, then return the flesh, regulate the teeth, and then take another cast, 
we could prove the facts; but at present we must be content with reason- 
ing upon the subject. That the bones under the lower part of the nose 
can be bent by applying force to the incisors I have had proof of in some 
of my operations. Let me tell how I first caught upon the fact. Several 
years ago (1886 and 1887) I had occasion to regulate a case of protruding 
upper teeth for a young lady about fourteen years of age; the lower part 
of her lower lip was somewhat prominent but the upper part was not as 
full as it should have been. I drew the lateral incisors posteriorly (after 
having caused the cuspids to naturally move into the places of the ex- 
tracted first bicuspids) by a gold skeleton mechanism anchored to the 
posterior teeth, and when these teeth were in their prop® places (against 
the cuspids) the same mechanism was applied to the centrals; but the 
anchorage resistance was not sufficient to move them far without moving 
the posterior teeth forward, therefore I was obliged to resort to the skull- 
cap or headgear, a sort of harness, having gold draught wire connect- 
ing it with the ends of the crowns of the incisors. By retightening this 
harness these teeth (crowns) moved posteriorly, in the same way as othet 
dentists have noticed in their operations; but now conies the point in- 892 
ORTHODONTICS-HISTORICAL REVIEW 
tended by mentioning this case. One day the father called on me and 
said, 'Myself and wife have concluded to take our family to Europe; 
now, how soon can you push my daughter's case through?' He also told 
me when he would like to sail. I replied, 'It can only be hurried by 
increasing the force, and perhaps the case will not permit of great increase 
without causing too much pain; but I will immediately begin the trial. ' 
The draught upon the teeth was increased gradually, and in a few days 
it was carried to a point that caused the head to ache slightly. Shifting 
lower a part of the anchorage so as to include the base of the occipital 
region, the full force was maintained. During all this time, however, the 
patient said that she noticed no pain about the teeth, but incidentally 
remarked that there was a peculiar feeling just under the nose. This, 
however, made no impression on my mind, as I had often similar re- 
marks from other patients under similar operations. 
"We were now applying all the force that the harness would permit 
without causing headache, and the teeth were moving gradually,-but 
not as rapidly as the parents desired. To my surprise, however, the 
father and daughter called one evening about ten o'clock, and said, 'My 
daughter's teeth are now moved in far enough.' I examined the case, 
and sure enough the teeth had moved more rapidly than I ever knew 
teeth to move before, and had reached their proper places. But what had 
caused the sudden change seemed mysterious until I examined the con- 
tour of the entire lip and nose, and found that the same changes had 
taken place that Dr. Case's casts present. The upper part of the lip 
was now filled out, and the end of the nose was slightly advanced. 
"It was plain to be seen that the drawing upon the ends of the crowns 
had thrown the roots forward, and that this was the cause of the outward 
changes in the lip and nose; but whether the suture between the halves of 
the upper jaw-bone had yielded and the borders of the bone turned out- 
ward, or whether sufficient decalcification had taken place in the bone to 
enable it to bend by the leverage of the teeth upon it, I could not deter- 
mine ; but one thing was certain, great changes had taken place in its 
contour and the roots of the teeth had moved forward en masse by tilt- 
ing on fulcrums at the necks. 
"This was a lesson that led me to an idea of the possibilities of such 
operations.; and I immediately determined to work upon this line with im- 
proved mechanisms. I now have some half dozen, all based upon philo- 
sophical laws. I have brought with me several engravings of these, taken 
from my forthcoming volume, which I will pass around after I have 
sketched them upon the blackboard, so as to explain their action. I wish 
to.say, however, before I proceed, that I regard Dr. Case's mechanism 
not only simple but philosophical; that it is practicable he has proved by JOHN NUTTING FARRAR 
893 
his results. Mine differs from his, and, therefore, the combination of his 
mechanism belongs to him. 
"As you will finally see, the engine of force in all my mechanisms for 
moving roots forward is placed within the dental arch, represented by 
this sketch (Fig. 593) ; the base of support is a transpalatine screw-jack, 
anchored by two clamp-bands, that embraces the side teeth; from this 
jack to the posterior sides of the neck of the incisors, and lying close to 
the sides of the arch, are two other screw-jacks to press against these 
front teeth; to hold these jacks upon them, each incisor has upon it a 
broad ferrule (cemented), with a U-shape lug on the lingual side, near 
the gum (see F in lower part of Fig. 593), in which a bar connecting the 
anterior ends of the jacks rests. To hold firmly the ends of the crowns 
of the incisors, and prevent them from moving forward when these jacks 
Fig. 594.-Showing- the principle of apply- 
ing- compensating- force (1895). 
Fig'. 593.-Mechanism for moving- the roots 
forward en masse (1895). 
are set at work against the necks of the teeth they (the ends) are tied 
to the transpalatine jack by two wire cords, connecting with a crossbar 
Lodged in otlier U-shape Ings soldered to the labial side of the ferrules, 
near the ends of the teeth, as represented by this sketch. (Fig. 594.) 
"In another mechanism I use more radial screw-jacks than in this one, 
for forcing the roots forward'; these are arranged thus (see Fig. 590). 
The ends of the crowns are held fixed by a wire bow placed in U-lugs, 
one being hooked into a wire ring soldered to the lingual side of the 
anchor-bands, and the other screwed to the corresponding side of the 
other band. It is a modification of my screw long band. 
"As will be seen, all these mechanisms are for moving forward the 
I 
roots of the front teeth where the upper part of the upper lip is sunken; 
but for moving the roots posteriorly, as needed in cases where the upper 
part of the lip is too prominent, they would not be practicable without ORTHODONTICS HISTORICAL REVIEW 
894 
some modifications being made in them; these modifications can be made 
easily. This mechanism, like all the others that I have described, acts 
compensatingly, one force upon the anchorage being balanced by the 
others. 
"The above sketch (Fig. 595) represents a mechanism designed for this 
purpose, and it is very similar to several that I published many years 
ago. The crowns are stayed by an inside rectangular frame resting in 
Fig. 596.- Showing the philosophy of the 
use of the brace and long band (1895). 
Fig. 59 5.-Mechanism for moving posterior- 
ly the roots of upper incisors (1895). 
Fig. 597.-Metallic slip noose rotating 
fixture. 
Fig. 599.-Adjustable clamp bands and 
arch as described by Farrar (1879). 
Fig. 598.-Appliance found in Farrar's 
Vol. II. (1877). 
IT-shaped lugs at the ends of the crowns, and braced against nuts soldered 
to two anchor-clamp bands on the side teeth ; the roots are drawn back 
by what I call a screw-acting long band resting across the labial sides of 
the necks of the teeth to be acted upon and attached to the clamp bands 
by screws." (Fig. 596.) 
In 1897 Farrar brought out his second volume of Treatise of Irregu- 
larities and Their Correction, a volume as large as his first one. Among 
the appliances devised by him is the one shown in Fig. 597 and repre- JOHN NUTTING FARRAR 
895 
sents "an elaborate gold mechanism, devised mainly for moving the cus- 
pid a short distance away from the central and lateral, and not for any 
other part of the operation. It consists of anchors, a hinged wing-piece, 
three screws, three pins, and a small screw-jack. The anchors consisted 
of two ferrules and two thumbscrews. To the anterior parts of the anchors 
were soldered two rigid bows, a lingual and a labial. 
"To the posterior parts of the ferrules were soldered two rigid wire 
loops. These extended posteriorly and embraced the molars. The thumb- 
screws were for tightening the rear parts of the loops upon these molars. 
The two screws on the patient's right were for moving the lateral toward 
the right central. 
"In order to make this screw bear sufficiently high upon the wing and 
under the lip of the gum, it was necessary to project it (the screw) 
through a place in the gum (made by a lance) between the central and 
lateral. To prevent the screw from irritating this gum-tissue, the threads 
on the wing extremity of it were filed away, leaving it smooth for about 
one-eighth of an inch from the end." 
Summary 
Magill claims to have used the plain bands, of platinum, in 1871, ce- 
menting them to the tooth. Shepard, however, states he used cemented 
bands as early as 1867. 
Hepburn, D., in 1870, says, "It seems to be generally accepted as a 
fact, that this particular deformity is the result of the artificial and the 
other causes attendant upon civilization." 
McQuillen (1871) gives a most adequate description of the manner 
under which the influence exerted by antagonizing teeth maintain den- 
tal irregularities. He describes with skill, beginning with incisors, ca- 
nines, premolars and molars, the occlusion and the manner in which the 
upper and lower teeth antagonize each other in ideal occlusion. 
Down (1871) called attention to lack of mental development as a 
result of irregularity of the teeth and deformity of the mouth. "The 
excessive vaulting of the palate is due to the arrest of development of 
the sphenoid or defective growth of the vomer. They are developmental 
defects and are caused long before the time when nursing is practiced, 
unless the habit be an intrauterine one." 
Kingsley (1872), "Father of Orthodontia," the foremost of the early 
modern pioneers in this branch of science, culminated his efforts in what 
was the first scientific and comprehensive work on "Oral Deformities 
as a Branch of Mechanical Surgery," published in America. His work 
summarized the efforts of those who preceded him, thereby stimulating 
to a greater degree the treatment of malocclusion of the teeth. He added 896 
ORTHODONTICS HISTORICAL REVIEW 
little to the etiology of irregularities, claiming that prolonged use of an 
artificial nipple, adenoids and mouth breathing were the main reasons. 
He classified the causes of irregularities according to, first, "develop- 
mental, meaning those that occur prior to the eruption of the crowns, 
and second, accidental, those that occur at the time of eruption or sub- 
sequently, and were either acquired or inherited." A perfect dental 
development is the result of a well balanced physical and nervous sys- 
tem, without hereditary taint. Kingsley is inseparably associated with 
the practice of "jumping the bite." By this procedure he demonstrated 
that protrusion of the upper jaw is not necessarily corrected by extrac- 
tion of the teeth, although he favored this at times, but rather by a 
readjustment of the two dental arches, bringing all the teeth into their 
normal relationship. This procedure consisted in shaping the dental 
arches so as to be in harmony with each other. Then by bringing the 
lower jaw forward, into occlusion with the upper, it was retained in that 
position until this relationship became the firmly established modus 
operandi, and at once changed the prevailing notion of protruding upper 
teeth to the true conception of distal occlusion, such as in Class II (Angle) 
cases. Vulcanite was Kingsley's chief method of treatment, used in 
conjunction with ligatures, elastic bands, jackscrew, bite plate and the 
chincap. His last article, written fifty years after his first, contains ad- 
vice that is worth consideration and reading, especially to the younger 
men just entering orthodontia. 
Fuller (1872) published a new method of making a coil wire band, 
while Stellwagen (1872) was under the impression that "the occlusion 
of the teeth had more to do with their moving than any power that 
could be produced either with plate or ligatures." 
Headridge, P. (1872), made use of a sectional plate to expand the 
dental arches, which he patented. 
Fleschmall (1873) calls attention to irregularity of teething as a diag- 
nosis of rachitis, which may be inherited or acquired. 
De Lessert (1873) considers the question of fruitless sucking and con- 
cludes "that there is little doubt but that the pressure exerted by the 
tongue, thumb, finger, or hand, materially assists in the development and 
expansion of the jaws-and is found in patients suffering from en- 
larged tonsils and whose respiration through the nares is almost impos- 
sible, so that an open mouth is necessary, and thus the dental arch is 
allowed to contract without any opposing force." 
Forbes (1873) did not believe that the premature extraction of the 
deciduous teeth had any effect on the permanent dentition. 
Richardson (1873) made use of a plate having "clasps attached and 
pinned to the centrals with wooden pegs resting against their anterior 
surface." N. W. KINGSLEY TO GEORGE C. AINSWORTH 
897 
Tomes, C. S. (1873), in considering the bearing of the development 
of the jaws on irregularities, considered "that the muscular structure 
of the lips and cheeks is perpetually exercising pressure perfectly sym- 
metrically, and on the inside the tongue is with equal persistency doing 
the same thing." In another paper, in describing a case of V-shaped 
contracted maxilla, he introduced his circular air cushion chincap. 
Coles (1873) discussed the possibilities of transmitting dental peculi- 
arities from one generation to another, but arrived at no definite con- 
clusions. In 1879-80 he expressed the idea, which was held by others at 
that time and later by Bonwill, viz., that the best type of English jaws 
made an equilateral triangle. He applied Greek names to the different 
classes into which he divided various types of dental arches, basing his 
classification on the form of the arch. Intermaxillary prognathism he 
attributed to a force originating in the sphenoid bone and acting on the 
intermaxillaries. He thus anticipated the idea of an endocrine disturb- 
ance, and was no doubt thinking of a type now commonly found in 
acromegaly. Under deformities of the upper jaw, he gives seven groups: 
1. Dolichoid jaw (long). 2. Brachoid jaw (short), contracted maxillae. 
3. Macroid jaw (large and massive). 4. Microid (small). 5. Intermaxil- 
lary prognathism. 6. Intermaxillary upognathism. 7. Lamboid jaw. 
Guilford, in 1874, stated there were three motions to be produced in 
treating all cases of irregularities; expansion, contraction and rotation, 
or tension, traction, and torsion. In treatment, he substituted metal for 
vulcanite in the construction of his appliances, and advocated the ex- 
traction of the first permanent molars. He also advised for rotation of 
the teeth, the plain band, with a platina-gold bar soldered to same, at an 
angle of forty-five degrees. 
Ogston, in 1874, classified congenital malformations of the lower jaw. 
1st. Nondevelopment of the inferior maxilla. 2nd. Excessive develop- 
ment. 3rd. Congenital smallness of the mandible, (a) both halves, (b) 
unilateral. 4th. Congenital dislocation. 
Salter (1874). Causes of irregularities may be (1) congenital and 
hereditary, (2) the prolonged retention of temporary teeth, (3) acci- 
dental mechanical influences, (4) disproportion of the size of the teeth 
and jaws, (5) faulty development of the jawbones. As to treatment, 
this may be divided into (1) simple, (2) compound or contingent. He 
also endeavored to improve the metal plate then in use, and advocated 
crowns on the deciduous molar teeth to open the bite. 
Potpeschnigg (1875) used a unique apparatus for pushing the teeth 
labially. The fulcrum was on the outside of the mouth, with a thin rod 
of metal fastened on a head cap; attached to this were elastic bands 
extending to the teeth. 898 
ORTHODONTICS HISTORICAL RLVIIAV 
Farrar (1875), "Father of Modern Orthodontia," began to study the 
problems of orthodontia in 1875, first considering the question of the 
physiologic and pathologic changes in animal tissues while regulating 
teeth. From that time until his death in 1913 he devoted his life to per- 
fecting appliances, especially the delivering of force to the movement of 
teeth as obtained by means of the screw. Therefore, the screw as a 
motive force was the basis of the first distinct "system" of regulating 
teeth. From a crude beginning, we find later evolved in rapid succes- 
sion, the introduction of many "systems." 
Farrar was a mechanical genius and the regulating of teeth was to 
him an intricate mechanical problem. His appliances were complicated 
and he developed this screw force to such an extent that at times it 
became unwieldy and cumbersome. 
The underlying principles of his work, "especially advocated in this 
work, is the importance of the observance of the physiologic law which 
governs tissues, during a movement of teeth, the object being to prevent 
pain." The "law" which he formulated is as follows, "In regulating 
teeth the dividing line between the production of physiologic and 
pathologic changes in the tissues of the jaw is found to lie within a 
movement of the teeth acted upon allowing a variation which will cover 
all cases not exceeding %40 or %60 of an inch every twelve hours." 
Farrar was the originator of the broad theory of Intermittent Force, 
this being considered not only the proper method physiologically, but 
also proving the most effective. He also was the first to recommend, in 
1882, lateral root movement of the teeth, "righting 'up' of crowns." 
In 1888 he published his voluminous treatises, but fails to mention a 
classification; two pages, however, are devoted to nomenclature. He 
takes the line of the arch, as a basis, and describes irregularities accord- 
ing to whether they deviate forward or backward, lingually, buccally 
or labially, to the left or right of the position which the tooth should 
normally occupy in the line of the arch. He also stated that a tooth might 
be displaced entirely or may be inclined. 
Balkwill (1876) in a series of articles described the various plates he 
devised to correct irregularities; these, however, were crude and cum- 
bersome. 
Magitot (1877) amplifies the classification of Schange, and greatly 
elaborates by dividing dental abnormalities into nine types: (1) of form, 
(2') of size, (3) of number, (4) of position, (5) of direction, (6) of erup- 
tion, (7) of nutrition, (8) of structure, (9) of arrangement. This was 
not devised, however, to be used as an orthodontic classification, though 
it was an advance over those so far known, especially the classes of posi- 
tion and direction. On the other hand Schange's was more complete, 
for it pointed out, and classified as well, the relationship of the dental N. W. KINGSLEY TO GEORGE C. AINSWORTH 
899 
arches and the question of interdigitation of the cusps. In treatment, 
Magitot made extensive use of the vulcanite plate with holes in the 
anterior portion drilled into it, to accommodate wooden pegs, or screws. 
These exerted a wedging pressure against malposed teeth. Cribs, very 
similar to those later advocated by Jackson, were used by him in con- 
junction with the plates. 
Apropos of the anomalies of structure, Magitot advances a very inter- 
esting question, namely, "that the corrosive markings of permanent 
teeth, congenital alterations in shape, furrows, indentations, etc., often 
considered, most wrongfully, as a pathognomonic sign of predisposition 
to certain diseases, the hereditary syphilis, for example, are to be 
esteemd as indelible and permanent traces of invasions of infantile 
affections. " 
Thompson (1876), though not interested in orthodontic problems, wrote 
on comparative dental anatomy and to orthodontists his contributions 
arc of extreme importance. 
Allan, Geo. S., in 1879, improved the head- and chincap, that was so 
commonly used at that time. 
At the Seventh International Medical Congress, 1881, a new interest 
in orthodontia seemed to have been aroused, and the result was that half 
of the papers delivered at the Congress were devoted to various subjects 
relating to the treatment of irregularities of the teeth. It was here that 
Coffin again introduced a new method of treatment, used by his father 
for many years and described for the first time by Coleman in 1877. The 
Coffin plate, so generally known, found immediate favor and was em- 
ployed extensively during the next two decades. It consisted of a di- 
vided vulcanite plate, the two halves being connected by a piece of piano 
wire bent to the shape of the letter W, and caps or clasps on the molars 
were used to hold it in place, and by means of the spring in the wire, a 
lateral pressure or expansive force was exerted. 
At the above named Congress, Gunning considered the causes of irreg- 
ularities of position of the teeth and expressed the following opinion as 
to a projecting jaw: 
"In cases of projection of the lower jaw, caused by muscular action 
drawing the condyles toward the eminentiae articulares, a plate which 
projects out from under the upper incisors down in front of the lower, 
will gradually press the jaw back, and, at the same time, it may be used 
to correct the positions of the teeth which caused the jaw to come for- 
ward. Or, if required, a plate on the lower teeth will throw the jaw 
back." 
"A projecting jaw, which is well seated in the glenoid cavities, cannot 
be pressed back by any apparatus in the mouth, nor by any outside 
around the head and jaw, whether as pictured in the books or otherwise. 900 
ORTHODONTICS-HISTORICAL REVIEW 
If the condyles were pressed back from their natural position, the ears 
would be closed." 
Gunning then showed that the "size and the shape of the jaws may 
cause irregularities of position of the teeth: (1) Diseases of the teeth 
may cause irregularity, when, except for it, all would be normal. (2) 
Premature loss of temporary teeth, more than undue retention of them, 
causes irregularities. (3) Disease of one or more of the temporary or 
permanent' teeth, or loss of either, may deform the lower jaw and also 
displace it. (4) Mistaken views in respect to the treatment." 
He also was the first to suggest the bodily movement of teeth, "in this 
way the apex of its root is carried out with its crown, etc." 
Coles also considered the origin and treatment of irregularities. 
Iszlai, in 1881 and again in 1891 and 1904, proposed a new nomen- 
clature according to the various ways of "biting," as well as the anom- 
alies of the position of the teeth; based upon Carabelli's work. As this 
is fairly complicated, mention will only be made of it here; its merit 
being the first to call attention to the relationship of occluding teeth, 
unfortunately, as treated, only a part of dental irregularities was 
considered. 
Gaillard, in 1881, not being satisfied with Magitot's classifications, of- 
fered a new one consisting of six divisions, according to the position of 
the teeth. He used one type of appliance for all eases, this consisted of 
caps or crowns of platinum joined together by a platinum bar. 
Museler, (1881) presented a method of correcting irregularities, a plate 
made of vulcanite, on the plan of an inclined plane, with screws inserted 
to force back the teeth. 
Patrick (1882) describes an expansion arch made of half-round wire, 
that slides through neatly fitting oval tubes, soldered to the molar bands, 
and set with a small thumb screw. He also introduced in 1887 a screw 
clamp band, which he substituted for set screws and plain bands. "To 
these smaller slides on the arch, different appliances for moving teeth 
are attached, such as wedges, hooks, T-bars, loops and bands." Liga- 
tures and rubber bands were also used. It will be seen that this mechan- 
ism comprises nearly all the valuable features found in our present-day 
expansion arch. 
Humby (1882) after applying a layer of ether-capal varnish to the 
incisors, wound round each of the teeth a strand of silk, and tied it in a 
knot, leaving the ends of the ligatures free. Then using strips of rubber 
dam, he added this to the teeth and again tied with a second ligature, 
varnishing the silk and rubber. At each subsequent visit new rubber 
was added. N. W. KINGSLEY TO GEORGE C. AINSWORTH 
901 
Quinby (1883) made use of screws and springs, securely inserted in 
a vulcanite frame, as the case required. 
Keely, in 1883, began to contribute a scries of orthodontic articles under 
the title of ''Regulating Teeth-A Case in Practice." Jackscrews or 
wooden pegs inserted in vulcanite were the means advocated to correct 
irregularities. 
Talbot (1888) confined himself to his own appliances and methods of 
treatment. He believed that the practitioner should be familiar with 
the etiology of the case in hand, and advanced some curious theories on 
this question. According to Talbot all malocclusal cases were either 
neurotics, idiots, degenerates or lunatics. Although he undoubtedly had 
a clear idea of these conditions, he unfortunately failed to clearly ex- 
press himself, for today we would not consider them such, but due to 
some endocrine disturbance, and would so classify them as types. He 
maintains that "Malnutrition resulting from disease, from insufficient 
oi* unsuitable food and unhealthy environment, is the cause of idiocy, 
insanity, blindness and other defects. Derangement of the nervous sys- 
tem usually underlies these conditions as found among the poor. But 
there is another class of individuals who suffer from neurotic conditions. 
They are those who are well fed and housed, but have overtaxed their 
nervous system by improper modes of life and various forms of excite- 
ment. The two classes have this in common, that the functions of the 
nervous system are impaired, and they show similar results of defective 
nutrition. This want of balance produces an osseous system that shows 
excessive development in some of its parts and arrested development in 
others. Nowhere is this more manifest than in the maxillae. Thus we 
have the causes of constitutional irregularities established." 
His classification is interesting and differed from those of the time. 
"All irregularities of the maxillae and teeth may be traced to the 
following causes: 
"I. Constitutional: malproportion and malrelation of the maxillae, 
due to excessive or arrested development. 
"II. Local or circumstantial: 
"(1) Improper occlusion; 
"(2) Want of accord between waste and repair; 
"(3) Neglect of function. 
"These causes are deviations from the general laws that govern the 
healthy relation and function of the teeth : 
"1. A proper relative size of the organs of mastication; 
"2. A proper occlusion of the teeth; 
"3. Accord between the processes of waste and repair; 
"4. Proper functional activity." 902 
ORTHODONTICS HISTORICAL REVIEW 
In treatment Talbot advocated in 1896, surgical correction, first cut- 
ting out a concave section of the alveolar process, and then the use of 
the jackscrew. 
Howard (1886) and Newkirk used a modification of the Coffin system 
while Byrnes made use of "springs" or elastic force of thin gold wire. 
Bcnwill (1886), in the American System, of Dentistry, contributed a 
chapter on the geometrical and mechanical laws of articulation of the 
human teeth. It was in this work that he considered and wrote concern- 
ing the equilateral triangle.' 
Davenport, I. B., (1887) amplified his views in regard to what con- 
stitutes correct or ideal occlusion, and the importance of trying to secure 
this occlusion in all cases treated. "By establishing normal occlusion 
we can hope to secure results in orthodontia." His clear conception of 
the normal in occlusion is further illustrated by models, showing the 
buccal aspect in one, the lingual in the other, and diagrams of the 
transverse molar occlusion. He strenuously opposed the extraction of 
teeth, "for besides the loss of important organs we shorten the bite, con- 
tract the mouth, disturb the facial expression and secure at least an 
arrangement of the teeth less favorable for their preservation than 
existed at first." 
Angle (1887) "Founder of Scientific Orthodontia." To Dr. Angle 
orthodontia owes that renewed impetus which this great thinker in- 
stilled into our science. Probably no other one man in dentistry did 
more to foster this branch of dental science as a specialty, causing its 
separation from the general practice and advocating it as a recognized 
and distinct science. He says, "In 1896 I advocated its teaching and 
practice as a specialty * * * ." 
"This is abundantly proved," says he, "by the fact that although 
orthodontia has been a part of the curriculum of all dental colleges 
from Harris' (1839) time down, not one dental student in all that time 
has gained sufficient knowledge of the subject in the dental college to 
enable him to practice it with sufficient success to make it his sole means 
of gaining a livelihood, in spite of the immense number of these deformi- 
ties in every community." "Having become entirely discouraged," 
continued Angle, "with my experiences in dental colleges, I became filled 
with the belief that if orthodontia was to make any material progress, 
a separate school, entirely independent of dental schools, must be formed, 
which would amply provide opportunity for those with aptitude and 
liking for the subject to study in a broad, thorough and comprehensive 
manner, and where it would be relieved from all blighting, handicap- 
ping influences which are necessarily thrown around it in dental col- 
leges. Hence was founded the Angle School of Orthodontia." The es- N. W. KINGSLEY TO GEORGE C. AINSWORTH 
903 
tablishment of this, the first postgraduate school of orthodontia occurred 
in 1900. 
The establishing of The Angle School laid the foundation of ortho- 
dontia as a specialty, and in order to fulfill the requirements, he helped 
organize in 1901, the American Society of Orthodontia, and was instru- 
mental in founding the publication of an independent journal, The Amer- 
ican Orthodontist, in 1907. We thus find, as in the case of Harris, Angle 
did for orthodontia, what Harris did for dentistry. 
In 1887 Angle introduced his "system." With the dawn of this cen- 
tury he elaborated a classification and terminology which has done more 
to advance and simplify orthodontia, than any one other step of which 
we know. The fundamental idea is that "classes are to be based on the 
mesialdistal relations of the teeth, dental arches and jaws, which depend 
primarily upon the positions mesiodistally assumed by the first perma- 
nent molars on their erupting and locking." He thus divides all oc- 
clusal manifestations into three classes. 
Class I. Arches in normal mesiodistal relations; 
" II. Lower arch distal to normal in its relation to the upper arch; 
Division 1. Bilaterally distal, protruding upper incisors; 
Subdivision. Unilaterally distal, retruding upper incisors; 
Division 2. Bilaterally distal, retruding upper incisors; 
Subdivision. Unilaterally distal, retruding upper incisors; 
" III. Lower arch mesial to normal in its relation to upper arch; 
Division. Bilaterally mesial; 
Subdivision. Unilaterally mesial. 
This has, since 1899, because of its simplicity, despite the various 
criticisms and the new ones at various times suggested, become the 
acknowledged classification. During the above year Angle also presented 
his new combination of well-known appliance, including the friction 
sleeve nut. 
A brief summary of Dr. Angle's development of his ideas is to be 
found in the beginning of his review and need not again be considered 
at this time. 
Angle, in 1907, in his "Malocclusion of the Teeth," finally sums up the 
influence and importance of the teeth in a few clearly stated propositions, 
(1) the following rule, "that the best balance, the best harmony, the 
best proportions of the mouth in its relation to the other features re- 
quire that there shall be the full complement of the teeth, and that each 
tooth shall be made to occupy its normal position-normal occlusion." 
(2) He also stated "that the mouth is a most potent factor making or 
marring the beauty and character of the face, and the form and beauty 
of the mouth largely depend in the occlusal relations of the teeth," 
therefore (3') "Orthodontia has for its object the correction of malocclu- 
sion of the teeth." 904 
ORTHODONTICS HISTORICAL REVIEW 
C. Wedl (1887) classified the forms of irregularities of the teeth into 
the following nine groups: "1. Where the anterior teeth are straight or 
flat. 2. Where the upper and lower anterior teeth projected. 3. Where 
the maxillae projected. 4. Projection of the mandible. 5. The two jaws 
in irregular position. 6. Anterior teeth were inclined backwards. 7. 
Open bite. 8. Hypertrophy of the alveolar arch. 9. Extreme overbite. 
Tiie basis of this classification depended upon the position of the teeth, 
their size and number." 
How (1887) introduced a new form of molar band, which he called a 
11 molar yoke." It consisted of, first, a threaded gold piece of wire, 
secondly, a coupling plate and nuts. To this "molar yoke" a bow spring 
(arch) was inserted, and sliding blocks were slipped onto the "bow" 
first and adjusted to the teeth he desired to move. 
G-uilford (1887) excepting Kingsley and Farrar, treated the subject 
of orthodontia more comprehensively than had yet been done by any 
author in this country, formulating laws that were essential and which 
are considered in detail in his historical review. His classification was 
not included until his fourth edition in 1905 on "Orthodontia." 
Jackson, in 1887, presented a simple wire device for regulating the 
teeth, which he termed a crib. This was designed as an anchorage at- 
tachment for plates of various kinds and became the foundation of what 
is now known as the Jackson system of appliances. In 1890 he devised 
a split plate, after Coffin, in order to force the intermaxillary portion 
of the process and the incisor teeth forward. In 1904, in his book en- 
titled "Orthodontia and Orthopedia of the Face," he considered at length 
the question of "bodily tooth movement," although he previously re- 
ported in 1887 "that I moved the incisors bodily both anteriorly and 
posteriorly." For some reason in this work as well as in all of his other 
articles, he remains silent as to terminology and classification but devotes 
nearly all of them to appliances. 
Sternfeld, in 1891, treats of the different forms of occlusion and their 
abnormalities. He recognizes two types of occlusion, one physiologic 
or ethnologic, and the other pathologic. He introduced a nomenclature 
which had for its basis terms employed in anthropology. 
Matteson in 1881 introduced his method of compound coil and lever 
springs. In 1892, he changed his method and followed the idea of the 
Angle system, as well as a few novel but not practical appliances. 
Shaw, (1888) described his regulating studs, as well as a system of 
pivoted levers operated by jackscrews. 
Siegfried (1889) made use of coiled springs, and in 1896 he presented 
his double spiral spring, a method Angle mentions again in 1916. N. W. KINGSLEY TO GEORGE C. AINSWORTH 
905 
Bogue (1889) began to preach early treatment and the reasons why 
it was essential to begin treatment with the deciduous teeth. 
Colyer (1889) covers the same ground as those of his contemporaries 
and adds nothing new. 
Dodge (1891) introduced his reciprocating tooth movement, but it, 
as well as his other methods, found little favor with the profession. 
Bryan (1892) believed in the surgical treatment, and made a specially 
constructed forcep to accomplish correction. 
Case before the World's Columbian Dental Congress of 1893, presented 
one of his first papers "The Esthetic Correction of Facial Contour." 
Unfortunately this paper as well as the one of the preceding year was 
practically forgotten until Angle in 1911 reintroduced the subject of 
root movement. Upon reviewing Farrar's second volume (1897) we fail 
to find any reference to same. In this paper Case not only showed the 
possibility and advisability of changing the position of malposed teeth 
in regulating, but also of applying force in such a manner, when neces- 
sary, as to produce anatomic changes in the bony tissues surrounding 
the teeth, thus bringing the parts into harmonious esthetic relations with 
the other features. To do this he said, "It would be necessary to move 
the roots of the teeth as well as the crowns." 
Besides the root movements in this first case, the entire mandible needed 
retracting and this was accomplished, or at least aided, by the use of 
intermaxillary elastics operating between buttons attached to the upper 
and lower appliances. It seems Case employed elastics for the sole pur- 
pose of retracting the mandible and as an auxiliary to an operation for 
labial movement of the upper incisor teeth and roots, as well as an 
auxiliary anchorage. Baker used the elastics to protrude the mandible 
and establish an ideal occlusion. 
Case's classification introduced in 1908 is interesting in so far as to 
the complication of it. He has divided this into two sections, the com- 
bined grouping embraces twenty-six divisions. The second part was 
designed with the special aim as to types of appliances necessary in 
their correction. This was based upon the relation of the teeth to the 
face, but fails to establish a fixed point, which is essential when deter- 
mining this relationship. 
Group T. Intrusion and Extrusion; 
' ' II. Malalignments; 
' ' III. Malturned Teeth; 
" IV. Contracted and Expanded Arches; 
" V. Abnormal Interproxi mate Spaces; 
" VI. Impacted Teeth. 
Class I. Maleruption of Cuspids-Three Types; 
" II. Protrusion of the Upper Teeth with Lower Normal-Fire Types; 
" III. Betrusion of the Lower Teeth with Upper Normal and Upper Protruded- 
Four Types; 906 
ORTHODONTICS HISTORICAL REVIEW 
" IV. Retrusion of the Upper Teeth with Lower Normal and Lower Protruded- 
Five Types; 
' ' V. Bimaxillary Protrusion; 
" VI. Bimaxillary Retrusion; and 
' ' VII. Open Bite Malocclusion. 
French (1893) designed several interesting appliances though they 
never found favor, while Wilder described "a novel appliance" in the 
hopes of having one type that would accomplish all movements. 
Goddard (1893) again brought up the question of the separation of 
the superior maxilla at the symphysis and in 1896 offered the following 
classification. 
Aberrations from the normal arch are almost numberless, but may be 
grouped into classes as follows: 
1. Lingual displacement: a tooth inside the normal arch. 
2. Labial displacement: a tooth outside the normal arch. 
3. A tooth rotated. 
4. A tooth extruded. 
5. A tooth partially erupted. 
6. Several teeth in any or all of these positions. 
7. Prominent cuspids and depressed laterals. 
8. Pointed arch. (V-shaped.) 
9. Upper protrusion. 
10. Double protrusion. 
11. Constricted arch. (Saddle-shaped.) 
12. Lower protrusion, or prognathism. 
13. Lack of anterior occlusion. 
14. Excessive overbite. 
15. Separation in the median line. 
Smale and Colyer (1893) in their works proposed the following classi- 
fication, abnormalities in, (1) size, (2) number, (3) position, and (4) 
structure. Under position (1) irregularities in position of individual 
teeth, (2) general crowding, (3) contracted arches, (4) protrusion of 
upper anterior teeth, (5) protru'sion of the lower teeth, (6) lack of oc- 
clusion. These in turn were greatly enlarged upon. 
Davenport, W. S., (1893) endeavored to elongate the posterior teeth by 
the use of ligatures and a bridge appliance that would first retract the 
anterior teeth. 
Ottolengui (1893) spoke of rapid movement of the teeth and the cause 
of death of the pulp. 
Ainsworth (1893) introduced his spread plate, bands and retaining 
plate, a modification of the Patrick band (arch). N. W. KINGSLEY TO GEORGE C. AINSWORTH 
907 
Baker (1893) proposed his method of protruding the mandible by 
means of intermaxillary elastics. 
Many novel appliances and suggestions were made during the next 
six years, but as they have already been described in detail it will not 
be essential to again reconsider them. 
Knapp (1899) introduced his "system" which consisted of a threaded 
arch bar, with clutch nuts. Threaded and plain bands with open tubes, 
wire used on the molars and into the slotted tubes, the arch bar could 
be readily inserted, and by means of "nuts of a telescope and fractional 
fit" expansion or contraction could be accomplished. 
Closing Remarks 
The foregoing study makes no pretension to a complete account of 
history of Orthodontics, prior to the time it became a specialty, but 
comprises the most notable instances and will serve to illustrate the 
difficulties that have attended the story of the early development of 
Orthodontic literature. 
"To the making of books there is no end"; notwithstanding this im- 
patient remark of the skeptic, the making of new books is not without 
its defense. 
Books are an important link, not only in the history, but also in the 
progress of a science. They are the monuments left by bygone ages. 
In them the past is made to live again, and the experiences of all the cen- 
turies are refined and crystallized for our own benefit and enjoyment. 
We need these records of thought and achievement to build our own 
lives better. The highest aspirations and achievements of the profession, 
committed to literature, have survived and have been transmitted to us. 
Without the agency of books they would have perished with succeeding 
generations. Books preserve the spirit of the past and should educate 
the present generation by acquainting it with the accumulated treas- 
ures of our ancestors. Each generation has the task of reshaping and 
reinterpreting the history and institutions of the past for the under- 
standing of the present. It will be interesting in this connection to bear 
in mind that many of our modern methods represent a change only in 
method, and not in the basic principles of Orthodontics. The difference 
is, that today with our knowledge, we are better able to cope with the 
problems which confront us. 
The future of Orthodontics seems likely to be a scientific future. Mod- 
ern Orthodontics has come into being through science and through the 
control of natural phenomena, which are bred of scientific knowledge. 
Orthodontics is the product of human reason applied to the human indi- 
vidual, its course has not been run. The future is bright with a promise 
that stands at the threshold of realization. 908 
ORTHODONTICS HISTORICAL REVIEW 
In the solution of the perplexing problems which today confront the 
profession, the experiences of the past must be our best, if not our only 
guide. To draw conclusions from false premises, then, must of necessity 
lead to false steps, steps which may well prove fatal. 
"History is to the world what memory is to the individual." 
The profession which is ignorant of or misinterprets its past experi- 
ences has lost perhaps its most valuable asset, has missed its best guide 
to the future, and will almost certainly continue to repeat the same mis- 
takes indefinitely. 
Ignoring of science by one generation bars the doors of progress and 
the next generation suffers accordingly. An understanding of the litera- 
ture as herein recorded is the greatest legacy I can bequeath to posterity 
and to our Science. 
"If we tried to sink the past beneath our feet, be sure the future 
would not stand." 
THE ENI), YET NOT THE END. ORTHODONTIC BIBLIOTHECA 
"Read not to contradict, nor to believe, but to weigh and consider. Some books 
are to be tasted, others to be swallowed, and some few to be chewed and digested." 
-Bacon. 
The following extensive bibliography has been prepared to cover the 
times from the Third Period, 1728, to 1900. The references to the first 
two Periods are to be found at the end of their respective chapters, but 
as footnotes, cross references and other material interfere greatly with 
one's pleasure in reading a book, 1 have thought it advisable to bring 
together the whole of the Orthodontic literature under one grouping. 
It is utterly impossible to mention all the works consulted and 1 realize 
there may have been publications in journals not accessible for refer- 
ences and therefore many valuable papers may have been omitted. ABBREVIATIONS OF TITLES OF PERIODICALS USED IN THE 
BIBLIOGRAPHY 
A. D. J. American Dental Journal 
A. D. R. American Dental Review 
A. D. W. American Dental Weekly 
A. Dentist American Dentist 
A. M. A. J. American Medical Association (Journal) 
Am. J. D. Sc. American Journal of Dental Science 
Am. J. M. Sc. American Journal of Medical Science 
Am. J. Obst. American Journal of Obstetrics 
Am. Nat. American Naturalist 
Am. Sys. of Den. American System of Dentistry 
Anz. d. k. k. Gesellsch. d. Aerzte Anzeiger der k. k. Gesellschaft der Aerzte in 
in Wien Wien 
Archives Archives of Dentistry (St. Louis) 
Archives (London) Archives of Dentistry (London) 
A. de Stom. Archives de Stomatologic 
Arch. f. Anat. u. Entwch. Archiv fur Anatomie und Entwickelungsge- 
schichte 
A. f. Anat. u. Phys. Archives fur Anatomie und Physiologic 
Arch. f. mikr. anat. Archiv fur mikroskopische anatomie 
Arch. gen. de med. Archives generales de medecine 
Ash Ash's Quarterly 
B. kl. W. Berliner klinische Wochenschrift 
Brief Brief, Dental (St. Louis) 
Br. D. J. , British Dental Journal 
Br. J. D. Sc. British Journal of Dental Science 
Br. Q. J. D. Surg. British Quarterly Journal of Dental Surgery 
Bull, et mem. Soc. de med. et chir. Bulletins et memoires de la Societe de medecine 
prat, de Par. et de chirurgie pratiques. Paris 
Can. J. D. Sc. Canada Journal of Dental Science 
C. C. of P. D. Catching's Compendium of Practical Dentistry 
Cent. Century, Dental 
Centr. Ztg. f. Kind. .Central Zeitung fur Kinderheilkunde. Berlin 
C. f. C. Centralblatt fiir Chirurgie 
Cincin. M. & D. J. Cincinnati Medical and Dental Journal 
Comptes rendus de l'acad. des sc. Comptes rendus hebdomadaires des seances de 
l'Academie des sciences 
Cor. f. Z. Correspondenzblatt fiir Zahnarzte 
Cosmos Cosmos, Dental 
D. Adver. Dental Advertiser 
D. Brief Dental Brief (St. Louis) 
Brief Dental Brief (Phila.) 
Cent. Dental Century 
D. C. & Exam. . Dental Circular and Examiner 
Cosmos Dental Cosmos 
Digest Dental Digest 
911 912 
ORTHODONTICS 
Head. Dental Headlight 
Instruct. Dental Instructor 
D. I. & Rec. Dental Intelligencer and Recorder of Theoret- 
ical and Practical Dentistry 
Jarius Dental Jarius 
News .Dental News (Knightstown, Ind.) 
D. News L. Dental News Letter 
Obtur. Dental Obturator 
D. & O. Sc. Mag. Dental and Oral Science Magazine 
D. Pract. Dental Practitioner 
D. Pract. & Adv. Dental Practitioner and Advertiser 
D. Reg. of W. Dental Register of the West 
Record Dental Record (London) 
Reporter Dental Reporter 
Rev. Dental Review (Chicago) 
Rev. Dental Review (London) 
Register Dental Register 
D. & S. M. Dental and Surgical Microcosm 
D. T. & Ad. Dental Times and Advertiser (Baltimore) 
D. M. f. Z. Deutsche Monatsschrift fur Zahnheilkunde 
D. V. f. Z. Deutsche Vierteljahrsschrift fiir Zahnheilkunde 
D. Z. Der Zahnarzt 
D. Z. W. Deutsche Zahnarztliche Wochenschrift 
D. Z. Z. Deutsche Zahnarztliche Zeitung 
D. Z. f. Chir. Deutsche Zeitschrift fiir Chirurgie 
Dom. D. J. Dominion Dental Journal 
Dublin Q. J. M. Sc. Dublin Quarterly Journal Medical Science 
Edin. M. J. Edinburgh Medical Journal 
F. D. J. Family Dental Journal 
Gaz. d. hop. Gazette des hopitaux 
Gaz. hebd. d. sc. med. Gazette hebdomadaire des sciences medicales 
Gaz. med. de Par. Gazette medicale de Paris 
Gior. di corresp. p. denti. Giornali di corrispondenza pei dentisti 
Guy's Hosp. Gaz. .Guy's Hospital Gazette (London) 
Head. Headlight, Dental 
Her. of Dent. Herald of Dentistry 
Ind. Pract. Independent Practitioner 
Ind. D. J. Indiana Dental Journal 
Instruct. .Instructor, Dental 
Int. D. J. International Dental Journal 
I. I. Items of Interest 
Jarius larius, Dental 
John. D. M. Tohnston's Dental Miscellany 
J. A. M. A. Tournal American Medical Association 
J. Anat. & Physiol. Tournal Anatomy and Physiology (London) 
J. Br. D. A. Tournal British Dental Association 
J. de clin. et de therap. inf. Paris Tournal de clinic ct d. therapeutique infantiles. 
Paris 
J. de l'anat. et physiol. Tournal de l'anatomie et de la physiologic nor- 
males et pathologiques de 1'homme et des 
animaux BIBLIOGRAPHY 
913 
J. med. de Brux. Journal medical de Bruxelles 
J. Morphol. Journal of Morphology (Boston) 
J. f. chir. u. Augen. Journal fiir chirurgie und Augenkrankheiten 
J. f. Z. Journal fiir Zahnheilkunde 
Lancet Lancet, The 
Liverpool M. & S. J. Liverpool Medical and Surgical Journal 
Med. Bresse & Circ. Medical Bresse and Circular (London) 
Med. Rec. N. Y. Medical Record, New York 
Med. Times Medical Times (Bhila.) 
Mem. soc. med. d'emulat. de Baris Memoires de la Societe medicale d'emulation de 
Baris 
M. D. J. Missouri Dental Journal 
M. d. Ver. d. Zahnkstl. Monatsschrift des Vereins deutscher Zahnkiinst- 
ler, Leipzig 
M. R. D. S. Monthly Review of Dental Surgery 
Nederl. Tijdschr. v. Geneesk. Amst._ Nederlandsch Tijdschrift voor Geneeskunde. 
Amsterdam 
N. E. J. D. New England Journal of Dentistry 
News News, Dental (Knightstown, Ind.) 
N. Y. D. J. New York Dental Journal 
N. Y. D. R. New York Dental Recorder 
N. Y. D. V. .New York Dental Visitor 
N. Y. M. J. New York Medical Journal 
N. Y. M. P. New York Medical Bress 
N. Y. M. R. New York Medical Record 
Obtur. .Obturator, Dental 
Od. Bl. Odontologische Blatter 
Odont. L'Odontologie 
Odont. J. Odontographic Journal 
O. U. V. f. Z. Oesterreichisch-ungarische Vierteljahrsschrift fiir 
Zahnheilkunde 
Office Office, Dental and Laboratory 
Ohio Ohio Dental Journal 
Ohio S. Ohio State Journal of Dental Science 
B. A. Med. Con. Ban American Medical Congress 
B. C. D. Dacific Coast Dentist 
B. C. D. & S. Bacific Coast Dentist and Stomatological Gazette 
B. M. & D. J. Bacific Medical and Dental Journal 
Denn. D. T. Bennsylvania Dental Times 
Benn. J. D. Sc. Bennsylvania Journal Dental Science 
Deo. D. J. Deople's Dental Journal (Toledo) 
D. C. D. N. Dremier Congres Dentaire National 
Dresse med. Dar. Dresse (La) medicale de Daris 
Drog. dent. Drogress dentaire 
D. Sc. M. Dopular Science Monthly 
Q. J. D. Sc. Quarterly Journal of Dental Science 
Q. M. J. Quarterly Medical Journal 
Rec. and Record .Record, Dental (Chicago) 
Record Record, Dental (London) 
Reg. Register, Dental 
Reporter Reporter, Dental 914 
ORTHODONTICS 
Rev. et Arch. Suisses odont. Revue et archives Suisses d 'odontologie 
Rev. Review, Dental 
Rev. d. S. Revue de stomatologic 
Rev. int. d'odont. Revue internationale d 'odontologie 
Rev. mens, de stom. Revue mensuell de stomatologie 
Rev. odontotechn. Revue odontotechnique 
Rev. trim. Suisse Revue trismestrulle Suisse d'odontologie 
Schw. V. f. Z. Schweizer Vierteljahrsschrift fur Zahnheilkundc 
S. D. J. Southern Dental Journal 
Stockton's Stockton's & Co. Dental Intelligencer 
Tex. D. J. . Texas Dental Journal 
Times Times, Dental 
Tr. A. D. A. Transactions of American Dental Association 
Tr. A. 0. A. Transactions of American Orthopedic Associa- 
tion 
Tr. Cal. S. D. A. Transactions of California State Dental Associa- 
tion 
Tr. D. S. N. Y. Transactions of Dental Society of the State of 
New York 
Tr. Ill. D. S. Transactions Illinois Dental Society 
Tr. I. M. C. 7th Transactions 7th International Medical Con- 
gress. London 
Tr. I. M. C. 9th Transactions 9th International Medical Con- 
gress. Washington 
Tr. M. A. Ga. Transactions of the Medical Association of 
Georgia 
Tr. N. D. A. Transactions National Dental Association 
Tr. N. J. D. S. Transactions New Jersey Dental Society 
Tr. N. Y. I. Transactions New York Institute Stomatology 
Tr. O. S. N. Y. Transactions Odontological Society, New York 
Tr. Odont. S. Gr. Br. Transactions Odontological Society, Great Brit- 
ain 
Tr. Odont. S. Lon. Transactions Odontological Society, London 
Tr. Path. Soc. Lon. Transactions of the Pathological Society of Lon- 
don 
Tr. Penn. S. D. S. Transactions Pennsylvania State Dental Society 
Tr. W. C. D. Cong. Transactions World Columbian Dental Congress 
V. d. d. od. G. Verhandlungen der deutsches odontologischen 
Gesellschaft 
West. Western Dental Journal 
W. kl. R. . Wiener klinische Rundschau 
W. med. Presse Wiener medizinische Presse 
W. m. W. Wiener medizinische Wochenschrift 
W. z. M. Wiener zahnarztliche Monatsschrift 
Z. . Zahnheilkunde 
Z. R. Zahnarztliche Rundschau 
Z. Wbl. Zahnarztliche Wochenblatt 
Zahnk. Zahnkunst 
Z. Ref. Zahntechnische Reform 
Z. f. Heilkunde Zeitschrift fur Heilkunde BIBLIOGRAPHY 
* Abadie, J. B. Essai s. quelques accidents de la premiere. LeMans, 1885, 54 pp., 4°. 
Abel. Methode nouvelle de redresser les dents incisives et canines. Jour, de med., 
de chir., et de pharmacol., etc., 1780, pp. 141-143. 
Abbott, F. Teeth of the lower jaw at birth. Int. D. J., 1893, p. 721; Tr. W. C. D. 
Cong., 1893, pp. 266-291. 
-Abonyi, J. A. Fogaszat es miiteteinek rovid kezikonyve orvostanhallgatok es 
gyakorlo orvosok szamara, Budapest, 1888, 128 pp. 
- A fogazabalyozasrol. (Regulating the Teeth.) Budapest Gyosgyaszet, 1891, pp. 
205-233. 
- Ueber Zahnregulierung. (Coffin expansion plate.) O. IT. V. f. Z., 1891, pp. 283- 
299; Pest. med. chir. Presse, 1891, p. 174. 
Achterberg, O. Schiefstehende Zahne auf einfache art zu regulieren. Cor. f. Z., 
1879, p. 159. 
Ackery, J. Absence of mandibular teeth. Tr. Odont. S., 1890, p. 245. 
Aeyraepaeae, Matti. (Helsingfors.) Ein neuer Fall von orthopedischer Behandlung 
der Sattelnase. Od. Bl., 1897, n. 23. 
Ainsworth, G. Orthodontia. Int. D. J., 1894, p. 263. 
- Some thoughts regarding methods and a new appliance for moving dislocated 
teeth into position. Int. I). J., 1904, p. 481. 
Albarran, J. Developpement des dents permanentes ebauche d'une troiseime denti- 
tion chez 1'homme. LeHarve, Bull. Soc. anat. de Par., 1887. 
- Du developpement des dents de la seconde dentition. Rev. Odontol., Feb., 1888. 
Albers. Ueber die Abnormitaten des Mundes und der Sprache der Blodsinngen 
Kinder. Verhandl. d. Naturh. d. preuss, 1862, p. 107. 
Albert, H. L. Successive eruption of supernumerary teeth from a bony tumor of the 
upper jaw. Ill. M. N., Eondon, 1889, p. 123. 
-- Case of asymmetry of the jaws. Tr. Odont. S. Lon., 1891, 2, n. s., pp. 57-64; Br. 
J. D. Sc., 1892, pp. 216-220; Rec., 1892, p. 758. 
-- Large inner cusps in maxillary deciduous incisors. Tr. Odont. S., 1897, p. 2. 
Albrecht, Ed. Wirkung der schiefen Stellung eines Zahn. Casper's Wchnschr. f. d. 
ges. Heilkunde, 1837, p. 125. 
* Albrecht, P. Sur les quatre os interinaxillaires, le bec-de-lievre et la varleur mor- 
phologique des dents incisives superieures de 1'homme. Bruxelles, 1883, 27 pp. 
- Sur les os interinaxillaires de 1'homme. Ann. S. d'anat. path, de Brux., 1883, 
pp. 195-197. 
- Diasteme dentaire chez 1'homme. Bull. Soc. d. Anthrop. de Brux., 1884-1885, p. 
183. 
- Ueber die morphologische Bedeutung der Kiefer, Lippen und Geschichtsspaltcn. 
Arch. f. klin. chir., Berlin, 1884, pp. 227-259; Verhandl. d. deutsch. Gesellsch. 
f. chir., Berlin, 1884, pp. 127-159; Abst. Bcr. u. d. Verhandl. d. deutsch. Ge- 
sellsch. f. Chir., Leipzig, 1884, pp. 37-45. 
- Ueber die Chorda dorsalis und 7 knocherne Wirbelzentrcnim Knorpligen Nasen- 
septum eines erwachsenen Rindes. Biol. Centralbl. Erlangen, 1885, pp. 144- 
159. 
*Asterisk indicates book. 
915 916 
ORTHODONTICS 
- Heber sechsschneiderzahnige Gebisse beim nornialen Menschen. Centralbl. f. 
Chir., 1885, No. 24. 
- Zur Zwischenkieferfrage. Erwiderung auf die Besprechung des Herrn. Prof. 
P. Stohr. Fortschr. d. Med., Marz, 1885, pp. 443-456. 
Allan, G. S. Protrusion of lower jaw and treatment. The case of Dr. Hodson. Tr. 
N. Y. Odont. S., 1879, pp. 6-11; Cosmos, 1879, p. 92. 
'Allen, Ch. Curious observations on that part of chirurgery relating to the teeth. 
Dublyn, 1687, 61 pp., 4°. 
Allen, H. Nasal disease and error of conformation of nasal chamber and studies in 
relation to the cause of irregularities of teeth. Cosmos, 1880, p. 163. 
- Irregularities of the dental arch. Cosmos, 1883, p. 273; P. A. N. Sc., 1883. 
- On a human lower jaw of unusual size. P. A. N. Sc., 1892, p. 289. 
Allen, John. Forms and expression of the face. Tr. I. M. C. 9th, 1887, pp. 500-503. 
Allen, Wm. H. Cases of irregularities. N. Y. I). R., March, 1850. 
- Irregularities of the teeth. Tr. A. D. A., 1863, pp. 36-54. 
Allport, W. W. Correcting irregularities. D. Reg. W., 1857, p. 21. 
- Report of a peculiar case of malformation of the jaws and the treatment. J. A. 
M. A., 1884, p. 458. 
Altmann, S. Ein fall von fruhzeitiger dentition. Med. Rundschau, Berl., 1898, p. 
425. 
Allwine, H. W. A complicated irregularity. Cosmos, 1895, p. 185; Cor. f. Z., 1895, 
p. 170. 
Amadie, G. Anomalie numerische del sistcma dentale nell' nomo. Arch, per l'antrop. 
Firenze, 1881, pp. 49-73; Arch. f. path. Anat., Berlin, 1883, pp. 364-368. 
Amer, W. N. Malposition of the canine teeth. Cosmos, 1860, p. 264; D. V. f. Z., 
1862, p. 57. 
Amoedo, M. O. Contribution a 1'etude de la correction du prognathisme. P. C. D. 
N., 1895, pp. 94-102. 
■ Andrieu, E. Conseils aux parents sur la maniere de diriger la seconde dentition de 
leurs enfants. Paris, 1865, 146 pp. 
- Traite complet de Stomatologic comprenant 1'anatomic, la physiologic, la patho- 
logic, la therapeutique, 1'hygiene et la prothese de la bouche. Paris, 1868, 22 
PP- 
- Conseils aux parents sur la maniere de diriger la seconde dentition de leur 
enfants. Paris, 1886. 
Andrew, John J. Development of sixth year molars. D. Rec., ix, pp. 145-146. 
Angell, E. C. Treatment of irregularities of the permanent teeth. Cosmos, 1860, p. 
540, 599; San Francisco Medical Press, 1860, pp. S3, 145. 
- Temporary teeth. San Francisco Medical Press, 1866, pp. 22-25. 
- Permanent teeth. San Francisco Medical Press, 1866, pp. 83-92, 145-150, 181-186, 
202-212. 
* Angle, E. H. First edition. A. small pamphlet published in 1887 or 1888, undoubt- 
edly a reprint of the paper presented before the Tr. 7th I. M. C. of 1887. 
- Retaining appliances. I. I., 1887, p. 529. 
--- Notes on orthodontia, with a new system of regulating and retention. Tr. 9th 
I. M. C., 1887, pp. 565-585; Ohio S., 1887, pp. 457-464; D. M. f. Z., 1887, p. 523. 
- Angle system of regulation and retention. Ohio S., 1888, pp. 19-24. 
- Report of cases in orthodontia. Ohio S., 1888, pp. 123-125, 306-309; Cor. f. Z., 
1888, pp. 249, 350. 
- A regulating and retaining device. Archives, 1888, p. 442. 
- Regulating appliances. Int. D. J., 1889, pp. 323-329. BIBLIOGRAPHY 
917 
- Report of cases in orthodontia. Ohio 8., 1889, pp. 27-29; S. D. J., 1889, p. 27. 
- A new method for the treatment of fractures of the maxillae. Int. D. J., 1890, 
p. 330. 
*- A system of appliances for correcting irregularities of the teeth, ed. 2, Wil- 
mington, 1890, 23 pp. 
- Some of the principles to Tie considered in the treatment of irregularities of the 
teeth and fractures of the maxillary bones. Rev., Chicago, 1890, pp. 380-383. 
- Das Angle'sche System, Briiche des Unterkiefers zu behandeln. Transl. from 
Br. J. D. Sc. in .1. f. Z., Breslau, 1890-1891, i-iii. 
- Efficiency and simplicity in regulating appliances. Rev., 1891, pp. 464-480; Tr. 
Ill. D. 8., 1891, p. 144. 
- Forcible protrusion of non or partially erupted teeth. Cosmos, 1891, p. 743; Z. 
Wbl., 1891, p. 109. 
*- The Angle system of regulation and retention of the teeth. 1892, ed. 3, 51 pp. 
- Appliances-regulating. I. I., 1892, pp. 384, 458. 
- Priority in the use of the screw in regulating teeth. Rev., 1892, pp. 385-390. 
*- The Angle system of regulating and retention of the teeth and the treatment 
of fractures of the maxillae. Phila., 1895, ed. 4, 101 pp.; Phila., 1899, ed. 5, 
100 pp.; Phila., 1900, ed. 6, 315 pp.; Phila., 1907, ed. 7, 628 pp. 
- A new method of applying force in regulating teeth. Digest, 1895, p. 6; Cor. f. 
Z., 1895, p. 54. 
- Orthodontia. Rev., 1896, p. 171. 
*- Angle's System zur Graderichtung und Festhalten unregelmassig gestellter 
Zahne und zur Behandlung von Kieferbriickcn. Berlin, 1897, 4th. aufl., 124 
pp.; 1902, 3d deutsche aufl. (5th Eng.), Berlin, 1904; 4th deutsche aufl. (5th 
Eng.), Berlin, 1907. 
- Classification of malocclusion. Cosmos, 1899, pp. 248-264, 350-357; W. Z. M., 
1899, p. 374. 
- Combination of well-known forms of appliances. Cosmos, 1899, p. 836. 
- The importance of the first permanent molars and their relative value in ortho- 
dontia. Cent., 1899, pp. 13-134. 
- Peridental membrane, Section of and Frenum Labii. Cosmos, 1899, p. 1143; Od. 
BL, 1900, No. 20. 
*- Behandlung der Okklusions anomalien d. Zahne, 1907. 
*- Angle's System fiber V. J. Griinberg. 1 deutsche aufl., 1913, 2d deutsche aufl. 
*- Orthodontia in American textbook of operative surgery, E. C. .Kirk, editor, 
1905, ed. 3, pp. 676-848; 1911, ed. 4, pp. 682-872. 
Arkovy, Jos. Diagnostik d. Zahnkrankheiten. 1885, 404 pp. 
*Arnulphy, B. S. Etude sur les anomalies de la dent de sagesse inferieure. Paris, 
1876, 76 pp. 4°. 
*- Same. 1876, 73 pp. 
*Arroga, F. P. Tratato de las operaciones que deben practicarse on la dentadura, 
y metado para eonservarda on buen cstado. Madrid, 1799, 12°. 
-Arthur, Robert. A popular treatise on diseases of the teeth. New York, 1845, 187 
pp. 
*- Same. Philadelphia, 1846, 187 pp. 
Ashburner, John. On dentition and some coincident disorders. London, 1834, 235 
pp. 
Assaky. Embryologic de la bouche. Odont., 1889, pp. 241-249. 
Atkinson, J. B. Irregularities of the teeth. Lancet, London, 1882, pp. 581-584. 918 
ORTHODONTICS 
Atkinson, W. H. On the reproduction of bone with special reference to the variable 
portions of the maxillae. Tr. I. M. 0. 7th, 1881, pp. 498-501. 
- Remarkable cases of defective development. Proc. Phila. Co. M. S., 1883, p. 82. 
- Thumb sucking causing irregularities. Cosmos, 1890, p. 199. 
■-- Occlusion and articulation. Cosmos, 1890, pp. 566-568. 
Audhoni, V. Du redressement des arcades dentaire. Therap. contemp., 1881, pp. 
657-666. 
*Audibran, J. L'art du dentiste. Paris, 1884, 46 pp. 
*Auge, A. De 1'influence de la premiere dentition sur le developpement de la 
blepharo-conjonctivite. Paris, 1881, 61 pp., 4°. 
* Angier, J. C. De la retrocession de la langue apres 1'ablation du maxillaire in- 
ferieur. Paris, 1856, 28 pp. 4°. 
Augustine, Robey. Dentition-its connection with irregularity. D. News L., July, 
1854. 
*Aussant, J. M. P. Dissertation sur les soins a donner aux dents de seconde denti- 
tion. Paris, 1828, 21 pp. 4°. 
*Auvity, A. Considerations generales sur la premiere dentition et sevrage. Paris, 
1812, 22 pp. 4°. 
*Auzeby, P. Traite d'odontalgie, ou 1'on represente un systeme nouveau sur 
1'origine et la formation des dents, uno description des differentes maladies 
qui affectent la bouche et les moyens de les guerir. Lyon, 1771, 167 pp. 12°. 
Badcock. A case of open bite. J. Br. D. A., 1899, p. 686; D. M. f. Z., 1900, p. 321. 
Bagnall, J. O. Is it necessary or expedient to extract the deciduous teeth, except 
when a permanent tooth is erupting? Cent., January, 1899, p. 21; Dom. D. .1., 
1898, p. 384. 
*Bahlcke, A. IJcber die Resection des Oberkiefors. Erlangen, 1861, 30 pp. 
Baker, E. On the use of India rubber in regulating teeth. N. Y. D. R., 1846, pp. 
15-18. 
Baker, G. T. Treatment of irregularities. Cosmos, 1863, p. 178. 
Baker, Henry Albert. Orthodontia. Int. D. J., 1894, p. 263. 
- Treatment of protruding and receding jaws by the use of the intermaxillary 
elastics. Int. D. J., 1904, pp. 344-356. 
Balding, E. On the treatment of irregularities of permanent teeth. Br. J. D. Sc., 
1876, p. 531. 
- Uber Behandlung von Unrcgclmassigkciten bei den Zweiten Zahnen. Cor. f. 
Z., 1877, p. 17. 
Baldwin, A. E. Some facial deformities; prevention. J. A. M. A., 1899, p. 23. 
Baldwin, H. Open bite. Record, 1899, p. 147; D. M. f. Z., 1899, p. 410. 
Balkwill, F. H. Irregularity of an upper wisdom tooth. Br. J. D. Sc., 1865, p. 506. 
- On regulation plates. Br. J. D. Sc., 1876, pp. 9-13, 70-73, 128-132, 174-177, 244- 
248. 
*- Mechanical dentistry in gold and vulcanite, arranged with regard to the difficul- 
ties of the pupil, mechanical assistant and young practitioner. London, 1880, 
189 pp. 
- A method of rotating incisor teeth. Br. J. D. Sc., 1881, pp. 1125-1127. 
- ' ' Habitation " or "Environment." Record, 1883, pp. 210-219, 256-262. 
- Notes on some morphologic dental irregularities in some of the skulls in the 
Museum of the Royal College of Surgeons of England. Br. D. J., 1891, pp. 
625-629; Tr. Odont. S., 1890-1, pp. 247-256. 
*- The testimony of the teeth of man's place in nature; with other essays on the 
doctrine of evolution. London, 1893, 236 pp. BIBLIOGRAPHY 
919 
- Eine scltene Zahnanomalie in Zwischenkiefer eines menschlichen Schadels. 
Arch. f. Anat. u. Entwch., 1895, pp. 286-288. 
Ballard, T. Cast of a deformity of jaw and teeth from a child age nine, caused by 
sucking the thumb. Tr. Path. S., London, 1860-61, p. 242. 
- Deformed jaws. Br. J. D. Sc., 1861, p. 192. 
- On the constitutional ill-effects of fruitless sucking, and the diagnostic value of 
deformed jaw in relation thereto. Tr. Odont. S., 1864-65, pp. 147-159. 
Ballowitz, E. Eine seltene Zalmanomalie im Zwischenkiefer eines menschlichen 
Schadels. Arch. f. Anat. u. Entwch., 1895, pp. 286-288. 
Barbe. Un nouveau moyen de fixer les bandes de caontchouc dans les appareils a 
redressement. Odont., 1888, pp. 294-551. 
*Barbin, G. Des rapports vicieux des arcades dentaires entre elles. Paris, 1838, 29 
pp. 4°. 
Barillet, A. Des anomalies dentaires de nombre. Union med. du nord-est, Reims, 
1893, pp. 270-274. 
Barker, Geo. T. Treatment of irregularities. Cosmos, 1862, p. 178. 
- Irregularities of the teeth and their treatment. Proc. D. S. Penn., July, 1872. 
- Correcting irregularities, old and new methods. Cosmos, 1874, p. 239. 
Barker, W. H. Malocclusion. Rev., 1895, p. 528; Digest, 1895, p. 552; Br. J. D. Sc., 
1895, pp. 953-954. 
Barkley, Wm. Pegs v. screws in cases of torsion. Br. J. D. Sc., 1873, pp. 307-308. 
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ORTHODONTICS 
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ORTHODONTICS 
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Abraham (2000 B.C.) 37 
Achiliini, Alessandro (1463-1525) 84 
Adamantus of Alexandria (c. 350 A.D.) 64 
Aeginetac, see Paul of Aegina 
Aesculapius (1250 B.C.) 41, 185 
Aetius of Amida (502-575) 65-67 
Ainsworth, George Cook (1852-*) 832, 833-4, 852, 855-62, 906 
Albucasis [Abulkasim] (936-1013) 74-77, 86, 100 
Alexander ''The Great" (356-323 B.C.) 45 
Ali Abbas, see Haly Abbas 
Allan, George S. (1837-1911) 589-92, 899 
Allen, Charles (c. 1686) 118-126, 131, 132, 135, 479 
Allen, William Henry (1821-1882) 357-60 
Allport, Walter Webb (1824-1893) 398-9, 481 
Al-mamun (813-833 A.D.) 69 
Andrews, Robert Rollins (1844-1921) 30, 35 
Andrieu, Edmond (1833-1889) 449 
Anema, Rene (*) 707 
Angell, Emerson Colon (1823-1903) 424-9, 438, 483, 799 
Angle, Edward Hartley (1855-*) 2, 12, 142, 195, 251, 344, 477, 482, 
509, 674-719, 737, 778, 788, 801, 
832, 834, 886, 902-3, 904 
Apollonia, Saint, [Appolonia] (c. 300 A.D.) 62 
Archagathus (218 B.C.) 53 
Archigenes of Apamea (48-117) 60, 86 
Archimedes (287-212 B.C.) 40 
Arculanus, Johannes, see Giovanni 
d'-Arcoli 
de Argelata, Pietro (1423) 81 
Aristarchus (c. 270 B.C.) 40 
Aristoteles (384-322 B.C.) 40, 41, 45-6, 47, 95 
Arnemann, Justus (1763-1807) 169 
Arsinoe (c. 1300 B.C.) 41 
Arsippi (c. 1300 B.C.) 41 
Arthur, Robert (1819-1880) 245, 315-20 
Atkinson, William Henry (1815-1891) 602, 610, 721, 871 
Audibran Chamby (Joseph) (c. 1865) 135 
Aurelianus, Caelius (2nd cent.) 41, 47 
Auzebi, Pierre (1736-1791) 135, 163-4 
Avcnzoar, Cordovan, [Ebn Zohr 
Abimeron] (1113-1162) 76-77 
Avicenna, [Ebn Sina] (980-1047) 73-4, 77, 99 
Baas, Johann Hermann (1838-1909) 6 
Baily, Horton (c. 1854) 375 
Baker, Elisha ( -1872) 321, 328-330, 483 
♦Indicates still living. 
984 INDEX OF PROPER NAMES 
985 
Baker, Henry Albert : (1848-*) 703, 770, 831, 832-7, 905, 907 
Balding, Edmund (c. 1876) 575-6 
Balkwill, F. H. (c. 1876) 570-5, 898 
Baldwin, Henry (c. 1894) 761-2 
Ballard, Thomas (1836-1878) 440-3, 446, 484 
Barker, George T. (1836-1878) 433-5, 556-7 
Barkley, William (c, 1873) 527-8 
Barrett, William Cary (1834-1903) 696 
Baume, Robert (1848-1907) 514, 598 
Baumes, Jean Theodore Baptiste (1756-1828) 135, 255 
Bedell, O. W. 1 (c. 1898) 844-5 
Bell, Thomas (1792-1880) 208-213, 217, 220, 239, 333, 
378, 384 
Benedetti, Alessandro de ('1460-1525) 108 
Berdmore, Thomas (e. 1768) 136, 153-7, 164, 236 
Bercngario da Carpi Giacomo (1480-1550) 84 
Bew, Charles (c. 1819) 183, 238 
Billroth, (Christian Albert) Theordor (1829-1894) 599 
Black, Green Vardiman (1836-1915) 745 6 
Blake, Robert (c. 1793) 166-8, 232, 237 
Blandin, Philippe Frederic (1798-1849) 135, 230-4, 240, 252, 256 
Blum, Michael (c. 1530) 91, 92, 93 
Blumenbach, Jean Frederic (1752- ) 233-4 
Bogue, Edward Augustus (1834-1921) 459, 749-56, 904 
Bond, Thomas Emerson (1813-1872) 245, 246, 247, 253 
Bontius, Jacobus (1598-1631) 35 
Bonwill, William Gibson Arlington (1833-1899) 435-8, 625, 658-73, 897, 902 
Borgognoni, Teoderico (1205-1298) 79 
Bourdet, Bernard (c. 1792) 131, 135, 141, 151-3, 154, 163, 
170, 234, 236, 252, 255 
Boyd, C. L. (c. 1S94) 827 
Breen, William A. rc> 1875) 514 
Brenizer, William K. ( -1870) 460-1 
Brewster, Christopher Starr (1799-1870) 252-3, 476 
Bridgeman, William Kencily (1812-1884) 409-11, 469, 482 
Broca, Paul (1824-1880) 580, 583, 620 
Brown, Solyman (1790-1876) 276-9 
Browne, Mason J. T. ( -1916) 515-7, 527 
Brugsch, Alexander 21 
Brunner, Adam Anton (c. 1771) 136, 153, 154, .163, 224 
Bruno of Longoburgh (C- 1252) 79 
Brunschwig, Hieronymus [Braunschweig]-(14454533) 90 
Bryan, Lyman Curtis (1852-1918) 793-4, 905 
Buckingham, Thomas Lea (1816-1883) 435 
Buddaeus, D. Augustinus (1678-1761) 138 
Budjuhn, Gustav Adolf (1891-1920) 97 
Bueff, Theodore F. F (c. 1833) 136 
de Buffon, Georges-Louis Leclerc (1707-1788) 233 
Bunon, Robert (1702-1748) 135, 147-9, 163, 263 
Bunsen, von R. W 485 
Burgh, Thomas (c. 1867) 458-9 
Burr, Hudson S. (c. 1853) 372-3, 481 986 
ORTHODONTICS 
Burton, Harry Sanford (1862-1910) 622-624 
Byrnes, B. S (c. 1886) 656-7, 902 
Calvert, William (c. 1854) 375 
Camper, Pieter (1722-1789) 233, 234, 256, 291 
Capuron, Joseph C (1767-1850) 152, 236 
Carabelli George [Elder von 
Lunkaszprie] (1787-1842) 35, 281, 285-7, 477, 597, 598, 
838, 867 
Carmeline, M. (c. 1720) 146 
Cartwright, Samuel (1815-1891) 390-8, 446, 484 
Case, Calvin Suveril (1847-1923) 245, 703, 769-90, 831, 891, 
892, 905 
Cascellius, Joannes (c. 90 A.D.) 59 
Catalan, L. J. E (1776c.-1830) 135, 180-1, 197, 237, 301 
Catching, Benjamin Holliday (1848-1899) 824-825 
Cauliaco, Guido de, see Guy de Chauliac 
Cellier, Francois (c. 1802) 170, 237, 284, 477 
Celsus, Aurelius Cornelius (25 B.C.-50 A.D.) 17, 53, 54-7, 58, 67, 86, 
97, 99, 110, 131, 166, 
178, 288, 481 
Cheuveau (c. 1883) 620 
Chupein, Theodore Francis (1830-1901) 829-32 
Cicero (106-4 B.C.) 41, 53 
Claudius, Emperor 60 
Clark, J. Patterson (1791-1864) 208, 229-30 
Clouston, Fred J (c. 1857) 388-9 
Coar, Firman (c. 1854) 375 
Cockayne, Thomas Oswald (1807-1873) 6 
Coffin, Alfred G (c. 1854) 375 
Coffin, Walter Harris (1853-1916) 448, 536-540, 604, 630, 724, 
899 
Cogburn, E. H (c. 1854) 375 
Cohn, Ben (c. 1854) 375 
Coleman, Alfred (1828-1902) 446-8, 536-40, 899 
Coles, James Oakley (1845-1906) 529-36, 597, 897, 900 
Colyer, Sir James Frank (*) 759-61, 816-18, 904, 906 
Crooke, Helkiah (1576-1635) 112-3, 131, 132 
Cunningham, George (1851-1919) 837-8 
Curtis, Winterton Conway (1875-*) 20, 39-40, 51-2, 67, 69-71, 77, 82-3 
Custer, Levitt Ellsworth (1862-1924) 745-8 
Cutter, H. E. (c. 1894) 827-9 
Cuvier, Georges (1769-1832) 135, 233 
Dabry, C. Pierre (1826-1898) 19 
Dalrymple, William (c. 1858) 401-2 
Darby, Edwin Tyler (1845-*) 602 
Darwin, Charles Robert (1809-1882) 620 
Davaine, Cassimir Joseph (1812-1882) 577 
Davenport, Isaac Burnett (1854-1922) 641-50, 674, 902 
Davenport, William Slocum (1868-*) 814-16, 873 
Daubman, Johan ( -1573) 91, 93 INDEX OF PROPER NAMES 
987 
David, Theophile (1861-1892) 604 
Dawbarn, Robert Hugh Mackay (1860-1915) 848 
Dawson, Sir Charles (1855-1916) 10, 15 
De Chambre, Amedee (1812-1886) 619-21 
Dclabarre, Antoine Francois Adolphe (1819-1878) 179 
Delabarre, Christopher-Francois (1777-1862) 136, 141, 183-195, 238, 240, 
247, 269, 270, 271, 280, 281, 
301, 378, 382, 449, 476, 720 
Delanda, Diego (c. 1864) 32, 35 
DeLessert, Alfred Alexander (1847-1907) 527, 896 
Deletzch 37 
de Londe, Charles (1795-1862) 251-2, 476 
Democritus of Abdera (494-404 B.C.) 40, 41 
Desirabode, Malagou Antoine (1781-185-) 135, 245, 246, 247, 288-300, 
477-8 
Dienierbroeck, Isbrand (1609-1674) 111-2, 131 
Diodes of Carystus (c. B.C. 350) 46, 47 
Dionis, Pierre (1658-1718) 126-9, 131, 132, 289 
Dioscorides, Anazarbeus, Pedacius (40-90 A.D.) 47, 91 
Dixon, Franklin Morris (1819-1893) 375 
Dodge, Henry N (c. 1891) 765-8, 905 
Down, J. Langdon H (c. 1872) 472-3, 895 
Draco - (c. 374 B.C.) 42 
Drake, D. F (c. 1873) 523 
Dryander, Eichmann Johann ( -1560) 100 
Dubois, Eugene 9 
Dubois, Jacques (Jacobus) [Sylvius] (1478-1555) 84 
Dubouchet, Charles A (1825-1879) 330 
Dupont (c. 1633) 159 
Durverny, Joseph [Guichard] (1648-1730) 113-5, 131 
Duval, Jacques Rene (1758-1854) 68, 135, 177-9, 180, 193, 207, 
234, 237 
Dwindle, William Henry (1819-1896) 281, 351-2, 387, 427, 438, 479 
Eames, William Henry (1828-1894) 25 
Ebers, George (1837-1898) 21, 22, 23 
Egenolff, Christian, [Ege., Egen., Egen- 
olph., Egenolffs, Erbon] , (1502-1555) 91, 92, 93, 100 
Eisenbrey, J. L . (1842-1895) 
Emerson, Ralph Waldo (1803-1882) 6, 87 
Empedocles of Agrigentum (504-443 B.C.) 40 
Emperor Claudius 60 
Emperor Trajan Marcus [Ulpius 
Tryames] (53-117 A.D.) 60 
Emperor Hadrian (76-138 A.D.) 60 
Endelman, Julio (1878-*) 101 
Engel, Joseph E (c. 1849) 101, 346, 479 
Erasistratus of Julius (300-245 B.C.) 41, 46, 6.1 
Essig, Charles James (1841-1901) 
Essig, Norman S (*) 822-4 
Estiennc, Charles or [Stephanus] (1504-1564) 84 988 
ORTHODONTICS 
Eustachius, Bartholoraaeus, [Bartolom- 
meo, Eustachi] (1520-1574) <85, 94-5, 9(5, 97, 106-9, 131, 
132, 720 
Evans, Thomas Wiltberger (1823-1897) 352, 360-9, 480 
Fabricius ab Aquapendentc [Girolomo 
Fabrizj] (1537-1619) 100, 111, 131 
Falkenstein, Constantin Karl (1801-1855) 89, 101 
Falloppio. Gabriele [Fallopius] (1523-1562) 81, 84, 96, 104-6, 131 
Fanton-Touvet, Richard (1833-1885) 604 
Farrar, John Nutting (1839-1913) 6,142,202, 237, 387,388,470, 
471, 487, 544, 548, 589, 677, 
720, 774, 777, 799, 803, 804, 
832, 863-895, 898, 904 
Fauchard, Pierre (1678-1761) 46, 130, 133, 135, 137-47, 151, 
154, 163, 174, 183, 224, 235, 
239, 243, 715 
Fernald, Adelbert (1872-*) 350 
Fields, George W (1838-1909) 448 
Fitch, Samuel Sheldon (c. 1829) 207-8, 243, 439 
Flagg, Joseph Foster (1828-1903) 377, 418-22 
Flagg, Josiah Foster (1789-1853) 243 
Fleschmall, L. (c. 1873) 520-1, 896 
Fletcher, John B (c. 1859) 411-2, 469, 482 
Forbes, Isiah (1810-1885) 519-20, 896 
Forget, Amedee F (1811-1869) 135 
Fox, Joseph (1776-1816) 136, 141, 158, 170-7, 179, 180, 
194, 197, 207, 212, 216, 237, 
238, 239, 245, 246, 247, 284, 
285, 287, 301, 357, 377, 378, 
383, 384, 401, 408, 474, 477 
Frazer, Samuel W (c. 1854) 375 
Frederick the Great 115, 133, 150 
French, A. J (c. 1854) 373, 905 
French, Frank (1832-1908) 794-7 
Fuller, Albert Homer (1841-1912) 513-4, 896 
Fuller, E. S (c. 1899) 850-1 
Fuller, John (c. 1810) 181, 238 
Gaillard, Georges (*) 592-3, 900 
Gaillardot, Claude-Antoine (1774-1833) 27 
Gaine, Charles (c. 1887) 281, 351, 377-388, 479, 481, 882 
Galen, [Galenus Claudius] (130-200 A.D.) 52, 54, 61-4, 66, 68, 74, 83, 
95, 102 
Garengeot, Rene Croissant de Jacques (1688-1759) 131 
Gariot, John Baptiste (c. 1805) 205 
Garretson, James Edmund (1828-1895) 461, 879 
Garrison, Fielding Hudson (1870-*) 19, 38, 47, 139 
Geist, Jacobi Georges Pierce (c. 1896) 24 
Geoffroy, Etienne, Saint Hilaire (1805-1861) 135, 577, 578 
Geraudly, Claude-Jaquier de, 
[Gerauldly or Gerauldy] (1609- ) 135, 147, 224 INDEX OF PROPER NAMES 
989 
Ghrimes, Samuel (c. 1813) 302 
Gidney, Eleazar (c. 1824) 243 
Gillies, Arnauld (c. 1622) 80 
Gilmer, Thomas Lewis (1849-*) 616-9 
Giovanni, Arcolani [Arculanus] (1412-1484) 81, 86, 100-1, 131 
Goddard, Clark LeMotte (1849-1905) 769, 799-813, 906 
Goddard, Paul Beck (1809-1866) 302-5, 375, 478 
Goodsir, John, Jr (1814-1867) 234-5, 240, 384 
Goodyear, Charles (1800-1860) 375 
Gordini, William (c. 1329) 79 
Gorges, William (c. 1854) 375 
Gothofredi, Dionysii 67 
Grandhomme, M. P. A (c.1846) 320-3, 478 
Gregory, William King (1876-*) 12, 14 
Grovers, J. E (c. 1897) 838-40 
Griffith, F. L 21 
Guerini, Vincenzo (1859-*) 47, 68, 85, 94, 96, 118 
Guidi, Guido [Vidius Vidius] (1500-1569) 85 
Guilford, Simeon Hayden (1841-1919) 545-56, 680, 897, 904 
Guillemeau, Jacques (1550-1613) 116, 131 
Gunnell, J. S (c. 1844) 284, 306, 307, 477, 478 
Gunning, Thomas Brian (1814-1889) 595-7, 899 
Guy de Chauliae [Cauliaco] (1298-1368) 80-1, 289 
Haines, Eri W (1824-t) 375 
Haly, ben Abbas [Ali Abbas] 930-994) 72-3, 74, 77 
Hamill, John G (1828-1863) 373-4 
Hamilton, Harry Fairfield (c. 1892) 791-2 
Hammurabi, King (c. 2250 B.C.) 37 
Hanning, J. H (c. 1899) 848-50 
Harbert, Samuel C (c. 1847) 330-3 
Harris, Chapin Aaron (1806-1860) 6, 133, 142, 243, 245, 246-50. 
375, 381, 384, 470, 474, 676 
869 
Harris, Joseph (c. 1830) 213 
Harrison, William Anthony (1800-1873) 413 
Harwood, Daniel (1801-1881) 350 
Harvey, William (1578-1657) 83 
Hawes, Arnold C (1813-1895) 557-8 
Hayden, Horace H (1769-1844) 245, 246, 284 
Headridge, Peter (1873-1921) 517-8, 536, 539, 896 
Heister, Lorenz (1683-1758) 129-31, 132 
Hellman, Milo . (1872-*) 14 
Hemard, Urbain (1548-1618) 95, 96, 97 
Hepburn, David (1821-1907) 467-70, 895 
Hepburn, Robert (1810-1901) 430-1 
Herbst, Wilhelm (1842-1917) 762, 766 
Heraclidcs (c. 75 B.C.) 46 
Herodotus (500-424 B.C.) 22-23, 24, 41, 288 
Herophilus of Chalcedon (335-280 B.C.) 46 
Highmore, Nathanael (1613-1684) 
Hill, Asa (1815-1874) 368 990 
ORTHODONTICS 
Hippocrates, Cos (460-377 B.C.) 40, 41-5, 47, 52, 55, 61, 83, 
86, 95, 96, 107, 110, 113, 
159, 288 
Hirsch, Frederick L. [Hirschfeld] (1753-1820) 136, 169 
Hise, Frankel L (1848-*) 636 
Hoang-Ti, Emperor (c. 2698-2590) 18 
Homer (B.C. c. 9th cent.) 41 
Horace [Quintus Horatius Flaccus] (B.C. 65-8) 54, 288 
Horstius, Jacobi [Horst, Jacob] (1535-1600) 112, 132 
Hough, John Stockton (c. 1873) 540-43 
How, Woodbury Storer (1829-1911) 369, 375, 650-5, 904 
Howard, F. E. (c. 1886) 655-6, 902 
Hrdlicka, Ales (1869-*) 14 
Hullihen, Simon P (1810-1857) 344, 347 
Humby, William, R (c. 1882) 605, 900 
Humphrey, George Murray (1820-1896) 443-6, 535 
Humphrey, Humphrey F (*) 14 
Hunter, John (1728-1793) 135, 136, 157-63, 166-7, 168, 
179, 180, 183, 198, 215, 216, 
224, 232, 236-7, 240, 243, 265, 
301 
Hurlock, Joseph (c. 1742) 136, 149 
Hutchinson, Sir Jonathan (1828-1913) 528-9 
Hyde, William E (c. 1878) 589 
I-em-Hetep (4500 B.C.) 21 
Imrie, William (c. 1834) 215-8, 239, 383 
Ingrassia [Giovanni Filippo] (1510-1580) 84 
Iszlai, Josef Dozent (1841-1903) 597-9, 838, 900 
Jack, Louis (1832-1914) 375, 818-20 
Jackson, Victor Hugo (1850-*) 720-36, 904 
James, Benjamin (c. 1814) 182-3, 243 
Janke, Johann Gottfried [Jancke] (1724-1763) 150 
Jarvie, William (1841-1922) 838 
Jean, Francis (c. 1893) 820-1 
Joachim, Heinrich (1860- ) 24 
Jobson, David Wemyss (c. 1835) 215 
Jordon, Peter ( -1536) 91, 92 
Jourdain, Anselme-Louis-Benard- 
Brechillet (1734-1816) 135, 153, 236 
Keely, George Washington (1822-1888) 605-11, 901 
Ketam or Ketham (Joannes) (c. 1492) 
King David 38 
King Solomon 38 
Kingsbury, Charles Andrew (1819-1891) 407-9 
Kingsbury, William B (c. 1878) 799 
Kingsley, Norman William (1829-1913) 6, 284, 402-7, 477, 481, 487- 
513, 548, 609, 636, 673, 701, 
788, 807, 886, 895-6, 904 
Kirk, Edward Cameron (1856-*) 763-5 
Knapp, James S (1823-1907) 543-4, 907 INDEX OF PROPER NAMES 
991 
Knapp, Myland A (1868*) 851-4 
Kneisel, Joan Friedrich Christoph (1797-1883) 136, 219-29, 240, 252, 284 
300, 301, 476, 477 
Koch, Charles Rudolph Edward (1844-1916) 97 
Koecker, Leonard (1785-1850) 201, 239, 243 
Kohler, J. G (c. 1854) 375 
Kolliker, Paul Alfred (1833-1909) 577, 620 
Krause, W. (c. 1888) 746 
Kuhns, Carl (1850- ) 616 
Lachaise, Claude (c. 1842) 283, 284, 476, 720 
Laforgue, Louis (c. 1792) 135 
Lanfranchi (c. 1300) 79 
Langsdorff, George Heinrich von (1774-1852) 440, 441, 442 
Laughlin, Bernard J (c. 1854) 375 
Leeuwenhoek, Anton van (1632-1723) 83 
Lefoulon, Pierre Joackim (c. 1841) 135, 245-6, 252, 253-71, 279-80, 
299, 337, 474-6, 481 
Legros, Charles (c. 1877) 577 
LeMaire, Joseph Jean Francois (1782-1834) 135 
Leszai, Daniel von (c. 1830) 213-4 
Leveille, Jean Baptiste Francois l (c. 1811) 232 
Levison, J. L (c. 1852) 360, 480 
Lindas, Henry E (c. 1900) 676, 677 
Lindenberger, H. (c. 1893) 797-8 
Linderer, C. Joseph (1771 1840) 35, 300-1, 478 
Linderer, Joseph (1809-1878) 136, 301 
Lintott, William (c. 1844) 271-6, 281, 476 
Lomnitz, C. B. A (c. 1839) 136, 252, 476 
Longbothom, B. T (c. 1802) 243 
Longhurst, Sidney (c. 1865) 457-8, 484 
Longoburgo, Bruno (c- 1252) 79 
Longstreet, C. S (c. 1877) 438 
Lucien 2 (125T-210) 54 
Mackall, R. Covington (c. 1840) 245 
Maclean, Samuel (1819-1864) 389 
Magill, William E (1825-1896) 470-1, 547, 895 
Magitot, Emile (1833-1897) 576-86, 592, 598, 604, 882, 
898, 900 
Magruder, J. H (c. 1889) 748-9 
Malian, John (c. 1836) 219 
Malpighi, Marcello (1628-1694) 83, 115 
Mantegazza, Paolo (1831- ) 620 
Marjolin Jean-Nicholas Rene (1780-1850) 195-7, 202, 234, 238, 239, 289, 
474 
Marmont, Charles (c. 1844) 306 
Martial (40-101 A.D.) 54, 58-60, 68, 288 
Martin, Benjamin (1704-1782) 116, 117, 131, 132 
Martin, F. (1800-1881) 253 
Martinez, Francisco [del Castrillo] (1518-1588) 93-4, 95 
Marvin, Cornelius Ackerson (1826-1906) 451-7, 484 992 
ORTHODONTICS 
Masson, Nicholas (1499-1569) 84 
Matteson, Arthur E (1842-1919) 736-42, 804, 904 
Maury, J. G. F (c. 1828) 135, 170, 202-7, 239, 253, 299, 
301, 477 
Maynard, Edward (1813-1891) 301-2, 478 
Mercer, Thomas B (e. 1900) 675, 676 
Merriam, John Campbel] (1889-*) 7, 15 
Mesue, Damascenus, Johannes (928-1016) 76, 99 
Mesue, Johannes, Senior (777-837) 81 
Miel, Edme-Maric (1777-1830) 179-80, 194, 198, 233, 237, 
257, 259-60, 462 
Mitchell, Grant (c. 1895) 837 
Mitchell, J. B (c. 1848) 341-2 
Mitchell, William Henry (I860-*) 854-5 
Moffatt, George Trifton (1836-1895) 438-9, 483 
Mondino de'Luzzi (1276-1326) 80 
Monson, George S (1869-*) 845-8 
Montaigne 37 
Moore, Charles Edward (1869-1913) 375 
Morgan, William Henry (1818-1901) 544 
Morrison, William Newton (1824-1896) 602, 609, 619 
Mortimer, William Henry (c. 1845) 136, 312-15, 478 
Moses (c. 1600 B.C.) 36 
Mouton, Claude (11786) 149 
Miihlreiter, Eduard (11918) 598 
Muller, W. Max (1862-1919) 21, 24 
Mummery, John Ridgcn (1809-1885) 23, 24, 449-51, 583 
Mundinus (see Mondino) 
Murphy, Joseph (c. 1811) 33, 35, 180, 181-2, 238 
Museler, M. J (c. 1881) 601, 900 
McCollom, A. (c. 1877) 438 
McCurdy, John R (c. 1867) 375 
McKellops, Henry Jerome Byron (1823-1901) 401 
McQuillen, John Hugh (1826-1879) 413-7, 422-3, 429-30, 483, 514, 
895 
Nasmyth, Alexander (t.1848) 158, 235, 240 
Nasmyth, Robert (1792-1870) 202 
Neal, E. Henry (1838-1900) 792 
Nesscll, F. . (c. 1840) 136 
Neuberger, Max (1868-*) 6 
Newkirk, Garrett (1847-1921) 658, 902 
Nicaise, Edouard (1838-1896) 78, 81 
Nicholles, John (c. 1833) 214-5 
Noyes, Frederick Bogue (1872-*) 708 
Nuck, Anton (1650-1692) 116, 131 
Ogston, Alexander (1844- ) 588-9. 897 
Oppenheim, Albin (*) 710 
Oribasius (326-403) 64, 66, 67 
Osborn, Henry Fairfield (1877-*) 15 
Osler, Sir William (1849-1919) 102 INDEX Ol-' PROPER NAMES 
993 
Osmun, J. A (c. 1891) 768 
Ottolengui, Rodriques (1861-*) 344, 825-7, 841-44, 873 
Oudet, Jean Etienne (1788-1868) 135, 179, 197-8, 232, 265 
Palmer, George B (I860-*) 709 
Paracelsus, Theophrast [Bombast van 
Hohenheim] (1493-1541) 83 
Pare, Ambroise (1510-1590) 84, 109-11, 131, 132, 159, 289 
Parmly, Eleazar (1797-1874) 243 
Parmly, Levi Spear (1790-1859) 197, 198, 243 
Parreidt, Julius (1849- ) 545, 621-2 
Parry, Ely (1804-1874) 375 
Patrick, John Joseph Ravenscroft (1828-1895) 602-4, 652, 900 
Paul of Aegina (625-690) 67, 68, 86 
Peebles, Henry E (1812-1871 399-400, 481 
Peirce, Cyrus Newlin (1829-1909) 375, 417-18 
Perry, Safford Goodwin (1844-1911) 821-2 
Pfaff, Philipp (1716-1780) 115, 150-60, 236 
Plateario, Giovanni (c. 1470) 81 
Plinius, Cajus Secundrus [Pliny] (23-79 A.D.) 17, 52, 54, 57-8, 67, 86, 90, 
108, 288 
Ploucquet, Guilielmus Godofredus de (1744-1814) 234, 255 
Pope, Julius 48 
Potpeschnigg, Heinrich (c. 1875) 566-8, 897 
Price, I. (c. 1854) 375 
Prinz, Herman (1868-*) 38, 47, 90, 101 
Proskauer, Curt (1887-*) 97, 101 
Pullen, Herbert Armitage (1874-*) 676, 677 
Purmann, Matthaeus Gottfried- ( -1711) 
(1648-1721) 114, 115-6, 131, 132 
Quinby, Henry Clay (1823-1908) 611-4, 900 
Redier, Jean Marie (1848- ) 604 
Redman, W. G (1821-1885) 584 
Rehwenkel, Fredrich (1825-1889) 370 
Reisner, George Andrew (1867- ) 21 
Renan, Joseph Ernest (1823-1892) 27 
Renard, Leon (c. 1880) 594 
Rhazes [Rhasis] (850-923) 71-2, 77 
Richardson, Sir Benjamin Ward (1828-1896) 584 
Richardson, Joseph (1824-1889) 521-3, 896 
Roberts, David (c. 1854) 375 
Robertson, William ( -1870) 218, 239 
Robin, Charles Philippe R (1821-1885) 577 
Robinson, James (1816-1862) 323-8, 337, 342 
Rodrigues, Benjamin Adolph (1815-1871) 250-1, 474 
Rogers, Williams (c. 1845) 245, 342-4, 478 
Ross, Harrison D (c. 1853) 373 
Rosseau, L. F. Em (1863-1899) 135 
Rothrock, J. M (c. 1854) 375 
Rubencame, John R (1820-1889) 375 994 
ORTHODONTICS 
Buffer, Sir Marc Armand (1859-1917) 23-4 
Rumbold, Thomas Frazier (1830-1901) 698 
Runchenbach, R. (c. 1896) 757 
Ruspini, Bartholomeo (c. 1750) 150, 236 
Ryff, Walter Herman [Gualtherus H. 
Rivius] (1500-1562) 91, 94, 100-1 
Sachs, Wilhelm (c. 1897) 840-1 
Saint Hilaire, see Geoffroy 
Salter, Samuel James Augustus (1825-1897) 559-66, 897 
Sauer, Carl (1835-1892) 575, 576, 762 
Saunders, Sir Edwin (1814-1901) 305-6 
Saville, Marshall Henry (1867-*) 28-33, 35 
Schange, J. M. Alexis (1807-t) 141, 184, 252, 271, 279-84, 287, 
301, 476-7, 480, 720, 865 
Schmidt, Emil (c. 1893) 23 
Schroder, Hermann (c. 1906) 35 
Schultes [Schultetus] [Johann] (1595-1645) 115-6, 131 
Scribonius, Largus (e. 47 A.D.) 60 
Sercombe, Edwin (1826-1875) 412-3 
Serres, Jacob Joseph (1759-1830) 135 
Servede, Miguel [Servetus, Michael] (1509-1553) 84 
Sewill, Henry Ezekiel (1843-1920) 464-7 
Shaw, Samuel Julius (1830-1920) 742-5, 904 
Shaw, Thomas H (c. 1854) 375 
Sheffield _(c. 1870) 527 
Shepard, Luther Dimmick (1837-1911) 471-2, 862 
Siegfried, Meissen - (c. 1889) 756-9, 904 
Sigmond, Joseph (1750-1826) 136, 198-201, 239 
Simpson, G. L (c. 1882) 601-2 
Skinner, Richard C (c. 1801) 243 
Smale, Morton Alfred (1847-1916) 816-8, 873 
Smith, Edwin (1822-1906) 21 
Smith, Edgar Fahs (1856-*) 674 
Smith, Grafton Elliot (1871-*) 12, 15, 23, 24 
Smith, Janies W (1854-1889) 599-601 
Smith, John S (c. 1871) 473-4 
Soemmering, Samuel Thomas (1755-1830) 234, 256, 291. 
Solon [Solinus] (640-558 B.C.) 41, 108 
Spaulding, Christopher W (1814-1896) 400-1, 487 
Spooner, Shearjashub (1809-1859) 229 
Starr, Eli Thompson (1834-1904) 636 
Stellwagen, Thomas Cook (1841-1918) 514, 863 
Sternfeld, Alfred (1857-1904) 762-3, 838, 904 
Sudhoff, Karl (1853-*) 85 
Sylvester, E. Ware (c. 1863) 439-40, 483 
Sylvius, Jacobus [Jacque Dubois] (1478-1555) 84 
S., W. H (c. 1886) 657-8 
Talbot, Eugene Solomon (1847-1925) 625-41, 901 
Talma, Amedee Francois ( -1864) 135, 179, 369-72, 480 
Tambu, Yasuhori (B.C. 892) 19 INDEX OF PROPER NAMES 
995 
Taylor, James (1809-1881) 375-6 
Thessalus (350 B.C.) 42 
Thompson, Alton Howard (1849-1914) 586-8, 899 
Thompson 37 
Thon, Ottocar (c. 1841) 136, 279 
Tolver, A. (c. 1750) 149 
Tomes, Charles Sissmore (1846-*) 523-7, 897 
Tomes, Sir John (1815-1895) 334-41, 375, 378, 384, 479, 
514, 620, 623 
Touvet, Richard Fanton (1833-1885) 604 
Townsend, Elisha (1804-1858) 374, 375 
Trenor, John (c. 1852) 243 
Trousseau, Armand (1801-1867) 583 
Trueman, Janies (1826-1915) 375 
Truman, William H. (1842-*) 97, 614-5 
Tucker, Elisha Gustavus (1808-1895) 346-50, 479 
Valverde, Juan de [Hamuseo] (c. 1560) 111, 132 
Van Marter, James Gilbert (1835-1901) 27 
Van Rippon, Beneban Adams (*) 35 
Vesalius, Andreas [Wesele] (1514-1564) 83, 84, 100, 102-4, 109, 131, 
132 
Vidius Vidius sec Guido Guidi 
Vidler, Thomas C. (c. 1864) 449 
Vigo, Giovanni di (1460-1520) 79, 289 
Virchow, Rudolf (1821-1902) 23, 763 
Waite, George (c. 1826) 201 
Waldeyer, Wilhelm (1836-1906) 577 
Walker, J. R. ( -1887) 544, 558 
Walkhoff, Otto (1860-1921) 793 
Wardle, Thomas (1819-1887) 593-4 
Ware, James S. (c. 1848) 245-6, 478 
Watson, Milton Tate (1872-*) 676, 677 
Weber, Andres ( * ) 93 
Wedl, Karl (1815-1891) 462-4, 514, 598, 904 
Weiss, Felix (1822-1892) 568-70 
Welchens, Samuel ( -1879) 544 
Werner, K. (c. 1868) 136 
Westcott, Amos (1815-1873) 306-12, 357, 478, 481-2, 879 
Whipple, J. W. (c. 1898) 344 
White, H. Meredith (c. 1862) 431-433 
White, James William (1826-1891) 387 
White, John de Haven (1815-1895) 352-7, 479, 483 
Wilder, Richard . (c. 1894) 798-9, 905 
Wilkinson, Sir Garanti ( ) 23 
Wilpart (c. 1877) 588 
Winckworth, John (c. 1831) 213 
Wood (c. 1851) 385 
Woodward, Arthur Smith (1864- ) 15 996 
ORTHODONTICS 
Woodward. J. A. (e. 1880) 615-6 
Wooffendale, John (c. 1768) 164 
Wooffendale, Robert (1742-1828) 136,153, 164-6,237 
Woolworth, Isaac . (1810-1879) 448-9 
W. H. 8. 657-8 
Yasuhori, Tambu (c. 892 B.C.) 19 
Zerbi, Gabriele de (1468-1505) 84 
Zsigmondy, Otto (1860-1917) 790-1 
Zwinger, Theodore (c. 1766) 289 SUBJECT INDEX* 
A 
Abnormalities in position and irregulari- 
ties of teeth in prehistoric 
man, 9-14 
Abscess, 18, 22, 27, 54, 55, 140, 229 
Abscesses, Chinese on, 18, 22 
Absence of teeth, 570, 584 
Absorption of walls of alveoli, 491 
Acquired causes of malocclusion (see 
Causes of irregularities of 
the teeth) 
Adenoids, 500, 848 
Advice of Desirabode as to success or 
failure, 312 
to young orthodontists, 509 
Africa, 12 
Age, advanced, for treatment, 4, 177, 215, 
252 
correct for treatment, 252, 274, 279, 
285, 304, 312, 318, 323, 324, 
329, 332, 373, 374, 411, 414, 
450, 453, 461, 468 
Ainsworth appliance, 855 
Albucasis, first to use orthodontic appli- 
ance, 75 
Alexandrian Library, 5, 37 
Alumni Society of the Angle School of 
Orthodontia, 508, 678, 709, 
713, 798 
Alveolar process, absorption of, 114, 191, 
330, 491 
development of, 168, 232, 461, 596, 
627 
general consideration of, 27, 67, 107, 
165, 179, 198, 231, 233 
American dentistry, South, 28 
Indian, South, 5 
Journal of Dental Science, 244, 246 
Journal and Library of Dental 
Science, 246 
Orthodontist, 678 
Society of Dental Surgeons, 244, 245, 
347 
Society of Orthodontists, 678, 697 
Anatomical theatre at Leyden, 128 
Anatomy, comparative, 45, 106, 216 
establishment of human, 83 
founder of, 45 
of teeth, 56, 71, 74, 78, 80, 83, 84, 
102, 103, 106, 107, 109, 
112, 113, 645 
Anchor bands, 877 
and cribs, (see Treatment) 
Anchorage, 883 
device for securing, 217, 218, 280, 362, 
617, 720 
forms of, 179, 224, 280, 362, 366 
occipital, 284, 477, 697 
principle of force in, 785 
reciprocal, 696 
sources of, 617 
stationary, 695 
Ancient man (see Prehistoric man) 
Anesthesia, 19, 33 
Angle's classification, 677, 689 
development of ideas, summary of, 677 
1 ' malocclusion of the teeth," 674 
School of Orthodontia, 675, 676, 678 
Anomalies of dental system, 583 
of teeth (see Teeth) 
Antagonism of the teeth, 889 
Anthropology, 3 
first to use term of, 45 
Antrum of Highmore, 153, 233, 597 
Apices of roots, 880 
Appendix, vermiform, 84 
Appliances (see Treatment and Author) 
Archaeological Museum at Athens, 44 
first for correcting malocclusion, 75, 
141, 143 
found at Civita Casteliana, 48 
Corneto, 50, 51 
Orvieto, 49, 51 
Satricum, 59 
Sidon, 25 
Teano, 53 
Villa Guilia, 53 
object of regulating, 617 
Appolonia, Patron Saint of dentistry, 
62, 65 
Arab science, 69 
Arabian literature, 17 
Arabians, 5, 17, 69-75, 77, 78, 81 
Arch, dental (see Dental arch) 
expansion (see Expansion and Treat- 
ment) 
form of, 279 
Archaeological research, 2, 20, 33, 39, 
59, 86 
Arsenic, 74 
Articulation, versus occlusion, 659 
Artificial dentures first used, 27, 44, 59 
removal prosthetic, 130, 164 
teeth, 59, 76, 110, 130 
Artisans, dental, 2 
"Artzney Buchlein, " 6, 55, 87, 93 (see 
Zene Artzney) 
Assyrians, 36 
Astronomy, 37, 69, 70, 71, 78 
Atacames specimen, 30 
♦Volume I includes pages 1 to 484 ; 
Volume II includes pages 485 to 1011. 
997 998 
SUBJECT INDEX 
Atomic theory, 40 
Aztecs, 28 
B 
Babylonians, earliest treatment of tooth- 
ache by, 38, 86 
as specialists, 37 
treatment of sick by, 37 
Baker anchorage, 703, 770, 831 
Baltimore College of Bental Surgery, 
244, 246 
" Bandelettes, " (see Bands) 
Bands, 876 (see also Treatment) 
Barber Surgeons, 79, 137 
Beginning of systems in orthodontia, 
863,' 864 
Best paper on irregularities of the teeth, 
prize, 347 
Bible, the, 36 
Biology, 3 
Bite, end to end, 10, 11 
general consideration of, 561, 598, 647, 
661, 768, 781 
jumping the, 272, 301, 496, 500, 701, 
761, 807, 850 
opening the, 272, 301, 761, 783 
plate, 217, 218, 227, 272, 283, 284, 
611, 617 
shortened, 301 
wax, 505 
Blackening the teeth, 234 
Japanese, 19 
Java, 34 
Sumatra, 34 
Bodily movement of teeth, 891, (see also 
Treatment) 
' ' Bone growing, " 708 
Bonwill's geometrical and mechanical 
laws, 658 
Botany, medical, 47 
Bourdet's strips (arch), 151 
Brahmins, 36 
Brass wire ligatures (see Ligatures) 
Bridge-work, Etruscan attempt at, 25-27, 
48-51, 86 
Grecian, 44, 45 
Roman, 52-64 
C 
Cairo, medical colleges at, 69 
hospital at, 78 
Cancer, 131 
Candy, ill effects of, 149 
' ' Capping" the teeth, results produced 
by, 272 
Caps or crowns (see Treatment) 
Carabelli's "Mordex proms," 597 
Caries, 6, 9, 13, 14, 22, 24, 38, 60, 63, 
72, 85, 147, 148, 156, 175, 
183, 228, 299, 300 
Case's appliance for bodily movement of 
teeth, 777-781 
Cases, treatment (see Treatment) 
Castellani collection, Etruscan appliance 
in, 48 
Casting inlays, 35 
Causes of irregularities of the teeth: 
accidental, 278, 423, 560, 624 
acquired, 248, 313, 413, 498, 549 
adenoids, 500, 848 
cleft palate, 558 
congenital, 206, 301, 303, 390, 
413, 464, 497, 558, 560, 
584 
considered by, Arthur, 315 
Baker, E., 329 
Ballard, 440 
Bell, 209 
Blake, 168 
Blandin, 231 
Bogue, 749, 754 
Bourdet, 157 
Brown, 277 
Bunon, 148 
Burton, 622 
Cartwright, S., 390 
Clark, 229 
Coleman, 446 
Coles, 529 
Colyer, 816 
Belabarre, 185 
BeLessert, 527 
BeLoude, 251, 476 
Besirabode, 295 
Brake, 523 
Buval, 178 
Flagg, J. F., 418 
Forbes, 519 
Fox, 171 
Gaine, 377 
Goddard, P. B., 302 
Guilford, 545 
Gunning, 595 
Harbert, 330 
Harris, 248 
Hepburn, B., 468 
Hough, 540 
Hunter, 160 
Hurlock, 149 
Imrie, 215 
Jobson, 215 
Kingsbury, 407 
Kingsley, 496 
Knapp, J. S., 543 
Kneisel, 223 
Lefoulon, 259, 263 
Lintott, 271, 274 
Magitot, 576 
Malian, 219 
Maury, 203 
McQuillen, 413, 422 
Mitchell, 341 
Mortimer, 312 
Murphy, 181 
Nicholles, 214 
Ogston, 558 
Cancer, 131 SUBJECT INDEX 
999 
Causes of irregularities, considered by- 
Cont'd 
Parmley, L. S., 197 
Parreidt, 621 
Peebles, 399 
Robinson, 324 
Rodrigues, 250 
Salter, 559 
Sewill, 464 
Sigmund, 198 
Smale, 816 
Talbot, 625, 633, 635 
Talma, 369 
Tolver, 149 
Tomes, Chas., 524 
Tomes, John, 334 
Wedl, 463 
Weiss, 568 
Woof endale, 165 
constitutional, 191, 259, 278, 295, 
475, 541, 626 
contraction of jaw, 275, 302, 324, 
331, 390, 414 
degeneracy, 441, 472, 525, 626, 
661 
disease, 259, 441, 475, 499, 622 
disproportion of size of teeth to 
jaw, 160, 162, 166, 177, 
185, 186, 198, 204, 205, 
208, 209, 211, 215, 229, 
236, 251, 295, 324, 329, 
342, 363, 368, 391, 560, 
596, 621 
disturbance of trigeminal nerve, 
498 
early eruption of permanent teeth, 
180, 185, 323, 331, 584 
early loss of deciduous teeth, 208, 
209, 229, 247, 251, 261, 
263, 271, 274, 313, 315, 
323, 364, 596 
embryonic defects, 577, 581 
environment, 262, 626 
excess number of teeth (see Su- 
pernumerary teeth) 
extraction of deciduous teeth, 323, 
330, 355, 357, 369, 400, 
413, 423, 497, 545 
family traits, 541 
faulty development, 185, 192, 198, 
209, 215, 223, 259, 274, 
560, 624, 633 
feeding, 422 
foods, soft, 422, 622 
germs of teeth, position of, 302, 
336 
grinding the teeth, 229 
habits, 199, 215, 229, 235, 250, 
264, 422, 440 
heredity, 206, 211, 223, 251, 259, 
277, 390, 407, 422, 440, 464, 
468, 489, 498, 500, 529, 541, 
549, 568, 569, 579, 621 
imperfect filling, 198, 270 
Causes of irregularities-Cout 'd 
jaws of one parent and teeth of 
another, 251, 523, 621 
large teeth, 174, 179, 624 
local, 170 
measles, 148 
mechanical, 171, 198, 237, 407 
missing teeth, 464 
mistaken views as to treatment, 
596 
mouth breathing, 500 
muscles, 250 
neglect of supervision of second 
dentition, 263 
neurotics, 626 
nonabsorption of roots, 468 
nondevelopment of teeth, 185, 198, 
207, 230, 234 
nutrition, 223, 626 
' prenatal, 258, 475 
pressure of teeth, 197, 224, 259, 
295 
prolonged retention of teeth, 128, 
132, 149, 157, 164, 181, 
204, 223, 229, 251, 258, 
295, 324, 364, 546, 560 
rickets, 148, 441, 520, 521 
scurvy, 259, 523 
supernumerary teeth, 157, 195, 
213, 247, 251, 275, 295, 
315, 317, 464, 468 
temporary teeth, 197, 247 
tongue, 43, 229, 235, 264, 270 
hypertrophy of, 560 
sucking, 576 
tonsils, 54 
sucking, fruitless, 441, 489, 527 
thumb sucking, 215, 235, 264, 373, 
422, 489, 500, 501, 560, 
608 
traumatic, 264 
tumors, 464 
want of space, 149, 150, 152, 160, 
162, 167, 170, 177, 185, 
188, 197, 207, 219, 224, 
247, 302, 303, 315, 318, 
334, 390, 461, 463 
Cauterization, 44, 61, 74, 139, 159 
Cautery, 57, 66 
Cavities, preparation of, 61 
Cement, 28 
Chair, operating, 213 
Chart for treatment, 806 
Chemical reaction on bands and teeth, 
322 
Chemistry, 70, 71, 78, 83 
Children, development of, 259 
Chin, prominent, 152, 178, 181, 182 
receding, 11 
Chincap, 170, 173, 220, 284, 285, 308, 
357, 412, 467, 489, 508, 
526, 590, 594, 718, 766, 
809 SUBJECT INDEX 
1000 
Chinese, anatomical notion of, 18 
dentistry of, 18, 85 
literature, 17 
Circulation of the blood, 63, 83, 84, 122 
Clamp bands, 874, 882 
Class III, general considerations of, 272, 
302, 303, 330, 401,' 420, 
546, 586 
treatment of, 163, 165, 174, 179, 196, 
230, 236, 272, 285, 344, 420 
Classifications of malocclusion: 
Andrieu, 449 
Angle, 677, 689 
Blandin, 234, 240 
Carabelli, 287, 477 
Case, 790 
Coles, 530 
Delabarre, 189, 238 
Desirabode, 295, 477 
Fitch, 207 
Fox, 175, 237 
Gaillard, 592 
Goddard, 813 
Grandhomme, 321, 478 
Grevers, 838 
Guilford, 555 
Iszlai, 598 
Kingsley, 479 
Kneisel, 219, 240 
Lefoulon, 262, 475 
Linderer, 300, 478 
Lomnitz, 252, 476 
Magitot, 580, 582 
Marjolin, 195, 238 
Maury, 205, 239 
Redier, 604 
Schange, 280, 476 
Smale and Colyer, 818 
Sternfeld, 762' 
Thon, 279 
Tomes, J., 335, 479 
Wedl, 464 
Clean teeth will never decay, 230, 647 
Cleansing of teeth by Greeks, 41 
Cleft palate, 558 
Clergy as professional men, 37, 78 
Coan and Cindian, schools of medicine, 
42 
Code of Hammurabi, 37 
Coffin split plate, 448, 537, 655, 667, 724 
Colleges of medicine, early, 79 
"Commissions," payment of, 512 
Comparative anatomy, 45, 106, 216 
Complement full, of teeth, 36 
Constitutional causes of malocclusion 
(see Causes of irregulari- 
ties of the teeth) 
"Crania progenaea, " 597 
Criminal code, 36 
Crowns, ancient artificial, 49, 51, 86, 
149 
Crusades, 78 
Cuneiform writing, 25, 37 
Cusps of molars, modification of, 579 
Custom of decorating teeth, 28, 29 
Cysts, dermoid, 583 
D 
Damascus, hospital at, 78 
Dark ages, 5 
Decay of teeth, 890 (see also Teeth, 
decay of) 
not a modern evil, 44, 230 
Deciduous teeth, importance of, 113, 128, 
146, 148, 169, 183, 188, 
210 
Decorating the teeth, 29, 31, 33, 34, 35 
Definitions of dentition, 462 
of dental hygiene, 290 
of orthodontia, Angle, 2 
of orthodontic terms, 245, 246, 260, 
294 
of orthopedia, 294 
of therapeutics, 269 
pertaining to dentistry, 245, 246, 290 
Degeneracy, 441, 472, 525, 626, 661 
Delphi, temple of Apollo at, 41 
Dental and surgical instruments of the 
Romans, 64 
anomalies (see Anomalies of teeth) 
Magitot on, 576 
appliances, ancient Etruscan, found at 
Orvieto, 49 
at Tarquinii, 50 
near Teano, Italy, 53 (see 
also Appliances found at) 
custom among primitive people, 33-35 
development, perfect result of, 498 
follicle, displacement of, 266 
literature, advent of, 89, 243 
first American, 243 
English, 118, 136, 243 
French, 95, 138, 243 
German, 90 
Italian, 94 
Spanish, 93 
maladies as given in Ebers Papyrus, 
21, 22 
' ' orthopedia, " 245, 246 
surgery, origin of, 41 
Dentiscalpia (toothpick), 59 
Dentist, Cascellius the first, 59 
duty of, 185, 292, 455 
examination of, as mentioned by Dela- 
barre, 185, 187 
by Fauchard, 137 
Herodotus speaks of, 22 
requirements of a, 289 
Dentistry as practiced by Alexandrians, 
37 
by Americans, 243 
by Ancients, 17 
by Arabians, 69-77, 86 
by Babylonians, 36-38, 86 
by Chinese, 18, 19, 85 
by Egyptians, 20-24, 85 
by English, 118, 136 SUBJECT INDEX 
1001 
Dentistry as practiced-Cont'd 
by Etruscans, 48-51, 86 
bv French, 95, 96, 135, 136, 137, 
138 
by Germans, 87-93 
by Greeks, 39-48, 86 
by Hebrews, 36, 37, 86 
by Italians, 94 
by Japanese, 19 
by Phoenicians, 25-27, 85 
by Pre-Columbians, 28-33, 85 
by Prehistoric man, 9, 14, 85 
by Romans, 51-68, 86 
by Spanish, 93, 94 
by Sumerians, 36 
in fifteenth century, 79, 86, 89 
in India, 33, 35 
in Java, 34 
in Medieval period, 78-81 
in Mexico, 28, 35 
in Sandwich Islands, 34 
in sixteenth century, 82-85, 89-104 
under Hammurabi, 37 
condition of, before Fauchard, 137 
earliest, 6, 21 
emergence of, 133 
first beginning of, 21, 41 
history of, 5 
operative, ancient, 24, 28 
Patron Saints of, 62, 65, 66 
practice of, by specialists in ancient 
Egypt, 23 
in Rome, 58 
Desirabode on, 288 
Dentition, accidents of, 148, 258 
causes of pain in, 161, 258, 293 
deciduous, no irregularities in, 278 
definition of, 462 
disorders of, 54, 98, 131, 157 
effect of illness during first, 148, 149 
first, 100, 113, 146/148, 184, 235, 
257, 462 
fourth, 620 
laws of, 620 
means of aiding difficult, 67, 74, 157, 
163, 203 
means to facilitate, 55, 63, 98, 130, 
149, 157, 163, 203, 293 (see 
Lancing the gums) 
process of, 55, 65, 98, 101, 106, 108, 
113, 118, 187, 235, 257, 
259, 269, 274, 293, 463, 
620 
tables of period of, 257, 463 
Dentrifice, 42, 72, 74 
Dentures, ancient, 27, 51, 59, 164 
artificial, first used, 27, 44, 59 
Desirabode on what constitutes the prac- 
tice of dentistry, 288 
Determination of age for treatment, 224 
Diagnosis (see Causes of irregularities 
of the teeth) 
" Dicharmosis, " 599 
Dictionaries, dental, 245 
Dies and counterdies, 136, 220 
Dietetics, laws of, 73 
Disease, predisposing cause of, by irreg- 
ularity, 201 
Dissection, 52, 61, 71, 77, 80, 84 
prohibited by the Koran, 71, 77 
Doctor, title of first, 60, 79 
'' Dolichocephalic, ' ' 623 
' ' Dryopitliecus, ' ' 10 
Dysentery, Chinese on, 18 
E 
Ear, 84 
Ebers on dental art of Egyptians, 22 
Papyrus, 21, 22 
Education of dentist, 137, 138, 185, 246, 
289 
Effective forces, 865 
slight pressure, 868 
Egypt, special doctors for the teeth, 23 
Egyptian dental art, 22, 36, 85 
pharmacy, 66 
prescription for toothache, 22 
Elastic, 869 
rubber, reason against use of, 870 
Elastics (see Treatment) 
Electro-chemical reaction, 322, 323 
Electro-plating, 742 
Electrum, 26 
Elevators, 75 
Embryology, 3, 45 
Embryonic effects, 577, 581 
Embryos, 620, 621 
Eminentiae articularis, 596 
Enamel, structure of dental, 150 
Enameling retaining appliances, 837 
"Enarmosis, " 598 
Endocrines, 536 
Endocrinology, 3 
Environment (see Causes of irregulari- 
ties of the teeth) 
"Eoanthropus Dawsoni, " 10, 12 
' ' Epharmosis, ' ' 598 
Equador, 28 
Equilateral triangle, 530, 660 
Erosion, dental, 22, 24 
Eruption, early, of permanent teeth, 180, 
185, 323, 331, 584 
of teeth, 42, 46, 55, 98, 104, 106, 108, 
120, 141, 187, 189, 190, 
202, 214, 280, 291, 399, 
401, 463, 475, 515 
Esmeraldas, Province of, 28, 30 
Ethnological, variation in lower jaw, 594 
Etiology of malocclusion (see Causes of 
irregularities of the teeth) 
Etruscans, dental appliances of, 25, 48- 
51 
art among the, 25, 27, 59, 77, 110 
Eustachian tube, 85 
Evolution, 40, 666 
organic, hypothesis of, 666 
Exostosis, 299 SUBJECT INDEX 
1002 
Expansion arch, 869, 870 (see also 
Treatment) 
Extraction forceps of Aureliauus, 41 
Erasistratus, 41 
Garengeot, 131 
Hippocrates, 44 
Romans, 56 
of deciduous teeth (see Causes of ir- 
regularities of the teeth) 
of teeth 22, 46, 47, 54, 55, 56, 71, 
72, 74, 75, 79, 81, 85, 86, 
94, 110, 146, 147, 160, 163, 
175, 186, 289, 294 (see 
also Treatment) 
Careless, 47 
Davenport on the question against, 
641-649 
first practiced, 41 
Eye for an eye, 36, 100 
teeth, 63 
origin of name of, 63 
uvea of the, 84 
F 
Face, beauty of, 64 
conformation of, 177, 181, 193, 194, 
271, 274, 454 
growth of, 231 
laws of balance of, 535 
primitive, 12 
relation of, to chin, 11 
study of the, 514 
Facial angle, change in, 84, 233 
expression, correct, what is it? 454 
" orthopedia, " 245, 290 
Falling out of teeth, 41 
Fallopian tubes, 84 
Family traits (see Causes of irregulari- 
ties of the teeth) 
Farrar's law in regulating teeth, 871 
theory as to movement of teeth, 866 
Fauchard, appliance to correct irregular- 
ity, 137, 236 
condition in France prior to, 137 
expansion arch of, 143 
pyorrhea alveolaris, 139 
Feeding of babies, 149 
Fetus, 166, 231 
Fever, Chinese, IS 
malignant, 148 
Filing of elongated teeth, 55, 58, 64, 
74, 76, 81, 85, 116, 117, 
126, 127, 155, 156, 166, 
182, 194, 199, 207, 230, 
264, 266, 280, 299, 300, 
304, 642 
of teeth by primitive races, 23, 32, 34, 
' 35, 85, 111, 116, 117 
Filling of teeth, cement, 72 
gold, 81, 230 
lead or lint, 56, 86, 139 
other methods, 61, 72 
Finger pressure, treatment by, 55, 153, 
174, 182, 197, ' 260,' 304, 
422 
sucking, 215, 235, 264, 373, 422, 489, 
500 
Fingers, extraction of teeth with, 6, 46 
First textbook on orthodontia, 548 
Food, value of, 545 
Force, application of, for tooth move- 
ment, 170, 176, 274, 283, 
323, 459, 546, 552, 880 
constant, for treatment, 856 
formula for application of, 548 
from inclined planes, 236 
intermaxillary, 237 
intermittent, for treatment, 471, 856 
Forceps, extraction, 41, 46, 56, 60, 115, 
131, 153 
Forces, classification of, 552 
definition of, 552 
for rotation, 546 
intermaxillary, 237 
proper distribution of, 176 
Fractures of jaws, 44, 74 
France, condition of dentistry, prior to 
Fauchard's time, 136 
dentistry in, 95, 96, 135, 137, 138 
Functional laws of tissues, 864 
G 
Garengeot's key, 131 
Gastric juice, 74 
German dentistry, 87-93 
Germs, 40 
transposition of, 194 
Ghent, University of, Etruscan appliance 
in Museum of, 49 
Gibraltar skull, 12 
Gingivitis, treatment of, 22 
Glands, submaxillary, 84 
Glenoid fossa, 591, 596 
God's, as attributed by the earliest 
faiths, 5 
Gold, appliance of the Arabians, 75 
Egyptians, 23 
Etruscans, 48 
Greeks, 45 
Phoenicians, 27 
Romans, 53 
crowns, early, 48, 49, 50, 53, 149 
expansion arch, first, 143 
fillings, early, 23, 28, 35, 81, 86 
inlays, 28, 30, 85 
teeth, substitution of, in Java, 42 
use of, mentioned in the Laws of the 
Twelve Tables, 53 
wire, use of, by Albucasis, 75 
Hippocrates, 44 
Greco-Roman culture continuity with 
Egyptians, 21 
Greece, 4, 25, 36, 39, 40 
antecedents of, 39 
intellectual, failure of, 40 SUBJECT INDEX 
1003 
Greek doctors in Rome, 52 
mind in modern science, 40 
Greeks, dental art of the, 20, 25, 39-48, 59 
Growth, as produced by stimulation, 272 
laws of, 247 
Gums, 47, 66, 67, 99, 100, 105, 106, 114, 
124, 300, 330, 459 
Gutta-percha impression, 604, 669 
H 
Habits of childhood (see Causes of ir- 
regularities of the teeth) 
Hammurabi, Code of, 37 
Hare lip, 295 
Harmony, reestablishment of, 259 
Harvard, 350 
Head gear, 884 
and chin retractors (see Chin and 
Skull cap) 
Heart, 84, 102 
fetal, 45 
Hebrews, 36, 40, 78, 86 
"Heidelberg Man," 10 
Helena, Saint, 66 
' ' Hellenistic Age, ' ' 52 
Hematite, 28 
Heredity (see Causes of irregularities of 
the teeth) 
Hieractic characters, 22 
Hieroglyphics, 25, 37, 39 
Highmore, antrum of, 153, 233, 597 
Hindoo dentist, 25 
science, 69 
Hippocrates, eminence of, 42 
Hipprocratic school of medicine, 40, 43, 
61 
"Histogeny, " dental, 577 
History, 1, 2, 4, 5, 6, 7, 17 
meaning of, 7 
need of, 1 
' ' Homo-Australianus, " 11 
" Homo-Heidelbergensis, " 10, 12 
"Homo-Neanderthal," 10, 12 
" Homo-Mousterian, " 10, 11, 24 
" Homo-Rhodensis, " 12 
' ' Homo-Sapiens, ' ' 12 
Hospital, first established, 78 
Hygiene of the mouth (see Prophylaxis) 
Hypothesis of organic evolution, 666 
I 
Idiocy, 472, 525, 626, 664 
Implantation of teeth, 29, 30, 159 
Impression, 151, 200, 216, 218, 225, 312, 
332, 376, 407, 448, 458, 
604, 606, 668, 874 
trays, introduction of, 136, 225 
Inclined planes, 176, 178, 179, 180, 197, 
218, 219, 239, 250, 265, 
270, 275, 283, 313, 322, 
328, 332, 354, 356, 372, 
383, 412, 431, 469, 474, 
494, 546, 762, 860 
' 'Incunabula, ' ' 89 
India, people of, customs of, relating to 
dentistry, 33 
Indians, South American, 5, 28-33 
Indigestion, 98 
Inferior dental canal, 233 
maxilla, fracture of, 18 
Inherited causes of malocclusion, 206, 
211, 223, 251, 259, 277, 
390, 422, 440, 464, 468, 
489, 498, 500, 529, 541, 
549, 568, 579, 621 
Inlays, gold and semiprecious stones, 
28-33, 35, 85 
Inoculation against smallpox by primi- 
tive Chinese, 18 
Instruction in orthodontia, 678, 805 
Instruments, 41, 44, 59, 60, 74, 76, 115, 
127, 129, 130, 131 
Intermaxillary elastics (see Treatment) 
prognathism, 533, 535 
Intermittent force, 864, 872 
Invention of pictorial writing, 37 
printing press, 79, 83, 84 
"Inversion," 196, 238, 263 
"Ishinho, " oldest Japanese work, 19 
J 
Jackscrew, 311, 351, 352, 424, 438, 489, 
493, 504, 544, 614, 619, 
628, 800, 878 
combination of, 311, 352 
description of, Dwindle's, 351 
Longstreet's, 438 
McCollom's, 438 
invention, 311, 351 
Jackson's system (see Treatment, gen- 
eral) 
Jadeite, 35 
Japanese, dentistry as practiced by, 18, 
19 
Java, dental customs, 34-35 
man, 9, 12, 13 
substitution of gold teeth by people 
of, 34 . 
Jaws, ancient, 9-14, 85 
angle of, 346, 410, 445 
conformation of, 185, 193, 205, 259 
contraction of (see Causes of irregu- 
larities of the teeth) 
development of, 559 
aids to, 223 
dislocation of, 229, 559 
disproportion of size of teeth to (see 
Causes of irregularities of 
the teeth) 
ethnological variation in lower, 594 
fracture of, treatment, 44, 74, 85, 110, 
153 
growth of, 22, 184, 213, 223, 247, 260, 
261, 443, 523, 596, 751 
in harmony of size, 162, 166, 167, 185, 
'596 1004 
SUBJECT INDEX 
Jaws-Cont 'd 
' ' Large teeth in small," 166, 185, 
186, 198, 204, 209, 251, 
295 
necrosis of, 848 
normal relation of, 178 
of one parent and teeth of another, 
251, 523, 621 
overdevelopment of, 559 
resection of, 344 
types of, 531 
Joachim, translation of Ebers Papyrus, 
22' 
Jumping the bite, 496, 500, 701 
K 
Key extracting, Bourdet, 131 
Garengeot, 131 
Koran, dissection prohibited by, 71, 77 
L 
Lactic acid, 599 
Lancing the gums, 55, 130, 157, 203 
Larynx, 84, 102 
Lateral movement, 877 
Law of the Twelve Tables, 53 
Laws of physiology, 329 
Lead for filling teeth, 56, 86, 139 
Letters of Gaine to Farrar, 387, 388 
Levers (see Treatment) 
Leyden, anatomical theatre at, 128 
Libraries, Alexandrian, 5, 37 
Chinese, 37 
Memphis, 37 
Library, Surgeon General's Office, 100 
Ligatures, 176, 195, 202, 205, 208, 213, 
215, 217, 249, 264, 283, 
296, 297, 298, 301, 313, 
314, 319, 322, 329, 383, 
403, 406, 413 
Albucasis on the use of, 75 
brass, 693 
clastic, 249, 301, 305, 341, 345, 348, 
349, 358, 359, 403, 414, 
415, 419, 490, 491, 494, 
529, 567, 571, 573, 590, 
604, 606, 611, 671, 742, 831 
gold wire, 154, 305, 376, 602 
grass line, 281, 600, 799 
Indian twist, 273 
mohair, 571, 572, 573 
silk, 154, 177, 183, 212, 216, 224, 239, 
249, 264, 270, 281, 28.7, 
297, 338, 345, 372, 411, 
414, 530, 547, 600, 605 
silver, 435, 593, 605 
thread, 143, 151, 1.61, 190, 196, 224, 
281, 296, 430, 432, 530, 540 
waxed, 506 
wire metal, 287, 372 
Lime, carbonate of, 44 
Lips, influence of abnormal, on the den- 
tal arch, 524 
Literature, advent of dental, 89, 243 
Arabian, 17 
Chinese, 17 
need of, 1, 2, 3, 4 
M 
Machine, earliest known, 20 
Malformation due to disease, 583 
Man has more teeth than woman, 45 
origin of, 9 
prehistoric, 2, 6, 9, 14, 85 
Martial, epigrams of, 54, 59 
Mastication, 114, 166, 216 
Masticatories, 44 
Mastodon, 13 
Materia medica, Chinese on, 18, 85 
Greeks on, 47 
originator of, 47 
Romans on, 57, 66 
Maxilla, inferior, Chinese idea of frac- 
ture of, 18 
Maxillary sinuses, 153, 233, 597 
Mayas, 28, 32 
Measles, 71, 148 
Mechanical dentistry, first work on, 93, 
95 
wear of teeth, 6 
Medicine, 4, 5, 20, 21, 36, 37, 40, 41, 45, 
47, 52, 53, 61, 71, 72, 73, 
78, 83, 89, 102, 104, 292 
ancient, 17-18 
various schools of, 42 
importance of, to dentistry and ortho- 
dontia, 4 
in ancient Egypt, 23 
most ancient work on, 21, 22 
origin of, 23 
primitive, 6 
special branches of, 23, 37, 58, 60 
Medieval period, dentistry during, 78 
Mental development, relation of teeth 
to, 472 
Metals, use of, in civilization, 20 
Mexico, dentistry as practiced in, 28, 35 
Mice, use of, for dental maladies, 47, 57 
Microscope, 83 
Minoan, civilization, 39 
Misr, Hospital at, 78 
Missing teeth (see Causes of irregulari- 
ties of teeth) 
Models, 9, 115, 131, 216, 225, 239, 240, 
249, 272, 275, 298, 510 (see 
also Impressions) 
Mohammedans, 69 
Molar, first upper, as a basis of diagno- 
sis, 699, 705 
Molars, five, 234 
importance of first, 215, 231, 272, 424, 
460, 673, 677, 699 
influence of third, 461 
reduction ami size of, 13, 14 
upper first, as a basis of diagnosis, 
699, 705 SUBJECT INDEX 
1005 
Monkeys, experiments of Oppenheim on, 
710 
Moorish, Kingdom, 69 
' ' Mordex Prorus, ' ' 597 
"Mousterian Youth," 10, 11, 24 
Mouth breathing (see Causes of irregu- 
larities of teeth) 
disease of, 184 
symmetry of, 175, 181 
wash, 44, 72, 346 
Mucous membrane, 66, 113 
Mummies, 23, 234 
Muscles, 250, 253, 303, 524 
myrtiform, incision of, 253 
Muscular pressure, influence of, 409 
system of the mouth, 587 
Museums of antiquity: 
Alexandria, 24 
Athens, 44 
Cairo, 23 
Corneto, 50, 51 
Florence, 49 
Heye, 31 
Kertch, 27 
Peabody, 34 
Pope Julius, 48 
' ' Mythical period, ' ' 4 
N 
Narcotics, 79 
National Association of Dental Facul- 
ties, 548 
Dental Association, 677 
Natural history, founder of, 45 
Nature, lessons from, 259 
"Neanderthal Man," 10, 13 
Necrosis of jaw, 848 
Negroe, 594, 634 
Nerve, disturbance of trigeminal (see 
Causes of irregularities of 
teeth ) 
Nerves, 63, 66, 67, 71, 84, 102, 147, 216, 
229 
Nestorians, 69, 78 
Neurotics, 626 
New York Historical Society, 21 
Nomenclature, 159, 245, 579 
of dental terms (see Definitions) 
of orthodontic terms, 245 
Normal occlusion of the teeth, 867 
Northwestern University, 676 
"Nosology," 186 
Nursing, 597 
children, 148 
Nutrition, 3, 223, 457, 521, 626 
and its effect on the development of 
teeth, 148 
O 
Object of correcting irregularities of 
teeth, 452 
Obsidian, 28 
Obturators, 110, 131, 140 
Occlusion, 159, 178, 183, 214, 221, 229, 
236, 238, 252, 275, 280, 320, 
333, 411, 416, 424, 456, 
499, 501, 514 
dynamics of, 586 
establishment of, 178, 236, 323 
importance of, 424, 439, 588 
normal, 159, 178, 214, 222, 236, 411, 
456, 641, 691, 699 
of inclined planes, 587 
versus articulation, 659 
' ' Odontagra, ' ' 46 
"Odontology," 245 
Operative dentistry, Fauchard, 139 
' ' Opharmosis, ' ' 598 
" Opistholnathism, " 597 
Origin of life, 40 
Orivento, 49, 51 
Orthodontia as a specialty, 697, 723 
earliest practice of, 4 
Orthodontics as a science, 3 
as a specialty, 677, 697 
basic principles of, 698 
definition of, 2, 245, 246, 260, 280, 
294 
knowledge of, how acquired, 3 
origin of the word, 245, 253 
what comprises, 3, 523 
" Orthodontosy, " 244, 245, 246, 253, 
260, 474 
"Orthognathism," 594 
"Orthopedia dentaire, " 245, 246, 253, 
372, 474 
"Orthopedia facial," 245, 290 
Orthopedies, 148, 236, 272, 290, 294 
Ossification of sutures, 633 
Osteoclasts, 745 
Overbite, 661 
Overlay of gold, 232, 235 
P 
Pain and treatment, 269 
" Palaeanthropus, " 10 
Palate, 43, 57, 108, 112, 207, 472 
Papyrii, medical, 21, 22 
Pathological and physiological tissues, 
867 
Pathology, dental, 18, 63, 81, 151, 202, 
243, 269, 299, 621 
Chinese, 18 
Egyptian, 23 
Patron Saints of dentistry, 62, 65, 66 
Pediatrics, 3 
Pelican (see Extracting forceps) 
Perfection not attainable, 890 
Pharmacology, 71, 78 
Philadelphia College of Dentistry, 374, 
375 
Phoenician, ancient dental appliance 
found at Sidon, 25, 26 
vase with portrayal of dental opera- 
tion, 25, 85 SUBJECT INDEX 
1006 
Phoenicians, dentistry of, 25-27, 85, 110 
influence of, on Etruscan dentistry, 25 
Photography, 3 
Physical diagnosis, 3 
Physicians, duty of, 61, 157, 184 
earliest known, 21, 36 
Physiognomy, 455 
Physiological and pathological tissues, 
867 
laws, 243 
governing tooth movement, 864, 868 
in treatment, 191, 193 
Piano wire, 617, 655 
Piltdown Man, 10, 12, 13 
"Pin and tube," appliance, 712, 716 
"Pithecanthropus," 9, 12 
Plaster of Paris models, 116, 131, 151, 
216, 220, 225 
Plates, type of, for treatment (see 
Treatment) 
"Positive System," 873 
Potter's wheel, 20 
Practice of dentistry, Desirabode on, 288 
Pre-Columbian dentistry, 28-33, 85 
Predetermining the size of the dental 
arch, 350 
Prehistoric Man, 2, 6, 9, 14, 85 
abnormalities in position and irregu- 
larities of teeth in, 9-14 
Prenatal Conditions, 258, 475 
Prescriptions, Chinese, 18 
Egyptian, 22 
Pressure, 523 
lateral, 217, 409 
in orthodontia, effect of, 746 
intermittent, 471, 745 
types of, lateral, 409-411 
Prevention by treatment, 183, 266, 277, 
300, 341 
of irregularities, 149, 389, 430, 547 
Primitive dentistry and medicine, 2 
man, 9 (see also Prehistoric man) 
people, customs relating to teeth of, 
33-35, 85 
Principles, basic, in orthodontia, 698 
Printing, art of, 25 
introduction of, 83, 84, 89 
Prize for best paper on the irregulari- 
ties of the teeth, 347 
' ' Prognathea Ethnologica, ' ' 597 
Prognosis, 211 
"Progression," 223, 356 
"Prominences," 196, 238, 262 
Prophecy, Farrar's as to standardized 
orthodontic appliances, 867 
Prophylaxis, 55, 57, 67, 74, 75, 86, 94, 
98, 101, 129, 148, 201, 
202, 279, 308, 837 
" Prosarmosis, " 598 
Protheses, 151, 153 
ancient dental, 4, 22, 23 
definition of, 297 
removable, 130 
Psychology, 3 
Pulp, 13, 60 
capping, 151 
devitalizing, 550 
inflammation of, recognized by Archi- 
genes, 60 
Pulpitis, 122 
Pyorrhea alveolaris, 57, 74, 138, 139 
Pyramid Age, 20, 21 
R 
Rate of tooth movement, 870 
Reasons for success and failure of mech- 
anisms, 878 
" Recession, " 196, 238 
Reciprocating tooth movement, 765 
Regeneration of mandible, 72 
Regulating appliances (see Treatment) 
Renaissance, 82, 102-117 
Replantation of teeth, 28, 76 
Research, archeological, 2, 20, 33, 39, 59, 
86 
scientific, 2' 
Resemblance of individuals, 541 
Results of too many teeth, 460 
Retaining devices (see Treatment) 
Retention, 875, 889 (see also Treatment) 
' ' Retrocession, ' ' 262 
Rhinology, 698 
"Rhizagra, " 57 
Rhodesian Man, 12-14 
"Ribbon arch," 713 
Rickets, 148, 441, 520, 521 
' ' Righting up ' ' of crowns, 880 
Roentgenology, 3 
Romans, dental art among, 4, 5, 36, 51- 
68, 77, 86 
Root movement, 866, 880, 893 
lateral, 880 
Rotation of teeth, 871 
Royal College of Surgeons of London, 12 
Rules for regulation, 873 
S 
Saalburg, forceps found in the ancient 
castle of, 56 
Saints, dental, 62, 65, 66 
Salerno, medical college of, 69, 79 
Saliva, 47, 120 
Salivary glands, 65 
Salt as a cleansing agent, 57 
Sandwich Islands, natives of, sacrifice 
front teeth, 34 
Saracens, 73, 78 
Satricum, example of gold crown work 
at, 59 
Saws, dental, used by Albucasis, 71 
Scaling teeth, 149 
Science, advancement of a, 3 
Abrabian, 69 
beginning of modern, 40 
earliest development of a, 2, 82 
importance of preparing histories of 
each, 1, 5, 17 SUBJECT INDEX 
1007 
Scientific 'research, 2 
truths, 3 
worker, 3 
Scrapers, 41, 70, 149 
Screw, 869 
as a motive force, 864 
history of, 281 
Scurvy, 148, 157, 259, 523 
Sea going ship, earliest, 20 
Secrecy among dentists, 137, 138 
Shops of doctors in ancient Greece and 
Rome, 44 
Sidon, 24, 25, 26, 85 
Significance of the natural form and 
arrangement of dental 
arches, 641 
Sixteenth century, dentistry in the, 82-85 
Skull cap (see Treatment) 
Skulls, dental variation, in ancient, 583 
Smallpox, 18, 71, 148 
Society of Dental Surgeons of the City 
and State of New York, 244 
South American Indian, 5, 28-33 
Specialists, first dental, 22, 23, 37, 58, 
60, 120 
Specialization, 512, 677, 697 
Specialties in dentistry, 867 
Specillum, 57 
Sphenoid bone, 472, 597 
Spontaneous generation, 40 
"Spy" skull, 12 
Stated periods to visit dentists, 324 
' ' Stomatonomy, ' ' 245 
Stonemasonry, first laid, 20 
Summarian dentistry, 36-38 
Supernumerary teeth, 9, 14, 57, 67, 73, 
85, 86, 113, 128, 131, 141, 
150, 157, 163, 195, 202, 
213, 234, 247, 251, 255, 
275, 291, 295, 317, 458, 
464, 468 
Surgpon-dentist, first, 80, 137 
Surgeon General's Library, 100 
Surgery, early dental, 5, 22, 81 
in orthodontia, 5 
origin of, 41 
Surgical instruments deposited in tem- 
ples of Apollo, 41 
Suture, rapid separation of median, 424, 
425, 429, 430, 483, 799 
Sutures, maxillo-palatine, 292 
Swedging, introduction of, in dentistry, 
225 
Syphilis, congenital, 558 
Sythians, 25, 26 
T 
Tables of anomalies, 582 
percentage of, 583 
period of dentition, 257, 463 
Talgi skull, 11, 12 
Talmud, 36 
Tarquinni, necropolis of, 50 
Tartar, dental, 75, 86, 148, 157, 278 
Teano, Italy, prosthetic piece found 
near, 53 
Teeth, abnormalities in position and ir- 
regularities in prehistoric 
man, 9-14 
absence of, 570, 584 
congenital, 584 
anatomy of, 56, 71, 74, 78, 80, 83, 84, 
96, 102, 103, 106, 107, 109, 
112, 113, 645 
animals, 45, 46, 98, 106, 114, 115, 
216, 277 
anomalies of, 107, 108, 111, 202, 255, 
462, 604 
studies in, 579 
types of, 577, 579 
arrangement of, 184, 202, 238, 254, 
291, 295, 645 
artificial, 59, 75, 139 
as defense, 46 
attachment of, 106 
bodily movement, 597, 717, 730 
carious, 6, 9, 13, 14, 22, 24, 38, 60, 
63, 156, 228, 299, 300 
classification of, 253 
cleansing of (see Prophylaxis) 
comparative anatomy of, 45, 106 
decay of, 31, 36, 44, 54, 72, 153, 156, 
175, 204, 208, 252, 303, 361 
deciduous, early loss of, 208, 209, 229, 
247, 251, 261, 263, 271, 274, 
313, 323, 364, 596 
replaced by permanent, age of, 44 
decorated, 28, 29, 30, 31, 35, 85 
defective, cause of, 440 
depressed in sockets, 507 
development of, 43, 96, 104, 105, 106, 
107, 109, 112, 120, 148, 
153, 184, 233, 235, 255, 
280, 324, 398, 594, 595, 
620, 621 
diastema of, 581 
■dyeing black, by married women of 
Japan, 19 
other races, 234 
elongation of, 58, 64, 67, 74, 76, 81, 
85, 98, 116, 117, 126 
enamel of, 622 
erosion of, 44, 148, 209, 621 
eruption of, 42, 46, 55, 98, 104, 106, 
108, 120, 141, 187, 189, 
197, 202, 203, 214, 280, 291, 
399, 401, 463, 475, 514 
anomalies of, 584 
early, 584 
early retardation, 570, 5S4 
extraction of false, 54 
methods of, 74 
rules for, 56, 74, 193, 230 
falling out of, 41 
filing of, for correction (see Treat- 
ment) 
filling of, ancient ideas, 22, 23, 86 1008 
SUBJECT INDEX 
Teeth-Cont 'cl 
fishes, 579 
formation of, 45, 63, 104, 112, 150, 
187, 188, 231, 254, 390, 
462, 521, 620, 621 
forms of, 45, 63, 103, 106, 183, 234, 
253, 334 
function of, 42, 98, 106, 627 
germs of, 104, 106, 302, 336 
gilding of the, in Sumatra, 34 
grinding of, 229 
hardness of, 113 
hereditary syphilis, 580 
honeycombed, 230, 256, 443, 580, 622 
impacted, 9, 10, 14, 85, 256 
implanted, 28, 29, 30, 76, 85 
importance of, 43, 58, 98, 149, 181, 
216, 220, 238, 276 
full complement of, 36, 424 
inclined planes of, 411 
individuals born with, 98, 108 
inversion of, 566 
irregularities of, as a cause of dis- 
ease, 201 
first books on, 136, 219 
to notice, 42, 43, 55, 85, 86, 98 
to treat, 42, 43, 55, 58, 85, 86, 
108, 111, 126 
ligaments of, 107 
literature on, earliest known, 42 
loose, ancient ideas as to tightening 
of, 22 
luxation of, 196 
man has more than woman, 46 
missing, 464 
nomenclature of, 159, 245, 579 
nondevelopment of, 185, 198, 207, 230, 
234 
noneruption of, 620 
numbers of, 45, 63, 141, 150, 221, 254 
occlusion of, 159, 178, 183, 214, 221, 
229, 236, 238, 252, 275, 
280, 320, 333, 411, 416, 
424, 456, 499, 514, 691 
of mummies, 23, 234 
of negroes, 255 
ornamental, 28-31, 35, 186, 276 
physiology of, 74, 106 
principles of movement of, 679 
rachitic, 24 
relation of, to alveolar process, 279 
to surrounding tissues, 599 
replantation of, 28, 76 
rules for preserving, 100 
shedding of, 108, 128, 141, 150, 165, 
179, 181, 197, 278, 316 
size of, 462 
structure of, 106, 141, 378, 462 
supernumerary, 9, 14, 57, 67, 73, 85, 
86, 113, 128, 131, 141, 150, 
157, 163, 195, 202, 213, 
234, 247, 251, 255, 275, 
291, 295, 317, 458, 464, 
468 
Teeth-Cont 'd 
syphilitic, 24 
tardy eruption of, 234 
tightening of, 22 
terminology of, 63 
transplanted, 28, 29, 30, 35, 110, 159 
transposition of, 566 
trepanning, 23 
typical form of, 581 
uterus, formed in, 107 
value of, to face, 214, 215, 562 
variety of, 233, 234, 254, 255 
varieties, types of, enumerated, 255- 
257 
wearing of, 10, 64 
wisdom, 123, 149, 163, 461 
Teething in children, 47, 120, 254 
Temple of Apollo, 41 
of Cos, 42 
Tension, 869 
' ' Teratogeny, ' ' 579 
Terminology, dental, 63, 119, 132, 136, 
157 
Therapeutics, dental, 47, 81 (see also 
prophylaxis) 
Thirteenth century, 79 
Thumb sucking (see Causes of irregular- 
ities of the teeth) 
Tongue, 270, 520, 560, 576 
influence of, 43, 229, 235, 264, 295, 
409, 524 
Tonsils, 54 
Toothache, ancient ideas of, 22, 38, 
44, 54, 5o 
cause of, 66 
treatment of, 22, 38, 54, 60, 74, 109, 
157 
"Tooth for a tooth," 36 
Toothpick (dentiscalpia), 57, 59, 60 
Traction, 868 
Training dental operators, Japanese on, 
19 
Trauma, 53 
Traumatic causes, Lefoulon on, 66 
Treatment: 
advantage of early, 155, 161, 166, 182, 
183, 189, 213, 215, 224, 
236, 248, 301 
advice on, 312, 679 
age, for, advanced, 4, 177, 215, 252 
' proper for, 252, 274, 279, 285, 304, 
312, 318, 323, 324, 329, 
332, 373, 374, 411, 414, 
450, 453, 550, 561, 668 
artificial pressure, 304, 522 
bands, 217, 296, 301, 352, 359, 362, 
402, 456, 615, 617 
anchor, adjustment of, 282, 283 
cemented, 470, 471, 609, 619 
clamp, 282, 283 
construction of, 217 
bodily movement of teeth, 597, 717, 
730 SUBJECT INDEX 
1009 
Treatment-Cont'd 
caps or crowns, 183, 212, 228, 239, 
249, 272, 301, 307, 314, 
319, 325, 332, 337, 373, 
412, 430, 469, 842 
chincap, 170, 173, 220, 284, 285, 308, 
357, 412, 467, 489, 508, 
526, 590, 594, 718, 766, 
809 
clasps, 310, 311, 345, 355, 376, 514 
cribs, 184, 281, 282, 287, 720, 838 
Davenport on the question against 
extraction, 641-649 
earliest mechanical, as in orthodontic 
procedure: 
first, finger pressure, 55 
fourth, pelican, 153-155 
second, filing or instrumenta- 
tion, 58, 64, 74, 76, 86 
third, resecting, 75, 76 
expansion arch, 141, 143, 151, 176, 
179, 180, 181, 187, 208, 
212, 239, 249, 252, 266, 
267, 268, 275, 282, 286, 
287, 297, 298, 306, 322, 
325, 339, 343, 356, 358, 
363, 364, 366, 371, 372, 
375, 405, 411, 412, 421, 
460, 462, 463, 611, 653, 
672, 684, 688, 695, 696, 
764, 805 
extraction against, 160, 186, 267, 
268, 333, 458, 632, 642, 
668 
for, 67, 76, 146, 152, 162, 165, 178, 
182, 186, 191, 192, 195, 
197, 201, 205, 214, 216, 
221, 224, 229, 236, 238, 
249, 259, 264, 280, 301, 
306, 318, 332, 352, 358, 
373, 419, 632, 795 
of deciduous teeth, for, 183, 204 
rules for, 553, 632 
Farrar's, 872, 874, 875, 880, 882 
filing of teeth, 55, 58, 64, 74, 76, 81, 
85, 116, 117, 126, 127, 155, 
156, 166, 182, 194, 199, 
207, 230, 264, 266, 280, 
299, 300, 304, 642 
finger pressure, 55, 153, 174, 182, 197, 
260, 304, 422 
force, constant, 856 
intermittent, 856 
forceps or pelican, 144, 153, 155, 164, 
169, 225, 236, 265, 271, 
299, 300, 516, 527 
friction sleeve, 678, 693 
gags used, 216, 265 
general consideration of, by: 
Ainsworth, 855 
Albucasis, 76 
Allan, 589 
Allport, 398, 481 
Angell, 425, 483 
Treatment-Cont 'd 
Angle, 679 
Baker, H. A., 832 
Balding, 575 
Balkwill, 570 
Barker, 433, 483, 556 
Barkley, 527 
Baume, 515 
Bedell, 844 
Bell, 212, 239 
Berdmore, 153, 236 
Bew, 183, 238 
Bogue, 749 
Bon will, 437, 667 
Bourdet, 151, 236 
Brewster, 252, 476 
Burgh, 459 
Burr, 372, 481 
Byrnes, 656 
Carabelli, 287, 477 
Case, 770 
Celsus, 55 
Chupein, 829 
Clark, 229 
Coffin, 536 
Cole, 529 
Colyer, 759 
Cunningliam, 837 
Cutter, 827 
Dalrymple, 401 
Davenport, W. S., 814 
Delabarre, 184, 186, 238 
Desirabode, 296, 477 
Dionis, 127, 131 
Dodge, 765 
Duval, 179 
Essig, 822 
Evans, 362, 480 
Fabricus, 111 
Fauehard, 140, 236 
Fox, 170, 177, 237 
French, 794 
Fuller, 850 
Gaillard, 592 
Gaine, 377, 481 
Galen, 63 
Gilmer, 616 
Goddard, C. L., 799 
Goddard, Paul, 304, 478, 
Grandhomme, 322, 478 
Guilford, 546 
Hanning, 848 
Harbert, 332 
Harris, 248, 474 
Hawes, 557 
Heister, 130, 132 
Hepburn, D., 468 
Hippocrates, 42 
How, 650 
Howard, 655 
Humby, 605 
Hunter, 161, 163, 164, 236 
Hutchinson, 528 
Imrie, 216, 239 1010 
SUBJECT INDEX 
Treatment-Cont 'd 
Jackson, 720 
Jacque, 819 
Jean, 820 
Keely, 606 
Ketching, 824 
Kingsbury, 407 
Kingsley, 403, 481, 487 
Kirk, 763 
Knapp, M. A., 851 
Kneisel, 227, 240 
Lefoulon, 264, 475 
Lindenberger, 797 
Lintott, 272, 274, 476 
Magitot, 581 
Magruder, 748 
Marjolin, 197, 238 
Marvin, 452, 484 
Matteson, 736 
McQuillan, 414, 483 
Mitchel], 854 
Monson, 845 
Mortimer, 313, 478 
Murphy, 181, 238 
Museler, 601 
Newkirk, 658 
Ottolengui, 825 
Pare, 110 
Patrick, 602 
Paul of Aegina, 67 
Pliny, 57 
Potpeschnigg, 566 
Quimby, 611 
Richardson, 521 
Robertson, 219, 239 
Robinson, 325, 482 
Rodrigues, 251, 474 
Rogers, 343, 478 
Sachs, 840 
Salter, 561 
Sauer, 762 
Schange, 281, 476 
Sewill, 466 
Shaw, 742 
Siegfried, 756 
Simpson, 601 
Smith, J., 473, 600 
Spaulding, 401, 481 
Talbot, 628 
Tomes, 526 
Tome, J., 336, 479 
Wardle, 593 
Ware, 345 
Westcott, 310, 478 
White, J. D., 355, 479 
White, H. M., 431 
Wilder, 799 
Wilpart, 588 
gutta-percha, stay-plate, 670 
ideals of, 679 
incision of myrtiform muscles, 252 
Treatment-Cent 'd 
inclined planes, 176, 178, 179, 180, 
197, 218, 219, 239, 250, 
265, 270, 275, 283, 313, 
322, 328, 332, 354, 356, 
372, 383, 412, 431, 469, 
474, 494, 546, 762, 860 
intermaxillary elastics, 703, 705, 809, 
831 
ivory blocks, 177, 287, 301 
jack-screw, 311, 351, 352, 424, 438, 
489, 493, 504, 544, 614, 
619, 628, 800 
lateral pressure, 409 
length of, rules for, 145, 229, 523 
levers, 362, 367, 402, 440, 442, 495 
method of, 597, 807 
nature as, 259 
occipital anchorage, 284 
"pin and tube," 712, 716 
plate, bite, 217, 218, 227, 272, 283, 
284, 611, 617 
Coffin split, 448, 537, 655, 667, 724 
expansion, 538 
gold, 161, 205, 218, 219, 249, 250, 
251, 252, 282, 305, 307, 
308, 313, 325, 338, 345, 
356, 366, 382, 388, 399, 
408, 412, 413, 419, 433 
435, 450, 452, 457, 459, 
474, 505, 517, 593 
ivory, 338, 479 
retaining, 600, 607, 612 
sectional, 518 
silver, 161, 437, 505, 507, 601, 841 
split, 846 
vulcanized rubber, 247, 252, 301, 
328, 341, 439, 445, 449, 
457, 459, 466, 474, 485, 
490, 506, 522, 571, 574, 
584, 601, 606, 608, 616, 
630, 672, 841 
predetermining the dental arch, 350 
pressure, slight continual, 329, 668 
prevention by, 183, 266, 277, 300, 341 
rapid movement, 523 
regulating- appliances, requirements 
for, 311, 323, 362 
resecting, 75, 76, 205, 344, 353 
results after, 839 
retaining device, real, 704 
retainer, universal, 511 
retention in, 283, 453, 476, 680, 797, 
830, 836, 837, 839, 861 
11 ribbon arch," 713 
root movement of teeth, 597, 709, 713, 
730, 769, 770, 772, 781, 787 
rubber tubes or rings, 348, 349 
rules on, 448, 550, 668 
seamless collars, 657 
sectional arch, 711 SUBJECT INDEX 
1011 
Treatment-Cont 'd 
screw, 271, 273, 276, 281, 286, 305, 
306, 325, 328, 358, 383, 387, 
399, 400, 426, 459, 470, 476, 
516, 558, 575, 607, 611, 612, 
613, 614 
skullcap, 285, 491, 496, 501, 554, 567, 
590, 610, 687, 689, 718, 
840, 842 
slow movement, 551, 710 
spring jack, 654 
springs, 216, 225, 252, 268, 269, 270, 
296, 302, 326, 341, 352, 373, 
437, 518, 629 
Siegfried's, 757 
study of cases before, 300, 312 
success of, 304 
surgical, 639, 762, 794 
table of anomalies, 582 
of eruption of, 257 
of percentage of anomalies, 583 
time required for, 229, 299, 401, 405, 
488 
traction, 305, 329, 546 
screw, 694 
use of rubber elastics, 283, 301, 302, 
304, 323, 325, 328, 329, 346, 
356, 358, 367, 404, 412, 414, 
421, 457, 487, 528, 571 
vulcanite crib, 829 
wedge, gum elastic, 302 
paper, 319 
wedges, 181, 200, 264, 302, 403, 413, 
487, 546 
wooden pegs, 573, 575, 601, 607, 608 
"working retainer," 709 
yoke, 651, 653 
Triangle, equilateral, 530 
Trituration, 587 
Tubes, soldered, first, 366 
Tumors, 153, 234, 464 
Turquoise tubes, first soldered, 183 
Tyre, City of, 25 
" Tyrpharmosis, " 599 
U 
Ulcerations, 18, 54 
Universities of: 
California, 21, 806 
Ghent, 49, 51 
Harvard, 350 
Maryland, 245 
Northwestern, 676 
Pennsylvania, 676 
V 
Value of moving teeth slowly, 868 
Variation, ethnological, 594 
Vase found at Sidon, Phoenician, 25 
" Villa Guilia, " 50, 53 
Vinegar as a mouth wash, 44 
"Volselles, " 657 
Vomer, 472 
Vulcanite, introduction of, 375 
W 
Wisdom teeth, 123, 149, 163, 461 
Worms in teeth, 19, 38, 74, 149 
Z 
"Zene (Zeen) Artzney," 6, 55, 81, 87- 
93, 97-100, 101 (see also 
Artzney Buchlein) 
Zoology, founder of, 45, 579