John Aitkin, in 1771, perfected the English key, so as to render the extraction of the teeth easier and to avoid the danger of fracturing the alveolus or the tooth itself, and of injuring the gums.[511]
Frère Côme, a celebrated French surgeon, also contributed to the perfecting of this instrument.[512]
In 1771-72, Fr. L. Weyland and Henkel recorded some very important cases of diseases of Highmore’s antrum.[513]
W. Bromfield, in a collection of surgical observations and cases published in London in the year 1773, also speaks of affections of the maxillary sinus. He says that he has had opportunity of persuading himself that the purulent gatherings of this cavity not unfrequently discharge spontaneously during the night, finding their exit through the natural orifice of the antrum, when the body is in the horizontal position.[514]
John Hunter, the celebrated surgeon, must be named among the most illustrious champions of odontology in England. He was born February 13, 1728. His first instructor in medical studies was his brother, William Hunter, a scientist of great merit, whose school of anatomy in London was attended by numerous students from all parts of the British Kingdom. Under so excellent a guide John Hunter made rapid progress, and in less than twenty years became the most famous physiologist and professor of surgery of that day. He was surgeon-general to the English army.
His Natural History of the Human Teeth (London, 1771) and his Practical Treatise on the Diseases of the Teeth (London, 1778) initiated in England a new epoch for the dental art, which, abandoning its blind empiricism, began to take its stand on the basis of rigorous scientific observation.
But although Hunter’s merits were great with respect to the scientific development of odontology, we must remember that he was a general surgeon, and not a dentist, and that precisely for this reason he had not, neither could he have, other than a restricted personal experience relative to the treatment of dental diseases. This explains why the anatomical and physiological part of Hunter’s works on the teeth is so far superior to the part concerning practical treatment.
Indeed, in the field of practice, this author often falls into grave contradictions, and is frequently hesitating and uncertain on important points of dental therapeutics.
Hunter gives a very long and detailed description of all the parts constituting the oral cavity and the masticatory apparatus. He sought to establish a scientific nomenclature for the teeth, and in fact the denominations of cuspidati for the canine teeth and of bicuspids or bicuspidati for the small molars originated with him. Hunter says that the enamel of the teeth is a fibrous structure, and that its fibers depart from the body of the tooth like rays. He believes it to be entirely inorganic, as it is absolutely impossible to convert it into animal mucus. The tooth is constituted for the most part by a long mass (it is thus he calls the dentine), which is, however, much harder and denser than any other bone. This part of the tooth is formed of concentric lamellæ, and is vascular, as is proved by the exostosis of the roots and the adhesions that exist at times between the roots and the alveoli. Hunter gives a good description of the pulp cavity and of the pulp itself. He studied odontogeny with great care, as is demonstrated by his special researches on this point. He admits the existence of distinct germs for the enamel and for the dentine. According to him the incisors are formed from three points of ossification, the canines from one, and the molars from three or four. The tooth after its eruption is an extraneous body “with respect to a circulation through its substance, but they have most certainly a living principle by which means they make part of the body, and are capable of uniting with any part of a living body.” The milk teeth, says Hunter, are not shed by a mechanical action of the second teeth, but by an organizing law of Nature. The physiology of the masticatory apparatus is treated by Hunter with great accuracy and most extensively. This author combats, by many arguments, the opinion that the teeth grow continually; he explains the apparent lengthening of those teeth whose antagonists are wanting, by the tendency of the alveoli to fill up, which, however, is not possible in normal conditions, because of the constant pressure exercised upon the teeth by their antagonists.