Bunon was, besides, the first author who studied accurately dental hypoplasia, and it is greatly to his honor that his ideas and observations about this pathological condition have been accepted and confirmed in substance by the greater part of the authors who have come after him, having remarkable worth even at the present day. According to him, this congenital defect of the teeth is owing to infantile maladies, such as hereditary syphilis, infantile scurvy, malignant fevers, smallpox, or measles; the harmful effects of these maladies, however, are limited to the teeth in progress of development, and have no influence on those that have already come forth. Erosion, as this defect was termed by Bunon, sometimes affects the first teeth, but is to be found much more frequently in the second or permanent ones. Those most often affected are the first molars, and in frequency follow the incisors, the canines, the premolars; the second and third molars are the most rarely affected.
Bunon studied with great accuracy the means of preventing anomalous positions of the permanent teeth, owing, according to him, almost always to want of space. In certain cases he advises the extraction of the milk tooth in order to facilitate the eruption of the permanent one, and, necessity urging, he does not hesitate to sacrifice one of the permanent teeth to procure the advantage of a normal position of the others. With regard to this subject, the following passage is worthy of note, for in it we find sketched out the theory of preventive extraction as a means of facilitating the eruption of the wisdom tooth: “It is better to have the teeth incomplete as to number than to have the ordinary number badly arranged; for the mouth will appear none the less well furnished because of having one or two teeth the less; the other teeth will be commodiously distributed, and the last molars will find sufficient room when they come forth; thus, the disorders which these teeth often occasion will be avoided.”[546]
After caries, Bunon considers dental tartar as the most potent enemy to the vitality of the teeth. He distinguishes three principal species: the black, the lemon or light yellow, and the brownish yellow; however, he allows of two other varieties of less frequent occurrence, the red and the green tartar.
At a period when an extraordinary confusion obtained with regard to gingivitis, because of the great number of varieties allowed, Bunon strongly affirms the unity of this morbid process, and considers tartar as the constant cause of it, without denying, however, that other causes of various kinds may contribute at the same time to produce it.
In cases of scorbutic stomatitis, Bunon advises, and very rightly, the complete removal of tartar from the teeth before having recourse to any other local treatment. He also insists on the necessity of attending to the teeth and gums, and especially of freeing the former from tartar before undertaking the specific treatment of syphilis, considering the good state of the teeth and gums as one of the most important prophylactic measures against mercurial stomatitis.
Anyone who takes the trouble of reading Bunon’s works attentively cannot help admiring his depth of insight, his spirit of observation, his exquisite clinical sense, and his ingenuity. As illustrating this last quality of his, we may cite two cases of fracture of the lower jaw that he succeeded in curing in a short time by the method of binding the teeth, the preceding attempts of experienced surgeons having entirely failed. One of these cases is particularly interesting. The seat of the fracture corresponded with the bicuspids, which, however, had fallen out from the effects of trauma; the neighboring teeth were also loosened. Bunon filled the empty space left by the bicuspids with a piece of ivory, provided with two holes; then, by an ingenious crossing of threads passing from the second molar on the one side to the second bicuspid on the other, very tightly tied, he formed, so to speak, one single block, and succeeded in bringing about the consolidation of the shaking teeth and the complete cure of the fracture, which was effected in less than a month.
RUSPINI WITH HIS FAMILY IN A COUNTRY PLACE
From an old painting in oil.
