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International Dental Stenography and Stenophony (Dental Steno-Nomenclature).
READ AT THE ANNUAL GENERAL MEETING HELD IN LONDON, AUGUST, 1901. BY V. HADERUP, M.D.(KOPENHAGEN).
Mr. PresidenT AND GENTLEMEN,-The most essential qualities required in the nomenclature of any science are certainly that it ought to be clear, consequent and short. Regarding this, there is a great lack in odontology, because (in spite of its being a young science) especially in its anatomical part, it makes use of old, traditional, illfitting designations. Besides this the nomenclature of odontology
requires to be as international as possible.
Whoever has followed our literature and the discussions at our meetings, will also have observed that the question of nomenclature day by day becomes more actual. Particularly during the last two decades, many proposals for stenographical nomenclature have appeared, and at the same time an increasing tendency is evident for making the designations international. Besides the communications in our periodicals and at local meetings, the question has been discussed at the International Dental Congresses, in Paris, 1889, and Chicago, 1893, as also in the odontological section of the International Medical Congress in Rome, 1894. At the first occasion an international committee was elected, "La commission de la stenographie dentaire," and on its proposal the Congress adopted a certain system of dental stenography. That such a decision was not the true way the result showed. The adopted system was not practical at all, and as Dr. Amoëdo remarks, it has not even been used by its mover, the late Dr. Dubois, in Paris. At the following Congresses nothing was determined. In Chicago (1893) the nomenclature question, with Dr. Kirk as introducer, was discussed generally, while at the Congress in Rome the discussion was confined to stenography. This discussion was introduced by the President of the Odontological Section, Dr. Couillaux (Milano), who, on the ground of his own experience, pleaded for "nomenclature dentale di Haderup," the system which I shall have the honour to present to-day. These discussions have only proved that for several reasons none of the so far recommended stenographical systems-about twenty-have been generally accepted.
Whence, then, do all these stenographical efforts arise? Quite naturally, I think, first from the present general situation of everyone, dentists not excepted, for whom, more than ever, "time is money"; secondly from the increasing means of communication, increasing personal and literary intercourse; and in consequence of these two facts the main points are the following:
In the first place, there must not be unnecessary waste of time by giving lessons, theoretical or practical, or in common practice by registering operations, &c., and next there must not be an unfitting nomenclature to obviate the understanding of foreign literature, or of papers and discussions at meetings, especially international ones.
I point out with all emphasis that what we need is not a stenography that only can be expressed by signs, but one by which the significations can be read as they are written.
Such a graphophonical system in the first place is important because of the always occurring and re-occurring anatomical designations of the single permanent teeth and the milk teeth, and then of the surfaces of the teeth, of the single roots, of the single anatomical forceps, and so forth. Hitherto only the permanent teeth-certainly the chief aim-have attracted attention.
As to the registering in common practice, one of the so far published systems seems to be used rather universally, and deserves to be used there, that is the oldest of them all-the stenographical system of the late Dr. Zsigmondy (in Vienna) published in the Vierteljahrsschrift der deutschen Zahnheilkunde, 1861.1
To Zsigmondy, sen., we are indebted for the present favourite numbering of the permanent teeth from 1-8: a 1er (oner) equal to a central incisor, a 2er (twoer) equal to a lateral incisor, a 3er to a canine a. s. f. to the 8er, the wisdom-tooth. His system, no doubt well known by my listeners, is based on the dividing of the rows of teeth by a vertical median-line, and then the dividing of these two halves by a horizontal line, by which a figure like a cross appears. Of the four angles of the cross indicates left upper, right lower and so on. The teeth are then designated by numbers, and the front tooth nearest the median line is designated number 1, the one farthest from the median line, number 8. 3 would mean the upper canine tooth to the right, the lower canine tooth to the left, &c. For private use the
For further information on other systems of dental stenography, which for the greatest part have their starting point from this, I must refer to a historical summary given by me in the Deutsche Monatsschrift für Zahnarzte, 1894, and to the recent work of Dr. Amoedo (Paris), L'art dentaire en médecine legale (Paris, 1898), the chapter, "Notation dentaire." Dr. Amoëdo has here treated the nomenclature question, espe cially with regard to the registering of our operations, and he ascribes "La notation dentaire" a triple utility :-commercial, scientifical and social.
teeth will in this way, even by an extensive examination and treatment easily and clearly be registered, as all the teeth may be placed in the figure of a cross.
This system, however, is not practical for the literature, as the designations neither can be recited nor dictated and also need atypical types. The chief want of this and similar systems is, that they are only satisfactory in regard to graphical use, but not phonetically, that is to say, that the significations may be shortly written, but not pronounced in the same way. The proposed system does not represent any nomenclature, only a stenography, but not at the same time a stenophony; and the possibility of also being able to express orally the written significations must be a principal demand in such a system.
When here at the British Dental Association I take the liberty to present a proposal of my own to a dental steno-nomenclature, the reason for my embracing the opportunity is a long-cherished wish to get my system tried in the English-speaking dental world. As you will see, I have tried to bring a steno-nomenclature into the daily dental language, in the conviction that a progress in language goes further than its own territory by forwarding progress in ideas. As to my system, compared with the other more or less arbitrary systems, I consider it to be at the same time natural and rational, as by building this system I have only based it on dental views. Instead of the median line (Zsigmondy) I start from the point of contact of the central incisors, a point I respectively name "upper" and "lower mesial point," and instead of an artificial horizontal line, I start from the broken line through the masticating planes: "the mastical line." If we suppose such a clenching of the normal and intact rows of the teeth, so that only the four mastical-mesial corners of the upper and lower central incisors are meeting, there results an articulation backwards open, which put in plane presents itself (schematically) as a horizontal St. Andrew's cross; and in the intersecting point of this cross are both mesial points meeting as a centre, a zero between Above and Below (see following drawing).
Commencing with the mathematical nought-building, by the adding of and, we get by separating the rows of the teeth and
hereby following disappearance of the o, the indication of + for the upper, the positive, and for the lower, the negative, mesial point (see following drawing).
If now we give numbers to the teeth and count from the centre 0 1 2 3 and so forth, and if we use for indication of the position the natural inclination of the longitudinal axes of all the teeth towards the mesial points, in this way combining the figures with the signs representing these points, then the above-mentioned method of indication comes of itself, as the sign always must be placed in a mesial way to the number of the tooth; therefore on the right hand side behind, and on the left hand side before, the figure.
Docent Dieck (Berlin), who has taken great interest in my nomenclature, expresses it thus: "If the sign is placed to the right of the figure, for instance, 8+, then the right side of the jaw is indicated, in this case Mol. iii., sup. dext.; if the sign is placed to the left. of the figure, then the left side of jaw is indicated, that is to say, for instance, 5 means praemolaris ii., inf. sinister."
SYSTEM OF HADERUP.'
8 + 7 + 6 + 5 + 4 + 3 + 2 + 1 + + 1 + 2 + 3 + 4 + 5 + 6 + 7 + 8
The indications for the teeth, which cannot very well be shorter, may evidently at once as easily be written and printed-Stenography, as spoken, read and dictated-Stenophony, and they are distinctly international without offending any national feeling.
When several teeth on the same side are counted, it will be sufficient to use only a single sign.
How quickly and clearly we may localise ourselves by this way of indication is easy to understand. If we name a figure, the thought is at once directed to the right side; if we name a sign first, both the jaw and the side are indicated.
Certainly it is not quite unnecessary to point out that a general examination of the teeth ought always to be made in a certain fixed order. I myself have learned and always taught: examine the upper jaw first, and always from the right side to the left, and consequently it is a matter of course that I am noting the respective teeth in the same order, by which I also get the best view.
For the first time published in Correspondenz Blatt für Zahnärzte, 1887.
In order to place the milk teeth in the system, I indicate them as a first decimal (without comma). For instance, + 5 lacteus is written +05 (means) plus nought five. By 1 2 3 4 0 5 6 7 8 is indicated a case in which the second lower milk molar to the left has remained at the change of teeth.
Wanting teeth 7+ + 348, seven plus plus three four When as here teeth in both
As an example of registering serves: 52 1 6 (means): Wanting teeth eight, five two minus minus one six. jaws are to be counted, the respective rows of teeth are divided by
In regard to tooth surfaces, I have since the year 1890 introduced in my practice that way of indicating, that they are placed as powers (first to fifth) of numbers 1-8, but are pronounced as cardinals.
The masticating surface is indicated as the first, the mesial as the second, the facial as the third, the distal as the fourth and the oral surface as the fifth. This way of indicating is for my part not arbitrary, as I range the surfaces after their importance.
I fear no contradiction when I ascribe the greatest importance to the masticating surface, and therefore place it foremost. On the other side, the oral surface without doubt gives us the least trouble, and must therefore come last of all. Between these the other surfaces are ranging themselves: second, third, fourth. For instance: caries simplex 7+ + 324414, 8141221,863714 (means) Caries simplex seven fourth plus plus three second and fourth four first fourth eight first four first second, two first and third minus minus six second, seven first fourth. A comma between the powers indicates separated carious spots.
As a proof of the steno-nomenclature of this system in relation to the English language may be taken:
"Caries (gold filling, &c.) of the masticating and facial surface of the first left lower molar" is written, "caries 618" and is pronounced "caries minus six first third."
Separated roots are indicated in the same way, for instance :extractio 62 (means) — 6 radix mesialis ; — 6a (means) radix distalis ; + 6° (means) radix oralis (palatinalis); + 43 radix facialis, &c. On forceps this system may also be used; for instance, the crownforceps destined for the left lower molars I name: 6 (forceps), the corresponding in the upper jaw: +6 (forceps); the resection forceps for right lower side: r for left lower : - r, and so forth.
The steno-nomenclature proposed by me (in which, I repeat, the designation of the single teeth is the main subject) is less meant for private practice; the way of indicating, with which you have become. familiar, might perhaps be considered the best, yet it is my opinion. that with the system in question the registration may easily be simplified.