COKKESIONDENCE

DISCLAIMER

HE paper by Dr. Samuel Friedman purports to review the problems of denture occlusion in order to relieve the practitioner of the confusion created by contending theories, I am flattered to find that the author has included one of my papers in his bibliography, but somewhat distressed to be unable to accept either credit or responsibility for proposing the use of flat, dulled teeth as Dr. Friedman states. To make certain that there is no ground for attributing such a recommendation to me, I have reread the paper referred to as number 12 in the bibliography and also another on the same subject published in October, 1938. In the paper cited by Dr. Friedman, an entire section is entitled The Lower Teeth as Cutters ; in it one may find the following remarks : The lower molars and bicuspids should have bucco-lingual ridges or cutting edges running parallel to the path of closure : and a sectorial type of tooth is more effective than a simple molar type. And in the next section: teeth must possessa degree of cutting efficiency or sharpness that will decrease the pressure required to cut fibrous morsels and diminish traumatism of denture supporting tissues. This scarcely supports the belief that I recommend the use of flat teeth. In his third paragraph Dr. Friedman observes that the possession of a thorougli and definite concept of the physiology of mastication . . . . would enable the operator to make a more intelligent evaluation of the problem. In heartiest agreement with this sentiment I am disappointed by his neglect to refer to the work of G. Y. Hildebrand, which has been ahundantly confirmed by Kurth, Roswell, and, recently Jankelson, and which would, if he had studied it, have spared him from certain other misconceptions about the normal chewing cycle. May I request that this disclaimer be published so the confusion which Dr Friedman essayedto dispel may not be aggravated i Thank you. $1. A. Pleasure, D.D.S., hI.S.P.I-I. 154 W. 71st Street New York City Feb. 21.1951 REPLY TO DR. PLEASURE

HAVE the highest esteem for Dr. Pleasures scientific contributions to dentistry. I fully concur in his specifications that teeth must possess a degree of cutting
Reprinted from the New York State Dental Journal 17244, 1951. 414

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CORRESPONDENCE

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efficiency or sharpness that will decrease the pressure required to cut fibrous morsels and diminish traumatism of denture supporting tissues. In my article, Dr. Pleasures technique of modification of non-anatomic teeth has been quoted almost verbatim from his paper Prosthetic Occlusion: A Prob(J.A.D.A. 24:1303-1315, 1937). Then in a follow-up anlem in Mechanics alysis of this procedure I wrote, Cutting efficiency must, of necessity, be sharply curtailed thereby. Generally, flat teeth and teeth that have been synthesized to simulate wear are dull and do not cut effectively. With flat teeth or teeth so created, there is a loss in cutting efficiency of the occlusal surface that is directly proportional to the extent of the deterioration of that surface. My subsequent reference to flat, dulled teeth is quite obviously, then, my c-karacterimtion and evaluation of his use of non-anatomic teeth which have been subjected to the clinical modification procedures recommended by him. Dr. Pleasure, in his article referred to above, says on page 1317: Lacking teeth carved in accordance with the several stabilizing and cutting principles herein described, I have regularly employed Halls teeth, after appropriate alteration, as the nearest available approximation. The occlusal depressions in such inverted cusp teeth may tend to collect food. The more food trapped, the greater the chewing force required. Not only do excessive forces traumatize the underlying bone and tissue supports, but they also induce more rapid muscular fatigue. It is quite evident, then, that the clinical treatment and modification procedures of the type of non-anatomic teeth actually used by Dr. Pleasure are the direct antithesis of, and at complete variance with his theoretical expositions on the subject. It doesnt seem likely, in my opinion, that his declared objectives of sharp cutting teeth can be thus attained. I am not unfamiliar with the writings concerning the chewing cycle alluded to by Dr. Pleasure. In the Nezv York State Dental Journal (15 ~323, 1949)? about twelve years after Hildebrancls publication in The Journal of Dental Research (16:551, 1937), Kurth, in an article entitled, The Physiology of Mandibular Movement Related to Prosthodontia, wrote : Knowledge of the physiological act of mastication A study related to the direction and extent of mandibular movement is incomplete. of past investigations of this movement reveals many conflicting theories. Kurth acknowledges the existence of different points of view. I, too, fully realize the controversial nature of this subject. All statements in my article are substantiated by outstanding, recognized national leaders in the field. Apparently, another school of thought, acceptable among equally eminent authorities, is branded a misconception by Dr. Pleasure. RespectfulIy submitted, Samuel Friedman, D.D.S. 1011 Freeman Street New York 59. N. Y. March 5, 1951