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 Textbook of
Operative Dentistry
 Textbook of
Operative Dentistry

Nisha Garg MDS (Conservative Dentistry and Endodontics) Amit Garg MDS (Oral and Maxillofacial Surgery)
Ex Resident, PGIMER, Chandigarh Ex Resident, Government Dental College, PGIMS
Ex Resident, Government Dental College, Patiala Rohtak
Presently at, Manav Rachna Dental College Presently at, Manav Rachna Dental College
Faridabad, Haryana Faridabad, Haryana
India India

Foreword
Dr Ravi Kapur

JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD

New Delhi • St Louis (USA) • Panama City (Panama) • Ahmedabad • Bengaluru • Chennai
Hyderabad • Kochi • Kolkata • Lucknow • Mumbai • Nagpur
Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India, Phone: +91-11-43574357, Fax: +91-11-43574314
Registered Office
B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi - 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021
+91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683
e-mail: [email protected], Website: www.jaypeebrothers.com

Offices in India
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• Bengaluru, Phone: Rel: +91-80-32714073, e-mail: [email protected]
• Chennai, Phone: Rel: +91-44-32972089, e-mail: [email protected]
• Hyderabad, Phone: Rel:+91-40-32940929, e-mail: [email protected]
• Kochi, Phone: +91-484-2395740, e-mail: [email protected]
• Kolkata, Phone: +91-33-22276415, e-mail: [email protected]
• Lucknow, Phone: +91-522-3040554, e-mail: [email protected]
• Mumbai, Phone: Rel: +91-22-32926896, e-mail: [email protected]
• Nagpur, Phone: Rel: +91-712-3245220, e-mail: [email protected]

Overseas Offices
• North America Office, USA, Ph: 001-636-6279734, e-mail: [email protected], [email protected]
• Central America Office, Panama City, Panama, Ph: 001-507-317-0160, e-mail: [email protected]
Website: www.jphmedical.com

Textbook of Operative Dentistry

© 2010, Jaypee Brothers Medical Publishers

All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means:
electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.

This book has been published in good faith that the material provided by authors is original. Every effort is made to ensure accuracy of
material, but the publisher, printer and authors will not be held responsible for any inadvertent error (s). In case of any dispute, all legal
matters are to be settled under Delhi jurisdiction only.

First Edition: 2010

ISBN 978-81-8448-775-6

Typeset at JPBMP typesetting unit

Printed at Ajanta Offset

 Dedicated to
Our Parents
And
Beloved Daughter
“Prisha”
 Foreword

A textbook written with the undergraduate students in mind has seldom come in my hands till I went through the
contents of the book in question. I am extremely pleased with the efforts put by authors in penning down the
chapters in a systematic and flowing order such that one leads to the other. The commendable expression of the text
has been painstakingly selected for the student to understand and grasp the subject of Operative Dentistry. The
Flow charts and the apt illustrations add to the understandability of the subject in various chapters. The authors
who have already written two well-accepted books have left no stone unturned to include each and every part of the
subject. They have tried to drive into the minds of students the basics along with reference to the advancements in
the field of Operative Dentistry. I recognize it as a perfect blend of the age-old accepted concepts with the emerging
trends. I would recommend it as a must-read book for one and all in the specific branch of dentistry.

Ravi Kapur
Registrar
MM University Mullana
Dean Dental Faculty MMU Mullana
Professor and Head
Department of Conservative Dentistry and Endodontics
MM College of Dental Sciences and Research
Mullana, Ambala
India
 Preface

Operative dentistry is one of the oldest branches of dental sciences forming the central part of dentistry as practised
in primary care. The clinical practice of operative dentistry is ever evolving as a result of improved understanding
of etiology, prevention and management of common dental diseases. The advances and developments within last
two decades have drastically changed the scope of this subject.
Since effective practice of operative dentistry requires not only excellent manual skills but also both understanding
of disease process and properties of dental materials available for use. The main objective of this book is to provide
students with the knowledge required while they are developing necessary clinical skills and attitude in their
undergraduate and postgraduate training in operative dentistry. We have tried to cover wide topics like cariology,
different techniques and materials available for restorations, recent concepts in management of carious lesions,
infection control, minimally intervention dentistry and nanotechnology.
So we can say that after going through this book, the reader should be able to:
• Understand basics of cariology, its prevention and conservative management.
• Tell indications and contraindications of different dental materials.
• Apply modern pulp protective regimens.
• Know the importance of treating the underlying causes of patient’s problems, not just the restoration of the
damage that has occurred.
• Select suitable restorative materials for restoration of teeth.
• Know recent advances and techniques like Minimally Intervention Dentistry (MID), nanotechnology, lasers,
diagnosis of caries and advances in dental materials.

Nisha Garg
Amit Garg
[email protected]
 Acknowledgments

The two and a half years taken to compile this project have been a voyage of discovery for us. We have come to
realize that undertaking of this magnitude cannot be completed single handedly without the help, support and
contribution of various people.
First and foremost, we bow in gratitude to Almighty God for endowing us strength, courage and confidence in
accomplishing this endeavor to best of our abilities. Without his blessings, we could not have completed this project.
Since a textbook is product of never ending efforts and contributions, words fall short to express our feelings for
persons who helped us.
We express our special thanks to staff of Government Dental College, Patiala, Dr Raghuvir Singh Kang,
Dr Jagvinder Singh Mann, Dr Daminder Singh, Dr Sheetal Bansal and Dr Parul Dham for their guidance, suggestions
and valuable support.
We are specially thankful to Dr Navjot Singh Khurana for providing us illustrations and important matter to be
used in this book.
We offer our humble gratitude and sincere thanks to Mr OP Bhalla (Chairman) and Mr Amit Bhalla
(Vice-Chairman), MRDC, Faridabad for providing healthy and encouraging environment for our work.
We shall express our sincere thanks to Dr AK Kapoor, Principal, MRDC, Faridabad who always appreciated our
over-occupation and inspired us to learn more and more.
We would like to express our thanks to staff of Department of Operative Dentistry, MRDC, Faridabad, Dr Arundeep
Singh, Dr Manish Gupta, Dr Sarika and Dr Sandhya Kapoor, for their “ready to help” attitude, constant guidance
and positive criticism which helped in improvement of this book.
We are grateful to Dr Pankaj Dhawan (Dean Academics) and Dr SK Mangal (Medical Superintendent) for their
support and constant encouragement.
We are thankful to Dr MK Anand (Medical Superintendent), Dr Vishal Juneja and staff of Prodental, Faridabad
for providing illustration to be used in this book.
We are very much thankful to our friend Dr Manoj Hans (KD Dental College, Mathura) for valuable suggestions.
We are thankful to Shri Jitendar P Vij (Chairman and Managing Director), Mr Tarun Duneja (Director-Publishing)
and staff of Jaypee Brothers Medical Publishers, New Delhi, for all encouragement as well as for bringing out this
book in an excellent form.
Last but not the least, we are thankful to students of this country, who appreciated our previous books “Textbook
of Endodontics” and “Review of Endodontics and Operative Dentistry” and encouraged us to venture out this
project.
 Contents

1. Introduction to Operative Dentistry .......................................................................................................................... 1

2. Tooth Nomenclature ..................................................................................................................................................... 7

3. Structure of Teeth ........................................................................................................................................................ 17

4. Physiology of Tooth Form ......................................................................................................................................... 31

5. Dental Caries ................................................................................................................................................................ 45

6. Cutting Instruments ................................................................................................................................................... 92

7. Principles of Tooth Preparation ............................................................................................................................. 125

8. Patient Evaluation, Diagnosis and Treatment Planning ................................................................................... 145

9. Patient and Operator Position ................................................................................................................................ 157

10. Isolation of the Operating Field ............................................................................................................................. 164

11. Infection Control ....................................................................................................................................................... 179

12. Pain Control ................................................................................................................................................................ 195

13. Matricing and Tooth Separation ............................................................................................................................ 203

14. Pulp Protection .......................................................................................................................................................... 218

15. Interim Restorations ................................................................................................................................................. 229

16. Bonding to Enamel and Dentin .............................................................................................................................. 237

17. Composite Restorations ........................................................................................................................................... 255

18. Tooth Preparation for Composite Restorations ................................................................................................... 281

19. Aesthetics in Dentistry ............................................................................................................................................. 299

20. Amalgam Restorations ............................................................................................................................................. 309

21. Pin Retained Restorations ....................................................................................................................................... 344

22. Direct Filling Gold .................................................................................................................................................... 359

23. Cast Metal Restorations ........................................................................................................................................... 373

 24. Glass Ionomer Cement ............................................................................................................................................. 397

25. Dental Ceramics ........................................................................................................................................................ 418

26. Tooth Hypersensitivity ............................................................................................................................................ 433

27. Management of Discolored Teeth ......................................................................................................................... 441

28. Minimally Intervention Dentistry ......................................................................................................................... 456

29. Cervical Lesions ......................................................................................................................................................... 463

30. Evidence-based Dentistry ........................................................................................................................................ 472

31. Nanodentistry and its Applications ...................................................................................................................... 475

Bibliography .................................................................................................................................................................. 479

Index .............................................................................................................................................................................. 487
Textbook of Operative Dentistry

xiv
 Chapter
Introduction to
1 Operative Dentistr
Dentistryy

DEFINITION
HISTORY
INDICATIONS OF OPERATIVE DENTISTRY
PROCEDURES
• Caries
• Loss of the Tooth Structure due to Attrition,
Abrasion, Abfraction and Erosion
• Malformed, Traumatized, or Fractured Teeth
• Aesthetic Improvement
• Restoration Replacement or Repair
SCOPE OF OPERATIVE DENTISTRY
PURPOSE OF OPERATIVE DENTISTRY
• Diagnosis
• Prevention
• Interception
• Preservation
• Restoration
• Maintenance
RECENT ADVANCES IN RESTORATIVE
DENTISTRY

Operative dentistry plays an important role in enhancing treatment and prognosis of defects of the teeth which do
dental health and now branched into dental specialities. not require full coverage restorations for correction.”
Today operative dentistry continues to be the most active Such corrections and restorations result in the
component of most dental practice. Epidemiologically, restoration of proper tooth form, function and aesthetics
demand for operative dentistry will not decrease in the while maintaining the physiological integrity of the teeth
future. in harmonious relationship with the adjacent hard and
soft tissues. Such restorations enhance the dental and
DEFINITION
general health of the patient.
According to Mosby’s dental dictionary. “Operative According to Gilmore, “Operative dentistry is a subject
dentistry deals with the functional and aesthetic which includes diagnosis, prevention and treatment of
restoration of the hard tissues of individual teeth.” problems and conditions of natural teeth vital or nonvital
According to Sturdvent, “Operative dentistry is defined so as to preserve natural dentition and restore it to the
as science and art of dentistry which deals with diagnosis, best state of health, function and aesthetics.”
 Prehistoric 5000 BC A Sumerian text describes “tooth worms” as the cause of dental decay.
era 500-300 BC Hippocrates and Aristotle wrote about dentistry, including the eruption pattern of teeth, treating
decayed teeth.
166-201 AD The Etruscans practiced dental prosthetics using gold crowns and fixed bridgework.
700 A medical text in China mentioned the use of “silver paste,” a type of amalgam.

Pre 1700. 1530 Artzney Buchlein, wrote the first book solely on dentistry. It was written for barbers and surgeons
who used to treat the mouth, it covered topics like oral hygiene, tooth extraction, drilling teeth and
placement of gold fillings.
1563 Batholomew Eusttachius published the first book on dental anatomy, ‘Libellus de dentibus’
1683 Antony van Leeuwenhoek identified oral bacteria using a microscope
1685 Charles Allen wrote first dental book in English ‘The operator for the teeth’

1700-1800 1723 Pierre Fauchard published “Le Chirurgien dentiste”. He is credited as Father of Modern Dentistry
because his book was the first to give a comprehensive system for the practice of dentistry.
1746 Claude Mouton described a gold crown and post for root canal treated tooth.
1764 James Rae gave first lectures on the teeth at the Royal College of Surgeons, Edinburgh.
1771 John Hunter published “The natural history of human teeth” giving a scientific basis to dental
anatomy.
1780 William Addis manufactured the first modern toothbrush.
1790 John Greenwood constructed the first known dental foot engine by modifying his mother’s foot
treadle spinning wheel to rotate a drill.

1800-1900 1832 James Snell invented the first reclining dental chair.
1830s- The ‘Amalgam War’ conflict and controversy generated over the use of amalgam as filling material.
1890s
1855 Robert Arthur introduced the cohesive gold foil method for inserting gold into a preparation with
minimal pressure.
1864 Sanford C. Barnum, developed the rubber dam.
1871 James Beall Morrison invented foot engine
1890 WD Miller formulated his “chemico-parasitic” theory of caries in “Microorganisms of the human
Textbook of Operative Dentistry

mouth”
1895 Lilian Murray became the first woman to become a dentist in Britain.
1896 GV Black established the principles of cavity preparation.

1900-2000 1900 Federation Dentaire Internationale (FDI) was founded.

1903 Charles Land introduced the porcelain jacket crown.
1907 William Taggart invented a “lost wax” casting machine.
1930-1943 Frederick S. McKay, a Colorado dentist showed brown stains on teeth because of high levels of
naturally occurring fluoride in drinking water.
1937 Alvin Strock develoed Vitallium dental screw implant.
1950s The first fluoride toothpastes were marketed.
1949 Oskar Hagger developed the first system of bonding acrylic resin to dentin.
1955 Michael Buonocore described the acid etch technique
1957 John Borden introduced a high-speed air-driven contra-angle handpiece running upto 300,000
rpm.
1960s Lasers were developed
1962 Rafael Bowen developed Bis-GMA.
1989 The first commercial home tooth bleaching product was made available.
2 1990s New advances in aesthetic dentistry including tooth-colored restorative materials, bleaching
materials, veneers and implants.
HISTORY
The profession of dentistry was born during the early
middle ages. Barbers were doing well for dentistry by
removing teeth with dental problems. Till 1900 AD, the
term ‘Operative dentistry’ included all the dental services
rendered to the patients, because all the dental treatments
were considered to be an operation which was performed
in the dental operating room or operatory. As dentistry
evolved dental surgeons began filling teeth with core
metals. In 1871, GV Black gave the philosophy of
“extension for prevention,” for cavity preparation design.
Dr GV Black (1898) is known as the “Father of Operative
dentistry”. He provided scientific basis to dentistry
because his writings developed the foundation of the
profession and made the field of operative dentistry
organized and scientific. The scientific foundation for Fig. 1.1: Pit and fissure caries
operative dentistry was further expanded by Black’s son,
Arthur Black.
In early part of 1900s, progress in dental sciences and
technologies was slow. Many advances were made
during the 1970s in materials and equipments. By this
time, it was also proved that dental plaque was the
causative agent for caries. In the 1990s, oral health science
started moving toward an evidence-based approach for
treatment of decayed teeth. The recent concept of
treatment of dental caries comes under minimally

Introduction to Operative Dentistry

invasive dentistry. In December 1999, the World Congress
of Minimally Invasive Dentistry (MID) was formed.
Initially MI dentistry focused on minimal removal of
diseased tooth structure but later it evolved for preventive
measures to control disease.
Current minimally intervention philosophy follows
three concepts of disease treatment:
1. Identify—identify and assess risk factors early
2. Prevent—prevent disease by eliminating risk factors
3. Restore—restore the health of the oral environment
Fig. 1.2: Smooth surface caries
INDICATIONS OF OPERATIVE DENTISTRY
PROCEDURES
Indications for operative procedures are divided into the
following main sections:

Caries
Dental caries is an infectious microbiological disease of 3
the teeth which results in localized dissolution and
destruction of the calcified tissue, caused by the action of
microorganisms and fermentable carbohydrates.
Based on anatomy of the surface involved dental caries
can be of following types:
• Pit and fissures carious lesions (Fig. 1.1)
• Smooth surface carious lesions (Fig. 1.2)
• Root caries (Fig. 1.3). Fig. 1.3: Root caries
 Loss of the Tooth Structure due to Attrition, Malformed, Traumatized, or Fractured
Abrasion, Abfraction and Erosion Teeth (Fig. 1.6)
Attrition Traumatic injuries may involve the hard dental tissues
and the pulp which require restoration.
Mechanical wear between opposing teeth commonly due
Sometimes teeth do not develop normally and there
to excessive masticatory forces (Fig. 1.4).
are number of defects in histology or shape which occur
Abrasion during development and become apparent on eruption.
Loss of tooth materal by mechanical means other than These teeth are often unattractive or prone to excessive
by opposing teeth (Fig. 1.5). tooth wear.

Erosion Aesthetic Iimprovement (Fig. 1.7)

Loss of dental hard tissue as a result of a chemical process Discolored teeth because of staining or other reasons look
not involving bacteria. unaesthetic and require restoration.
Textbook of Operative Dentistry

Fig. 1.4: Attrition of teeth

Fig. 1.6: Fractured and discolored tooth

Fig. 1.5: Abrasion of teeth Fig. 1.7: Discolored teeth requiring aesthetic improvement
 Prevention
To prevent any recurrence of the causative disease and
their defects, it includes the procedures done for
prevention before the manifestation of any sign and
symptom of disease.

Interception
Preventing further loss of tooth structure by stabilizing
an active disease process. It includes the procedures
undertaken after signs and symptoms of disease have
appeared, in order to prevent the disease from developing
into a more serious or full extent. Here teeth are restored
to their normal health, form and function.
Fig. 1.8: Defective amalagam restoration requiring
replacement Preservation

Restoration Replacement or Repair Preservation of the vitality and periodontal support of

remaining tooth structure. Preservation of optimum
Repair or replacement of previous defective restoration health of teeth and soft tissue of oral preparation is
is indicated for operative treatment (Fig. 1.8). obtained by preventive and interceptive procedures.

SCOPE OF OPERATIVE DENTISTRY

Restoration
Scope of operative dentistry includes the following:
• To know the condition of the affected tooth and other Includes restoring form, function, phonetics and
teeth. aesthetics.
• To examine not only the affected tooth but also the

Introduction to Operative Dentistry

oral and systemic health of the patient. Maintenance
• To diagnose the dental problem and the interaction of After restoration is done, it must be maintained for
problem area with other tissues. providing service for longer duration.
• Provide optimal treatment plan to restore the tooth to
return to health and function and increase the overall
well being of the patient. RECENT ADVANCES IN RESTORATIVE
• Thorough knowledge of dental materials which can DENTISTRY
be used to restore the affected areas. Concept of tooth preparation has been remained the same
• To understand the biological basis and function of the as given by GV Black for many decades. That is extension
various tooth tissues. for prevention for treatment of dental caries. Later on,
• To maintain the pulp vitality and prevent occurrence scope of operative dentistry widened to involve all lesions
of pulpal pathology. affecting the hard tooth tissues, i.e. caries, fracture,
• To have knowledge of dental anatomy and histology. attrition, erosion, abrasion and developmental and
• To understand the effect of the operative procedures acquired defects. The modern concept of operative
on the treatment of other disciplines.
dentistry is based on conservation and prevention of
• An understanding and appreciation for infection
diseases. Many advancements have been made in the area
control to safeguard both patient and the dentist
of operative dentistry so as to meet its goals in better ways.
against disease transmission.
Basically advances in operative dentistry has occurred 5
in following areas:
PURPOSE OF OPERATIVE DENTISTRY
1. Advances in diagnosis
Purpose of operative dentistry basically is: a. Advances in visual method
i. Ultrasonic illumination
Diagnosis ii. Ultrasonic imaging
Proper diagnosis is vital for treatment planning. It is the iii. Fiberoptic Transillumination (FOTI)
determination of nature of disease, injury or other defect iv. Digital Imaging FOTI (DIFOTI)
by examination, test and investigation. v. Caries detecting dyes
 b. Recent advances in radiographic techniques • Mercury free alloys
i. Digital imaging • Gallium based silver alloy
ii. Computerized image analysis • Bonded amalgam restorations
iii. Tuned aperture computerized tomography Advances in other restorations:
(TACT) • Packable composites
iv. Magnetic resonance microimaging (MRMI). • Flowable composites
c. Electrical conductance measurement • Modifications in glass ionomers cements
d. Lasers • Compomers
i. Qualitative laser fluorescence • Giomers
ii. Diagnodent (Quantitative laser fluorescence) • Ormocers
iii. Optical coherence tomography • Ceromers
e. Computerized occlusal analysis • Tooth colored inlays.
2. Recent advances in treatment planning 5. Recent advances in techniques and equipments
• Minimal intervention dentistry • Incremental packing and C-factor concept in
• Ozone therapy. composites.
3. Recent advances in tooth preparation • Soft start polymerization
• Use of air abrasion technique • High intensity QTH polymerization.
• Chemomechanical caries removal 6. Recent advance in handpieces and rotary instruments
• Use of lasers in tooth preparation like:
• Use of ultrasonics in tooth preparation • Fibroptic handpiece
• Management of smear layer. • Smart prep burs
4. Recent advances in restorative materials • CVD burs
Modification in silver amalgam: • Fissurite system.
Textbook of Operative Dentistry

6
 Chapter
2 Tooth Nomenclature

CLASSES OF HUMAN TEETH • Anatomic Crown

• Incisors • Clinical Crown
• Canines NOMENCLATURE RELATED TO DENTAL CARIES
• Premolars • Dental Caries
• Molars • Primary Caries
SETS OF TEETH • Recurrent Caries
TOOTH NUMBERING SYSTEMS • Residual Caries
• Zsigmondy-Palmer System • Active Carious Lesion
• Universal System • Inactive/Arrested Carious Lesion
• FDI—Fédération Dentaire Internationale (Two-digit • Pits and Fissure Caries
Notation) • Smooth Surface Caries
• Comparison of Tooth Numbering Systems • Root Caries
• Acute Dental Caries
NOMENCLATURE OF TOOTH SURFACES
• Rampant Caries
• Buccal
• Chronic Dental Caries
• Labial
NOMENCLATURE RELATED TO NONCARIOUS DEFECTS
• Facial OF TEETH
• Mesial • Attrition
• Distal • Abrasion
• Lingual • Erosion
• Occlusal • Abfraction
• Incisal • Resorption
• Gingival • Localized Non-hereditary Enamel Hypoplasia
• Cervical • Localized Non-hereditary Enamel Hypocalcification

Dental anatomy or anatomy of teeth is the branch of

anatomy which deals with the study of human teeth
structures. It includes development, appearance and
classification of teeth. Dental anatomy is also a
taxonomical science; it is concerned with the naming of
teeth and the structures of which they are made.
For convenience human dentition is divided into four
quadrants viz; upper (maxillary) right, upper (maxillary)
left, lower (mandibular) right and lower (mandibular)
left (Fig. 2.1). Right and left here relate to patient’s right Fig. 2.1: Photograph showing division of whole dentition into
and left side. four quadrants, i.e. upper right, upper left, lower right and lower
It is important to understand anatomy of teeth because left. Here right and left relate to patient’s right and left
of following reasons:
• For maintenance of supporting tissues in the healthy • For restoration of damaged tooth to its original form.
state • For optimal functions of teeth.
 CLASSES OF HUMAN TEETH Molars (Fig. 2.5)
Depending upon their form and function human teeth Distal to premolars are the molars. There are six molars
can be divided into following classes: on each arch (three on each side), therefore a total of 12
inside the mouth. They have multiple cusps which help
Incisors in crushing and grinding the food. These teeth also help
The square-shaped teeth located in front of the mouth, in maintenance of vertical height of the face.
with four on the upper and four on the lower are called
incisors. Incisors are important teeth for phonetics and SETS OF TEETH
aesthetics. They help in cutting the food (Fig. 2.2). There are two sets of teeth that develop in a person’s
mouth (Fig. 2.6). The first set of teeth is called as “Milk or
Canines
Baby“ or “primary teeth”. The total number of teeth in
The sharp teeth located near the corner of the mouth. this set are twenty. Primary teeth erupt at the age between
Because of their anatomy and long root, they are strong 6 months and 2 years. Most children develop all their
teeth. They help in tearing and cutting of food (Fig. 2.3). primary teeth at the age of three.

Premolars
There are a total of eight premolars inside the mouth
present after the canines. four premolars are present in
upper and lower arch, two on each side of the canine.
Facially they resemble canines and lingually as molars
(Fig. 2.4). They help in tearing and grinding of the food.
Textbook of Operative Dentistry

Fig. 2.2: Maxillary central and lateral incisors Fig. 2.4: Photograph showing premolars

Fig. 2.3: Maxillary canine showing sharp tip and long root Fig. 2.5: Photograph showing molars
Fig. 2.6: Figure showing two sets of teeth. The outer ring Fig. 2.7: Diagram showing presentation of Zsigmondy-Palmer
represents the permanent teeth. The inner ring represents the notation of both deciduous and permanent dentitions
deciduous teeth

The second set of teeth, i.e. the permanent teeth erupt the idea in 1861, using a Zsigmondy cross to record
at the age of six. There are a total of 32 permanent teeth quadrants of tooth positions.
in an adult mouth. Total number of teeth are divided into Adult teeth were numbered 1 to 8 and the primary
two arches, i.e. an upper and a lower arch each found on dentition as Roman numerals I, II, III, IV, V from the
the upper and lower jaws respectively. Normally, a total midline. Palmer changed this to A, B, C, D, E. This makes
of 16 teeth may be found on each complete arch. it less confusing and less prone to errors in interpretation.
The Zsigmondy Palmer notation consists of a symbol

Tooth Nomenclature
TOOTH NUMBERING SYSTEMS
( ) designating in which quadrant the tooth is
There are different tooth numbering systems for naming found and a number indicating the position from the
a specific tooth. The three most commons systems are midline. Permanent teeth are numbered 1 to 8 and
the FDI World Dental Federation notation, Universal primary teeth are indicated by a letter A to E.
numbering system and Zsigmondy-Palmer notation
method. The FDI system is used worldwide and the Advantages
universal is used widely in the USA. • Simple and easy to use.
• Less chances of confusion between primary and
Most commonly used tooth numbering systems permanent tooth as there is different notation, e.g.
1. Zsigmondy-Palmer system permanent teeth are described by numbers while
2. Universal system (ADA system) primary teeth by alphabets. 9
3. FDI system (Federation Dentaire Internationale)
Disadvantages
Zsigmondy-Palmer System (Fig. 2.7)
• Difficulty in communication.
It was originally termed as “Zsigmondy system” after • Confusion between upper and lower quadrants, while
the Austrian dentist Adolf Zsigmondy who developed communication and transferring a data.
 Features a child’s first tooth on the upper right would be 1d and
the last tooth on the lower right would be 20d.
• Introduced by ‘Zsigmondy’ in 1861
• Each quadrant is designated by symbol ( )
Modified Version of Universal System Order for
• Permanent teeth are numbered 1-8
the Primary Dentition
• Primary teeth are indicated by A-E
It is denoted by English upper case letters A through T
Universal System instead of number 1 to 20, with A being the patient’s
upper right second primary molar and T being the lower
This system was given by American Dental Association
right second primary molar, e.g.
in 1968. This system is most popular in the United States.
The universal numbering system uses a unique letter or B is maxillary right deciduous first molar
number for each tooth. P is mandibular right deciduous central incisor
5 is maxillary right permanent first premolar
The Universal/National System is represented as
follows Advantages: Unique letter or number for each tooth
Permanent Teeth avoiding confusions.

For permanent teeth, 1 is the patient’s upper right third Disadvantages: Difficult to remember each letter or
molar and follows around the upper arch to the upper number of tooth
left third molar 16, descending to the lower left third
molar 17 and follows around the lower arch to the lower Features
right third molar (32) (Fig. 2.8). • Given by American dental association in 1968
In this system, the teeth that should be there are • Use a unique number/letter for each tooth
numbered. If wisdom tooth is missing the first number • Permanent teeth are numbered 1-32 starting from upper
will be 2 instead of 1, acknowledging the missing tooth. right molar
If teeth have been extracted or teeth are missing, the • Deciduous teeth are designated as A-T, in this A is upper
right second molar
missing teeth will be numbered as well.
In the original system, children’s 20 primary teeth were
FDI—Fédération Dentaire Internationale
numbered in the same order, except that a small letter (Two-digit Notation)
“d” follows each number to indicate deciduous teeth. So,
Textbook of Operative Dentistry

This two digit system was first introduced in 1971 which

later on, was adopted by ADA (1996). This system is
commonly practiced in European countries and Canada.
Now it is gaining popularity in India also.
This system is known as two digit system because it
uses a two-digit numbering system in which the first
number represents a tooth’s quadrant and the second
number represents the number of the tooth from the
midline of the face. Both digits should be pronounced
separately while communication. For example, the lower
left permanent second molar is 37; however, it is not said
thirty-seven, but rather three seven.

Permanent Teeth (Fig. 2.9)

In the FDI (Fédération Dentaire Internationale) notation
10 1s are central incisors, 2s are laterals, 3s are canines, 4s
are 1st premolars, 5s are 2nd premolars, 6s are the 1st
molar, etc. up through 8s which are 3rd molars. The
permanent teeth quadrants are designated 1 to 4 such
that 1 is upper right, 2 is upper left, 3 is lower left and 4 is
lower right, with the resulting tooth identification a two-
digit combination of the quadrant and tooth (e.g. the
Fig. 2.8: Diagram showing presentation of universal system upper right canine is 13 and the left is 23) (Figs 2.10
of tooth nomenclature for both deciduous and permanent teeth and 2.11).
 Fig. 2.11: FDI system of permanent teeth

Advantages
• Simple to understand
• Simple to teach
• Simple to pronounce
• No confusion
• Each tooth has specific number
• Easy to record on computers
• Easy for charting.
Fig. 2.9: Diagram showing presentation of FDI system of Disadvantages
tooth nomenclature for permanent and primary teeth • May be confused with universal tooth numbering
system.

Features
• Introduced in 1971
• Also known as two-digit notation
• In two digit system, first number represents tooth’s

Tooth Nomenclature
quadrant while second number—number of tooth from
midline
• Permanent right central incisor is designated as 11
• Deciduous right central incisor is designated as 51.

Comparison of Tooth Numbering Systems

As a result, any given tooth has three different ways to
identify it, depending on which notation system is used
(Fig. 2.12). The permanent left maxillary central incisor
is identified by the number “9” in the universal system.
Fig. 2.10: Diagrammatic presentation of FDI notation of In the FDI system, the same tooth is identified by the
maxillary right canine and left second molar 11
number “21”. The palmer system uses the number and
symbol, L1, to identify the tooth. Further confusion may
Deciduous Teeth
result if a number is given on a tooth without assuming a
In the deciduous dentition the numbering is common notation method. Since the number, “21”, may
correspondingly similar except that the quadrants are signify the permanent left mandibular first premolar in
designated 5, 6, 7 and 8. Teeth are numbered from the universal system or the permanent left maxillary
number 1 to 5, 1 being central incisor and 5 is second central incisor in the FDI system, the notation being used
molar. must be clear to prevent confusion.
Textbook of Operative Dentistry

Fig. 2.12: Diagram showing all nomenclature (All systems)

12 First row describes – Zsigmondy-Palmer
Second row describes – Universal
Third row describes – FDI
 Permanent Teeth
Zsigmondy-Palmer Notation
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
Universal Numbering System
Upper right Upper left
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
Lower right Lower left
FDI Two-Digit Notation
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28
48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

Deciduous Teeth
Palmer Notation
E D C B A A B C D E
E D C B A A B C D E
Universal Numbering System
Upper right Upper left
A B C D E F G H I J
T S R Q P O N M L K
Lower right Lower left
FDI Two-Digit Notation
55 54 53 52 51 61 62 63 64 65
85 84 83 82 81 71 72 73 74 75

NOMENCLATURE OF TOOTH SURFACES Buccal

Coronal portion of each tooth is divided into surfaces that Tooth surface facing the check.
are designated according to their related anatomic
structures and landmarks (Fig. 2.13). Labial

Tooth Nomenclature
Tooth surface facing the lip.

Facial
Labial and buccal surface collectively form facial surface.

Mesial
Tooth surface toward the anterior midline.

Distal
Tooth surface away from the anterior midline. 13

Lingual
Tooth surface towards the tongue.

Occlusal
Fig. 2.13: Diagrammatic representation of Masticating surface of posterior teeth (in molar or
different surfaces of teeth premolar)
 Incisal
Functioning/cutting edge of anterior tooth (in incisors
and cuspids).

Gingival
Tooth surface near to gingiva.

Cervical
Tooth surface near the cervix or neck of tooth.

Anatomic Crown
It is part of tooth that is covered with enamel (Fig. 2.14).

Clinical Crown
It is part of tooth that is visible in oral cavity (Fig. 2.14).
In case of gingival recession, clinical crown is longer than Fig. 2.15: When there is gingival recession, clinical
anatomical crown (Fig. 2.15). crown is more than anatomical crown

NOMENCLATURE RELATED TO
DENTAL CARIES

Dental Caries
It is defined as a microbiological disease of the hard
structure of teeth, which results in localized demineraliza-
tion of the inorganic portion and destruction of the
organic substances of the tooth (Fig. 2.16).
Textbook of Operative Dentistry

Primary Caries
It denotes lesions on unrestored surfaces.

Fig. 2.16: Photograph showing dental caries

Recurrent Caries
Lesions developing adjacent or beneath the restorations
are referred to as either recurrent or secondary caries
(Fig. 2.17).

Residual Caries
14
It is demineralized tissue left in place before a restoration
is placed. It can occur by clinician’s neglect or
intentionally.

Active Carious Lesion

A progressive lesion is described as an active carious
Fig. 2.14: Anatomical crown and clinical crown lesion.
 Fig. 2.17: Radiograph showing recurrent caries Fig. 2.19: Smooth surface caries

Inactive/Arrested Carious Lesion Root Caries

A lesion that may have formed earlier and then stopped Root caries occur on exposed root cementum and dentin
is referred to as an arrested or inactive carious lesion. usually following gingival recession.
Arrested carious lesion is characterized by a large open
preparation which no longer retains food and becomes Acute Dental Caries
self-cleansing. Acute caries travels towards the pulp at a very fast speed.

Pits and Fissure Caries Rampant Caries

Pit and fissure caries are the caries which occur on It is the name given to multiple active carious lesions
occlusal surface of posterior teeth and buccal and lingual occurring in the same patient, frequently involving
surfaces of molars and on lingual surface of maxillary surfaces of teeth that are usually caries-free. Rampant
incisors (Fig. 2.18). caries is of following three types:
• Early childhood caries is a term used to describe dental
caries presenting in the primary dentition of young
children.
• Bottle caries or nursing caries are seen in the primary

Tooth Nomenclature
dentition of infants and young children. The clinical
pattern is characteristic, with the four maxillary
deciduous incisors most severely affected.
• Xerostomia induced rampant caries are commonly
seen after radiotherapy of malignant areas because of
reduced salivary flow.

Chronic Dental Caries

Chronic caries progresses very slowly towards the pulp.
They appear dark in color and hard in consistency.

NOMENCLATURE RELATED TO NONCARIOUS 15

DEFECTS OF TEETH
Fig. 2.18: Pit and fissure caries
Attrition
It is defined as a physiological, continuous, process
Smooth Surface Caries
resulting in loss of tooth structure from direct frictional
Smooth surface caries occurs on gingival third of buccal forces between contacting teeth. It occurs both on occlusal
and lingual surfaces and on proximal surfaces (Fig. 2.19). and proximal surfaces. Attrion is accelerated by
 parafunctional mandibular movements, especially Abfraction lesion appears as a wedge shaped defect with
bruxism. sharp line angles.

Abrasion Resorption
It refers to the loss of tooth substance induced by Resorption is defined as “a condition associated with
mechanical wear other than that of mastication. Abrasion either a physiologic or a pathologic process resulting in
results in saucer-shaped or wedge-shaped indentations the loss of dentin, cementum or bone.”
with a smooth, shiny surface (Fig. 2.20). If resorption occurs, it is because of some pathologic
reasons but deciduous teeth show physiologic resorption
before they are shed off.

Localized Non-hereditary Enamel Hypoplasia

It refers to the localized defects in the crown portion of
tooth caused due to injury to ameloblasts during the
enamel matrix formative stage. These lesions may appear
as isolated pits or widespread linear defects, depressions
or loss of a part of enamel. Injury to ameloblasts may be
caused by the following:
• Traumatic intrusion of deciduous teeth.
• Fluorosis.
• Exanthematous diseases.
• Deficiency of vitamins A, C and D.
Fig. 2.20: Photograph showing abrasion cavities • Hypocalcemia.

Erosion
Localized Non-hereditary Enamel
Textbook of Operative Dentistry

It can be defined as a loss of tooth substance by a chemical Hypocalcification

process that does not involve known bacterial action. The
It refers to the localized defects in crown portion of tooth
eroded area appears smooth, hard and polished.
due to injury caused to the ameloblasts during
mineralization stage. In these, the enamel is normal in
Abfraction
structure but its mineralization is defective. The color of
Abfractions are the microfractures which appear in the lesion changes fast from chalky to yellow, brown, dark
enamel as cervical area of tooth flexes under heavy loads. brown or grayish.

16
 Chapter
3 Structure of TTeeth
eeth

ENAMEL • Structure of Dentin

• Composition • Difference between Enamel and Dentin
• Structure • Difference between Primary, Secondary and Reparative/
• Thickness Tertiary Dentin
• Color • Clinical Considerations of Dentin
• Strength DENTAL PULP
• Structure Present in Enamel • Histology of Dental Pulp
• Functions of Enamel • Anatomy of Dental Pulp
• Clinical Significance of Enamel • Functions of Pulp
DENTIN • Age Changes in Pulp
• Composition PERIRADICULAR TISSUE
• Color • Cementum
• Thickness • Periodontal Ligament
• Hardness • Alveolar Bone

Good knowledge of dental anatomy, histology, tooth. It is the normally visible dental tissue of a tooth
physiology and occlusion is the foundation stone of which is mainly responsible for color, aesthetics, texture
operative dentistry. In other words, thorough knowledge and translucency of the tooth. One of the main goal in
of morphology, dental anatomy, histology, is essential to operative dentistry is preservation of enamel. So today’s
get optimal results of operative dentistry. Though the dentistry mainly revolves around simulating natural
dental tissues are passive, the occurrence of caries can
enamel in its color, aesthetics, contours and translucency
only be understood when the structure of the teeth is
by replacing with synthetic restorative materials.
understood.
The teeth consist of enamel, dentin, pulp and Although enamel can serve lifelong, but it is more
cementum (Fig. 3.1). susceptible to caries, attrition (physical forces) and fracture
due to its structural make up, i.e. mineralized crystalline
ENAMEL structure and rigidity. One of the interesting features of
Tooth enamel is the hardest and most highly mineralized enamel is that it cannot repair itself. So, loss in enamel
substance of the body which covers the crown of the surface can be compensated only by restorative treatment.
 The rods or the prisms run in an alternating coarse of
clockwise and anticlockwise direction (twisting course).
Initially there is wavy coarse in one-third of enamel
thickness adjacent to DEJ, then the coarse becomes more
straight in the remaining thickness.
Enamel rods are arranged in such planes so as to resist
the maximum masticatory forces. Rods are oriented at
prependicular to the dentino-enamel junction. Towards
the incisal edge these become increasingly oblique and
are almost vertical at the cusp tips. In the cervical region,
there is difference in the direction of the enamel rods of
deciduous and permanent teeth (Fig. 3.2). The cervical
enamel rods of deciduous teeth are inclined incisally or
occlusally, while in permanent teeth they are inclined
apically. This change in direction of enamel rods should
be kept in mind during tooth preparation so as to avoid
unsupported enamel rods.
Fig. 3.1: Diagrammatic representation of enamel,
dentin, pulp and supporting structures

Composition
It is highly mineralized structure which mainly contains
inorganic contents in the form of crystalline structure.
Main inorganic content in the enamel is hydroxyapatite.
In addition to inorganic content, it also contains a small
portion of organic matrix along with small amount of
water which is present in intercrystalline spaces.
Textbook of Operative Dentistry

Composition
1. Inorganic content (by vol.)
a. Hydroxyapatite—90-92%
b. Other minerals and trace elements—3-5%
Fig. 3.2: Diagram showing direction of enamel rods in
Organic content (by vol.) deciduous and permanent teeth
1. Proteins and lipids—1-2%
2. Water—4% Structure
• Composed of millions of rods or prisms
Structure
• Diameter of enamel rod increases from dentinenamel
Enamel is mainly composed of millions of enamel rods junction towards outer surface of enamel in 1:2
or prisms as well as sheaths and a cementing inter rod • Enamel rods lie perpendicular to dentino-enamel junction
• In cervical region, direction of enamel rod is incisally/
substance. Each rod has a head and tail. The head is
occlusally in deciduous while in permanent, it is apically.
directed occlusally and the tail is directed cervically. The
rod is formed of number of hydroxyapatite crystals which
vary in size, shape and number. Each rod formed of about Thickness
18
300 unit crystal length and 40 units wide and 20 unit thick The thickness of enamel varies in different areas of the
in three-dimensional hexagon. In transverse sections, same tooth and from one type of tooth to another type of
enamel rods appear as hexagonal and occasionally round tooth. The average thickness of enamel at the incisal edges
or oval. Rods may also resemble fish scales. of incisors is 2 mm; at the cusp of premolar and molar
The diameter of rods increases from dentino-enamel from 2.3 to 3.0 mm. Thickness of enamel decreases
junction towards the outer surface of enamel in a ratio gradually from cusps or incisal edges to cemento-enamel
of 1:2. junction.
 Thickness of enamel Structure Present in Enamel (Fig. 3.3)

Tooth type Thickness Gnarled Enamel

Anterior tooth-incisal edges 2.0 mm There are group of irregular enamel that is more resistant
Premolar tooth-cusp 2.3-2.5 mm to cleavage called Gnarled enamel present mostly in
Molar tooth-cusp 2.5-3.0 mm cervical, incisal and occlusal portion. This consists of
bundles of enamel rods which interwine in an irregular
Color manner with other group of rods, finally taking a twisted
and irregular path towards the tooth surface.
The color of enamel is usually gray and translucent in
nature. Color of tooth mainly depends upon three factors: Significance: This part of enamel is resistant to cutting
(a) color of underlying dentin (b) thickness of enamel while tooth preparation.
(c) amount of stains in enamel. The translucency of Bands of Hunter-Schreger
enamel is directly related to degree of mineralization and
homogenicity. Anomalies occurring during develop- Hunter-Schreger bands usually occur because of
mental and mineralization stage, antibiotic usage and alteration of light reflection (optical phenomenon) due
excess fluoride intake affect the color of tooth. to changes in rod direction. This results in alternating
light and dark zones under the microscope. It is best seen
Color of enamel is affected by in longitudinal ground sections seen under reflected light.
They are mainly found in the inner surface of tooth. H-S
• Color of underlying dentin
bands are composed of different contents of organic
• Thickness of enamel
• Amount of stains in enamel material and varied permeability.
• Anomalies occurring during developmental and Significance: They are considered to resist and disperse
mineralization stage like antibiotic usage and excess
the strong forces.
fluoride intake affects the color.
Enamel Tufts
Strength Enamel tufts are ribbon-like structures which run from
Enamel has a rigid structure. It is brittle, has a high dentin to enamel. They are named so because they
modulus of elasticity and low tensile strength. The resemble tufts of grass. They contain greater concentra-
specific gravity of enamel is 2.8. Hardness of enamel is tion of enamel proteins.
different in different areas of the external surface of a Significance: Hypomineralized structure in the enamel,
tooth. The hardness also decreases from outer surface of thus it plays role in spread of dental infection.
the enamel to its inner surface. Also the density of enamel
increases from dentino-enamel junction to the outer

Structure of Teeth
surface. When compared, dentin has high compressive
strength than the enamel, this acts as a cushion for enamel
when masticatory forces are applied on it. For this reason
during tooth preparation, for maximal strength of
underlying remaining tooth structure all enamel rods
should be supported by healthy dentin base.

Structure present in enamel

1. Gnarled enamel
2. Bands of Hunter-Schreger 19
3. Enamel tufts
4. Enamel lamellae
5. Enamel spindles
6. Striae of Retzius
7. Prismless layer
8. Dentino-enamel junction Fig. 3.3: Diagram showing different
9. Occlusal pits and fissures. structures present in enamel
 Enamel Lamellae Prismless Layer
These are leaf like defects present in enamel and may There is structureless layer of enamel near the cervical
extend to DEJ. They contains organic substances. line and to a lesser extent on the cusp tip which is more
Lamellae are commonly found at the base of occlusal pits mineralized.
and fissures. Bodecker in 1906 was the first to describe
Dentino-enamel Junction
these developmental defects of enamel which he named
‘lamellae’. Dentino-enamel junction is pitted/scalloped in which
These are caused by ‘imperfect calcification of enamel crests are toward enamel and shallow depressions are in
tissue’. dentin. This helps in better interlocking between enamel
Pincus suggested that if developing cusps fail to and dentin. This is a hypermineralized zone and is about
coalesce when forming a fissure, a gap in the enamel 30 microns thick.
occurs. Such a gap may vary in size from a crack or Significance: Shape and nature of the dentino-enamel
lamella. junction prevents tearing of enamel during functions.
Three types of lamellae are commonly seen:
• Type A composed of ‘poorly calcified rod segments’ Occlusal Pits and Fissures
• Type B composed of degenerated cells Pits and fissures are formed by faulty coalescence of
• Type C arising after eruption where the crack is filled developmental lobes of premolars and molars (Fig. 3.4).
with mucoproteins from the oral preparation These are commonly seen on occlusal surfaces of
Type A lamellae is confined to enamel while types B premolars and molars. These are formed at the junction
and C may extend into dentin. of the developmental lobes of the enamel organs. Grooves
Various studies have shown that lamellae might be are developed by smooth coalescence of developmental
the site of entry of caries. lobes.
Ten Cate stated that tufts and lamellae are of no
significance and do not appear to be sites of increased
vulnerability to caries attack.
A lamella at the base of an occlusal fissure provides
an appropriate pathway for bacteria and initiate caries.
Textbook of Operative Dentistry

Enamel Spindles
Odontoblastic processes some times crosses DEJ and their
end is thickened. Spindles serve as pain receptors, that is
why, when we cut in the enamel patient complains of
pain.
Fig. 3.4: Showing pits and fissures of premolars and molars
Striae of Retzius
They appear as brownish bands in the ground sections Significance:
and illustrate the incremental pattern of enamel. These • Thickness of enamel at the base of pit and fissure is
represent the rest periods of ameloblast during enamel less.
formation, therefore also called as growth circles. • Pits and fissures are the areas of food and bacteria
When these circles are incomplete at the enamel surface, impaction which make them caries prone (Fig. 3.5).
it results in alternating grooves called imbrications lines • V-shaped grooves provide escapement of food when
of pickerills, the elevations in between called perikymata. cusps of teeth of opposite arch occlude during
20 Perikymata are shallow furrows where the striae of mastication.
Retzius end. These are continuous around the tooth and
parallel the CEJ. Functions of Enamel
Striae of Retzius are stripes that appear on enamel 1. It is hardest structure of tooth which supports
when viewed microscopically in cross-section. Formed masticatory forces
from changes in diameter of Tomes’ processes, these 2. It is mainly responsible for color, aesthetics, surface
stripes demonstrate the growth of enamel, similar to the texture and transleuency of the tooth
annual rings on a tree. 3. It also supports the underlying dentin and pulp.
 restorative material that wears at a same rate as
enamel.
• Acid etching: Acid etching is used in fissure sealants
and bonding of restorative material to enamel. Acid
etching has been considered as accepted procedure for
improving the bonding between resin and enamel.
Acid etching causes preferential dissolution of enamel
surface and helps in increasing the bonding between
resin and enamel.
• Permeability: Enamel has been considered to be
permeable to some ions and molecules. Hypo-
mineralized areas present in the enamel are more
permeable than mineralized area. So, these hypo-
Fig. 3.5: Deep pits and fissures making areas mineralized areas are more sensitive to dental caries.
favorable for food impaction • Defective surfaces like hypoplastic areas, pits and
fissures are at more risk for dental caries
• Cracks present on the enamel surface sometimes lead
Functions of enamel
to pulpal death and fracture of tooth.
• Hardest structure of tooth supporting the masticatory • To avoid fracture of tooth and restoration, enamel
forces walls should be supported by underlying dentin. Also
• Responsible for color and aesthetics the preparation walls should be made parallel to
• Responsible for surface texture and translucency of tooth
direction of enamel rods since enamel rod boundaries
• Support underlying dentin and pulp
are natural cleavage lines through which fracture can
occur.
Clinical Significance of Enamel
• Remineralization: Remineralization is only because of
• Color: Color of the enamel varies because of following enamel’s permeability to fluoride, calcium and
factors: phosphate (available from saliva or other sources).
– Age
– Ingestion of tetracycline during the formative stages DENTIN
– Ingestion of fluoride
– Extrinsic stains Dentin, the most voluminous mineralized connective
– Developmental defects of tooth. tissue of the tooth, forms the hard tissue portion of the
• Attrition: The change usually seen in enamel with age dentin-pulp complex, whereas the dental pulp is the
due to wear of occlusal surfaces and proximal contact living, soft connective tissue that retains the vitality of
dentin. Enamel covers the dentin in crown portion while

Structure of Teeth
points during mastication. Sometimes bruxism or
contacts with porcelain also lead to attrition (Fig. 3.6). cementum covers the dentin in root portion. Dentin
So, in these patients, try to avoid placing the margins contains closely packed dentinal tubules in which the
of restoration in occlusal contact area or place a dentinal fluid and the cytoplasmic processes of the
odontoblasts, are located. Hence, dentin and bone are
considered as vital tissues because both contain living
protoplasm. Dentin is type of specialized connective
tissue which is mesodermal in origin, formed from dental
papilla.
The unity of dentin-pulp is responsible for dentin
formation and protection of the tooth. 21

Composition
Dentin contains 70% inorganic hydroxyapatite crystals
and the rest is organic substance and water making it
more resilient than enamel.
The organic components consist primarily of collagen
type 1.
Fig. 3.6: Attrition of teeth
 Composition (by wt.). Hardness of dentin
Inorganic material 70% • 1/5th of enamel
Organic material 20% • Compressive hardness is 266 Mpa
Water 10% • Tensite strength—40-60 Mpa
• Hardness increases with age.
Color
Structure of Dentin
The color of dentin is slightly darker than enamel and is
generally light yellowish in young individuals while it Structure of dentin
becomes darker with age. On constant exposure to oral
1. Dentinal tubules
fluids and other irritants, the color becomes light brown
2. Predentin
or black (Fig. 3.7). 3. Peritubular dentin
4. Intertubular dentin
5. Primary dentin
a. Mantle
b. Circumpulpal
6. Secondary dentin
7. Reparative dentin
8. Sclerotic dentin

Dentinal Tubules (Table 3.1)

The dentinal tubules follow a gentle ‘S’-shaped curve in
the tooth crown and are straighter in the incisal edges,
cusps and root areas. The ends of the tubules are
perpendicular to dentino-enamel and dentino-cemental
junctions (Fig. 3.8). The dentinal tubules have lateral
branches throughout the dentin, which are termed as
canaliculi or microtubules. Each dentinal tubule is lined
with a layer of peritubular dentin, which is much more
Textbook of Operative Dentistry

Fig. 3.7: Photograph showing dark colored

mineralized than the surrounding intertubular dentin.
dentin because of irritants

Thickness
Dentin thickness is usually more on the cuspal heights
and incisal edges and less in the cervical areas of tooth. It
is around 3-3.5 mm on the coronal surface. With
advancing age and various irritants, the thickness of
secondary and tertiary dentin increases.

Hardness
The hardness of dentin is one-fifth that of enamel.
Hardness is not the same in all its thickness. Its hardness
at the DEJ is 3 times more than that near the pulp so it is
important to keep the depth of preparation near the DEJ.
22 Hardness of dentin also increases with advancing age
due to mineralization. Compressive hardness is about 266 Fig. 3.8: Diagram showing course of dentinal tubules
MPa. The modulus of elasticity is about 1.67 × 106 Psi. As
the modulus of elasticity of dentin is low, so it indicates Table 3.1: Dentinal tubules
dentin is flexible in nature. The flexibility of dentin
provides support or cushion to the brittle enamel. The Pulp DEJ
tensile strength of dentin is 40-60 MPa. It is approximately Diameter 2-3 µm 0.5-0.9 µm
one-half of that of enamel. Numbers 45,000-65,000/mm2 15,000-20,000/mm2
Number of dentinal tubules increase from 15,000-20,000/ dentin. Secondary dentin forms at a slower rate than
mm2 at DEJ to 45,000-65,000/mm 2 toward the pulp. primary dentin.
Dentinal tubules may extend from the odontoblastic layer
to the dentino-enamel junction and give high Reparative Dentin/Tertiary Dentin
permeability to the dentin. In addition to an odontoblast Tertiary dentin frequently formed as a response to
process, the tubule contains dentinal fluid, a complex
external stimuli such as dental caries, attrition and
mixture of proteins such as albumin, transferrin, tenascin
trauma. If the injury is severe and causes odontoblast cell
and proteoglycans.
death, odontoblast like cells synthesize specific reparative
Predentin dentin just beneath the site of injury to protect pulp
tissue. The secondary odontoblasts which produce
The predentin is 10–30 µm unmineralized zone between
reparative dentin are developed from undifferentiating
the mineralized dentin and odontoblasts.
mesenchymal cells of pulp. Unlike physiological dentin,
This layer of dentin, lie very close to the pulp tissue
reparative dentin is irregular, with cellular inclusions.
which is just next to cell bodies of odotoblasts. It is first
Also the tubular pattern of the reparative dentin ranges
formed dentin and is not mineralized.
from a irregular to an atubular nature. Reparative dentin
Peritubular Dentin matrix has decreased permeability, therefore helping in
prevention of diffusion of noxious agents from the
This dentinal layer usually lines the dentinal tubules and
tubules.
is more mineralized than intertubular dentin and
predentin. Sclerotic Dentin
Intertubular Dentin It occurs due to aging or chronic and mild irritation (such
This dentin is present between the tubules which is less as slowly advancing caries) which causes a change in the
mineralized than peritubular dentin. Intertubular dentin composition of the primary dentin. In sclerotic dentin,
determines the elasticity of the dental matrix. peritubular dentin becomes wider due to deposition of
calcified materials, which progress from enamel to pulp.
Primary Dentin This area becomes harder, denser, less sensitive and more
This type of dentin is formed before root completion, protective of pulp against irritations.
gives initial shape of the tooth. It continues to grow till 3 Psysiologic sclerotic dentin: Sclerotic dentin occurs due
years after tooth eruption. to aging.
a. Mantle dentin: At the outermost layer of the primary
Reactive sclerotic dentin: Reactive sclerotic dentin occurs
dentin, just under the enamel, a narrow zone called
due to irritants.
mantle dentin exists. It is formed as a result of initial
mineralization reaction by newly differentiated Eburnated dentin: It is type of reactive sclerotic dentin

Structure of Teeth
odontoblasts. In other words, it is first formed dentin which is formed due to destruction by slow caries process
in the crown underlying the dentino-enamel junction. or mild chronic irritation and results in hard, darkened
b. Circumpulpal dentin: It forms the remaining primary cleanable surface on outward portion of reactive dentin.
dentin and is more mineralized than mantle dentin.
Dead Tracts
This dentin outlines the pulp chamber and therefore
it may be referred to as circumpulpal dentin. It is This type of dentin usually results due to moderate type
formed before root completion. of stimuli such as moderate rate caries or attrition. In this
case, both affected and associated odontoblasts die,
Secondary Dentin
resulting in empty dental tubules which appear black
Secondary dentin is formed after completion of root when ground sections of dentin are viewed under 23
formation. In this, the direction of tubules is more transmitted light. These are called dead tracts due to
asymmetrical and complicated as compared to primary appearance of black under transmitted light.
 Difference between Enamel and Dentin

Enamel Dentin
Color Whitish blue or white gray Yellowish white or slightly darker than enamel
Sound Sharp, high pitched sound on moving fine explorer tip Dull or low pitched sound on moving fine
explorer tip
Hardness Hardest structure of the tooth Softer than enamel
Reflectance More shiny surface and reflective to light than dentin Dull and reflects less light than enamel

Difference between Primary, Secondary and Reparative/Tertiary Dentin

Primary Secondary Tertiary

1. Definition Dentin formed before root Formed after root completion Formed as a response to any
completion external stimuli such as dental
caries, attrition and trauma
2. Type of cells Usually formed by primary Formed by primary odontoblasts Secondary odontoblasts or
odontoblasts undifferentiated mesenchymal
cells of pulps
3. Location Found in all areas of dentin It is not uniform, mainly present Localized to only area of
over roof and floor of pulp chamber external stimulus
4. Orientation of tubules Regular Irregular Atubular
5. Rate of formation Rapid Slow Rapid between 1.5 µm to 3.5
µm/day depending on the stimuli
6. Permeability More Less Least

Functions of dentin
1. Provide strength to the tooth
2. Offers protection of pulp
Textbook of Operative Dentistry

3. Provides flexibility to the tooth

4. Affects the color of enamel
5. Defensive in action (initiating pulpal defence mechanism).

Clinical Considerations of Dentin

1. As dentin is known to provide strength and rigidity
to the tooth, care should be taken during tooth
preparation.
2. Tooth preparations should be done under constant air
water spray to avoid build up of heat formation which,
in further, damages dental pulp.
3. Dentinal tubules are composed of odontoblastic
processes and dentinal fluid. The dehydration of Fig. 3.9: Diagram showing fluid movement in dentinal
dentin by air blasts causes outward fluid movement tubules resulting in dentin hypersensitivity
and stimulates the mechanoreceptor of the
24 odontoblast, resulting in dentinal sensitivity (Fig. 3.9). has to be removed or modified. This can be done by
4. Dentin should always be protected by liners, bases or etching or conditioning.
dentin bonding agents. 6. Etching of dentin causes removal of smear layer and
5. When tooth is cut, considerable quantities of cutting etching of intertubular and peritubular dentin for
debris made up of small particles of mineralized micromechanical bonding.
collagen matrix are formed. This forms a layer on 7. Restoration should be well adapted to the preparation
enamel of dentin called smear layer for bonding of walls so as to prevent microleakage and thus damage
restorative materials to tooth structure, this smear layer to underlying dentin/pulp.
DENTAL PULP Odontoblastic Layer

The dental pulp is soft tissue of mesenchymal origin Odontoblasts consist of cell bodies and their cytoplasmic
located in the center of the tooth. It consists of specialized processes. The odontoblastic cell bodies form the
cells, odontoblasts arranged peripherally in direct contact odontoblastic zone whereas the odontoblastic processes
with dentin matrix. This close relationship between are located within predentin matrix. Capillaries, nerve
fibers and dendritic cells may be found around the
odontoblasts and dentin is known as ‘Pulp – dentin
odontoblasts in this zone.
complex”. The pulp is connective tissue system composed
of cells, ground substances, fibers, interstitial fluid, Cell Free Zone of Weil
odontoblasts, fibroblasts and other cellular components.
Central to odontoblasts is subodontoblastic layer, termed
Pulp is actually a microcirculatory system consists of
as cell free zone of Weil. It contains plexuses of capillaries
arterioles and venules as the largest vascular component.
and fibers ramification of small nerve.
Due to lack of true collateral circulation, pulp is
dependent upon few arterioles entering through the Cell Rich Zone
foramen. Due to presence of the specialized cells, i.e.
This zone lies next to subodontoblastic layer. It contains
odontoblasts as well as other cells which can differentiate
fibroblasts, undifferentiated cells which maintain number
into hard tissue secreting cells. The pulp retains its ability
of odontoblasts by proliferation and differentiation.
to form dentin throughout the life. This enables the vital
pulp to partially compensate for loss of enamel or dentin Contents of pulp
occurring with age.
1. Cells
a. Odontoblasts
Histology of Dental Pulp b. Fibroblasts
c. Undifferentiated mesenchymal cells
Basically the pulp is divided into the central and the d. Defense cells • Macrophages
peripheral region. The central region of both coronal and • Plasma cells
radicular pulp contains nerves and blood vessels. • Mast cells
The peripheral region contains the following zones 2. Matrix
a. Collagen fibers • Types I and II
(Fig. 3.10): b. Ground • Glycosaminoglycans
a. Odontoblastic layer substance • Glycoproteins
b. Cell free zone of Weil • Water
c. Cell rich zone. 3. Blood vessels • Arterioles, Venules, Capillaries
4. Lymphatics • Draining to submandibular,
submental and deep cervical
nodes

Structure of Teeth
5. Nerves • Subodontoblastic plexus of
Rashkow
• Sensory afferent from Vth nerve
and superior cervical ganglion

Structural or Cellular Elements

1. Odontoblasts: They are first type of cells encountered
as pulp is approached from dentin. The number of
odontoblasts has been found in the range of 59,000 to
76,000 per square millimeter in coronal dentin with a 25
lesser number in root dentin. In the crown of the fully
developed tooth, the cell bodies of odontoblasts are
columnar and measure approximately 500 µm in
height, whereas in the midportion of the pulp, they
are more cuboid and in aptical part, more flattened.
Ultrastructure of the odontoblast shows (Fig. 3.11)
Fig. 3.10: Diagram showing different zones of dental pulp large nucleus which may contain up to 4 nucleoli.
 in the coronal portion of the pulp, where they form
the cell-rich zone. These are spindle shaped cells which
secrete extracellular components like collagen and
ground substance (Fig. 3.12). They also eliminate
excess collagen by action of lysosomal enzymes.
3. Undifferentiated mesenchymal cells: Undifferentiated
mesenchymal cells are descendants of undifferentiated
cells of dental papilla which can dedifferentiate and
then redifferentiate into many cells types.
4. Defence cells (Fig. 3.13):
a. Histiocytes and macrophages: They originate from
undifferentiated mesenchymal cells or monocytes.
They appear as large oval or spindle shaped cells
which are involved in the elimination of dead cells,
debris, bacteria and foreign bodies, etc.
b. Polymorphonuclear leukocytes: Most common form of
Fig. 3.11: Diagram showing odontoblasts leukocyte is neutrophil, though it is not present in
healthy pulp. They are major cell type in micro
abscesses formation and are effective at destroying
Nucleus is situated at basal end. Golgibodies is located
and phagocytising bacteria and dead cells.
centrally. Mitochondria, rough endoplasmic reticulum
(RER), ribosome are also distributed throughout the
cell body.
Odontoblasts synthesize mainly type I collagen,
proteoglycans. They also secrete sialoproteins, alkaline
phosphatase, phosphophoryn (phosphoprotein
involved in extracellular mineralizations).
Irritated odontoblast secretes collagen, amorphous
Textbook of Operative Dentistry

material and large crystals into tubule lumen which

result in dentin permeability to irritating substance.
2. Fibroblasts: The cells found in greatest numbers in the
pulp are fibroblasts. These are particularly numerous Fig. 3.12: Histology of pulp showing fibroblasts

26

Fig. 3.13: Cells taking part in defence of pulp

 c. Lymphocytes: In normal pulps, mainly T-lymphocytes Pulp Chamber
are found. They are associated with injury and
It reflects the external form of enamel at the time of
resultant immune response. eruption, but anatomy is less sharply defined. The roof
d. Mast cells: On stimulation, degranulation of mast of pulp chamber consists of dentin covering the pulp
cells release histamine which causes vasodilatation, chamber occlusally.
increased vessel permeability and thus allowing
fluids and leukocytes to escape. Root Canal
It is that portion of pulp preparation which extends from
Extracellular Components canal orifice to the apical foramen. The shape of root canal
The extracellular components include fibers and the varies with size, shape, number of the roots in different
ground substance of pulp: teeth.
The apical foramen is an aperture at or near the apex
Fibers of a root through which nerves and blood vessels of the
pulp enter or leave the pulp cavity.
The fibers are principally type I and type III collagen.
Collagen is synthesized and secreted by odontoblasts and Functions of Pulp
fibroblasts.
The pulp lives for dentin and the dentin lives by the grace
Ground Substance of the pulp.
It is a structureless mass with gel like consistency forming Pulp performs four basic functions, i.e.:
bulk of pulp. 1. Formation of dentin
Components of ground substance are: 2. Nutrition of dentin
1. Glycosaminoglycans 3. Innervation of tooth
2. Glycoproteins 4. Defense of tooth.
3. Water.
Formation of Dentin
Functions of ground substance:
1. Forms the bulk of the pulp. It is primary function of pulp both in sequence and
2. Supports the cells. importance. Odontoblasts are differentiated from the
3. Acts as medium for transport of nutrients from the dental papilla adjacent to the basement membrane of
enamel organ which later deposits dentin. Pulp primarily
vasculature to the cells and of metabolites from the
helps in:
cells to the vasculature.
• Synthesis and secretion of organic matrix.
• Initial transport of inorganic components to newly
Anatomy of Dental Pulp
formed matrix.

Structure of Teeth
Pulp lies in the center of t ooth and shapes itself to • Creates an environment favorable for matrix
miniature form of tooth. This space is called pulp mineralization.
cavity which is divided into pulp chamber and root canal
(Fig. 3.14). Nutrition of Dentin
Nutrients exchange across capillaries into the pulp
interstitial fluid, which in turn travels into the dentin
through the network of tubules created by the
odontoblasts to contain their processes.

Innervation of Tooth
27
Through the nervous system, pulp transmits sensations
mediated through enamel or dentin to the higher nerve
centers. Pulp transmits pain, also senses temperature and
touch.

Defense of Tooth
Odontoblasts form dentin in response to injury
Fig. 3.14: Diagrammatic representation of pulp cavity
particularly when original dentin thickness has been
 compromised as in caries, attrition, trauma or restorative Physiologic Changes
procedure.
• Decrease in dentin permeability provides protected
environment for pulp-reduced effect of irritants.
Age Changes in Pulp
• Possibility of reduced ability of pulp to react to irritants
Pulp like other connective tissues, undergoes changes and repair itself.
with time. Pulp can show changes in appearance
(morphogenic) and in function (physiologic). PERIRADICULAR TISSUE
Periradicular tissue consists of cementum, periodontal
Morphologic Changes
ligament and alveolar bone (Fig. 3.17).
• Continued deposition of intratubular dentin-
reduction in tubule diameter.
• Reduction in pulp volume due to increase in secondary
dentin deposition (Fig. 3.15).
• Presence of dystrophic calcification and pulp stones
(Fig. 3.16).
• Decrease in sensitivity.
• Reduction in number of blood vessels.
Textbook of Operative Dentistry

Fig. 3.17: Diagram showing cementum periodontal

ligament and alveolar bone

Fig. 3.15: Reduced volume of pulp cavity

because of secondary dentin deposition
Cementum
Cementum can be defined as hard, avascular connective
tissue that covers the roots of the teeth. It is light yellow
in color and can be differentiated from enamel by its lack
of luster and darker hue. It is very permeable to dyes
and chemical agents, from the pulp canal and the external
root surface.
Cementum consists of approximately 45 to 50 percent
inorganic matter and 50 to 55 percent organic matter and
28 water by weight. It is softer than dentin. Sharpey’s fibers,
which are embedded in cementum and bone, are the
principal collagenous fibers of periodontal ligament.

Composition
• Inorganic content—45-50% (by wt.)
• Organic matter—50-55% (by wt.)
• Water
Fig. 3.16: Diagrammatic representation of pulp stones
Types
There are two main types of root cementum
1. Acellular (Primary)
2. Cellular (Secondary)
1. Acellular cementum
a. Covers the cervical third of the root.
b. Formed before the tooth reaches the occlusal plane.
c. As the name indicates, it does not contain cells.
d. Thickness is in the range of 30-230 µm.
e. Abundance of sharpey’s fibers.
f. Main function is anchorage.
2. Cellular cementum
a. Formed after the tooth reaches the occlusal plane.
b. It contains cells.
c. Less calcified than acellular cementum.
d. Sharpey’s fibers are present in lesser number as Fig. 3.18: Diagrammatic representation of
compared to acellular cementum. periodontal ligament fibers
e. Mainly found in apical third and interradicular.
f. Main function is adaptation.
Transeptal fibers: These fibers run from the cementum
Periodontal Ligament
of one tooth to the cementum of another tooth crossing
Periodontal ligament is a unique structure as it forms a over the alveolar crest.
link between the alveolar bone and the cementum. It is
Apical fibers: These fibers are present around the root
continuous with the connective tissue of the gingiva and
apex.
communicates with the marrow spaces through vascular
channels in the bone. Periodontal ligament houses the Interradicular fibers: Present in furcation areas of
fibers, cells and other structural elements like blood multirooted teeth.
vessels and nerves. Apart from the principal fibers, oxytalan and elastic
The periodontal ligament comprises of the following fibers are also present.
components:
I. Periodontal fibers Cells
II. Cells The cells present in periodontal ligament are:
III. Blood vessels a. Fibroblast

Structure of Teeth
IV. Nerves b. Macrophages
c. Mast cells
Periodontal Fibers (Fig. 3.18) d. Neutrophil
The most important component of periodontal ligament e. Lymphocytes
is principal fibers. These fibers are composed mainly of f. Plasma cells
collagen type I while reticular fibers are collagen type g. Epithelial cells rests of Mallassez.
III. The principal fibers are present in six arrangements.
Nerve Fibers
Horizontal group: These fibers are arranged horizontally
emerging from the alveolar bone and attached to the root The nerve fibers present in periodontal ligament, is either
cementum. of myelinated or non-myelinated type. 29
Alveolar crest group: These fibers arise from the alveolar Blood Vessels
crest in fan-like manner and attach to the root cementum.
These fibers prevent the extrusion of the tooth. The periodontal ligament receives blood supply from the
gingival, alveolar and apical vessels.
Oblique fibers: These fibers make the largest group in
the periodontal ligament. They extend from cementum Functions:
to bone obliquely. They bear the occlusal forces and • It supports the tooth and is suspended in alveolar
transmit them to alveolar bone. socket.
 • This tissue has very rich blood supply. So, it supplies Cells and Intercellular Matrix
nutrients to adjoining structures such as cementum,
1. Cells present in bone are:
bone and gingiva by way of blood vessels.
a. Osteocytes
• It also provides lymphatic drainage.
• These fibers perform the function of protection b. Osteoblasts
absorbing the occlusal forces and transmitting to the c. Osteoclasts
underlying alveolar bone. 2. Intercellular matrix: Bone consists of two-third
• The cells of PDL help in formation of surrounding inorganic matter and one third organic matter.
structures such as alveolar bone and cementum. Inorganic matter is composed mainly of minerals
• The resorptive function is also accomplished with the calcium and phosphate along with hydroxyapatite,
cells like osteoclasts, cementoclasts and fibroblasts carbonate, citrate etc. while organic matrix is composed
provided by periodontal ligament. mainly of collagen type I (90%).
Bone consists of two plates of compact bone
Functions of Periodontal Ligament
separated by spongy bone in between. In some area,
1. Supportive there is no spongy bone. The spaces between
2. Nutritive trabeculae of spongy bone are filled with marrow
3. Provides lymphatic drainage
which consists of hemopoitic tissue in early life and
4. Protective
fatty tissue latter in life. Bone is a dynamic tissue
5. Formative
continuously forming and resorbing in response to
6. Resorptive function is accomplished with cells like
functional needs. Both local as well as hormonal factors
osteoclasts and cementoclasts.
play an important role in metabolism of bone. In
Alveolar Bone healthy conditions, the crest of alveolar bone lies
Bone is specialized connective tissue which comprises of approximately 2-3 mm apical to the cemento-enamel
inorganic phases that is very well designed for its role as junction but it comes to lie more apically in periodontal
load bearing structure of the body. diseases. In periapical diseases, it gets resorbed easily.
Textbook of Operative Dentistry

30
 Chapter
4 Physiology of TTooth
ooth Form

FUNCTIONS OF TEETH • Interproximal Spaces

• Mastication • Proximal Contact Areas
• Speech • Trauma from Occlusion (TFO)
• Aesthetics OCCLUSION AND OPERATIVE DENTISTRY
• Protection of Supporting Tissues • Definitions
PHYSIOLOGY OF TOOTH FORM • Centric Relation
• Gingiva • Angle’s Classification for Interarch Relationship
• Preservation of the Periodontium • Occlusal Schemes
• Contour • Various Mandibular Movements During Function
• Height of Epithelial Attachment • Features of an Ideal Occlusion
• Marginal Ridge • Factors of Occlusion Affecting Operative Dentistry
• Embrasures • Interarch Tooth Relationships

As we have already discussed that there are different

types of teeth (incisors, canines, premolars and molars)
which have specific form to perform their functions. In
general, teeth perform different functions viz;
mastication, aesthetics, speech and protection. To perform
all these functions to the optimal level, teeth should have
normal form and proper alignment (Fig. 4.1). Form and
alignment of anterior as well as posterior teeth helps in
articulation of sounds which has an important effect on
phonetics.
For aesthetics, anterior teeth also need to have proper
form and alignment. Similarly proper form and Fig. 4.1: Maxillary and mandibular arches
alignment of teeth help in maintenance of teeth in dental showing teeth in proper alignment
 arches along with the development and the protection of
the periodontium which support them. Therefore, we
should always make an effort to make dental restoration
that would comply with normal form and alignment for
periodontal physiology and health.

FUNCTIONS OF TEETH
1. Mastication
2. Speech
3. Aesthetics
Fig. 4.2: Diagrammatic representation of normal gingiva
4. Protection

Mastication Attached Gingiva

Teeth play an important part during mastication of food. It is continuous with marginal gingiva. It is usually firm,
Every class of teeth serves different functions in the arch. resilient and tightly bound to underlying periosteum of
For example: alveolar bone. The width of attached gingiva vary in
a. Incisors Cutting and shearing different areas of the oral cavity. It is greatest in the incisor
b. Canines Tearing region (3.5-4.5 mm in maxilla, 3.3-3.9 mm in mandible)
c. Premolars and molars Grinding and narrower in posterior segments.

Gingival Sulcus/Crevice
Speech
Gingival sulcus is the sulcus present between the free
Teeth are important in pronunciation of certain sounds
gingiva and tooth. It is lined with sulcular epithelium
and thus play vital role during speech. which is not keratinized. It extends from free gingival
margin to functional epithelium. The average depth of
Aesthetics
gingival sulci is about 1.8 mm.
The form, alignment and contour of anterior teeth has The health of periodontal tissue is one of the important
Textbook of Operative Dentistry

been considered to play important role in maintaining aspect in restorative dentistry. It is important to note that
aesthetics of face. margins of restorations should be placed supragingivally
to preserve the gingival health.
Protection of Supporting Tissues
Preservation of the Periodontium
Teeth also helps in protection of certain supporting tissues
such as gingiva, periodontium and alveolar bone Periodontal health should be optimal before placement
of dental restoration. Adequate time should be given after
scaling and root planning. Surface gingival appearance
PHYSIOLOGY OF TOOTH FORM
and health depends on adequate supragingival plaque
Before going into detailed description of this topic, we control.
should have an idea about normal periodontium. Desirable characteristics of gingival health prior to
restorative procedure are:
Gingiva 1. There should be thin gingival margin closely adapted
Gingiva covers the cervical potion of the crown (Fig. 4.2). to enamel.
Anatomically gingiva is divided into 3 parts: 2. Color of gingival tissue should be uniform pale pink.
32 • Marginal or unattached gingiva 3. Gingival tissue should be firm and dense
• Attached gingiva 4. No bleeding on touching/probing
• Gingival sulcus or crevice. Long term success of restoration and preservation of
periodontium depends upon following factors:
Marginal/Unattached Gingiva
Contour
It is border of gingiva encircling the tooth in collar like
fashion. It can be differentiated from attached gingiva A prominent contour present on the crowns of teeth(on
by free gingival groove. mesial, distal, buccal and lingual surfaces) is of essential
importance as it protects the gingival tissue against
bruising and trauma from food. It also prevents the food
being packed into gingival sulcus (Fig. 4.3).
All protective contours are most functional when the
teeth are in proper alignment. The buccal and lingual
surfaces of tooth possess some degree of convexity. This
convexity is generally located at:
• Cervical third of facial surfaces (all teeth)
• Cervical third of lingual surfaces (anterior teeth) Fig. 4.5: Undercontoured tooth showing food
• Middle third of lingual surfaces (posterior teeth). impaction and irritation to gingiva
The type of curvature determines the direction in
which the food would be passed either in buccal Height of Epithelial Attachment
vestibular area or lingual area. There are two clinical
The epithelial attachment seals the soft tissue to the tooth.
conditions, usually seen in practice are:
This is unique system which is capable of adjusting
normal physiologic changes but vulnerable to physical/
pathological injury. The teeth may be injured by careless
probing during examination, improper sealing and in
tooth preparation techniques.
The height of normal gingival tissue, mesially and
distally on approximating teeth is directly dependent on
the heights of the epithelial attachment on these teeth.
Normal attachment of tissue follows the curvature of
cementoenamel junction if teeth are in normal alignment
and in contact (Fig. 4.6).
The extent of curvature usually depends upon two
Fig. 4.3: Diagram showing normal contour of a main factors:
tooth helping in stimulation of gingiva 1. Location of contact area above the crown cervix
2. Diameter of crown faciolingually or buccolingually.
Usually crowns of anterior teeth show greatest
Overcontouring: This type of contouring is considered
curvature while premolars and molars have rather
more health hazard to periodontal tissues than under

Physiology of Tooth Form

uniform but slight curvatures. To avoid possibility of
contouring as it enhances the supragingival and
injuring the mesial and distal periodontal attachment
subgingival plaque accumulation at the overcontoured
during tooth preparation, height of attachment must be
crowns (Fig. 4.4). These are commonly seen in
ascertained by careful probing and by the continuous
interproximal restorations, cast restorations and pontics.
observation of landmarks during the operation.

33
Fig. 4.4: Diagram showing overcontoured surface deflecting
the food away from gingiva resulting in its understimulation

Under-contouring (Fig. 4.5): It means too little contouring.

Important consequences of under-contouring are food
impaction and trauma to attachment apparatus. Fig. 4.6: Height of epithelial attachment
 Marginal Ridges
Marginal ridges are defined as rounded borders of
enamel which form the mesial and distal margins of
occlusal surfaces of premolars and molars and mesial and
distal margins of lingual surfaces of the incisors and
canines (Fig. 4.7).
Significance of marginal ridges
1. Help in balancing of teeth in both the arches
2. Improve the efficiency of mastication
3. Prevent food impaction in interproximal areas.
Fig. 4.8A: Correct embrasure resulting in
In restorative dentistry, marginal ridges should be stimulation of supporting tissues
restored in two planes, i.e. buccolingually and cervico-
occlusally and also restore adjacent marginal ridges at
the same height.

Fig. 4.8B: Improper contour of restoration

Textbook of Operative Dentistry

Fig. 4.7: Photograph showing marginal ridges resulting in improper embrasure form

Embrasures
When two teeth are in contact with each other, their In case embrasure size is decreased/absent, then
curvatures adjacent to contact areas form spillway spaces additional forces are created in teeth and supporting
called embrasures. (Figs 4.8A and B). In other words, structures during mastication.
embrasures can be defined as V-shaped spaces that If embrasure size is enlarged, they provide little
originate at proximal contact areas between adjacent teeth protection to supporting structures as food is being forced
and are named for the direction towards which they into interproximal space by opposing cusp.
radiate. These are:
i. Labial/buccal and lingual embrasures: These are Interproximal Spaces
spaces that widen out from the area of contact
labially or buccally and lingually. Interproximal space is triangular shaped area that is
ii. Incisal/occlusal embrasures: These are spaces that usually filled by gingival tissue. In this triangular area,
widen out from area of contact incisally/occlusally. the base is formed by alveolar process, the sides are
iii. Gingival emrasure: These are the spaces that widen proximal surfaces of contacting teeth and apex is area of
out from the area of contact gingivally. contact. This area usually varies with the form of teeth in
34 contact and also depends upon relative position of contact
Functions of Embrasure areas.
1. Provides a spillway for food during mastication
Proximal Contact Areas
2. Prevents food to being forced through contact area.
The correct relationships of embrasures, marginal The periodontal importance of proximal contact areas
ridges, contours, grooves of adjacent and opposing teeth was first observed by Hirschfeld long ago. Each tooth in
provide for escape of food from the occlusal surfaces the arch has two contacting members adjoining it, one
during mastication. on mesial side and other on distal side (Fig. 4.9). Except
 Fig. 4.9: Contact areas of teeth are usually located at
junction of incisal and middle third

third molar, positive contact relation should take mesially

and distally of one tooth with another in each arch.

Advantages of Proper Contact Relation Fig. 4.11: Labiolingual contour

1. Stabilize the dental arches by combined anchorage

Improper proximal contact area can result in:
effect of all the teeth.
i. Food impaction
2. Serves to keep food away from packing between the
ii. Periodontal disease
teeth.
iii. Carious lesions
3. Protect interdental papillae.
iv. Mobility of teeth.
Proximal contact area denotes area of proximal height
of contour of the mesial or distal surface of a tooth that
Trauma from Occlusion (TFO)
contacts its adjacent tooth in the same arch. In maxillary
and mandibular central incisors, the proximal contact Periodontal tissue injury caused by repeated occlusal
area is located in incisal third. Proceeding posteriorly forces that exceeds the physiological limits of tissue
from the incisor region through all remaining teeth, tolerance is called trauma from occlusion (TFO).
proximal contact area lies near the junction of incisal and
Types of Trauma from Occlusion
middle third or in middle third.
Proximal contact areas must be observed from two 1. Types of trauma from occlusion based on etiology.
different aspects: i. Primary trauma from occlusion—usually results
1. Labial/buccal aspect when occlusion is primary etiological factor.

Physiology of Tooth Form

2. Incisal/occlusal aspect For example,
a. Insertion of new restoration placed above the line
Labial/buccal aspect: It shows the relative position of
of occlusion
contact area cervicoincisally or cervico-occlusally
b. Movement or extrusion of teeth into spaces
(Fig. 4.10).
created by unreplaced missing tooth
Incisal/occlusal aspect (Fig. 4.11): It shows the relative ii. Secondary trauma from occlusion—usually results
position of contact area labiolingually or bucccolingually. when excessive force is applied on a tooth with bone
loss and inadequate alveolar bone support.
2. Type of trauma from occlusion based on chronicity.
i. Acute—usually results from abrupt change in
occlusal biting such as on hard object or placement
of new restoration high above the occlusal line
ii. Chronic—usually results from gradual change in
occlusion such as attrition, extrusion of teeth, 35
parafunctional habits such as bruxism.
The periodontium tries to accommodate the forces
exerted on the crown of tooth. The adaptive capacity of
periodontium may vary from one person to another and
may be different in different tooth at same time.
When the magnitude of occlusal force exceed the tissue
Fig. 4.10: Cervicoocclusal contour injury results.
Other documents randomly have
different content
 Against the first kind of argument, as formulated by Moses
Mendelssohn, Kant advances the objection that, although we may
deny the soul extensive quantity, division into parts, yet we cannot
refuse to it intensive quantity, degrees of reality; and consequently
its existence may be terminated not by decomposition, but by
gradual diminution of its powers (or to use the term he coined for
the purpose, by elanguescence). This denial of any reasonable
ground for belief in immortality in the Critique of Pure Reason
(Transcendental Dialectic, bk. ii. ch. i.) is, however, not his last word
on the subject. In the Critique of the Practical Reason (Dialectic, ch.
i. sec. iv) the immortality of the soul is shown to be a postulate.
Holiness, “the perfect accordance of the will with the moral law,”
demands an endless progress; and “this endless progress is only
possible on the supposition of an endless duration of the existence
and personality of the same rational being (which is called the
immortality of the soul).” Not demonstrable as a theoretical
proposition, the immortality of the soul “is an inseparable result of
an unconditional a priori practical law.” The moral interest, which is
so decisive on this question in the case of Kant, dominates Bishop
Butler also. A future life for him is important, because our happiness
in it may depend on our present conduct; and therefore our action
here should take into account the reward or punishment that it may
bring on us hereafter. As he maintains that probability may and
ought to be our guide in life, he is content with proving in the first
chapter of the Analogy that “a future life is probable from similar
changes (as death) already undergone in ourselves and in others,
and from our present powers, which are likely to continue unless
death destroy them.” While we may fear this, “there is no proof that
it will, either from the nature of death,” of the effect of which on our
powers we are altogether ignorant, “or from the analogy of nature,
which shows only that the sensible proof of our powers (not the
powers themselves) may be destroyed.” The imagination that death
will destroy these powers is unfounded, because (1) “this supposes
we are compounded, and so discerptible, but the contrary is
probable” on metaphysical grounds (the indivisibility of the subject in
which consciousness as indivisible inheres, and its distinction from
the body) and also experimental (the persistence of the living being
in spite of changes in the body or even losses of parts of the body);
(2) this also assumes that “our present living powers of reflection”
must be affected in the same way by death “as those of sensation,”
but this is disproved by their relative independence even in this life;
(3) “even the suspension of our present powers of reflection” is not
involved in “the idea of death, which is simply dissolution of the
body,” and which may even “be like birth, a continuation and
perfecting of our powers.” “Even if suspension were involved, we
cannot infer destruction from it” (analysis of chapter i. in Angus’s
edition). He recognizes that “reason did, as it well might, conclude
that it should finally, and upon the whole, be well with the righteous
and ill with the wicked,” but only “revelation teaches us that the next
state of things after the present is appointed for the execution of
this justice” (ch. ii. note 10). He does not use this general
anticipation of future judgment, as he might have done, as a positive
argument for immortality.

Adam Ferguson (Institutes of Moral Philosophy, p. 119, new ed.,

1800) argues that “the desire for immortality is an instinct, and can
reasonably be regarded as an indication of that which the author of
this desire wills to do.” From the standpoint of modern science John
Fiske confirms the validity of such an argument; for what he affirms
in regard to belief in the divine is equally applicable to this belief in a
future life. “If the relation thus established in the morning twilight of
man’s existence between the human soul and a world invisible and
immaterial is a relation of which only the subjective term is real and
the objective term is non-existent; then I say it is something utterly
without precedent in the whole history of creation” (Through Nature
to God, 1899, p. 188, 189). Whatever may have been Hegel’s own
belief in regard to personal immortality, the logical issue of his
absolute idealism has been well stated by W. Windelband (History of
Philosophy, p. 633). “It became clear that in the system of perpetual
Becoming and of the dialectical passing over of all forms into one
another, the finite personality could scarcely raise a plausible claim
to the character of a substance and to immortality in the religious
sense.” F. D. Schleiermacher applies the phrase “the immortality of
religion” to the religious emotion of oneness, amid finitude, with the
infinite and, amid time, with the eternal; denies any necessary
connexion between the belief in the continuance of personal
existence and the consciousness of God; and rests his faith on
immortality altogether on Christ’s promise of living fellowship with
His followers, as presupposing their as well as His personal
immortality. A. Schopenhauer assigns immortality to the universal
will to live; and Feuerbach declares spirit, consciousness eternal, but
not any individual subject. R. H. Lotze for the decision of the
question lays down the broad principle, “All that has once come to
be will eternally continue so soon as for the organic unity of the
world it has an unchangeable value, but it will obviously again cease
to be, when that is not the case” (Gr. der Psy. p. 74).

Objections to the belief in immortality have been advanced from

the standpoints of materialism, naturalism, pessimism and
pantheism. Materialism argues that, as life depends on a material
organism, thought is a function of the brain, and the soul is but the
sum of mental states, to which, according to the theory of
psychophysical parallelism, physical changes always correspond;
therefore, the dissolution of the body carries with it necessarily the
cessation of consciousness. That, as now constituted, mind does
depend on brain, life on body, must be conceded, but that this
dependence is so absolute that the function must cease with the
organ has not been scientifically demonstrated; the connexion of the
soul with the body is as yet too obscure to justify any such
dogmatism. But against this inference the following considerations
may be advanced: (1) Man does distinguish himself from his body;
(2) he is conscious of his personal identity, through all the changes
of his body; (3) in the exercise of his will he knows himself not
controlled by but controlling his body; (4) his consciousness
warrants his denying the absolute identification of himself and his
body. It may further be added that materialism can be shown to be
an inadequate philosophy in its attempts to account even for the
physical universe, for this is inexplicable without the assumption of
mind distinct from, and directive of, matter. The theory of
psychophysical parallelism has been subjected to a rigorous
examination in James Ward’s Naturalism and Agnosticism, part iii., in
which the argument that mind cannot be derived from matter is
convincingly presented. Sir Oliver Lodge in his reply to E. Haeckel’s
Riddle of the Universe maintains that “life may be something not
only ultra-terrestrial, but even immaterial, something outside our
present categories of matter and energy; as real as they are, but
different, and utilizing them for its own purpose” (Life and Matter,
1906, p. 198). He rejects the attempt to explain human personality
as “generated by the material molecular aggregate of its own
unaided latent power,” and affirms that the “universe where the
human spirit is more at home than it is among these temporary
collocations of matter” is “a universe capable of infinite
development, of noble contemplation, and of lofty joy, long after this
planet—nay the whole solar system—shall have fulfilled its present
spire of destiny, and retired cold and lifeless upon its endless way”
(pp. 199-200).

In his lecture on Human Immortality (3rd ed., 1906), Professor

William James deals with “two supposed objections to the doctrine.”
The first is “the law that thought is a function of the brain.”
Accepting the law he distinguishes productive from permissive or
transmissive function (p. 32), and, rejecting the view that brain
produces thought, he recognizes that in our present condition brain
transmits thought, thought needs brain for its organ of expression;
but this does not exclude the possibility of a condition in which
thought will be no longer so dependent on brain. He quotes (p. 57)
with approval Kant’s words, “The death of the body may indeed be
the end of the sensational use of our mind, but only the beginning of
the intellectual use. The body would thus be not the cause of our
thinking, but merely a condition restrictive thereof, and, although
essential to our sensuous and animal consciousness, it may be
regarded as an impeder of our pure spiritual life” (Kritik der reinen
Vernunft, 2nd ed., p. 809).

Further arguments in the same direction are derived from the

modern school of psychical research (see especially F. W. H. Myers’
Human Personality, 1903).

Another objection is advanced from the standpoint of naturalism,

which, whether it issues in materialism or not, seeks to explain man
as but a product of the process of nature. The universe is so
immeasurably vast in extension and duration, and man is so small,
his home but a speck in space, and his history a span in time that it
seems an arrogant assumption for him to claim exemption from the
universal law of evolution and dissolution. This view ignores that
man has ideals of absolute value, truth, beauty, goodness, that he
consciously communes with the God who is in all, and through all,
and over all, that it is his mind which recognizes the vastness of the
universe and thinks its universal law, and that the mind which
perceives and conceives cannot be less, but must be greater than
the object of its knowledge and thought.

Pessimism suggests a third objection. The present life is so little

worth living that its continuance is not to be desired. James
Thomson (“B.V.”) speaks “of the restful rapture of the inviolate
grave,” and sings the praises of death and of oblivion. We cannot
admit that the history of mankind justifies his conclusion; for the
great majority of men life is a good, and its continuance an object of
hope.

For pantheism personal immortality appears a lesser good than

reabsorption in the universal life; but against this objection we may
confidently maintain that worthier of God and more blessed for man
is the hope of a conscious communion in an eternal life of the Father
of all with His whole family.

Lastly positivism teaches a corporate instead of an individual

immortality; man should desire to live on as a beneficent influence in
the race. This conception is expressed in George Eliot’s lines:

“O, may I join the choir invisible

Of those immortal dead who live again
In minds made better by their presence: live
In pulses stirred to generosity,
In deeds of daring rectitude, in scorn
For miserable aims that end with self,
In thoughts sublime that pierce the night like stars,
 And with their mild persistence urge man’s search
To vaster issues.”

But these possibilities are not mutually exclusive alternatives. A man

may live on in the world by his teaching and example as a power for
good, a factor of human progress, and he may also be continuing
and completing his course under conditions still more favourable to
all most worthy in him. Consciously to participate as a person in the
progress of the race is surely a worthier hope than unconsciously to
contribute to it as an influence; ultimately to share the triumph as
well as the struggle is a more inspiring anticipation.

In stating constructively the doctrine of immortality we must

assign altogether secondary importance to the metaphysical
arguments from the nature of the soul. It is sufficient to show, as
has already been done, that the soul is not so absolutely dependent
on the body, that the dissolution of the one must necessarily involve
the cessation of the other. Such arguments as the indivisibility of the
soul and its persistence can at most indicate the possibility of
immortality.

The juridical argument has some force; the present life does not
show that harmony of condition and character which our sense of
justice leads us to expect; the wicked prosper and the righteous
suffer; there is ground for the expectation that in the future life the
anomalies of this life will be corrected. Although this argument has
the support of such great names as Butler and Kant, yet it will repel
many minds as an appeal to the motive of self-interest.

The ethical argument has greater value. Man’s life here is

incomplete, and the more lofty his aims, the more worthy his
labours, the more incomplete will it appear to be. The man who lives
for fame, wealth, power, may be satisfied in this life; but he who
lives for the ideals of truth, beauty, goodness, lives not for time but
for eternity, for his ideals cannot be realized, and so his life fulfilled
on this side of the grave. Unless these ideals are mocking visions,
man has a right to expect the continuance of his life for its
completion. This is the line of argument developed by Professor
Hugo Münsterberg in his lecture on The Eternal Life (1905),
although he states it in the terms peculiar to his psychology, in
which personality is conceived as primarily will. “No endless duration
is our goal, but complete repose in the perfect satisfaction which the
will finds when it has reached the significance, the influence, and the
value at which it is aiming” (p. 83).

More general in its appeal still is the argument from the affections,
which has been beautifully developed in Tennyson’s In Memoriam.
The heart protests against the severance of death, and claims the
continuance of love’s communion after death; and as man feels that
love is what is most godlike in his nature, love’s claim has supreme
authority.

There is a religious argument for immortality. The saints of the

Hebrew nation were sure that as God had entered into fellowship
with them, death could not sever them from his presence. This is the
argument in Psalms xvi. and xvii., if, as is probable, the closing
verses do express the hope of a glorious and blessed immortality.
This too is the proof Jesus himself offers when he declares God to
be the God of the living and not of the dead (Matt. xxii. 32). God’s
companions cannot become death’s victims.

Josiah Royce in his lecture on The Conception of Immortality

(1900) combines this argument of the soul’s union with God with the
argument of the incompleteness of man’s life here:—
 “Just because God is One, all our lives have various and
unique places in the harmony of the divine life. And just because
God attains and wins and finds this uniqueness, all our lives win
in our union with Him the individuality which is essential to their
true meaning. And just because individuals whose lives have
uniqueness of meaning are here only objects of pursuit, the
attainment of this very individuality, since it is indeed real,
occurs not in our present form of consciousness, but in a life
that now we see not, yet in a life whose genuine meaning is
continuous with our own human life, however far from our
present flickering form of disappointed human consciousness
that life of the final individuality may be. Of this our true
individual life, our present life is a glimpse, a fragment, a hint,
and in its best moments a visible beginning. That this individual
life of all of us is not something limited in its temporal
expression to the life that now we experience, follows from the
very fact that here nothing final or individual is found expressed”
(pp. 144-146).

R. W. Emerson declares that “the impulse to seek proof of

immortality is itself the strongest proof of all.” We expect immortality
not merely because we desire it; but because the desire itself arises
from all that is best and truest and worthiest in ourselves. The desire
is reasonable, moral, social, religious; it has the same worth as the
loftiest ideals, and worthiest aspirations of the soul of man. The loss
of the belief casts a dark shadow over the present life. “No sooner
do we try to get rid of the idea of Immortality—than Pessimism
raises its head.... Human griefs seem little worth assuaging; human
happiness too paltry (at the best) to be worth increasing. The whole
moral world is reduced to a point. Good and evil, right and wrong,
become infinitesimal, ephemeral matters. The affections die away—
die of their own conscious feebleness and uselessness. A moral
paralysis creeps over us” (Natural Religion, Postscript). The belief
exercises a potent moral influence. “The day,” says Ernest Renan, “in
which the belief in an after-life shall vanish from the earth will
witness a terrific moral and spiritual decadence. Some of us perhaps
might do without it, provided only that others held it fast. But there
is no lever capable of raising an entire people if once they have lost
their faith in the immortality of the soul” (quoted by A. W. Momerie,
Immortality, p. 9). To this belief, many and good as are the
arguments which can be advanced for it, a confident certainty is
given by Christian faith in the Risen Lord, and the life and
immortality which he has brought to light in his Gospel.

In addition to the works referred to above, see R. K. Gaye,

The Platonic Conception of Immortality and its Connexion with
the Theory of Ideas (1904); R. H. Charles, A Critical History of
the Doctrine of a Future Life in Israel, in Judaism and in
Christianity (1899); E. Pétavel, The Problem of Immortality (Eng.
trans. by F. A. Freer, 1892); J. Fiske, The Destiny of Man, viewed
in the Light of his Origin (1884); G. A. Gordon, Immortality and
the New Theodicy (1897); Henry Buckle, The After Life (1907).
(A. E. G.*)

IMMUNITY (from Lat. immunis, not subject to a munus or public

service), a general term for exemption from liability, principally used
in the legal sense discussed below, but also in recent times in
pathology (for which see Bacteriology). In international law the term
(“not serving,” “not subject”) implies exemption from the jurisdiction
of the state which otherwise exercises jurisdiction where the
immunity arises. It is thus applied to the exceptional position
granted to sovereigns and chiefs of states generally, and their direct
representatives in the states to which they are accredited.

Under Exterritoriality is treated the inviolability of embassies and

legations and the application of the material side of the doctrine of
immunity. As a right appertaining to the persons of those who enjoy
it, the doctrine has grown out of the necessity for sovereigns of
respecting each other’s persons in their common interest. To be able
to negotiate without danger of arrest or interference of any kind with
their persons was the only condition upon which sovereigns would
have been able to meet and discuss their joint interests. With the
development of states as independent entities and of intercourse
between them and their “nationals,” the work of diplomatic missions
increased to such an extent that instead of having merely occasional
ambassadors as at the beginning, states found it expedient to have
resident representatives with a permanent residence. Hence the
sovereign’s inviolability becomes vested in the person of the
sovereign’s delegate, and with it as a necessary corollary the
exterritoriality of his residence. Out of the further expansion of the
work of diplomatic missions came duplication of the personnel and
classes of diplomatic secretaries, who as forming part of the
embassy or legation also had to be covered by the diplomatic
immunity.

In no branch of international intercourse have states shown so

laudable a respect for tradition as in the case of this immunity, and
this in spite of the hardship which frequently arises for private
citizens through unavoidable dealings with members of embassies
and legations. The Institute of International Law (see Peace) at their
Cambridge session in 1895 drew up the following rules,1 which may
be taken to be the only precise statement of theory on the subject,
for the guidance of foreign offices in dealing with it:—

Art. 1.—Public ministers are inviolable. They also enjoy

“exterritoriality,” in the sense and to the extent hereinafter
mentioned and a certain number of immunities.

Art. 2.—The privilege of inviolability extends: (1) To all classes

of public ministers who regularly represent their sovereign or
their country; (2) To all persons forming part of the official staff
of a diplomatic mission; (3) To all persons forming part of its
non-official staff, under reserve, that if they belong to the
country where the mission resides they only enjoy it within the
official residence.

Art. 3.—The government to which the minister is accredited

must abstain from all offence, insult or violence against the
persons entitled to the privilege, must set an example in the
respect which is due to them and protect them by specially
rigorous penalties from all offence, insult or violence on the part
of the inhabitants of the country, so that they may devote
themselves to their duties in perfect freedom.

Art. 4.—Immunity applies to everything necessary for the

fulfilment by ministers of their duties, especially to personal
effects, papers, archives and correspondence.

Art. 5.—It lasts during the whole time which the minister or
diplomatic official spends, in his official capacity, in the country
to which he has been sent.
 It continues even in time of war between the two powers
during the period necessary to enable the minister to leave the
country with his staff and effects.

Art. 6.—Inviolability cannot be claimed: (1) In case of

legitimate defence on the part of private persons against acts
committed by the persons who enjoy the privilege; (2) In case
of risks incurred by any of the persons in question voluntarily or
needlessly; (3) In case of improper acts committed by them,
provoking on the part of the state to which the minister is
accredited measures of defence or precaution; but, except in a
case of extreme urgency, this state should confine itself to
reporting the facts to the minister’s government, requesting the
punishment or the recall of the guilty agent and, if necessary, to
surrounding the official residence to prevent unlawful
communications or manifestations.

Immunity with Respect to Taxes.

Art. 11.—A public minister in a foreign country, functionaries

officially attached to his mission and the members of their
families residing with them, are exempt from paying: (1)
Personal direct taxes and sumptuary taxes; (2) General taxes on
property, whether on capital or income; (3) War contributions;
(4) Customs duties in respect of articles for their personal use.

Each government shall indicate the grounds (justifications) to

which these exemptions from taxation shall be subordinated.

Immunity from Jurisdiction.

 Art. 12.—A public minister in a foreign country, functionaries
officially attached to his mission and the members of their
families residing with them, are exempt from all jurisdiction, civil
or criminal, of the state to which they are accredited; in
principle, they are only subject to the civil and criminal
jurisdiction of their own country. A claimant may apply to the
courts of the capital of the country of the minister, subject to the
right of the minister to prove that he has a different domicile in
his country.

Art. 13.—With respect to crimes, persons indicated in the

preceding article remain subject to the penal laws of their own
country, as if they had committed the acts in their own country.

Art. 14.—The immunity attaches to the function in respect of

acts connected with the function. As regards acts done not in
connexion with the function, immunity can only be claimed so
long as the function lasts.

Art. 15.—Persons of the nationality of the country to the

government of which they are accredited cannot claim the
privilege of immunity.

Art. 16.—Immunity from jurisdiction cannot be invoked: (1) In

case of proceedings taken by reason of engagements entered
into by the exempt person, not in his official or private capacity,
but in the exercise of a profession carried on by him in the
country concurrently with his diplomatic functions; (2) In respect
of real actions, including possessory actions, relating to anything
movable or immovable in the country.

It exists even in case of a breach of the law which may

endanger public order or safety, or of crime against the safety of
 the state, without prejudice to such steps as the territorial
government may take for its own protection.

Art. 17.—Persons entitled to immunity from jurisdiction may

refuse to appear as witnesses before a territorial court on
condition that, if required by diplomatic intervention, they shall
give their testimony in the official residence to a magistrate of
the country appointed for the purpose.

Further questions connected with Immunity and Exterritoriality

(q.v.) arise out of the different industrial enterprises undertaken by
states, such as posts, telegraphs, telephones, railways, steamships,
&c., which require regulation to prevent conflicts of interest between
the state owners and the private interests involved in these
enterprises.
(T. Ba.)

1 The rules were drawn up in French. The author of this article is

responsible for the translation of them.

IMOLA (anc. Forum Cornelii), a town and episcopal see of Emilia,

Italy, in the province of Bologna, from which it is 21 m. S.E. by rail,
140 ft. above sea-level. Pop. (1901) 12,058 (town); 33,144
(commune). The cathedral of S. Cassiano has been modernized; it
possesses interesting reliquaries, and contains the tomb of Petrus
Chrysologus, archbishop of Ravenna (d. 451), a native of Imola. S.
Domenico has a fine Gothic portal and S. Maria in Regola an old
campanile. The town also contains some fine palaces. The
communal library has some MSS., including a psalter with
miniatures, that once belonged to Sir Thomas More. The citadel is
square with round towers at the angles; it dates from 1304, and is
now used as a prison. Imola has a large lunatic asylum with over
1200 inmates. Innocenzo Francucci (Innocenzo da Imola), a painter
of the Bolognese school (1494-1549), was a native of Imola, and
two of his works are preserved in the Palazzo del Comune. The
Madonna del Piratello, 2 m. outside the town to the N.W., is in the
early Renaissance style (1488); the campanile was probably built
from Bramante’s plans in 1506.

The ancient Forum Cornelii, a station on the Via Aemilia, is said by

Prudentius, writing in the 5th century a.d., to have been founded by
Sulla; but the fact that it belonged to the Tribus Pollia shows that it
already possessed Roman citizenship before the Social war. In later
times we hear little of it; Martial published his third book of epigrams
while he was there. In the Lombard period the name Imolas begins
to appear. In 1480, after a chequered history, the town came into
the possession of Girolamo Riario, lord of Forli, as the dowry of his
wife Caterina Sforza, and was incorporated with the States of the
Church by Caesar Borgia in 1500.

IMP (O. Eng. impa, a graft, shoot; the verb impian is cognate
with Ger. impfen, to graft, inoculate, and the Fr. enter; the ultimate
origin is probably the Gr. ἐμφύειν, to implant, cf. ἔμφυτος,
engrafted), originally a slip or shoot of a plant or tree used for
grafting. This use is seen in Chaucer (Prologue to the Monk’s Tale,
68) “Of fieble trees ther comen wrecched ympes.” The verb “to imp”
in the sense of “to graft” was especially used of the grafting of
feathers on to the wing of a falcon or hawk to replace broken or
damaged plumage, and is frequently used metaphorically. Like
“scion,” “imp” was till the 17th century used of a member of a family,
especially of high rank, hence often used as equivalent to “child.”
The New English Dictionary quotes an epitaph (1584) in the
Beauchamp chapel at Warwick, “Heere resteth the body of the noble
Impe Robert of Dudley ... sonne of Robert Erle of Leycester.” The
current use of the word for a small devil or mischievous sprite is due
to the expressions “imp of Satan, or of the devil or of hell,” in the
sense of “child of evil.” It was thus particularly applied to the
demons supposed to be the “familiar” spirits of witches.

IMPATIENS, in botany, a genus of annual or biennial herbs,

sometimes becoming shrubby, chiefly natives of the mountains of
tropical Asia and Africa, but also found widely distributed in the
north temperate zone and in South Africa. The flowers, which are
purple, yellow, pink or white and often showy, are spurred and
irregular in form and borne in the leaf-axils. The name is derived
from the fact that the seed-pod when ripe discharges the seeds by
the elastic separation and coiling of the valves. Impatiens Noli-me-
tangere, touch-me-not, an annual succulent herb with yellow
flowers, is probably wild in moist mountainous districts in north
Wales, Lancashire and Westmorland. I. Roylei, a tall hardy succulent
annual with rose-purple flowers, a Himalayan species, is common in
England as a self-sown garden plant or garden escape. I. Balsamina,
the common balsam of gardens, a well-known annual, is a native of
India; it is one of the showiest of summer and autumn flowers and
of comparatively easy cultivation. I. Sultani, a handsome plant, with
scarlet flowers, a native of Zanzibar, is easily grown in a greenhouse
throughout the summer, but requires warmth in winter.

IMPEACHMENT (O. Fr. empechement, empeschement, from

empecher or empescher, to hinder, Late Lat. impedicare, to entangle,
pedica, fetter, pes, foot), the English form of judicial parliamentary
procedure against criminals, in which the House of Commons are the
prosecutors and the House of Lords the judges. It differs from bills
of attainder (q.v.) in being strictly judicial. When the House of
Commons has accepted a motion for impeachment, the mover is
ordered to proceed to the bar of the House of Lords, and there
impeach the accused “in the name of the House of Commons, and of
all the Commons of the United Kingdom.” The charges are
formulated in articles, to each of which the accused may deliver a
written answer. The prosecution must confine itself to the charges
contained in the articles, though further articles may be adhibited
from time to time. The Commons appoint managers to conduct the
prosecution, but the whole House in committee attends the trial. The
defendant may appear by counsel. The president of the House of
Lords is the lord high steward, in the case of peers impeached for
high treason; in other cases the lord chancellor. The hearing takes
place as in an ordinary trial, the defence being allowed to call
witnesses if necessary, and the prosecution having a right of reply.
At the end of the case the president “puts to each peer, beginning
with the junior baron, the questions upon the first article, whether
the accused be guilty of the crimes charged therein. Each peer in
succession rises in his place when the question is put, and standing
uncovered, and laying his right hand upon his breast, answers,
‘Guilty’ or ‘Not guilty,’ as the case may be, ‘upon my honour.’ Each
article is proceeded with separately in the same manner, the lord
high steward giving his own opinion the last” (May’s Parliamentary
Practice, c. xxiii.). Should the accused be found guilty, judgment
follows if the Commons move for it, but not otherwise. The
Commons thus retain the power of pardon in their own hands, and
this right they have in several cases expressly claimed by resolution,
declaring that it is not parliamentary for their lordships to give
judgment “until the same be first demanded by this House.” Spiritual
peers occupy an anomalous position in the trial of peers, as not
being themselves ennobled in blood; on the impeachment of Danby
it was declared by the Lords that Spiritual peers have the right to
stay and sit during proceedings for impeachment, but it is customary
for them to withdraw before judgment is given, entering a protest
“saving to themselves and their successors all such rights in
judicature as they have by law, and by right ought to have.” An
impeachment, unlike other parliamentary proceedings, is not
interrupted by prorogation, nor even by dissolution. Proceedings in
the House of Commons preliminary to an impeachment are subject
to the ordinary rules, and in the Warren Hastings case an act was
passed to prevent the preliminary proceedings from discontinuance
by prorogation and dissolution. A royal pardon cannot be pleaded in
bar of an impeachment, though it is within the royal prerogative to
pardon after the lords have pronounced judgment. The point was
raised in the case of the earl of Danby in 1679, and the rule was
finally settled by the Act of Settlement. Persons found guilty on
impeachment may be reprieved or pardoned like other convicts.
Impeachment will lie against all kinds of crimes and misdemeanours,
and against offenders of all ranks. In the case of Simon de
Beresford, tried before the House of Lords in 1330, the House
declared “that the judgment be not drawn into example or
consequence in time to come, whereby the said peers may be
charged hereafter to judge others than their peers,” from which
Blackstone and others have inferred that “a commoner cannot be
impeached before the Lords for any capital offence, but only for high
misdemeanours.” In the case of Edward Fitzharris in 1681, the
House of Commons in answer to a resolution of the Lords
suspending the impeachment, declared it to be their undoubted right
“to impeach any peer or commoner for treason or any other crime or
misdemeanour.” And the House of Lords has in practice recognized
the right of the Commons to impeach whomsoever they will. The
procedure has, however, been reserved for great political offenders
whom the ordinary powers of the law might fail to reach. It has now
fallen into desuetude. The last impeachments were those of Warren
Hastings (1788-1795) and Lord Melville (1806), but an unsuccessful
attempt was made by Thomas C. Anstey to impeach Lord Palmerston
in 1848. The earliest recorded instances of impeachment are those
of Lord Latimer in 1376 and of Pole, earl of Suffolk, in 1386. From
the time of Edward IV. to Elizabeth it fell into disuse, “partly,” says
Hallam, “from the loss of that control which the Commons had
obtained under Richard II. and the Lancastrian kings, and partly
from the preference the Tudor princes had given to bills of attainder
or pains and penalties when they wished to turn the arm of
parliament against an obnoxious subject.” Revived in the reign of
James I., it became an instrument of parliamentary resistance to the
crown, and it was not unfrequently resorted to in the first three
reigns after the Revolution.

In the United States the procedure of impeachment both in the

national and in almost all of the state governments is very similar to
that described above. The national constitution prescribes that the
House of Representatives “shall have the sole power of
impeachment” and that “the Senate shall have the sole power to try
all impeachments.” The House appoints managers to conduct the
prosecution at the bar of the Senate, and the vote of the Senate is
taken by putting the question separately to each member, who,
during the trial, must be on oath or affirmation. In ordinary cases
the president or president pro tempore of the Senate presides, but
when the president of the United States is on trial the presiding
officer must be the chief justice of the United States Supreme Court.
A two-thirds vote is necessary for conviction. The president, vice-
president or any civil officer of the United States may be impeached
for “treason, bribery or other high crimes and misdemeanours,” and
if convicted, is removed from office and may be disqualified for
holding any office under the government in future. The officer after
removal is also “liable and subject to indictment, trial, judgment and
punishment, according to law.” The term “civil officers of the United
States” has been construed as being inapplicable to members of the
Senate and the House of Representatives. The president’s pardoning
power does not extend to officers convicted, on impeachment, of
offences against the United States. Since the organization of the
Federal government there have been only eight impeachment trials
before the United States Senate, and of these only two—the trials of
Judge John Pickering, a Federal District judge for the District of New
Hampshire, in 1803, on a charge of making decisions contrary to law
and of drunkenness and profanity on the bench, and of Judge W. H.
Humphreys, Judge of the Federal District Court of Tennessee, in
1863, on a charge of making a secession speech and of accepting a
judicial position under the Confederate Government—resulted in
convictions. The two most famous cases are those of Justice Samuel
Chase of the United States Supreme Court in 1805, and of President
Andrew Johnson, the only chief of the executive who has been
impeached, in 1868. There is a conflict of opinion with regard to the
power of the House to impeach a Federal officer who has resigned
his office, and also with regard to the kind of offences for which an
officer can be impeached, some authorities maintaining that only
indictable offences warrant impeachment, and others that
impeachment is warranted by any act highly prejudicial to the public
welfare or subversive of any essential principle of government. The
latter view was adopted by the House of Representatives when it
impeached President Johnson.

IMPERIAL CHAMBER (Reichskammergericht), the supreme

judicial court of the Holy Roman Empire, during the period between
1495 and the dissolution of the Empire in 1806. From the early
middle ages there had been a supreme court of justice for the
Empire—the Hofgericht (or curia imperatoris, as it were), in which
the emperor himself presided. By his side sat a body of assessors
(Urtheilsfinder), who must be at least seven in number, and who
might, in solemn cases, be far more numerous,1 the assessors who
acted varying from time to time and from case to case. The
Hofgericht was connected with the person of the emperor; it ceased
to act when he was abroad; it died with his death. Upon him it
depended for its efficiency; and when, in the 15th century, the
emperor ceased to command respect, his court lost the confidence
of his subjects. The dreary reign of Frederick III. administered its
deathblow and after 1450 it ceased to sit. Its place was taken by the
Kammergericht, which appeared side by side with the Hofgericht
from 1415, and after 1450 replaced it altogether. The king (or his
deputy) still presided in the Kammergericht and it was still his
personal court; but the members of the court were now officials—
the consiliarii of the imperial aula (or Kammer, whence the name of
the court). It was generally the legal members of the council who
sat in the Kammergericht (see under Aulic Council); and as they
were generally doctors of civil law, the court which they composed
tended to act according to that law, and thus contributed to the
“Reception” of Roman law into Germany towards the end of the 15th
century. The old Hofgericht had been filled, as it were, by amateurs
(provided they knew some law, and were peers of the person under
trial), and it had acted by old customary law; the Kammergericht, on
the contrary, was composed of lawyers, and it acted by the written
law of Rome. Even the Kammergericht, however, fell into disuse in
the later years of the reign of Frederick III.; and the creation of a
new and efficient court became a matter of pressing necessity, and
was one of the most urgent of the reforms which were mooted in
the reign of Maximilian I.
 This new court was eventually created in 1495; and it bore the
name of Reichskammergericht, or Imperial Chamber. It was
distinguished from the old Kammergericht by the essential fact that
it was not the personal court of the emperor, but the official court of
the Empire (or Reich—whence its name). This change was a natural
result of the peculiar character of the movement of reform which
was at this time attempted by the electors, under the guidance of
Bertold, elector of Mainz. Their aim was to substitute for the old and
personal council and court appointed and controlled by the emperor
a new and official council, and a new and official court, appointed
and controlled by the diet (or rather, in the ultimate resort, by the
electors). The members of the Imperial Chamber, which was created
by the diet in 1495 in order to serve as such a court,2 were therefore
the agents of the Empire, and not of the emperor. The emperor
appointed the president; the Empire nominated the assessors, or
judges.3 There were originally sixteen assessors (afterwards, as a
rule, eighteen): half of these were to be doctors of Roman law, while
half were to be knights; but after 1555 it became necessary that the
latter should be learned in Roman law, even if they had not actually
taken their doctorate.

Thus the Empire at last was possessed of a court, a court resting

on the enactment of the diet, and not on the emperor’s will; a court
paid by the Empire, and not by the emperor; a court resident in a
fixed place (until 1693, Spires, and afterwards, from 1693 to 1806,
Wetzlar), and not attached to the emperor’s person. The original
intention of the court was that it should repress private war (Fehde),
and maintain the public peace (Landfriede). The great result which
in the issue it served to achieve was the final “Reception” of Roman
law as the common law of Germany. That the Imperial Chamber
should itself administer Roman law was an inevitable result of its
composition; and it was equally inevitable that the composition and
procedure of the supreme imperial court should be imitated in the
various states which composed the Empire, and that Roman law
should thus become the local, as it was already the central, law of
the land.

The province of the Imperial Chamber, as it came to be gradually

defined by statute and use, extended to breaches of the public
peace, cases of arbitrary distraint or imprisonment, pleas which
concerned the treasury, violations of the emperor’s decrees or the
laws passed by the diet, disputes about property between immediate
tenants of the Empire or the subjects of different rulers, and finally
suits against immediate tenants of the Empire (with the exception of
criminal charges and matters relating to imperial fiefs, which went to
the Aulic Council). It had also cognizance in cases of refusal to do
justice; and it acted as a court of appeal from territorial courts in
civil and, to a small extent, in criminal cases, though it lost its
competence as a court of appeal in all territories which enjoyed a
privilegium de non appellando (such as, e.g. the territories of the
electors). The business of the court was, however, badly done; the
delay was interminable, thanks, in large measure, to the want of
funds, which prevented the maintenance of the proper number of
judges. In all its business it suffered from the competition of the
Aulic Council (q.v.); for that body, having lost all executive
competence after the 16th century, had also devoted itself
exclusively to judicial work. Composed of the personal advisers of
the emperor, the Aulic Council did justice on his behalf (the erection
of a court to do justice for the Empire having left the emperor still
possessed of the right to do justice for himself through his
consiliarii); and it may thus be said to be the descendant of the old
Kammergericht. The competition between the Aulic Council and the
Imperial Chamber was finally regulated by the treaty of Westphalia,
which laid it down that the court which first dealt with a case should
alone have competence to pursue it.

See R. Schröder, Lehrbuch der deutschen Rechtsgeschichte

(Leipzig, 1904); J. N. Harpprecht, Staatsarchiv des
Reichskammergerichts (1757-1785); and G. Stobbe,
Reichshofgericht und Reichskammergericht (Leipzig, 1878).
(E. Br.)

1 For instance, all the members of the diet might serve as

Urtheilsfinder in a case like the condemnation of Henry the Lion, duke of
Saxony, in the 12th century.

2 The attempt to create a new and official council ultimately failed.

3 More exactly, the emperor nominates, according to the regular

usage of later times, a certain number of members, partly as emperor,
and partly as the sovereign of his hereditary estates; while the rest, who
form the majority, are nominated partly by the electors and partly by the
six ancient circles.

IMPERIAL CITIES OR TOWNS, the usual English translation of

Reichsstädte, an expression of frequent occurrence in German
history. These were cities and towns subject to no authority except
that of the emperor, or German king, in other words they were
immediate; the earliest of them stood on the demesne land of their
sovereign, and they often grew up around his palaces. A distinction
was thus made between a Reichsstadt and a Landstadt, the latter
being dependent upon some prince, not upon the emperor direct.
The term Freie Reichsstadt, which is sometimes used in the same
sense as Reichsstadt, is rightly only applicable to seven cities, Basel,
Strassburg, Spires, Worms, Mainz, Cologne and Regensburg. Having
freed themselves from the domination of their ecclesiastical lords
these called themselves Freistädte and in practice their position was
indistinguishable from that of the Reichsstädte.

In the middle ages many other places won the coveted position of
a Reichsstadt. Some gained it by gift and others by purchase; some
won it by force of arms, others usurped it during times of anarchy,
while a number secured it through the extinction of dominant
families, like the Hohenstaufen. There were many more free towns
in southern than in northern Germany, but their number was
continually fluctuating, for their liberties were lost much more
quickly than they were gained. Mainz was conquered and subjected
to the archbishop in 1462. Some free towns fell into the hands of
various princes of the Empire and others placed themselves
voluntarily under such protection. Some, like Donauwörth in 1607,
were deprived of their privileges by the emperor on account of real,
or supposed, offences, while others were separated from the Empire
by conquest. In 1648 Besançon passed into the possession of Spain,
Basel had already thrown in its lot with the Swiss confederation,
while Strassburg, Colmar, Hagenau and others were seized by Louis
XIV.

Meanwhile the free towns had been winning valuable privileges in

addition to those which they already possessed, and the wealthier
among them, like Lübeck and Augsburg, were practically imperia in
imperio, waging war and making peace, and ruling their people
without any outside interference. But they had also learned that
union is strength. They formed alliances among themselves, both for
offence and for defence, and these Städtebünde had an important
influence on the course of German history in the 14th and 15th
centuries. These leagues were frequently at war with the
ecclesiastical and secular potentates of their district and in general
they were quite able to hold their own in these quarrels. The right of
the free towns to be represented in the imperial diet was formally
recognized in 1489, and about the same time they divided
themselves into two groups, or benches, the Rhenish and the
Swabian. By the peace of Westphalia in 1648 they were formally
constituted as the third college of the diet. A list drawn up in 1422
mentions 75 free cities, another drawn up in 1521 mentions 84, but
at the time of the French Revolution the number had decreased to
51. At this time the Rhenish free cities were: Cologne, Aix-la-
Chapelle, Lübeck, Worms, Spires, Frankfort-on-the-Main, Goslar,
Bremen, Hamburg, Mühlhausen, Nordhausen, Dortmund, Friedberg
and Wetzlar. The Swabian free cities were: Regensburg, Augsburg,
Nuremberg, Ulm, Esslingen, Reutlingen, Nördlingen, Rothenburg-on-
the-Tauber, Schwäbisch-Hall, Rottweil, Ueberlingen, Heilbronn,
Memmingen, Gmünd, Dinkelsbühl, Lindau, Biberach, Ravensburg,
Schweinfurt, Kempten, Windsheim, Kaufbeuern, Weil, Wangen, Isny,
Pfullendorf, Offenburg, Leutkirch, Wimpfen, Weissenburg, Giengen,
Gengenbach, Zell, Buchorn, Aalen, Buchau and Bopfingen. But a
large proportion of them had as little claim to their exceptional
positions as the pocket boroughs of Great Britain and Ireland had
before the passing of the Reform Bill of 1832.

By the peace of Lunéville in 1801 Cologne, Aix-la-Chapelle, Worms

and Spires were taken by France, and by the decision of the imperial
deputation of 1803 six cities only: Hamburg, Lübeck, Bremen,
Augsburg, Frankfort-on-Main and Nuremberg, were allowed to keep
their Reichsfreiheit, or in other words to hold directly of the Empire.
This number was soon further reduced. On the dissolution of the
Empire in 1806 Augsburg and Nuremburg passed under the
sovereignty of Bavaria, and Frankfort was made the seat of a duchy
for Karl Theodor von Dalberg, elector and archbishop of Mainz, who
was appointed prince primate of the Confederation of the Rhine.
When the German Confederation was established in 1815 Hamburg,
Lübeck, Bremen and Frankfort were recognized as free cities, and
the first three hold that position in the modern German empire; but
Frankfort, in consequence of the part it took in the war of 1866, lost
its independence and was annexed by Prussia.

In the earlier years of their existence the free cities were under
the jurisdiction of an imperial officer, who was called the Reichsvogt
or imperial advocate, or sometimes the Reichsschultheiss or imperial
procurator. As time went on many of the cities purchased the right of
filling these offices with their own nominees; and in several
instances the imperial authority fell practically into desuetude except
when it was stirred into action by peculiar circumstances. The
internal constitution of the free cities was organized after no
common model, although several of them had a constitution drawn
up in imitation of that of Cologne, which was one of the first to
assert its independence.

For the history of the free cities, see J. J. Moser,

Reichsstädtisches Handbuch (Tübingen, 1732); D. Hänlein,
Anmerkungen über die Geschichte der Reichsstädte (Ulm,
1775); A. Wendt, Beschreibung der kaiserlichen freien
Reichsstädte (Leipzig, 1804); G. W. Hugo, Die Mediatisirung der
deutschen Reichsstädte (Carlsruhe, 1838); G. Waitz, Deutsche
Verfassungsgeschichte (Kiel, 1844 fol.); G. L. von Maurer,
 Geschichte der Städteverfassung in Deutschland (Erlangen,
1869-1871); W. Arnold, Verfassungsgeschichte der deutschen
Freistädte (Gotha, 1854); P. Brülcke, Die Entwickelung der
Reichsstandschaft der Städte (Hamburg, 1881); A. M.
Ehrentraut, Untersuchungen über die Frage der Frei- und
Reichsstädte (Leipzig, 1902); and S. Rietschel, Untersuchungen
zur Geschichte der deutschen Stadtverfassung (Leipzig, 1905).
See also the article Commune. (A. W. H.*)

IMPEY, SIR ELIJAH (1732-1809), chief justice of Bengal, was

born on the 13th of June 1732, and educated at Westminster with
Warren Hastings, who was his intimate friend throughout life. In
1773 he was appointed the first chief justice of the new supreme
court at Calcutta, and in 1775 presided at the trial of Nuncomar
(q.v.) for forgery, with which his name has been chiefly connected in
history. His impeachment was unsuccessfully attempted in the House
of Commons in 1787, and he is accused by Macaulay of conspiring
with Hastings to commit a judicial murder; but the whole question of
the trial of Nuncomar has been examined in detail by Sir James
Fitzjames Stephen, who states that “no man ever had, or could
have, a fairer trial than Nuncomar, and Impey in particular behaved
with absolute fairness and as much indulgence as was compatible
with his duty.”

See E. B. Impey, Sir Elijah Impey (1846); and Sir James

Stephen, The Story of Nuncomar and the Impeachment of Sir
 Elijah Impey (1885).

IMPHAL, the capital of the state of Manipur (q.v.) in eastern

Bengal and Assam, on the north-east frontier of India, situated at
the confluence of three rivers. Pop. (1901) 67,903. It is really only a
collection of villages buried amid trees, with a clearing containing
the palace of the raja, the cantonments, and the houses of the few
European residents.

IMPLEMENT (Lat. implementum, a filling up, from implere, to

fill), in ordinary usage, a tool, especially in the plural for the set of
tools necessary for a particular trade or for completing a particular
piece of work (see TOOLS). It is also the most general term applied
to the weapons and tools that remain of those used by primitive
man. The Late Lat. implementum, more usually in the plural,
implementa, was used for all the objects necessary to stock or “fill
up” a house, farm, &c.; it was thus applied to furniture of a house,
the vestments and sacred vessels of a church, and to articles of
clothing, &c. The transition to the necessary outfit of a trade, &c., is
easy. In its original Latin sense of “filling up,” the term survives in
Scots law, meaning full performance or “fulfilment” of a contract,
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