From Kievan Rus to the Reforms of Peter the Great
Dentistry originated in deep antiquity, but for a long time remained a craft. In Kievan Rus (from the 9th century), folk healers, herbalists, barbers, and even blacksmiths engaged in relieving toothache.
In the Tsardom of Russia (from the 16th century), medical care began to be systematized. Foreign physicians and graduates of the Medical School (opened in 1654) appeared. Tooth extraction was practiced by tooth-pullers. At the same time, a division of labor took place: physicians performed complex surgical interventions, including jaw surgeries, while barbers were assigned "minor surgery"—phlebotomy and tooth extraction.
The instruments of that era, according to inventories from the late 17th century, included pincers (forceps), gimlets, and "saws for filing teeth." Experience in treating maxillofacial trauma (gunshot and slash wounds) was actively accumulated in military field surgery.
The Era of Peter the Great and Hospital Schools
A breakthrough in domestic medicine occurred in the 18th century thanks to the reforms of Peter the Great. The emperor himself was fond of medicine, knew how to bandage wounds, perform bloodletting, and extracted teeth "with great enthusiasm."
In 1707, the first hospital and hospital school were opened in Moscow. Its founder and head was N.L. Bidloo. In his work "Instructions for Those Studying Surgery..." (1710), he detailed the anatomy of the maxillofacial region and surgical techniques, such as cleft lip repair.
Hospital schools became the base where dentistry united with surgery and traumatology. In 1710, the title of "dental practitioner" was officially introduced, requiring an examination to obtain.
Establishment of the Scientific School in the 19th Century
In the 19th century, dentistry developed within the framework of surgery. The main scientific centers became the St. Petersburg Medico-Surgical Academy and Moscow University. During this period, the first unique operations were performed: resection of the maxilla and mandible, and reconstruction of the lower lip.
A colossal contribution to the development of maxillofacial surgery was made by N.I. Pirogov (1810–1881). He:
- Initiated the anatomo-experimental approach.
- Was among the first in 1847 to use ether anesthesia (along with I.V. Buyalsky and F.I. Inozemtsev).
- Established the laws of tissue transplantation.
- Personally performed dozens of plastic surgeries that were unique at the time (rhinoplasty, cheiloplasty).
- Described the surgical access to the lingual artery (the so-called Pirogov's triangle).
Specialized literature also developed. The works of P.P. Zablotsky-Desyatovsky on diseases of the maxillary sinus and oral cavity were published. In 1882, S.P. Kolomnin described the use of intratracheal anesthesia during maxillary resection.
Briefly: answers to topical questions
What maxillofacial surgeries did N.L. Bidloo describe in his 1710 guide?
In his 1710 guide "Instructions for Those Studying Surgery in the Anatomical Theater," N.L. Bidloo described methods for performing maxillofacial operations, specifically cleft lip surgery. The work details the stages of this surgical intervention, including a description of the initial incision and the final stage of suture placement. The guide also thoroughly detailed the anatomy of the maxillofacial region.
What are the anatomical boundaries of Pirogov's triangle?
The anatomical boundaries of Pirogov's triangle, located within the submandibular triangle, are formed by a nerve and the muscles of the neck.
- Superior boundary — hypoglossal nerve (n. hypoglossus, XII cranial nerve).
- Anterior boundary — posterior border of the mylohyoid muscle (m. mylohyoideus).
- Inferior and posterior boundaries — tendon of the posterior belly of the digastric muscle (m. digastricus).
- Floor of the triangle — hyoglossus muscle (m. hyoglossus), which separates the lingual vein and artery.
What types of facial plastic surgery did N.I. Pirogov perform?
N.I. Pirogov performed several types of plastic surgery in the maxillofacial region, acting as a pioneer in this field. During his work at the hospital surgery clinic, he performed the following interventions:
- Rhinoplasty — performed about 40 nasal reconstruction operations.
- Cheiloplasty — performed 20 lip operations.
- Cleft lip surgery — performed 7 interventions.
- Stomatoplasty — performed 1 operation.
Class and exam questions
In what year was the title of "dental practitioner" officially introduced in Russia?
The official title of "dental practitioner" was introduced in 1710, and obtaining it required passing a special examination.
What is "Pirogov's triangle" and why is it needed in dentistry?
This is a topographic and anatomical region described by N.I. Pirogov. It is important for maxillofacial surgeons as it serves as a landmark for surgical access to the lingual artery.
Who performed tooth extractions in Russia before the 18th century?
Tooth extraction was considered "minor surgery," which was mainly performed by barbers, folk healers, and so-called "tooth-pullers."
What else to study on this topic
- Organization of training for dentists and dental practitioners in the early 19th century
- The evolution of dental instruments from dental pelicans to modern forceps
- The contribution of I.V. Buyalsky and his "Anatomic and Surgical Tables"
- The first scientific dissertations on dentistry (Ya. Europeus, M.S. Kruten)
Master the entire topic in the course "Surgical Dentistry"
This is a summary. The course covers everything tested in classes and exams.
- Complete study guide on "History of the Development of Oral and Maxillofacial Surgery" and 866 more pages of the subject
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 28 video lessons on the subject
Other topics in the section «Chapter 1. History of the Development of Surgical Dentistry (K.A. Pashkov, A.V. Belolapotkova)»
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.