Palmer notation
Palmer notation (named after Ohio dentist Corydon Palmer[1]) is a system used by dentists to associate information to a specific tooth. Also known as the Military System. Although supposedly superseded by the FDI World Dental Federation notation, it overwhelmingly continues to be the preferred method used by orthodontists, dental students and practitioners in the United Kingdom.[2]
It was originally termed the Zsigmondy system after the Hungarian dentist Adolf Zsigmondy who developed the idea in 1861, using a Zsigmondy cross to record quadrants of tooth positions..[3] Adult teeth were numbered 1 to 8, and the child primary dentition (also called deciduous, milk or baby teeth) were depicted with a quadrant grid using Roman numerals I, II, III, IV, V to number the teeth from the midline. Palmer changed this to A, B, C, D, E. This makes it less confusing and less prone to errors in interpretation.
The Palmer notation consists of a symbol (┘└ ┐┌) designating in which quadrant the tooth is found and a number indicating the position from the midline. Adult teeth are numbered 1 to 8, with deciduous (baby) teeth indicated by a letter A to E. Hence the left and right maxillary central incisor would have the same number, "1", but the right one would have the symbol, "┘", underneath it, while the left one would have, "└".
Table of codes
Orientation of the chart is traditionally "dentist's view", i.e. patient's right corresponds to notation chart left. The designations "left" and "right" on the chart, however, nonetheless correspond to the patient's left and right, respectively.
| Permanent Dentition | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| upper right | upper left | ||||||||||||||
| 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 |
| lower right | lower left | ||||||||||||||
| Primary Dentition | |||||||||||||||
| upper right | upper left | ||||||||||||||
| E┘ | D┘ | C┘ | B┘ | A┘ | └A | └B | └C | └D | └E | ||||||
| E┐ | D┐ | C┐ | B┐ | A┐ | ┌A | ┌B | ┌C | ┌D | ┌E | ||||||
| lower right | lower left | ||||||||||||||
With the move from written dental notes to electronic records, some difficulty in reproducing the symbols has been encountered.[4] On a standard keyboard 'slash' and 'backslash' may be used as a crude approximation to the symbols with numbers placed before or afterwards; hence 3/ is 3┘ and /5 is ┌5
Daniel Johnson has put together a Palmer Tooth Notation TrueType font called FreePalmer. It can be downloaded: Lua error in package.lua at line 80: module 'strict' not found. It is covered by the GPL 3 license. This font is descended from FreeSans, part of the Lua error in package.lua at line 80: module 'strict' not found. A screenshot showing it working in OpenOffice can be seen here: Lua error in package.lua at line 80: module 'strict' not found. A derivative which enables the grid patterns to be produced that correspond to handwritten Palmer tooth notations is available for download as well Lua error in package.lua at line 80: module 'strict' not found.
One advantage of Palmer notation is that it can produce a very graphical image, akin to a 'map' of the dentition; tooth transpositions or edentulous spaces can easily be depicted if desired. It would also be feasible to introduce additional alphabetic characters or other symbols, for example to denote supernumerary teeth or bridge pontics, to which a purely numerical method such as the FDI system does not lend itself easily.[4]
See also
References
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