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96 THE TECHNICAL PROCEDURES IN FILLING TEETH.

placed firmly in the interproximate space against the gum septum
while the gutta-percha is being packed, and afterward removed.
This will protect the gum septum from being absorbed by the
continued pressure of the gutta-percha. This point should never
be neglected, as a full gum septum is necessary to the health of
the parts, and it should be carefully protected against injury.
When the patient is discharged temporarily he should be directed'
to make vigorous use of the tooth in chewing. The impact of
the food will cause the gutta-percha to spread and carry the teeth'
apart sufficiently within a week or two. This is a very effective
method of slow wedging in cases in which the teeth have dropped
together from loss of the contact point, and has the merit of
moving the teeth without creating soreness.
In cases requiring much movement it can be hurried a great
deal by first putting on the Perry separator and lifting the teeth
apart as much as possible, and making the gutta-percha filling,
as indicated above, and giving sufficient time for the gutta-
percha to become fully hard before removing the separator.
This may be repeated at intervals of two or three days until
sufficient separation has been obtained to fully restore the
width of the interproximate space and mesio-distal breadth of
the tooth.
It occasionally happens that a tooth has lost the greater part
of its crown, and the teeth on either side have dropped together
over it, so that the restoration of the form of the crown is
impossible without a very considerable separation. In this case
the breadth of two interproximate spaces are to be recovered by
separation. If the lingual and buccal walls are still sufficiently
strong, it is still possible to accomplish this with gutta-percha,
but when they are not it is better to cut away most of the
remaining portions of the crown, and insert a piece of hard, dry
hickory wood in place of the missing crown in such a way that
the length of the grain of the wood shall be from buccal to
lingual. This should be cut to fit snugly between the two teeth
on either side, and forced into position. This will absorb mois-
ture from the saliva, and swell and slowly carry the teeth apart.
The wood should be exchanged for a new piece once in two or
three days, and continued until space is gained for the restora-
tion of the full mesio-distal breadth of the crown. This plan is
especially useful in gaining the necessary space for restoration