Page 119 - My FlipBook

FILLING WITH GOLD. 115

Combination of Non-Cohesive and Cohesive Gold in
Proximate Cavities in the Bicuspids and Molars.

Combinations of non-cohesive and cohesive gold may be used
effectively in many positions in filling teeth, but I attach great
importance to it only in the gingival portion of proximate cavities
in the bicuspids and molars. The best cohesive gold workers
fail, when they do fail, oftenest at this point. And so difficult is
it to make perfect adaptation of cohesive gold to this wall that
my observation teaches me that our very best men fail in ten per
cent of their cases. A much larger per cent of success can be
obtained by the combination of non-cohesive foil, with a saving
of both time and labor. This is sufficient reason why I should
urge this plan of filling. It is not, however, an easy matter to
learn this method. It will not be gained without careful study
and effort in practice.
This combination consists of laying a large flat cylinder
or mat of non-cohesive foil on the gingival wall and then
beginning upon this to build cohesive gold.
The beginning and continuation of the building with cohesive
gold is the same in every respect as if the non-cohesive gold had
not been used, except that it will be necessary to continue the
use of the assistant plugger for a longer time before the mass is
perfectly secure in its position.
The flat cylinder or mat is made by first folding a sheet foil,
or such part of a sheet as may be required, to the right width,
and then rolling the ribbon formed upon a flat steel instrument
of suitable width. The length of the cylinder is controlled by
the width of the ribbon, and the breadth is controlled by the
width of the flat instrument. The length should be such that
when placed flat upon the gingival wall with one end against the
axial wall the other end protrudes over the gingival cavo-surface
angle of the cavity. The breadth should be such that it will
extend fully from the buccal wall to the lingual wall and require
some crowding to make it lay flat. Simply lay this in position
and begin building upon it, practically as has been described for
beginning with all cohesive gold.
Instead of this flat cylinder or mat, ordinary round cylinders
may be used by laying the first in the linguo-gingival angle, a
second in the bucco-gingival angle, and a third between the two.