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EXPOSURE AND REMOVAL OF THE DENTAL PULP. 143

angle in order to better reach the mesio-buccal root canal. This
may be done most readily and in the best form by a scraping
movement with the cleoid. The case is now ready for the
removal of the pulp. Incidentally much of the tissue of the
bulb of the pulp, possibly all of it, will have been removed in
doing this cutting, but no attempt should be made to remove
the pulp from the canals until this cutting is satisfactorily com-
pleted.
In many cases after the first opening has been made the roof
of the pulp chamber can be cut away quicker and much more
satisfactorily with the chisel and mallet.
If the exposure is from a mesial cavity the cutting will
be, of course, to the distal and often will involve the removal of
the middle third of the occlusal surface with the whole of the
dentin intervening between it and the pulp. If a distal cavity,
the middle third bucco-lingually of the occlusal surface with the
intervening dentin should at once be removed to a point well
toward the mesial marginal ridge.
In the bicuspids the exposures are almost uniformly from
cavities in the proximate surfaces, and the chambers are broad
bucco-lingually. The cutting for the opening of the chambers
must be directed first to the central part of the crown, but later
broadened from buccal to lingual ; for the horns of the pulp,
when long, in these teeth spread out toward the points of the
cusps. These should be fully opened into so that they may be
cleaned, also the root canals in these teeth, especially in upper
first bicuspids, are given off from the extreme buccal and
extreme lingual portions of the chamber, and unless this cutting
is broad in this direction, the broach will not have direct entrance
into them.
In the incisors and cuspids exposures are generally from
proximate cavities. In opening these for the removal of the
pulp, the orifice of the exposure should be first extended to the
gingival wall of the cavity, and. to the full breadth of the cham-
ber. The approach should be carefully considered. Generally
a broach will not readily slide into the canal without being bent
more or less. This is unfavorable, and a better approach must
be made. Generally when a cavity is so large that the pulp has
been reached, the lingual wall should be cut away, and this will
improve the approach, the instrument being passed to the lingual