Page 26 - My FlipBook

22 THE TECHNICAL PROCEDURES IN FILLING TEETH.

the formation of cavities, should not be neglected. When the
general form of the cavity has been developed, modifications are
to be made that will render the form more convenient for packing
the filling material. Often by cutting a wall away to a certain
inclination the plugger point will reach some portion of the
cavity better, or at a more available angle, enabling the operator
to pack gold more certainly and more securely in certain impor-
tant parts of the cavity. Also such cutting may render the
filling so much more convenient as to save time and much wear
and tear upon both patient and operator.
A second order of convenience form is slight undercuts situ-
ated in angles or other parts of the cavity as starting points in
packing gold, or that will hold the first portions of the filling
material while other portions are being packed, or until the true
retention form of the cavity has been filled. The study of the
use of these conveniences and the wise placing of them is espe-
cially important, as it assists in starting the filling and securing
the first portions.
These pits and grooves are usually placed in the axio-linguo-
gingival and axio-bucco-gingival angles of proximate cavities, and
in similar positions in other cavities.
Removal of Remaining Carious Dentin.— Generally
when the cavity has been cut to form, no carious dentin will
remain. But in the larger decays it will often be a question
whether or not the pulp will be exposed when all decayed den-
tin overlaying it is removed. It is especially an object that we
do not cut toward the pulp until the cavity is otherwise well pre-
pared, for the reason that if a pulp exposure is found the cavity
shall be fully cleaned and ready for the immediate treatment of
the pulp in any way indicated. Then when this stage in cavity
preparation has been reached, the remaining softened dentin is
carefully and completely removed with broad spoon excavators,
usually with the 20-9-12. It will often be required that the pulp
of a tooth be exposed for the purpose of making an application
to destroy it. In all of these cases the overhanging enamel
should be removed and the walls of the cavity completely cleaned
and so formed as to safely hold the temporary filling, before cut-
ting toward the pulp. When all of this has been done and after
the rubber dam is securely in place, lift off the remaining decay