Page 54 - My FlipBook

50 THE TECHNICAL PROCEDURES IN FILLING TEETH.
hand. If the Hgature has been well waxed, the first half of the
knot will not slip or loosen ; but it must not be pulled or dis-
turbed in the least while forming the other half of the knot.
Let the ends fall perfectly loose while forming the second half
and work it up carefully until it is just right and then draw it
tight at a single pull, again keeping the fingers close against the
arch, both to the mesial and distal. A ligature tied in this way
will always be tight around the tooth.
Rubber-Dam Clamps.
The question of rubber- dam clamps is always a troublesome
one. Nothing is entirely satisfactory in all positions. The
selection on the list is as good for the purpose as can be had.
With them all can be done that clamps will do.
In filling cavities in the bicuspids the rubber should be
secured on the molar tooth distal to them with a rubber-dam
clamp. The bow of the clamp holds the rubber out of the way
and gives space and a better view of the field of operation. In
excavating and filling cavities in the molars this is still more nec-
essary. Whenever practicable the clamp should be placed upon
the first molar for operations on the bicuspids, and on the second
molar for operations on the first molar. Generally, in operations
on the second molar not involving the distal surface, a clamp with
a bow standing well to the distal should be placed on the same
tooth in order to avoid the difficulty of placing the dam on the
third molar. Rubber-dam clamps on the bicuspids are not per-
missible at all except in cases where the molar teeth are missing;
and even then they are of doubtful usefulness, and are so
unsteady as to cause the patient much annoyance, and often
considerable pain.
In buccal and labial cavities, that approach near to, or pass
beyond the gingival line, the special clamp should be used on
the molars and the Hatch clamp on the bicuspids and front'
teeth. Except in the most difficult cases, the special clamp will
answer the purpose if the rubber, after being placed on the
tooth, is drawn well away from the buccal and the clamp
applied, or if the clamp is put on first and the rubber passed
over it. When the Hatch clamp is applied to the front teeth
with labial cavities, the rubber must be drawn well away from
the labial surface and the points placed in position and the set-