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220 THE TECHNICAL PROCEDUEES IN FILLING TEETH.
been worn in the i^rocess, these should be built up at once, making
the fillings as hard and substantial as possible. These fillings
will take the wear for several years. If later the enamel of the
points of others have worn until the dentin appears, they should
be built up in the same way. In this way, hindrances to the
abrasion may be continually placed which will serve to limit it
and keep it within reasonable bounds.
In such a case as that shown in Figure 300, in which the
cusps are worn flat and the dentin has begun to be cupped out,
if the cusps had been built up earlier, or as soon as the dentin
had been exposed, much of the wear on these and other teeth
would have been prevented. As it stands, sufiScient cavities may
yet be cut and strong cusps built, which will intercusp with simi-
lar building on the lower teeth, so shaping them that the teetli will
slide into full occlusion normally. The wear will thus be greatly
limited upon all of the denture. This building should, of course,
include both sides of the mouth. Generally, more should not
be imdertaken at one time. Later, other teeth may be treated
as necessary, but on the same plan. To do this best, recjuires a
careful study of the occlusion and of the motions of the lower
jaw. The recent methods of obtaining models so mounted as to
show the motions of the lower teeth will, as they are devel-
oped, do much toward exjjlaining the relations of this wear to
motion and assist in the development of the treatment of exces-
sive abrasion. By this method, the building of cusps can be
more methodically done than is possible by noting the motions
of the jaws without measurements.
It is certain that some well chosen work with this idea in
view will greatly increase the usefulness of the teeth, without
burdening the patient with extensive operations done at one time.
Fillings made as proposed would generally be small and easily
done. They would be spread over considerable time. Some
would be worn away by the friction of mastication; cutting
deeper and renewing them would become necessary. The most
extensive fillings in the first instance would be in the incisors,
in which the cutting edges have been worn until more or less
of the dentin has become exposed. One series of illustrations
in which the abrasion has been allowed to become excessive will
be given. As the rule, however, the wear of incisor teeth should
be limited by such care of the bicuspids and molars as will relieve
them of the stress of the occlusion, rather than by building fill-
ings in them.
Figure 305 shows the al)raded cutting edge of the central