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CHAPTER IX.

REMOVAL OF REMAINING CARIOUS DENTINE.—FINISHING
ENAMEL WALLS.—TOILET OF THE CAVITY.

Removal of Remaining: Carious Dentine.
Definition. This order is the secondary consideration of af-
fected dentine. In the smaller cavities the previous steps in cav-
ity preparation Avill have removed all affected dentine and this step
has little consequence. However, it is well to have this step come
to the mind even in these cases so that the minute corners and ob-
scure localities are not allowed to pass imperfectly prepared.
In Large Decays the pulp is often in question. The dentine has
been softened to a near approach to the pulp. If all of this be re-
moved early in the procedure, the pulp will be exposed to the dam-
aging effects of air drafts from the chip blower, or possibly low
temperatures in the operating room. Pulps thus exposed not in-
frequently take on the initial stages of destructive diseases from
which they never recover, resulting in much pain to the patient
and chagrin to the operator. The foregoing is particularly true
when one is making a filling for each of two large proximal cavities.
Two Large Proximal Cavities. It is often desirable to prepare
both cavities at the same sitting, particularly when filling Avith
amalgam.
With the cavity first prepared, there might be a long exposure
of the pulp to a lower than l)ody temperature, if the overlying de-
cayed dentine is removed at the time the major portion is ex-
cavated.
Technic. The remaining decay in this step of procedure should
be removed Avith broad spoon excavators, when working on axial
or pulpal walls. In small cavities Avhere there is no danger of pulp
exposure the instruments should be small hatchets, with which the
dento-enamel junction should be examined around the entire cav-
ity. In case a softened area is found and removed the overlying
enamel should be chiseled away, thus restoring the correct out-
line.
Where Exposed Pulp is expected or pulp treatment is intended,
the decay is removed just folloAving outline form.
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