Page 70 - My FlipBook

26 PATHOLOGY OF THE HAED TISSUES OF THE TEETH.
way a fairly good tooth form, being careful, however, not to
expose the dentin on the labial surface. Exposure of the dentin
on the cutting edge is not very objectionable.
Frequently much harm is done to these malformed teeth by
attempting to fill blackened pits. At the points where these
occur, the teeth are often very thin and an injudicious effort
to excavate results in cutting through to the lingual surface,
and after removing perhaps considerable material to gain the
proper anchorage, the operator finds the incisal portion of the
tooth too weak to stand. No filling should be made for the pur-
pose of closing up blackened pits, unless it is first found that
there is abundant tooth material for strength after the excava-
tion has been made. Also it must be remembered that the pulps
of these malformed incisors are very near the incisal edge as a
rule, and exposure of this organ in the excavation is very liable
to occur.
Incisor teeth that are so malformed as to be very unsightly
in appearance, should not be treated hurriedly. They should
be tided along until such time as the pulps may be removed, not
only with safety, but that the roots may be filled in such a manner
that they may do service for the lifetime. If they can be kept
in position without other treatment than that intended as tem-
porary, until the patient is eighteen to twenty years old, it is
very much better that it should be done. Then the crowns can
be cut away and artificial crowns put on with the best prospect
for future service. Certainly no crowning operations should be
undertaken in these teeth before the patient is sixteen years old,
and eighteen to twenty is very much better.
Long observation of the removal of the pulps and filling
roots for young people shows that these teeth do not do well.
It is true that we can remove the pulps and fill the roots of the
central incisors at twelve years old in very many cases with
results that, within the first year or two, seem perfect, but it is
also true that these teeth tend to break down, the roots to split,
or some catastrophe is very likely to happen to them before the
patient is twenty-five years old, and the teeth are lost.
Many of them suppurate after they have been apparently
in perfect health for several years after the root filling has been
made. All of these considerations unite to advise that the
removal of crowns for the purpose of placing artificial crowns
be delayed as long as possible. The roots of these teeth are just
as good for the purpose of artificial crowns as the roots of fully
developed teeth ; in fact, all of that portion of the tooth root-wise
of the injured part is normally developed as a rule.