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even take first rank as a filling material. Its indications as a filling mate-
rial may be classified, first, as general, and second, as local. The follow-
ing will be considered under the first classification
1. For those patients who really have an appreciation of the esthetic
quality of dental operations, and who object to the conspicuousness of
metallic fillings. Many patients fancy that they appreciate this quality,
but they measure their appreciation rather by the cost and permanency of
the work than by an esthetic standard.
2. For those patients whose physical condition is such that the inser-
tion of a large gold filling would give rise to a nervous shock. We should
consider the effect of such shock on the system and endeavor to avoid
subjecting our patients to long, tedious and painful operations.
3. For those patients w'hose pericementum and alveolar process are
diseased, a condition which almost excludes any material that requires
considerable condensation.
4. For those patients who are suffering from caries that has pro-
gressed to such an extent that the pulp is almost involved, and in whose
teeth the pulp would die, if filled with gold, because of the irritation
caused by thermal changes.
The indications under the second classification are
1. All cavities on the labial and very many on the buccal surfaces
of teeth.
2. Some simple approximal cavities on incisors and cuspids.
3. Approximo-incisal cavities, if these cavities can be prepared in
such a manner that the retentive resistance will be greater than the stress.
4. Cavities involving the incisal edge.
5. Approximo-occlusal cavities on bicuspids and molars in which
the cavities are so prepared that a large enough mass of porcelain may be
used to withstand the stress applied, and in which the frail margins will
not be exposed to the stress of mastication, or in which the cavity extends
far beneath the gingival margin.
6. Deep cavities on the occlusal surface of lower molars.
7. Cavities involving the entire occlusal surface of pulpless molars.
The choice of porcelain is contra-indicated in
the following conditions:
Gontra-Tndications.
I. In those cavities from which the stress will
dislodge the filling or cause it to fracture.
2. In those simple approximal cavities on incisors and cuspids in
"which a gold filling is scarcely noticeable.
3. In disto-occlusal cavities of upper bicuspids and molars.
4. In nearly all occlusal cavities in upper molars and those occlusal
cavities in lower molars in which severe usage in the process of mastica-
tion might cause the margins of the inlay to fracture.
21
even take first rank as a filling material. Its indications as a filling mate-
rial may be classified, first, as general, and second, as local. The follow-
ing will be considered under the first classification
1. For those patients who really have an appreciation of the esthetic
quality of dental operations, and who object to the conspicuousness of
metallic fillings. Many patients fancy that they appreciate this quality,
but they measure their appreciation rather by the cost and permanency of
the work than by an esthetic standard.
2. For those patients whose physical condition is such that the inser-
tion of a large gold filling would give rise to a nervous shock. We should
consider the effect of such shock on the system and endeavor to avoid
subjecting our patients to long, tedious and painful operations.
3. For those patients w'hose pericementum and alveolar process are
diseased, a condition which almost excludes any material that requires
considerable condensation.
4. For those patients who are suffering from caries that has pro-
gressed to such an extent that the pulp is almost involved, and in whose
teeth the pulp would die, if filled with gold, because of the irritation
caused by thermal changes.
The indications under the second classification are
1. All cavities on the labial and very many on the buccal surfaces
of teeth.
2. Some simple approximal cavities on incisors and cuspids.
3. Approximo-incisal cavities, if these cavities can be prepared in
such a manner that the retentive resistance will be greater than the stress.
4. Cavities involving the incisal edge.
5. Approximo-occlusal cavities on bicuspids and molars in which
the cavities are so prepared that a large enough mass of porcelain may be
used to withstand the stress applied, and in which the frail margins will
not be exposed to the stress of mastication, or in which the cavity extends
far beneath the gingival margin.
6. Deep cavities on the occlusal surface of lower molars.
7. Cavities involving the entire occlusal surface of pulpless molars.
The choice of porcelain is contra-indicated in
the following conditions:
Gontra-Tndications.
I. In those cavities from which the stress will
dislodge the filling or cause it to fracture.
2. In those simple approximal cavities on incisors and cuspids in
"which a gold filling is scarcely noticeable.
3. In disto-occlusal cavities of upper bicuspids and molars.
4. In nearly all occlusal cavities in upper molars and those occlusal
cavities in lower molars in which severe usage in the process of mastica-
tion might cause the margins of the inlay to fracture.
21
