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CHAPTER XIV.

COMBINATION! FILLINGS.

By Dwight M. Clapp, D. M. D.

The use of more than one material for filling a single cavity was
suggested by the observation of the condition of fillings composed of
but one material and noting the effects of time and use thereon.
If a large number of amalgam fillings in crown cavities are exam-
ined, many will be found to have imperfect edges. One cause of this
imperfection is, undoubtedly, the brittle character of amalgam, in con-
sequence of which the edges have become broken. In other words,
amalgam as a filling material lacks edge strength. Its dark, sometimes
almost black, color also renders it very objectionable, especially if used
in conspicuous positions.
If the same number of gold fillings in occlusal cavities are examined,
the edges will be found in better conditi(in than was the case with the
amalgam. One reason for this is, undoubtedly, because gold is not
brittle, but possesses sufficient edge strength to withstand the force
of mastication. Its color is also less unsightly than that of amalgam.
For occlusal cavities, therefore, gold is regarded as the better filling
material.
If a series of occluso-approximal cavities filled with gold be studied,
it will be found that the teeth are in much better condition on the oc-
clusal surface than at the cervical borders of the fillings. Compare gold
fillings with a series of amalgam fillings in the same class of cavities,
and the condition of the teeth will be reversed : at least a much larger
percentage of the teeth will be found in good condition around the ap-
proximal portion of the fillings than was the case with the gold. Hence,
the deduction is inevitable that, of these two materials, amalgam is the
better to fill the cervical jiortion of approximal cavities.
! The term "combination " is adopted for the various fillings here described, in which
more than one material is used, because it seems to be the most comprehensive. The
putting together of different materials in filling teeth makes in no sense a chemical combi-
nation, in which "any part of the compound is the same as any other part of it."
Strictly speaking, the fillings are more "mixtures" than "combinations." According to
the best authorities, however, the meaning given to combination makes its use here quite
admissible.
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