Page 657 - My FlipBook

PREPARATION OF TEETH FOR PLANTATION. 655

prominence in the arch, and yet be able to secure a bone covering for
its labial surface. As a rule there is sufficient process in the canine
region to enable the operator to secure all the attachment desirable.
The bicuspid and molar regions present the danger of perforation of the
floor of the maxillary sinus. This is liable ta happen anywhere from
the first bicuspid to the second molar. Extreme caution should be ex-
ercised to avoid it. In two instances in practice the perforation was fol-
lowed by no unpleasant complications. Care was taken not to infect the
sinus, the teeth were implanted in the usual manner, and the cases re-
sulted successfully. Subsequently one of these teeth was lost, but dur-
ing the process of root attachment or encystment the perforation into
the sinus was closed.
In the lower jaw the principal difficulties encountered are the follow-
ing : In the incisive region there is a deficiency of alveolar process, and
hence much difficulty is encountered, at times, in securing a sufficiently
deep bony socket. At the location of the canine tooth the lower jaw
becomes broader and there is usually sufficient room to enable the
making of a good socket. In the bicuspid region the principal pre-
caution necessary is in regard to the mental foramen. It must be borne
in mind that normally the exit of the nerves and vessels at this point
is directly below the second bicuspid tooth and that when resorption of
the alveolar process has taken place this foramen is often near the upper
border of the jaw. From this point posteriorly implantations are rarely
performed, and when done the principal precaution must be in regard
to the inferior dental canal, which is near the surface if much resorp-
tion has taken place.
Artificial Crowns.—The precautions necessary in the selection of
a tooth for transplantation or implantation have been noted, and it
might be proper at this time to describe the prepara-
tion of a root with an artificial crown, presuming that
it is only in rare instances that a suitable entire
natural tooth can be obtained. Attention was called
to the necessity of securing asepsis of the root, and
the filling of the root-canals has been described. The
most suitable form of crown has been found to be the
Natural root with
Logan, which is ground to suit the occlusion and
artiticial crown.
, .
cemented into the root canal without much regard as
to a careful fit at the cervix of the crown to the root. After the
cement has hardened, the margin between the root and crown is pre-
pared with engine burs, and a filling of gold introduced, making a
circle around the tooth. When this is polished down there is a
perfect gold filling level with the root and crown, which is preferable
to a soldered band. (See Fig. 580.)