Page 681 - My FlipBook

FILLING PULP CANALS. 679

as to allow the paste to come in contact with the o;nm tissue, should
warn one to have the patient return much sooner than wlien the case
is an occlusal cavity from which it is impossible for the paste to escape.
]\[uch has been said about the danger of application of arsenic in
deciduous teeth when the roots are undergoing resorption, but the
writer has never seen any bad effects from such use still it must be
;
admitted that the ratio of danger varies with the degree of resorption
of the root. An examination of Prof. Peirce's diagram (Fig. 593) will
show the average amount of resorption at different ages, and enable
one to discriminate. The writer believes that the sensitiveness of a
deciduous pulp varies inversely M'ith the amount of resorption of the
root, and that devitalization is called for in very few cases in which
there is danger of deleterious action.
Prof. L. L. Dunbar advises the use of aqua ammonias for devitaliz-
ing the pnlp of a temporary tooth, by applying it on a })ledget of cotton
in the cavity, one or two applications being sufficient in most cases.
This plan is not open to the objections urged against the use of arsenous
oxid.
When the pulp is devitalized, open the cavity freely into the pulp
chamber and apply on cotton a solution of tannic acid in glycerol.
Leave this about a week, by which time the pulp tissue will have be-
come so hardened by the tannin that it may be removed much more
readily than Avithout such treatment.
The application of mummifying paste is advised by many, after
devitalization, to avoid the necessity of removing the pulp. If a real
mummifying paste can be found, its application will be the ideal
treatment.

Pilling Pulp Canals.
In the pulp canals apply iodoform paste made by mixing iodoform
and glycerol to such a consistence that it can be readily ajiplied on a
probe.
Fill the pulp chamber with " temporary stopping " or gutta-percha,
and the cavity with cement, gutta-percha, or amalgam according to
indications.
If the tooth be very frail, fill the cavity with cement, because, owing
to its adhesive properties, it strengthens the tooth. If the cavity be
approximal and it is desirable to wedge the teeth apart, use pink gutta-
percha.
If the walls be strong and some time will elapse before the natural
exfoliation of the tooth will occur, fill with amalgam.
If absorption of the roots occurs, the iodoform in the canals will not
interfere.