Page 703 - My FlipBook

ACCIDENTS WHICH MAY HAPPEN DURING TREATMENT. 701
cusps to the cusps of opposing; teeth, instead of the normal interlock-
ing of cusps which gives the greatest efficiency.
The question as to the extraction of a tooth will depend also on
its condition. In the writer's opinion it will be better in many cases
to crown the roots of a molar decayed too much for filling, and remove
some other tooth that is less useful in mastication. (This question is
further discussed on page 745.)
Salivary Calculus.—As the accumulation of salivary calculus is
impossible upon parts of the teeth subjected to use in mastication or
easily cleansed with the brush, so any abnormality of arrangement that
prevents thorough use of the brush favors the deposit, with all of its
possible consequences.

Accidents which may Happen during Treatment.
Death of the Pulp.—This may occur from strangulation at the
apical foramen from too rapid movement of the tooth. The possibility
of this accident is least when movement is begun while the apical fora-
men is large, before the root is completely formed ; it increases with the
age of the patient, and is greatest after the root is fully formed and the
foramen is constricted to its permanent size.
Death of the pulp may also occur from rupture of the bloodvessels
at the apex of the root from too rapid elevation of the tooth. The
liability of such accident will vary according to the age of the patient
and size of the apical foramen.
Rupture of the Pericementum.—This may occur also from too
rapid elevation of a tooth. After such an accident, a tooth returned
to its socket would be in the condition of a replanted tooth, subject
to the same chances of attachment and retention.
Permanent Enlargement of the Alveoli.—Dr. Talbot ' says :
"The probability of a perfectly satisfactory result in regulating
decreases yearly after the age of puberty, and after the age of twenty-
six the chances of a really satisfactory result are very meagre, for at
this time the entire osseous system is fully developed and there is little
probability of extensive deposit of ossitic material."
The writer would, however, fix the date later than that — perhaps
at thirty years.
Pressure at any age will cause resorption, therefore teeth may be
moved in the case of adults, though more slowly on account of the greater
rigiditv of the alveolar process. Greater force will be needed to produce
resorption in advance of the moving tooth, and there is a possibility,
even a probability, that no ossific deposit will take place behind the
' Irref/ulurities of the Teeth and their Treatment, 2(1 ed., p. 172.