Page 173 - My FlipBook

CROWN- AND BRIDGE- WORK. l6l
crown before the latter is removed, or (if not exposed by
excising- the tootli ), throui^ii an opening into the pulp, made
with a drill revohed by the dental engine, after excision.
Devitalization of the Pulp.—There are several ways of
extirpating- a dental pulp. One of the older and still not
uncon-imon methods of operating- consists, first, in devital-
izing it with arsenious acid and then removing it with a
broach. Another method practiced by some is to thor-
oughly expose the pulp, apply cocain, or neurocane, securely
sealing this in the cavity with a piece of very pliable rubber,
—a piece of unvulcanized rubber or artificial vellum or
" palate " rubber. Pressure is then made with a large
blunt instrument, such as a ball burnisher; applied gently
at first and gradually increased. This pressure sends the
anaesthetic into the dentinal tubuli and if continued for a
few minutes the pulp in many cases may be painlessly
removed.
Excision of Crown and Instantaneous Extirpation of the
Pulp.—A somewhat heroic method, though one with which
several operators have claimed much satisfaction, by which
a living pulp may be quickly and successfully removed, with
comparatively little pain, consists in cutting the labial and
palatal grooves as has been directed, making them as deep
as possible, without inflicting too much pain ; then with the
excising forceps, the cutting edges of which are inserted
in these grooves, the crown is quickly severed from the root.
This usually leaves the pulp fully exposed and paralyzed,
when a piece of orang-e wood — previously cut and shaped
to about the size of the canal, not larger, and the point satu-
rated with carbolic acid—is carefully placed against the
exposed point of the pulp and quickly driven with one light
blow from the mallet into the pulp canal. When the wood
is withdrawn, the pulp sometimes adheres to it ; if not, it
may be quickly removed Avith a broach. In this operation
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