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86 METHODS OF FILLING TEETH.

form be reproduced, without danger of future failure ? This requires
often a keen knowledge of the mechanical arrangement of the cavity
for the retention of the of the probable strength of the
filling, special
tooth under consideration, of the force of leverage which under masti-
cation the will exert upon its anchorage, and of the amount of
filling
usage which the particular patient will give to it. There are men who
chew with such energy that they not only wear out their teeth early
by abrasion, but the best gold filling will become roughened rapidly
in their mouths. In such cases it would be to an exten-
folly attempt
sive contour with doubtful anchorage ; whereas in the jaw of a refined
and delicate woman, the be made with much
experiment might safety.
The lateral incisor of the superior jaw offers the greatest problem in
contour, but fortunately it is a tooth so variable in shape that we may
be enabled in almost any case to so fashion the filling that it will be
durable and at the same time sightly ; that is, if compelled, we may
a contour which is of not similar to the
produce good form, though
original structure.
FIG. 65. FIG. 66. FIG. 67.

Fig. 65 shows a lateral incisor with a cavity which is often puzzling.
Where the has been removed, we obtain such
pulp may good anchorage
in the upper part of the cavity, packing the gold well into the canal if
need be, that we would have no hesitation in a full contour
producing
as seen in 66. But be alive, and
Fig. suppose that the pulp despite
the ravages of caries sufficiently well covered by dentine to render its
salvation assured ? It would be most reprehensible to devitalize it.
Yet to attempt to obtain an anchorage which would retain such a con-
tour as shown in 66 would in most cases be
Fig. impossible, and even
where attained, we would be to so at
likely approach the pulp closely
some point that it would be liable to die subsequently. I will give a
case of this character from But
practice, which will be instructive.
first let me We
dispose of this lateral incisor with its living pulp. may
fill the tooth, preserve the life of the and
pulp, produce a presentable
and durable contour, by resorting to a screw, and as shown
shaping
in
Fig. 67. The distal corner of the lateral incisor is often a fairly sharp
angle, but it is more often a curve, and sometimes as much curved
as shown in the last If 66 and 67 be
figure. Figs. compared, it will be
seen that in the former the of the
length gold along the incisive edge