Page 105 - My FlipBook

TREA TMENT OF MASTICA TING SURFA CES. g i

There is no object in burring- out two deep pits such as are found in
the normal crowns, but as the occlusion in this region is usually very
of the lower teeth
accurate, the cusps opposing biting squarely and
sharply into the sulci of their antagonists, it becomes essential in form-
to remember this, and to accommodate the form to the
ing the filling
In molars I think that a middle is safest. We
requirements. ground
should not make an extensive gold filling and leave it absolutely flat,
for we thus offer a very poor masticating surface. At the same time,
to attempt to carve out an exact reproduction of sulci as seen in a real
tooth would not only be time unnecessarily spent, but the result would
bad. I am certain that gold thus carved will not be as dura-
be really
ble as where a mere approximation is aimed at. Such depressions as
may be produced vi\\\\. fairly large-sized gold-cutting burs will leave
a surface sufficiently cusped for service without making it difficult to
produce a perfect polish, which is essential to durability.
This brings us to a consideration of cases where, by the attrition of
energetic mastication, a patient presents with a complete set of teeth,
all of them having lost about one-third of their original length. Is it
necessary here to attempt a complete contour? I think not. Such a
person has gradually become accustomed to having the jaws close
more than when the teeth were therefore there is no
together perfect,
discomfort to him because of the loss in length. The necessity for
interfering at all arises from the desire to prevent further destruction.
In tipping a whole set of teeth with gold in this class of cases, it is
to build on a sufficient thickness of so that what
only necessary gold,
is placed may be strong enough to prove resistant. If a molar on
each side be treated in this way at the first sitting, the mouth will be
opened a trifle all round, and the other teeth in turn may be built up
to suit the new occlusion. In the incisors it will be found that the
are quite broad, so that there is little difference between
cutting-edges
them and the cuspids and bicuspids. No attempt should be made to
produce cutting-edges similar to what was in the first place. What is,
is what the man is accustomed to, and he will be happier if his teeth
are left to him as they are. Of course the filling following the lines
narrow the but this should not be
of contour may slightly edges,
carried to an extreme.
Many cases will occur in every practice where any attempt at con-
because of the fact that the of the
tour will be impossible position
Often we
tooth has changed since the destructive process began.
see teeth lifted from their sockets, as the decay advances, so that
an occlusion is effected. To build up such a tooth to original pro-
portions would be to open the mouth, by making that the only tooth
which strikes. In these and other similar conditions judgment must
and direct the hand. There will be
have sway, many cases, too,