Page 108 - My FlipBook

METHODS OF FILLING TEETH.
94
another form was chosen. But these men select a foot-plugger which
is narrow, and reaches a sharp point at one end. Thus in one instru-
ment is had the action ofa foot-plugger, or of a point. Such a plugger
Fig. 84, and is most useful. What I am
is shown in advising against is
flat, and This con-
a broad, unusually long foot-plugger.
denses so much surface at once that thorough cohesion is
if ever, obtained.
doubtfully,
One more essential point : In packing any filling I make
it my rule that, from the very initial pieces, the shape of the
cavity must be such that I can use the mallet, without needing
another tool to hold the gold steady. This is the rule :
exceptions exist, but are very rare. Applied to contour fill-
no
ings, the rule -must have absolutely exceptions. Every
of as it is added, must a as far as
piece gold produce filling,
the work has progressed, to dislodge which would require the engine
drill. How this may be attained in specified cases, and in cavities
will be discussed later. I call atten-
offering special difficulty, merely
tion here to the fact that, in contouring, this rule must hold complete
sway. If at any time it is found that the filling will tip, or move in
the slightest, the operator may as well remove his gold and reshape
his cavity. To emphasize this point, I will relate a case which
occurred early in my career.
I was asked by a dentist, whose experience and
skiu were much respected by myself, to be at his
FIG. 85.
office one afternoon to assist him in a
i placing large
contour filling. He wished me to mallet and pass
the gold. I did so. The tooth was a central incisor,
and the cavity as he prepared it is shown in Fig. 85.
It is seen that the is absent. The
cutting-edge opera-
tor had prepared a cavity retentive in shape, merely
because with a wheel-bur he had made an undercut, or
groove, all around. This is exactly the plan to be followed in similar
cases, where from abrasion the ends of teeth have been worn away, and
it is desired to stop the destruction by offering masticating surfaces of
gold. Then the filling is made flush with the top of the tooth, and will
remain in place even though it must be held with another instrument all
thro ugh the process of packing. (This, of course, need not be if the
groove be properly shaped to retain the first pellet.) To so arrange a
cavity, however, where, as in the case which I am citing, about one-
quarter of the length of the tooth was to be restored, was absurd. Thus I
thought, but of course made no comment. The dentist began with a
rather and much as he had been
large pellet, proceeded though using
non-cohesive gold. That is, he was mainly depending upon wedging
the pieces across from one groove to the other, using one instru-