Page 113 - My FlipBook

THE USE OF SCREWS.
99
over the plaster model, forming a contoured cap to cover the oxy-
phosphate, which I insert at the next sitting. The inner side of this
cap is treated as before, either with pins or loops soldered in. Fig.
89 shows a molar thus filled, the appearance being simply that of a
gold contour filling, because the edges are polished down to the finest
taper, which can be done so nicely that the point of an explorer will
pass over them, and silk not catch under the gingival margin. Fig.
90 shows the cap with loops within.
It may be as well mentioned here as elsewhere, though not strictly
speaking in the nature of contour work, though all restoration may
be so counted, that these for
caps oxyphosphate become invaluable in
the treatment of children's permanent teeth. When the little ones come
to us with cavities in their
gaping sixth-year molars, what are we to do ?
We frequently find extensive caries without real exposure of the pulp.
It is desirable to save these teeth alive, as a dead in a
greatly pulp
sixth-year molar, at this time, even though thoroughly removed, may
almost surely be counted a forerunner of an abscess later in life, and
FIG. 91. FIG. 92.

probable loss of the tooth before the age of twenty-five. So far from
considering these teeth good subjects for extraction, I take unusual
to save them. I think this can be with
pains accomplished oxyphos-
phate better than with anything else. Here again I fill the cavity
temporarily, in this condition placing cotton, which carries a medica-
ment first, and covering with gutta-percha or temporary stopping,
carving the same into fair shape for mastication. I then take an im-
and if it be make dies and a
pression, necessary swage piece of pure
gold to cap my cavity and give me a good masticating surface. Fig.
91 shows a tooth so filled, and Fig. 92 the cap with loop. These caps
should never be made to do service over gutta-percha, as that material
by swelling may dislodge the gold covering. In all cases- the edges
should be as down as though it were a true
thoroughly polished gold
filling.
TJie Use of Screws. The judicious use of screws in connection with
the restoration of teeth which have been badly decayed, enables us to
save permanently many teeth which would otherwise be lost or
crowned. The screw first comes into play when caries has advanced
so far that any preparation of the cavity, removing tooth-substance,