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too METHODS OF FILLING TEETH.

in order to obtain retentive shape, would leave the remaining portion
so weakened that fracture subsequent to or during the filling opera-
tion would be rendered probable. Again we resort to the screw when
necessary excavation might too nearly approach, or even expose the
is shown
pulp itself. A case which combines both of these possibilities
which is a lateral incisor from which both corners have been
in Fig. 93,
removed by carious action. Supposing that the pulp were alive in
such a case, I think it better to restore by gold contours than to crown,
without destruction of
even where crowning could be accomplished
the pulp. Using the How drills, taps, and gold screws, a threaded
hole is drilled in the tooth, care being taken neither to enter the pulp-
chamber, nor to pass through the side. The screw is then turned
into place tightly and cut off long enough to reach almost to the end
of the corner which is to be builded on. The figure shows the screws
in position. To secure permanent results, the greatest skill and care

FIG. 93. FIG. 94. FIG. 95.

are in around the screw. Only very small
requisite filling pieces
should be used, and each of these should be thoroughly condensed.
As a screw renders an operation doubly difficult, it should be re-
sorted to only in cases of absolute necessity. Fig. 94 shows a good
arrangement of screws in a molar, the pulp being alive, and the tooth
so sensitive that proper excavation of the cavity becomes of doubtful
Here we have four screws so that assist one
expediency. placed they
another. Where it is designed to depend upon amalgam, a screw of
platinum and iridium is preferable to one of gold, which could be
readily destroyed by amalgamation. We sometimes find molars badly
scooped out by abrasion, a considerable surface of the dentine being
thus denuded. these are
Occasionally places extremely sensitive.
Here screws may be depended upon to do good service. I have
placed as many as six in a single tooth, as shown in Fig. 95, which
represents a molar ready to receive the amalgam, no undercutting
been reliance the screws.
having attempted, being placed entirely upon
In concluding this subject, I will give a few odd cases from practice
which may indicate the unusual application of principles which become
necessary in unique cases.
Case i A called me with the
.
young lady visiting the city upon
statement that she had fallen and broken a lateral incisor. Her den-