Page 115 - My FlipBook

THE USE OF SCREWS. IOI
i.
where she resided, did not care to undertake the
tist, in the city opera-
tion, and as she was about to visit New York kindly gave her my
address. Examination showed that the tooth, if a lateral incisor at
all, was misshapen, being indeed a supernumerary tooth. Though
narrow, its loss would have been deplorable, because the arch was
well curved and filled with teeth The fracture had
regularly placed.
removed about one-quarter of the crown, yet the pulp had not become
exposed thereby. The end of the tooth was broken off square, and
being small in proportion tothelengthof the restoration required, made
the chances of success next to impossible if
any attempt were made to
form a cavity by undercutting, which should retain the filling without
danger to the pulp. I built down a full contour, retaining it entirely
by three screws. The arrangement before filling is shown in Fig. 96,
and the restored end in Fig. 97. To start the filling, I took a narrow
rope of gold and wove it between and around the screws.

FIG. 96. FIG. 97. FIG. 98. FIG. 99.

Case 2. This case exemplifies another use of a screw. The patient
was a young man, and the tooth a first bicuspid. Approximal cavities
had approached each other till the cavity extended through from
front to back, as seen in Fig. 98, which also shows the disposition
which I made of a screw. The labial and palatal walls were so weak
that they could be sprung together slightly between the fingers, so
that I feared fracture from the force of mastication. As an additional
precaution, the edges of the natural cusps were slightly beveled, so
that after filling they were capped and protected by the gold, as shown
in The ends of the screw were ground off after
Fig. 99. filling, ap-
pearing like small fillings.
Case 3. A young woman of twenty, of comely features, applied to
me to have a gold crown placed over a first bicuspid. Examination
showed the
very extensive decay along posterior approximal por-
tion, which also extended so far up under the gum-margin that not
only would it have been difficult, but I thought that it would even
have been impossible to successfully crown the root after cutting off
what was left of the natural crown. The condition is shown in Fig. i oo,
where it is seen that the involves the root as well as the crown.
cavity
The natural crown itself offers poor support for a filling, yet this tooth
was successfully contoured, and is doing good service now, seven years