Page 125 - My FlipBook

APPROXIMAL CA VITIES IN INCISORS. 1 1 1

simplify matters vastly, but if such a procedure was wrong in the last
it would be In the former instance the
cavity, doubly so in this.
retention of the palatal plate gave only an added support to the gold,
whereas here the labial plate not only serves the same purpose, but
it also covers and hides the gold from view. An extensive filling of
this nature may be placed and scarcely be seen from a front view.
Wherever there is found sufficient strength, therefore, to this part of
a tooth, I should allow it to remain. As in the last case, the cut-
ting-edge should be removed, allowing the gold to be built over it,
thus protecting it. But for cosmetic effects only the merest trifle
should be taken so that a line of will show from
away, barely gold
the front. The formation of the cavity is the same as in the last
instance, save that the groove now occurs along the palatal border,
to avoid weakening the labial plate.
The insertion of the filling will tax the skill of beginners, as it does
that of many of mature experience. This is one of those conditions
where a judicious alternation of mallet and hand-pressure produces
the most satisfactory results. Because of the inaccessibility, and be-
cause of the difficulty to see all parts of the cavity, the danger from
fracture by the mallet blow is increased tenfold. My habit is to partly
condense every piece by hand-pressure before taking up the mallet.
Of course this is slow, but rapidity is not invariably preferable. The
main point always is to obtain the best result, in safety. If the ope-
rator has a chair which will allow him to tip his patient back, so that
into the it would be a most
he can see directly cavity, advantageous
procedure. If not, he must be skilled in the use of a mirror and de-
pend upon it. After filling the labio- and palato-gingival extensions,
I should gradually extend the gold toward the cutting-edge, following
the and the whole inner surface with a veneer of
groove covering gold.
Up to this point I should use the mallet but sparingly, but with this
to the weak wall, the mallet used for com-
protection supplied maybe
the with less fear. A momentary warning, however,
pleting filling
against too free a use of hand-pressure ! Beware lest in the attempt
to conscientiously condense the gold too much force be exerted, and
a fracture occur. More teeth have been broken by hand-pressure than
with the mallet.
has removed
Next we reach the condition where the depredation
the corner. The restoration of these teeth is classed with contour
but are also approximal cavities. An important warn-
fillings, they
ing is to be given at the very outset. Be sure to obtain sufficient space
in which to work. The absence of the corner is apt to prove mislead-
ing. Apparently there may be abundance of space, especially where
the cavity is extensive. In reality there never is, where the teeth are
has not been removed. The
normally situated, and the neighbor