Page 128 - My FlipBook

METHODS OF FILLING TEETH.
II 4
result of the concussion, it is wiser not to attempt any operation at
all until the sixteenth to eighteenth year. By that time, especially if
the patient be a female, something must be done. Should it be de-
cided to contour with gold, the first step will be to determine whether
the two centrals may be shortened with impunity. This often is a
A cas^ from will best illustrate. A
material advantage. practice pa-
tient came to me, a young woman, with two leaky fillings appearing
121. The two centrals below
as seen in Fig. drooped considerably
the laterals, as often occurs, and I shortened them. After refilling
they appeared as in Fig. 122. To return to Fig. 120 ; should shorten-
ing not be desirable, which of course would reduce the condition to an
of upon an of
approximation Fig. 119, we must decide arrangement
the cavity which will retain this unusually extensive contour. In the
FIG. 121.

main this will be the same as in Fig. 119, including the screw, but in
addition to this, now that we may reach the opposite side of the pulp-
canal we may with advantage form a retaining extension in the direc-
tion shown by the dotted line at a. It must not be forgotten, how-
ever, that there is danger of reaching an elongated cornua of the pulp
and the must be advanced with
at this point, preparation great cau-
tion, extreme sensitiveness being a danger signal not to be overlooked.
Although this retainer would be an advantage, it is not a necessity,
and should not be obtained at the expense of possible need for de-
struction of the pulp.
Up to this point it is of course immaterial whether
FIG. 123.
the cav jties described occur on the mesial or distal
surface. In either case they would be treated alike.
Should they occur on both surfaces of a tooth, each
would be a condition by itself, without relation to the
other. There comes a point, however, where approxi-
mal cavities occurring on both distal and mesial sur-
faces of the same tooth do bear a relation to one another,
alter the rule of
and materially management. Fig.
119 has been introduced to mark the point at which we abandon the sole
dependence upon retentive shaping and resort to the screw. Should
two such cavities occur in one tooth of nearly the pictured dimension,
we would no longer need a screw. Fig. 123 shows such a tooth
after the insertion of the It suffices to convey my idea. It is
filling.