Page 130 - My FlipBook

Il6 METHODS OF FILLING TEETH.
and extensions a
connect thelabio-gingival palato-gingival by groove.
That is because ordinarily such undermining would weaken the
enamel remaining at this point. Here we find that caries has removed
the enamel. The root has been encroached upon. We need no
dread fracture, since the enamel has vanished, and we
longer may
consequently make as deep a groove as possible, from our labial dove-
tail toward the palatal angle as shown at/". Now we reach the palato-
gingival angle, or what is left of it. While we cannot get the strong
retainer that we ordinarily obtain, yet the bulbous portion of the tooth
extends all along the palatal aspect, and much of it is at our dis-
posal. Continuing downward from the gingival groove, we make
a deep undercut into this bulbous portion at b, and obtain an an-
tagonizing retainer for the labial dovetail at a. Next with fine burs
narrow the labial and
cut deep, grooves along palatal borders, pass-
between the and the two outer surfaces, at c and e.
ing just pulp
At d attempt no more than the usual incisive concavity. I have
filled just such cavities as this, where the caries had gone even
farther and removed the natural corner. Consequently I know that
even here we need no undercut at d. Lastly, with a small rose bur,
dip the bur-head here and there, in all undercuts, and wherever it
The is to make the surface of the
can be done with safety. object
as as If this be filled with small
cavity rough possible. cavity quite
made into
pieces, thoroughly cohesive, and packed carefully every
undercut and roughness, it will be found in place years afterward.
I believe I may now pass from the central incisor to other teeth.
Of lateral incisors there is little to be said which is not covered by
cases in the central. It must be remembered that being a smaller
tooth it is frailer, and therefore very deep undercuts are to be decided
with extreme caution. There is one odd circumstance that
upon very
I may allude to. I have noted, after a careful study of the facts, that
seemingly the superior lateral incisor is more prone to abscess than
the centrals, or than any other teeth at all. I have also come
possibly
to the conclusion that the pulp of a lateral incisor is less responsive,
than other. It is more to and more
painfully, any easy destroy, apt
to die under a In short, it seems to have less This
filling. vitality.
leads one to be more cautious in preparing cavities, for it is not at all
uncommon to find a pulp exposed after one has begun to place his
gold, when the excessive heat of a freshly annealed pellet at last
causing pain attracts the dentist's closer attention, and causes him to
discover a minute over which and excavators
exposure, engine-burs
may have passed without remonstrance from the patient. Thus we
might easily, through rapid excavation, actually expose a pulp, which
accident could have been avoided by more caution, born of the
knowledge that lateral incisor pulps are comparatively irresponsive.