Page 132 - My FlipBook

1 1 8 ME THODS OF FIL L IXG TEE TIL
of a screw, and it is therefore resorted to in all cases of contour. Thus
to work
we find that the cuspid is comparatively easy upon. Distal
when the condition is what
cavities are often troublesome, especially
I have called a palato-approximal cavity. If it is found difficult to
obtain much separation, which is not at all unusual, the work is sure
to be very tedious. Yet even farther back than the cuspid region
distal cavities may be made to seem almost like mesial, if the patient
be tilted sufficiently to bring the cavity within range of the eye, as is
often possible.
There is one cavity which we sometimes find in a cuspid, to which I
may make special allusion. It is shown in Fig. 127, where it is seen
to occupy a position along the neck of the tooth just above the bulge
of the enamel, and extending around toward the palatal portion. This
kind of cavity is most often found where an ill-fitting clasp has been
used to retain an artificial denture. Where this is the case, the first
bicuspid is commonly absent, which facilitates the operation. But let
us suppose that the first bicuspid is not absent, and that the clasp has
been the cuspid. To
stupidly placed between the two teeth, encircling
produce retentive shape, all that is needed is to cleanse out all decay
and then undercut along the full extent toward the gum and toward
the incisive edge. At the palatal end of the cavity, b, make a pit
deep enough to hold the first pellet of gold securely ; in filling, use the
mirror, and with hand-pressure build the gold from that point well
around into the approximal portion. It may then be thoroughly con-
densed with the mallet, and the filling completed as though only the
approximal portion had been involved. Great care is needed to
because it is above the of enamel.
properly polish this filling, bulge
I may pass now to bicuspids, and at once we approach an almost en-
different field. Many dentists claim that the
tirely approximal cavity
in the distal surface, is the most
in a bicuspid, especially trying in the
mouth. Omitting extreme or unusual cases, this is probably true.
An evidence of this is the fact that recurrence of decay at thegingival
border of is more often found in bicuspids than elsewhere, with
fillings
the possible exception of molars, which are much the same. This fact
is also an argument that such recurrence is rather due to faulty filling
than to any idiopathic causes connected with the position, as is claimed
by many.
In general, the main difficulty is that it is harder to obtain sufficient
for in the absence of the
space. This is shown readily, adjacent tooth,
even the distal approximal cavity in a bicuspid is really simpler than
a similar cavity in an incisor. That this should be so is due to the fact
is a wide tooth, and
that the bicuspid through a narrow space it is
often difficult to reach all of the When the bicus-
quite parts cavity.
pid happens to be unusually long, and the cavity nevertheless reaches