Page 144 - My FlipBook

METHODS OF FILLING TEETH.
I 3
I met her, and
seen little of the girl in the interim, my glance at once
which I noticed had to about the
wandered toward that filling, grown
size indicated by the dotted line c in Fig. 141. Questioning elicited
the information that the cavity had been refilled three times, each
operation enlarging the area of gold. The last
FIG. 141. a
filling, though poor one, has remained in place,
but the young lady is disfigured for life, or as
long as she retains the tooth.
When a patient presents with a fracture of
this nature, the first care of the dentist should
be to examine carefully in order to determine
whether the dentine has been denuded at any
place. If not, it often occurs that the fracture
may be stoned down and polished, even where there may be a con-
siderable concavity, making a much more presentable appearance
than after the insertion of gold. The concavity may be made less
conspicuous by the judicious beveling of the labial surface near the
incisive edge. Even where the dentine has been uncovered, I have
sometimes polished it and so left it, whilst in other cases where this
seemed inadvisable I have first ground down the tooth, as directed,
as far as could be done with safety, and then prepared and filled that
where the dentine had become Thus it is seen that the
part exposed.
aim should always be, first, to avoid filling at all, and second, to make
the cavity as limited as possible.
Where the fracture is so deep that a filling is peremptorily demanded,
only the finest of burs should be used in forming the cavity. I should
recommend that drills be avoided, as tending to shiver and split the
enamel. A new rose bur is safest and best. The first step will be to
use the corundum, polishing down what need not be included in the
and and the border lines decided
cavity proper, sharpening perfecting
upon. Next, with the rose bur, cut a tiny groove around the semi-
circle, making it deeper laterally at a, a in Fig. 141, and deepest at the
mesial and distal corners b, b. This cavity should be first floored over
with the tiniest of pellets, and then completed with heavy foil not
heavier than No. 30, cut into quite small pieces. Small points are
needed, and light taps of a hand-mallet. Such a place as this is
a good one in which to avoid a power-mallet of any kind.
In order to make more clear the fact that this plan avoids the
danger of disaster such as occurred in the case described previously,
I must point out the difference in the arrangement.
When I examined the first filling which had been placed in the
child's tooth,. had I criticised it I should have called attention to the
following facts, as indicative of future failure The surface of the gold
:
was pitted, showing that it was not densely packed. Yet other work