Page 157 - My FlipBook

MOLARS.
'43
at a. In Fig, 159 I advised retaining extensions at the labio-
approximal angles. In this case they are to be made at the palato-
approximal angles also. Thus we would have a filling which, if
removed from the tooth for examina-
tion (the tooth having been extracted FIG. 161. FIG. 162.
and cracked open), would appear to
have four legs to stand upon, which
legs would flare outwardly to a slight
extent. Fig. 162 gives a section
through the tooth and filling, where
the retentive is
arrangement readily
seen. Where the depredation extends beyond this, so that good
retaining-grooves and extensions could not be made without endan-
the it would be better to four screws, which
gering pulp, depend upon
should be thoroughly well anchored when asked to hold so great a
contour.
In molars we find a of crown cavities. As
greater variety in
bicuspids, there is a class which should receive our immediate atten-
tion. I said that with children I usually begin by searching for and
the cavities in the sulci of This done, I next exam-
filling bicuspids.
ine the crowns of the superior sixth-year molars. In the pit at
the bottom of the anterior sulcus we are most to find at least a
likely
small cavity. Call it a cavity, and fill it with gold, if the point of a
fine can be made to so that there will be some
explorer penetrate
difficulty in removing it. When caries has but begun, there is no
trouble to fill with gold, for the dam is not a requisite, though always
an advantage if it can be used without serious objection. I seldom
resort to it with these teeth, because they can be filled so quickly that
it is better to depend upon the napkin than to risk too much annoy-
ance to a young patient. Usually a rose bur will sufficiently shape
the cavity, cleansing it and making it retentive at the same time.
Nevertheless, before filling, it is safer to examine with an excavator,
lest some white caries be left. The cavity all ready, fold a large
napkin once, and introduce the doubled edge into the mouth and
back behind the first molar, where it is held in place with a mouth-
mirror, which at the same time reflects light into the cavity. Should
there be danger from the saliva flowing from the duct of Steno, a roll
of bibulous between the gums and cheek will suffice to
paper placed
darn it off. Dry the cavity thoroughly with hot air, and select for
the first pellet one which will wedge in the cavity. Better still, use
crystal. Use a shepherd's-crook plugger if working by the reflection
in the mirror, or a slightly-bent bayonet if the patient is tipped back
so that the cavity can be easily seen. Depend upon hand-pressure
to start the but as soon as the floor is covered and the
filling, gold