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144 METHODS OF FILLING TEETH.

packed is immovable, resort to the mallet. Here the engine-mallet
or the electric is most convenient, because one hand is engaged with
the mirror. In such small cavities will be more convenient
pellets
than heavy foil, but the latter should be used at the last. Fill with
pellets up to the level with the actual borders of the cavity, and com-
with so as to lessen the of the
plete heavy foil, building up depth
sulcus.
Next, attention should be given to the posterior sulcus. Here we
often find a cavity which will be much more trying, for which reason
the rubber is more necessary than in the last case. In this place the
decay often extends, though perhaps merely as a line of discolora-
tion, into the palatal groove. When this occurs, or in fact in all
cases except where the groove is scarcely defined, the cavity should
be extended into it, as is well shown in 18. It is this extension
Fig.
which will often try the patience of the operator, especially should he
be compelled to trust to the mirror for a view of his work. After
many and varied experiences, I have decided upon the following
method as being the most feasible, and applicable to the greatest
number of cases : After fully extending the cavity to the extreme end
of the palatal groove, with a sharp spear-drill make a deep pit at this
point obliquely, being careful, however, not to wound the pulp.
Next this after which the bur
enlarge pit with a rose bur, bring
forward toward the crown cavity proper, forming an undercut along
the sides of the palatal extension. Now exchange for a wheel bur,
and pass it the full length of the crown cavity, forming an undercut
each side and at the buccal end. A
along point of interest is worthy
of note here. The caries which decided the operator to fill this
most
cavity probably was noticed at this buccal end of the sulcus,
and is usually found burrowing toward the pulp rather than toward
the distal aspect of the tooth. Thus it is essential, after using these
engine instruments, to explore for caries at this buccal end of the
In the of instances it will be to remove
cavity. majority necessary
decay, and pain, if experienced at all, will be felt at this time. Thus
it is a valuable axiom, that in all distal or inaccessible crown cavities
the mesial side of the cavity should invariably be explored iciih a
s-crook .uind-excavator, or other suitable for
shepherd shape reaching
this unseen part of the tooth.
The the should be with and is to be
cavity prepared, filling gold,
in the made at the end of the extension.
started with crystal pit palatal
All of this extension may be partly filled until the gold is built well
over into the crown portion. It may then be continued with pellets
and the mallet until two-thirds completed, when heavy foil should be
used in pieces that are narrow, and long enough to extend from the
buccal to the palatal end of the cavity. By thus beginning at the