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166 METHODS OF FILLING TEETH.

expense of time and pain that scarcely excuses the effort. An amal-
on the contrary, may be with and ease,
gam filling, placed rapidity
and if afterward will serve all purposes.
properly polished
similar cavities are more common, and at the
In the superior jaw
same time less difficult. I will introduce here a case from practice
which offered unusual features. Fig. 193 shows a first molar in which
is seen a narrow cavity, a, along the palatal side
near t^ie um > wmlst a second cavity, b, appears
&
FIG icn
at the At first
palato-approximal angle. glance
one would naturally say that they should be
connected and filled as one cavity. This I could
not do, for the reason that there was great diffi-
culty in placing the dam. The twelfth-year
molar had not to retain the
sufficiently erupted
which therefore was
clamp, necessarily placed
over the affected tooth. Again, this tooth was so
conical, and both of the cavities were so near the gum, that I found
it impossible to place the dam and tie a ligature before placing the
clamp. Neither did I succeed in tying a silk around the tooth after
the As a I found that
placing clamp. consequent result, though I
could force the dam back with the clamp so that I could fill either
moisture would leak in through the other. In this dilemma I
cavity,
filled the b with then placed the dam
'cavity gutta-percha temporarily,
and filled the a with the other. I
cavity gold, subsequently filling
filled these cavities with gold, for the reason that the teeth were
excessively sensitive, and the young man was obliged to wear an
obturator, which needed clasps to hold it in place. I felt satisfied
that, if filled with amalgam, the gold clasps in contact with amalgam
in this instance would prove mischievous. As I decided to fill
special
the two cavities separately, I could not form any extension in either
at the end near the slight separation of dentine at c, without under-
mining that point. I therefore made an extension at the opposite
ends in each, and formed slight undercuts along the length of the
cavities. In each case the first was packed into the pit at the
pellet
end, and the gold built forward toward c. The patient was tipped
back so that I could direct view of the work across the
get looking
mouth, the tooth being upon the left side. These two fillings were
placed three years ago, and though a fixture with clasps has been
worn constantly since, no annoyance has been reported.
Buccal cavities are difficult or in as are
simple proportion they
large or small, sensitive or otherwise, and near to or distant from the
gum. The simplest form is the small, almost circular cavity found in
the buccal sulcus, oftener in the lower than in the upper teeth. Their
preparation is easy, necessitating the use of a rose bur which will not