Page 198 - My FlipBook

1 84 METHODS OF FILLING TEETH.

might be possible to pass a flexible broach and remove the pulp,
but it is evident that to attempt to fill the root might result in im-
between the
proper treatment of that part opening, a, and the end
of the canal at b. Consequently, my
custom is to insert a sharp rose bur
FIG. 231. FIG. 232.
through the opening as far as the wall
of the canal, and then bring it for-
ward toward b, removing the part
intervening. Even with the opening
thus enlarged, ready access will often
be impeded because of the angle at c,
so that with a bur I effect further en-
largement, till the canal, fully opened,
appears as seen in Fig. 232. Where
these canals are large enough, they
need no further reaming than at the
aperture ; but where they are dis-
torted, attenuated, or partly stopped
up because of deposits of secondary
dentine the I use the
along walls,
reamer as far as possible.
As the of or not canals is one which is much
subject reaming reaming
discussed and disputed, and as seemingly equal authorities will most
positively adopt one side to the entire exclusion of the other, I may
as well here take up this point and give my own views, based upon
my experience. The chief objections to using a reamer to enlarge a
canal throughout are, first, the danger of making an aperture through
the side of the root or near its apex ; secondly, danger of crowding
debris forward, so that even where it does not pass through the root,
carrying possible infection into the territory beyond, it may become
packed into the canal itself, limiting further progress, and so after all
preventing the proper drilling or filling of the canal ; lastly, the drill
may be broken off and remain in the root.
The advocates of all canals that
reaming say by enlarging they
insure better and that in teeth where pulps have been long
filling,
dead the canal-walls are in a softened and
probably partly certainly
septic condition. In these teeth is it not better to remove this, than
to endeavor to disinfect or to sterilize it ?
Extremists are not good teachers. The man who reams out every
canal io its apex is as unworthy of a following as the other man who
can Jill all canals without having a reamer in his office. The true
method is to have a good assortment of reamers, to know how, when,
and where to use them, and to use them with skill and caution
that will assure success. I hope that I belong to this last class, and