Page 207 - My FlipBook

WHEN AND HOW TO FILL ROOT-CANALS.
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canal. Chloro-percha is most useful when not relied upon alone.
Forced into a canal and followed with a cone, it renders the
operation
of oftentimes more easy and more
filling perfect.
Other materials have from time to time been advocated, but none
so generally adopted as the ones I have named.
The first condition in which a tooth requires root-filling is where
the pulp is freshly removed. Here several phases obtain.
The pulp may be removed fully, coming away so that the operator
is satisfied that there is none left behind. Here is the
thoroughly
ideal place for immediate root-filling. Where the canal is accessible,
there is no need for a reamer ; but if it be attenuated or irregular, the
reamer is to be cautiously used as has been described. The dam
being on, I would use a hot-air syringe, drying the cavity thoroughly,
continuing the blast until the patient complains of the heated condi-
tion of the tooth. Then I insert a cone of Gilbert's temporary stop-
which I have into
ping, previously dipped chloro-percha, and force
this up into the canal. Where I am sure that the canal is hot, I do
not heat the cone. In a stiff condition it is more forced into
readily
place, and the heated walls soften it so that it is easily packed to the
end. This, however, should be done with the utmost care, and the
of from the such as wrinkles between
slightest expression pain patient,
the eyebrows, is a sign to stop. It is a danger signal which, when
obeyed, may prevent pressing the material through the apex.
It is to be observed that at the very outset I advocate a material
not mentioned in the list upon which I made comments. Still, tem-
porary stopping is a form of gutta-percha, being only that material
mixed with wax. I prefer it to the gutta-percha alone, for the reason
that it softens at a much lower temperature, and remains so longer.
Where I have succeeded in getting the canal-walls properly heated I
have often inserted my cone cold, and in a moment found it nearly as
as soft wax. its either
plastic It is also less liable to change shape by
shrinkage or expansion, chloro-percha having been often accused of
the one and gutta-percha of the other.
Where the is taken out bit by bit, the reamer is more neces-
pulp
as where it can be used it will remove the odontoblasts adherent
sary,
to the walls.
Where the removal of the pulp is followed by hemorrhage, imme-
diate is contraindicated, save where the hemorrhage is
root-filling
controllable, as it often is by the packing of cotton dipped in tannin
and into the canal, and the
glycerin or other styptic leaving dressing
there for ten minutes. If the hemorrhage persists, a similar dressing
may be left in for twenty-four hours. It should be removed with
great care. Drawing it out slowly until it is loosened, and then
syringing thoroughly with warm water, will often disengage the cotton
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