Page 209 - My FlipBook

U'HEN A\D HOW TO FILL ROOT- CANALS. 195

Next we have teeth presenting with abscesses. If the abscess is
acute, I think it wiser to cure it before filling the root, except where
the tooth is single-rooted, and it is decided to amputate the apex and
remove it with the abscess attached. Then it is best to fill the root
at once, so that the amputation will not leave an empty canal with a
gaping opening at the end. These teeth should be filled with the
temporary stopping packed solidly into the root. The amputation
is accomplished thus : Select a spear-drill, and with it pass through
gum, process, and root, along its central axis as high up as is decided
for the amputation. Follow this hole with a sharp fissure-bur, with
first one the
which, by laterally cutting way and then the opposite,
end of the root is severed. Where there has been much
easily
destruction of the process, its removal will not be difficult. Where,
however, this has not occurred, as, for example, in a cuspid where
there is a root and dense alveolus, it may be so difficult to do
long
this that it; would be wiser to anesthetize the patient. Then the labial
plate of the alveolus may be removed with burs and the amputated
root-end extracted.
In chronic abscesses I scarcely ever treat other than surgically, so
is more here.
that immediate root-filling permissible Still, I prefer
the silk and gutta-percha in all cases where there is the least chance
that some day this must be removed.
It may be argued that I should not advocate seemingly temporary
methods ; but while it is true that we should hope to make our work
as permanent as possible, in the matter of root-filling, too positive
It never can
permanence is a detriment rather than an advantage.
be certainly asserted of any tooth that its roots will never need to be
unfilled. If in no other way, the natural crown may continue to
decay till it is lost, when a crowning process may make it imperative
to empty the canal or canals. Where they are found filled with
a resistant material, there will always be some difficulty ex-
very
perienced. Again, I have seen teeth lost, where pericementitis had set
treated because the root-canals were
in, which could not be adequately
so filled that they could not be emptied, the teeth being too sore to the
When such a case
touch to make the necessary drilling possible. pre-
' '
sents the dentist will quickly say to himself, I wish this root were
filled with temporary stopping, which I could remove with a heated
instrument." Of course the other method, using the silk-and-gutta-
percha cone, is satisfactory.
that at least a of oxy-
Either of these methods require slight layer
should cover them before gold is packed
phosphate or oxychloride
upon them. This will be unnecessary where amalgam is to be de-
pended upon.