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METHODS OF FILLING TEETH.
10
often because the position of the cavity is such that the shank of the
which can be reached. All cavities
instrument limits the territory
should be scraped with spoon excavators, and all undercuts explored
with a right-angled hatchet. For this reason all crown cavities should
be opened sufficiently to permit the use of hand instruments.
shows an extreme case. The patient presented, complaining
Fig. 1 7
that there was a dull pain in an indicated region, which she could not
locate in tooth. A second left superior bicuspid
definitely any special
appearing discolored, an examination was made in search of a cavity.
A fine explorer was passed, requiring some pressure, into an opening
in the anterior pit of the sulcus. On attempting to remove the instru-
ment the entire crown came away, much to the horror of the patient.
Close examination showed that the only defect in the enamel was
the small aperture through which the explorer had been passed.
Caries had its starting-point here, and reaching the dentine, the de-
vastation continued, without further affecting the enamel, until the
pulp had been reached and killed. The crown when cleansed of decay
FIG. 18. FIG. 19. FIG. 20.
FIG. 17.
I /-
presented as a complete hollow shell or cup of enamel. In Figure 17,
which shows a section through the crown, the enamel b is seen to be
intact except where the probe passed, a representing the dentine, all
of which was carious.
There is a lesson to be learned here. Whenever caries reaches the
dentine, whether through a sulcus in a crown or through the smooth
enamel on an approximal surface, further extension of decay will be
in the dentine. of the orifice is due to the fact that as
Enlargement
the enamel loses its support from being undermined, the thinned
borders chip or crumble off. This is specially true of masticating
surfaces. It follows therefore that all discoloration in the sulci is to
be with Dark fissures should be
regarded suspicion. opened along
their whole extent, sufficiently to allow proper examination with
a hatchet excavator. If it is found that the enamel is undermined,
the cavity can best be further enlarged with a chisel and light taps of
a mallet, thus off borders with the least
splitting overhanging pain,
and revealing the true extent of the cavity.
Fissure-cavities, however, are to be opened even when not dis-
colored, if a cavity is found at any part of the sulcus. It is poor.
10
often because the position of the cavity is such that the shank of the
which can be reached. All cavities
instrument limits the territory
should be scraped with spoon excavators, and all undercuts explored
with a right-angled hatchet. For this reason all crown cavities should
be opened sufficiently to permit the use of hand instruments.
shows an extreme case. The patient presented, complaining
Fig. 1 7
that there was a dull pain in an indicated region, which she could not
locate in tooth. A second left superior bicuspid
definitely any special
appearing discolored, an examination was made in search of a cavity.
A fine explorer was passed, requiring some pressure, into an opening
in the anterior pit of the sulcus. On attempting to remove the instru-
ment the entire crown came away, much to the horror of the patient.
Close examination showed that the only defect in the enamel was
the small aperture through which the explorer had been passed.
Caries had its starting-point here, and reaching the dentine, the de-
vastation continued, without further affecting the enamel, until the
pulp had been reached and killed. The crown when cleansed of decay
FIG. 18. FIG. 19. FIG. 20.
FIG. 17.
I /-
presented as a complete hollow shell or cup of enamel. In Figure 17,
which shows a section through the crown, the enamel b is seen to be
intact except where the probe passed, a representing the dentine, all
of which was carious.
There is a lesson to be learned here. Whenever caries reaches the
dentine, whether through a sulcus in a crown or through the smooth
enamel on an approximal surface, further extension of decay will be
in the dentine. of the orifice is due to the fact that as
Enlargement
the enamel loses its support from being undermined, the thinned
borders chip or crumble off. This is specially true of masticating
surfaces. It follows therefore that all discoloration in the sulci is to
be with Dark fissures should be
regarded suspicion. opened along
their whole extent, sufficiently to allow proper examination with
a hatchet excavator. If it is found that the enamel is undermined,
the cavity can best be further enlarged with a chisel and light taps of
a mallet, thus off borders with the least
splitting overhanging pain,
and revealing the true extent of the cavity.
Fissure-cavities, however, are to be opened even when not dis-
colored, if a cavity is found at any part of the sulcus. It is poor.
