Page 47 - My FlipBook

LIGA TURES.
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been spread apart by wedging, are slightly loose, and sore to pressure.
Because of some necessity, let us suppose that it is impossible to defer
the operation. The teeth must be filled at once, yet the hand-press-
ure, or mallet, used for condensing the gold causes excruciating
pain. Proceed as follows : Imagine that the cavities are at the me-
dian line, in the anterior approximal surfaces of the central incisors.
The dam is made to include six teeth. A stout flax thread is waxed
and passed between the lateral incisor and the cuspid on one side. A
surgeon's double knot is made so that it occurs between the lateral and
central incisors. This being firm, the two ends are passed around the
central incisor, and the double twist drawn tightly along the anterior
approximal surface ; the central is thus drawn tightly against the lateral.
The knot being completed, the two ends are next carried back and
tied along the posterior surface of either the lateral or the cuspid,
should the lateral not be firm enough to give good support. The
same on the other side of the mouth
proceeding produces the result
that both central incisors are bound firmly to their neighbors. To
complete the stability a wooden wedge must be forced between the
incisors, giving all the space possible, and acting as a keystone to the
arch. Teeth thus held may be filled with gold when otherwise they
could not be touched.
When from pyorrhea or other causes a single tooth is found to be
quite loose, it is frequently advisable to unite it to its neighbor with a
It has been advised to the dam and then encase
gold filling. apply
the teeth with oxyphosphate of zinc (some use plaster of Paris).
This is sometimes best, especially with the anterior lower teeth.
Where the tooth is either a molar or a bicuspid, I have usually been
able to obtain satisfactory stability by the use of ligatures. In Fig.
49 are shown a first and second molar, with a continuous groove from
one to the other, and ligatures binding the two together. Only two
rows of ligatures show, and these would be insufficient ; but I have
allowed the artist to draw but two, lest the figure be confusing. The
dam being in position, the waxed flax is passed between the first
molar and the bicuspid, and a double knot made between the molars,
in the manner already described. Then the ends are carried back
around the second molar and tightly tied along the posterior surface,
thus drawn the
th*e loose tooth, whichever it be, being tightly against
firmer one. This is what I term the figure 8 ligature, and is to be
followed by the figure O, which is accomplished by bringing the ends
around and tying them along the anterior surface of the first molar,
Fig. 49 a. Thus the two teeth are brought toward each other by different
is seen nearest to the gum, and
ways. In Fig. 49 the figure 8 ligature
between the teeth, while the figure O is the higher one, seen
passing
As has been already said, these two alone are not
to span the space.
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