Page 73 - My FlipBook

CHOICE OF FILLIXG-MA TERIALS.
59
Cavities in the crowns of molars, though out of sight, should be
filled with gold, the rule being relaxed only as the cavity becomes
If a be small, and therefore of that class which
larger. cavity may
be safely rilled with anything and be preserved as long as the duration
of the material, it is the very placefor gold, because gold is the most
durable and reliable of all materials. A phosphate or a gutta-percha
filling will stop caries, but these must be considered temporary, and
amalgam preferred to either. For a similar reason gold must be chosen
instead of amalgam. As we come to consider cavities of larger s'.ze
the rule becomes less till at last the is reached where
binding, point
it becomes a decidedly difficult question to determine which material
must have preference. One way of reaching a decision is to consider
that the frail walls will still a because
seemingly support gold filling,
of the fact that the pulp is still living. In a similar cavity, where the
pulp has been removed, it might be safer to depend upon amalgam.
After this point has been passed, and the cavities presented for con-
sideration are of great size, amalgam should be the first choice, and
gold used only where everything combines to make a perfect operation
possible. Thus, if the patient is of good health, with strong nervous
stamina, and willing to endure fatigue, it becomes possible to place a
with the that the last third as well con-
large gold filling, hope maybe
densed as the first. Too often operator and patient undertake that
which, because of the tediousness, becomes so great a tax, that in the
end the work is hastily finished, and thus improperly completed.
Either the gold is not packed with sufficient force to produce a resistant
density of surface, or there is not sufficient material used to allow of
proper contour or occlusion. Again, given favorable circumstances
as to health and of
strength patient, the welfare of the tooth itself
must be considered ; that is, whether the placing of a gold filling
would become a hazardous operation. Where a recent attack of perice-
mentitis has been aborted, it might be attended with unfortunate results
to work upon the tooth for a period long enough to fill it with gold.
Thus, as I have said, as the cavity increases in size, the demand
for amalgam is correlatively increased, though a gold filling properly
made is
always preferable.
An important place for amalgam is where the cavity- border is below
the gum-line. No filling will succeed here unless the finished surface
border can be made There
along the gingival scrupulously smooth.
are many such cavities which should be filled with amalgam rather
than with gold, solely for the reason that the amalgam may be made
smooth more readily than gold. Many such may be filled with gold by
a dentist dexterous in placing the dam, and yet the filling after comple-
tion may defy the efforts of even a skillful operator to properly polish
border. Approximal trimmers will do much, but
along the gingival