Page 86 - My FlipBook

METHODS OF FILLING TEETH.
72
walls. It could be hollow in the center, and serve as well. Indeed,
to show and
hollow fillings have been made, merely dexterity, they
have preserved the teeth. In large cavities surrounded with strong
walls it is not very difficult to accomplish this. The floor and sides
are covered with a solid but thin veneer, and then the top is roofed
from the
over by building margins toward the center, finally closing
the last orifice, and leaving the interior of the filling hollow. It is not
quantity of gold therefore that is needed. At the same time we must
at the surface, as that means This is best
have solidity durability.
achieved when we depend upon heavy gold for at least the final third.
A filling so completed will receive a higher and more beautiful finish,
and will retain its luster longer than any other.
I have hinted that there are places, however, where we must de-
pend upon this gold entirely. I will describe them in more detail.
We have all of us seen, in crowded jaws, bicuspids so solidly rooted
that it becomes almost impossible to obtain extensive separation.
Approximal cavities in these teeth, especially where they reach almost
to the gum, are most trying. The orifice at the masticating surface
is so small that an ordinary pellet is compressed in passing, and yet,
when within the cavity, is so loose that it is most difficult to attach it
firmly against any gold already in position. Our manipulations only
it more, when in the end most it becomes a non-
compress probably
plastic nodule unfitted for use. It is here that we may turn to heavy
gold with entire confidence. Because of its thinness it can readily be
passed between the teeth and led into place, when its impaction be-
comes comparatively easy. Undoubtedly a tooth thus filled entirely
with this material will be well filled. If the question be asked, Why
not do this in all cases ? the reply is, that to do so would be a waste
of time, as it takes longer to fill exclusively with heavy foil than where
we use a plastic, pellets, or both, for the first two-thirds.
Another most important position for heavy foil is where in, let us
say a lower molar, we find a cavity in the masticating surface, and
another in the this latter to be what
posterior approximal. Imagine
we term a saucer-shaped cavity, one of those exasperating places
where we find absolutely no retentive shape, and a tooth so highly
organized that every attempt to use the engine, or an excavator, causes
excruciating agony to the patient. It is seen that if the two cavities
be united, the whole would at once receive and retain a
filling perma-
This is done, but now the
nently. question arises, At what point shall
the be started ? It is to at the bottom
filling simply impossible begin
of the approximal cavity, because there is no retentive pit or groove
to aid us. We therefore begin at the wrong end, according to ordi-
nary principles ; that is, we begin at the top and work downward.
in the
We fill the cavity masticating surface, and then try to build over