Page 99 - My FlipBook

THE V-SHAPED SPACE.
85
In conditions of disease where pyorrhea alveolaris has been pres-
and well that until we can
ent, we have been taught, taught, produce
of the teeth, we cannot to see the disease cured or even
rigidity hope
temporarily controlled. Why is this ? Because as long as the teeth
are readily movable, the soft tissue will be in a constant condition of
irritation due to such motion. If this be, and it is true, should we not
pause before producing or leaving spaces between teeth ? As soon as
a space is made, do we not destroy the integrity of the abutments in
the arch, and so make mobility of all the teeth more possible
than before ? This is especially true of the two teeth on either side of
the space. Whenever food is chewed in that region, it is packed be-
tween the slanting planes, and acts as a wedge to drive the teeth apart.
Not infrequently this results in a loosening of the two teeth, accom-
panied coincidently by an inflammation of the gingiva. This inflam-
mation goes on till a suppurative stage presents ; then there may
occur hypertrophy, and often pyorrhea directly results. I have noted
mouths where several teeth were affected with this dreadful disease,
and then have found that the teeth most involved were two between
which the V-shaped space had been made. I have no hesitation in
saying that in these cases the pyorrhea was first caused as I have
specified, and that subsequently the neighboring teeth suffered by in-
fection. Thus the dentist who filled the space invited, and I may say
induced, pyorrhea. Of course these are extreme cases, and there are
instances where the V space has been entirely successful ; but in all
cases that have come under my observation, and they have been very
few, I have noted that the gum-tissue was dense and tightly drawn
over the alveolus, the between the teeth being of a carti-
pedicles
laginous firmness, short, and tough.
In brief, my chief reason for advocating contour fillings, aside from
any consideration of cosmetic effects, is that to leave a space, or to
form one, between two teeth, is liable to result in a loosening of the
In the latter case, caries
teeth, or a diseased condition of the gingiva.
will almost certainly reappear along the gingival margin of the cavity,
and undermine the
filling.
The production, then, of a perfect contour, is the most important
of teeth. A novice soon be
element in the successful filling may taught
to stop a small cavity which is surrounded by strong walls. To insert
a contour of such a form that beauty, usefulness, and strength
filling,
relation to the conditions
shall each be attained in the highest present-
ing, requires a skillful manipulation, a knowledge of tooth-form, and
a mature judgment, which only experience can give. I can only hope
to direct attention in the proper channel. No theorizing can give the
student such attainment.
In every case which presents, the question will arise, Can the original