Page 231 - My FlipBook

PREPARATORY TO FILLING 215
cation of mummifying paste will probably prevent
the decomposition of the pulp for a considerable
time, and whatever may be said against its use
as an alternative to pulp removal and root-filling,
there can be no doubt of its value in these cases
as a temporary expedient. A paste contain-
ing formaldehyde in some form is especially
valuable, for formaldehj^de is in itself a pulp de-
stroyer, and it will no doubt in many cases cause
the pulp to die more rapidly. Formaldehyde
applied to an exposed or nearly exposed pulp will
cause considerable pain, but the writer has so far
had no cases of pain caused by this mummifying
paste after a pulp has been treated with arsenic, and
has ceased to give pain. A free exposure should
be made, and as much of the bulbous portion of the
pulp removed as can be done without causing pain.
Paraform, thymol, and oil of cloves, made into a
paste with oxide of zinc, is very efficacious. When
a pulp is completely dead—a condition readily
ascertained by delicately inserting a fine Donaldson
bristle, or a fine Swiss broach, down the canals—it
is necessary to remove it if possible. The bulbous
portion in the crown may be easily cut out with
engine-burs, and the prolongations down the roots
extracted by means of the ordinary " nerve ex-
tractors" if the canals are fairly large, and with