Page 158 - My FlipBook

58 PATHOLOGY OF THE HABD TISSUES OF THE TEETH.
erosion will go on beside the fillings and continue spreading,
leaving the margins of the fillings standing as they were placed.
One who has had a wide observation of erosion and of its
progress from year to year may do much good by filling in
certain selected cases. These should be those deep cuts across
the teeth that show little or no disposition to lateral spreading.
In a number of cases of this character I have cut the groove
fully to the mesial and distal surfaces, and filled them with gold
without other preparation. These have generally been success-
ful. Early in my work I filled two of these without the exten-
sion mentioned. The erosion soon made the extension, and
refilling became necessary. These include very few of the cases.
The wedge-shaped forms have in a few instances done well with
fillings, and certainly the depth of the cutting can be materially
limited. Most of my efforts with these, however, have failed
to stop the spreading. With the dish forms I have seen no suc-
cess short of cutting away the remainder of the labial surface
and replacing it. The artificial crown is the better treatment.
In other forms of cutting, filling seems to be of no use except
to limit the sensitiveness for a considerable time, and to prevent
depth. The filling may be done with porcelain inlays when that
seems desirable. In the great majority of cases, however, it
will be better not to make fillings of any kind.
I am therefore of the opinion that, as a general rule, fillings
should not be made in the treatment of erosion. That which
now promises the best results is to keep watch of the cases, and
at the proper time cut away the remaining parts of the crowns
and place artificial crowns.
The sensitiveness when very annoying may be relieved,
temporarily at least, by severe burnishing. The best way to do
this is with the burnisher cut in ridges something like a coarse
cut bur, with the edges rounded and polished. Some use has
been made of these for burnishing fillings. Place the bur on the
eroded and sensitive surface while rapidly rotating, and go over
its surface quickly with strong pressure. Repeat this several
times and then leave it alone. The first application will cause
sharp pain momentarily, but afterward there will be less, or no
pain. This will generally relieve the sensitiveness for some
time. This may be repeated when necessary.
When erosion has progressed so far that the teeth have
become much disfigured, the crowns should be cut away and por-
celain crowns of some form substituted. These, if well made,
will give excellent service.