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VITAL PULPS 215

(B) Pulps Incapable of Restoration to the Normal.—The

treatment is known as Radical treatment and consists in the
adoption of one or the other of the following procedures, viz.,
(i) Devitalization.
(2) Anesthetization,

(i) Devitalization.
Technic.— (a) Under aseptic precautions establish the out-
line form, remove the decay and make the cavity slightly re-
tentive, avoiding pressure on the pulp, (b) If the pulp is

aching, place gently over the exposure a pledget of cotton sat-
urated with an anodyne, such as eugenol or clove oil, and seal
(avoiding pressure) with base plate gutta percha or cement,
allowing it to remain for from 24 to 48 hours, (c) Remove

the dressing under aseptic precautions, and gently place di-
rectly over the exposure, or slightly to one side, with a pair of
dressing pliers, a small pledget of cotton or piece of asbestos,
on which has been placed a minute amount of arsenical paste.
(d) Seal, avoiding pressure, with gutta percha or cement, and
allow to remain from one to seven days (usually two days), at
the end of which time the vitality of the pulp is destroyed, and

it may be painlessly removed.
Arsenical Paste is a mixture of arsenic trioxid with cocaine
or novacaine hydrochlorid and other drugs for the relief of
pain. The arsenic trioxid gradually produces death of the

pulp through a process of inflammation, finally causing
strangulation of the vessels by cutting off the blood supply at
the apical foramen. Its action is usually painful, hence its
combination with cocaine and other pain-alleviating drugs.

If the minutest amount of arsenic trioxid escapes from the
cavity and comes in contact with the gums, it will produce
inflammation and death of these parts (arsenical poisoning),
which is liable to extend to the bony tissues, hence great care

must be observed in placing arsenical dressings to see that