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2l6 THE TREATMENT OF PULPS

they are perfectly sealed. The tendency in modern practice
is to abandon the devitalization method on account of its
slowness and the dangers involved.

(2) Anesthetization. (Pressure anesthesia.)
Novocaine hydrochlorid has the property of temporarily
depriving the tissues of sensation. When forced into the
tissues of the pulp, that organ is for a time anesthetized,
when it may be painlessly removed.
Technic.— (a) and (b) Perform the same procedures as

described under the same headings for ''devitalization."
(c) Place a small piece of novocaine hydrochlorid in the
bottom of the cavity, and after adding a drop of sterile water,
when it will be dissolved, cover it with a pledget of cotton.

(d) Cut a piece of soft, unvulcanized rubber of a size sufficient
to fill the cavity, and with a large amalgam plugger or smooth
burnisher, slowly and gradually apply pressure, thus forcing
the novocaine solution into the pulp, constantly maintaining
pressure until it does not elicit pain, when the rubber and

cotton are removed and the pulp is ready for extirpation (re-
•
The rubber is placed so that it acts as a washer and
moval) .
prevents the backward flow of the novocaine solution.
Sterilization of the cavity before pulp removal is important,
because it is necessary to avoid infecting the pulp and apical

tissues during the subsequent procedures. In addition to the
application of the dam and sterilizing agents, all instruments
and appliances should be sterilized. Coagulating agents,
such as phenol, should be avoided for sterilizing cavities, pre-
ceeding the operation. Use for the purpose a 10 per cent
solution of formalin, i to 500 solution of mercuric chlorid,

25 per cent solution of sulphuric acid, or sodium dioxid.
Grieves has recently recommended for this purpose one part
beechwood creosote in ten parts clove oil, sealed into the cavity
for 2 or 3 days preceding the operation.