The Archives of Dentistry, Vol. VII, No. 12, December 1890Various
Science
The Archives of Dentistry, Vol. VII, No. 12, December 1890
Various
Dentistry -- Periodicals
I do not hesitate, however, in destroying a pulp to-day so much
as I did some years ago, when we were taught to believe that the
devitalizing of an exposed pulp was almost a certain forerunner to the
total destruction of the tooth. There has been a radical change in that
theory, Dr. Atkinson, of New York, has written a paper in which he
speaks of the amputation of a pulp. If I remember rightly, he claims
that you may amputate a pulp up to the bifurcation of the roots, that
it is good surgery and it will live. I do not agree with him; and
yet when I have been trying to destroy pulps up in the canals, I have
sometimes thought they would live, no matter what you did to them.
I do not hesitate to destroy pulps to-day, because we have such an
excellent knowledge of the structure of the tooth, and we now know that
simply because the pulp is lost we must not suppose the tooth to be
entirely dead, but there is still life from the membranes of the root.
So I am now inclined to cap only those pulps which present the best
conditions for capping. If a pulp presents any symptoms of congestion
or inflammation, I believe you had better dispatch it at once, in order
to give the best results to the patient, but I am not a believer in the
wholesale destroying of pulps. I believe, gentlemen, in conservative
treatment.
DR. EDDY:—Mr. President and Gentlemen: I am a firm believer in
treating exposed pulps, with arsenious acid. I have tried almost
everything else during the last fifteen years and have found nothing
that will especially preserve the life of a pulp. I have had cases
apparently benefited by some kinds of treatment; but I think it has
been due fully as much to the temperament of the patient and general
condition of health. I believe that oxyphosphate will destroy a pulp
just as surely as arsenic, only not as soon. I believe this because
I used it nearly eight years, and have seen some of the results. I
have also had cases where I have used oxyphosphate of zinc underneath
amalgam fillings, as a cement, a non-conductor, but not in direct
contact with the pulp, and the pulps have died, and I laid it to the
oxyphosphate of zinc. Of course, I have had my experience with fresh
exposure, which I suppose was due to my being a graduate, and in those
cases I think I have had good results by doing nothing more than
touching the exposed pulp with carbolic acid and packing gold directly
over that, and it seemed to work very well. I have tried almost
everything that has come before us; and in those cases of exposure
resulting from decay, or even in cases where there is no exposure, but
a zone of softened tissue remains, which is liable to break down, I
think it will give the patient the most satisfaction to devitalize the
pulp. It may be a little more painful at first, but it is better than
having the neuralgia every now and then for from one to five years and
then destroy the pulp.
Public-domain text, read in full here on John Shaqi.
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