The Archives of Dentistry, Vol. VII, No. 12, December 1890 — John Shaqi
The Archives of Dentistry, Vol. VII, No. 12, December 1890Various
Science
The Archives of Dentistry, Vol. VII, No. 12, December 1890
Various
Dentistry -- Periodicals
DR. WERNER:—I look upon the treatment of a pulp principally from the
standpoint of whether such pulp is absolutely necessary for the welfare
of the tooth. The pulp is a formative organ. Its function decreases
as the tooth develops. In young persons it is largest; grows smaller
and smaller, and in old age it is nearly ossified or obliterated; that
is, its retrogressive stage begins materially after the crown of the
tooth erupts through the gum. I have seen three different times what
Dr. Smith spoke of—the actual pulsation of the pulp—which in a large
exposure, in a favorable light, is easily seen. All of those three
pulps were capped and they seemingly are alive to-day, but I think
the teeth would be quite as serviceable had the pulp been destroyed.
From a surgical standpoint the amputation of part of the pulp may at
times be successful, for we know how resistive they often are to any
kind of arsenious acid treatment, yet I should never do it unless
it were in a partially developed tooth, where the life of the pulp
is essential. What the surgeon does after trepanning the skull, we
should do in capping or bridging over the pulp cavity. He does not
flow escharotics like oxychloride or oxyphosphate of zinc over the
brain. He mechanically covers and takes good care not to press on the
contents of the cavity. The tooth pulp must be treated in the same
way; a simple mechanical covering over it being all that is necessary.
Whether you put a metallic cap, or whether you put court plaster, or
one of gutta-percha (though I should hesitate about using the latter),
makes little difference, only be sure that you do not press upon the
pulp. With the knowledge we have to-day in treating devitalized teeth,
there seems little reason for a young man to risk trying to save bad
cases of exposed pulps. It is in extreme practice successful only for
the time being—sooner or later ending in failure. To me many so-called
successful records are only apparent successes, the operations
only hastening the pulps to degeneration. The flowing over of all
escharotics, I think, is highly unscientific.
DR. CLAPP:—The last speaker has made the statement that after the
tooth is formed it no longer requires the presence of a pulp. I would
like to ask him when he considers a tooth formed?
DR. WERNER:—In many cases the pulps of teeth are very large at
twenty-five years. A tooth, however, is usually formed and the apical
foramen closed up at from three to five, or, at the latest, ten years
after the eruption.
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