The Archives of Dentistry, Vol. VII, No. 12, December 1890Various
Science
The Archives of Dentistry, Vol. VII, No. 12, December 1890
Various
Dentistry -- Periodicals
The good results attending its use with amalgam, suggested at once
numerous uses to which it might be put, as: anchorage for gold,
foundation for any other filling at one operation, lining for thin
walls when objectionable color of filling material could show through,
cementing fillings which had fallen out or loosened intact, last to
place temporarily or otherwise. As an anchorage, its greatest is, I
believe, under amalgam fillings in cases of badly broken down molar
and bicuspid crowns where, on account of excessive decay and nearness
of the pulp, reliable undercut cannot be obtained, and if it could be,
would so weaken what remained of the crown as to deprive it of strength
to carry the filling. It is especially useful in molars where the
buccal surface and a half or more of the grinding surface is gone, in
bicuspids whose proximate surfaces are gone with a large share of the
grinding, so that the opening of the cavity is the full size of the
circumference of the tooth and the remaining walls thin. It is
astonishing how many of these latter cases can be shaped and contoured
with amalgam without a particle of the amalgam being in sight after the
work is finished. If in an anterior proximal filling proper contouring
make it necessary for some of the amalgam to show, the anchorage may
be thoroughly relied on to permit of cutting out a small portion and
facing with gold. The shading of the thin walls by the amalgam is
absolutely prevented by the cement. I have in my own mouth a molar in
which the filling was loosened by mastication five times on account of
the cavity being one of the kind where reliable anchorage could not be
obtained. The pulp finally became exposed from frequent cutting away of
tooth structure, and the sixth filling was anchored by taking advantage
of the pulp chamber, or a portion of it. To use cement as anchorage for
amalgam, this is the process: Mix the amalgam according to your custom;
place on a slab for mixing cement a small quantity of the liquid and
powder ready to mix; then, the cavity being prepared, dry it thoroughly
and keep it so while mixing the cement. This being done, place a small
amount in the cavity, and at once upon it place a piece of amalgam,
which should be so manipulated with the instrument suited to the size
and shape of cavity as to force the cement under the amalgam all over
the floor of the cavity. Care should be taken to not force the cement
entirely to the cervical edge in proximal cavities, and any excess
of cement used should be worked out at a point easy of access. By
this time the cement is hard enough to be easily chipped off whenever
it has been forced beyond the inner edge of the enamel. The filling
with amalgam is proceeded with and finished in the usual manner. It
is essential that the cement should not be smeared over the edges of
the cavity, but carefully worked all over the dentine, closing the
mouths of the tubuli, allowing the enamel edge free for contact with
the amalgam.
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