Procedures in modern crown and bridgework : the principles and technique of stationary and removable bridges / by Lee Walter Doxtater, illustrated with 577 engravings.

  • Doxtater, Lee Walter, 1885-1935.
Date:
1931
Catalogue details

Licence: In copyright

Credit: Procedures in modern crown and bridgework : the principles and technique of stationary and removable bridges / by Lee Walter Doxtater, illustrated with 577 engravings. Source: Wellcome Collection.

    36/504 page 12
    the abutment teeth. This is not only a trying- experience for the patient, but is an economic loss to both patient and dentist as regards time lost in repairing the damage. And in such circumstances it not infrequently happens that the tooth is eventually lost, when better judgment at the out¬ set might have resulted in the execution of a satisfactory root canal opera¬ tion. There will of course be cases in which, for various reasons, the performance of root canal operations may be inadvisable. Experience and histological evidence both teach us that when the enamel and dentin on any portion of the tooth crown is lost, there is a reflex disturb¬ ance in the pulp. It seems logical to expect that the removal of enamel and dentin the more pro- Dangers of Cutting Into Sound Teeth the more extensive nounced this disturbance will be. It is likely, although we cannot be sure, that the physical removal of tooth structure for deep seated inlays, has quite as much to do with the death of pulps under such restorations, as the possible introduction of bacteria into the dentinal tubuli during cavity preparation. Whatever the true explanation, it is a fact that many pulps have suffered as a result of this type of cavity preparation, especially when performed in previously sound teeth. Whether we are to regard the preservation of sound tooth structure as an ideal from the standpoint of its inherent superiority over artificial substitutes, or whether we base our argument on the desirability of avoid¬ ing unfortunate accidents, the fact remains that we shall best serve our patients if we plan our operations so as to remove as little as possible of sound tooth substance. This means that where a proposed abutment tooth has suffered no previous encroachment by caries, we should, if possible, use some form of attachment which will involve only shallow cutting of the tooth. In many instances, where sound teeth are to be used as abutments, it may be better practice to use a clasp, even though this may later result in decalcification. When it is determined by a care¬ ful study, that the teeth, as a whole, are relatively immune to caries, and where there is evidence that the patient is conscientious in the care of his mouth, and where, also, it is reasonably certain that the case may be kept under periodic observation, this type of attachment may be used without fear of untoward consequences. If superficial decalcification oc¬ curs, the damage may readily be repaired by the insertion of shallow fillings, preferably gold inlays, on which the clasps may rest with but little lear of further damage. This process of decalcification, because of its usually slow progression, arouses what may possibly be considered a more natural, and certainly a less violent reaction in the pulp, than will the
    digitised image 1
    digitised image 2
    digitised image 3