FILLING PULP CAVITIES
BY C. E. LATIMER, D.D.S., NEW YORK.
UNTIL within the last eight or ten months I have been dissatisfied with my efforts at filling the roots of teeth, and have been earnestly wishing and searching for some better plan.
Expressa o desejo de obter uma forma mais adequada de obturar os canais radiculares.
It is true that those easy of access could be filled with gold foil quite compactly, but the great majority were not of this class, and when I had used my best efforts, I could not feel satisfied that the fillings were what they ought to be. Some of the roots I found so small and tortuous as to admit only the finest broach, and if I succeeded in getting gold half way to the apex it was all I could do, and in many cases I was not even thus fortunate, where, from the inaccessible position, I could not succeed in getting a particle of gold in the root.
Apresenta a dificuldade de obturar canais finos e tortuosos, observando que ficam incompletamente obturados.
Moreover, in order to obtain the free access requisite for a foil filling, much of the strength of the tooth frequently had to be sacrificed.
Avalia que para avançar no interior do canal, frequentemente ocorre enfraquecimento excessivo da estrutura da raiz dentária.
This was a grave objection and gave me much trouble. With regard to enlarging the canals, my experience has not been very flattering. Those which did not need it, could be drilled out, but those which really did require it, were not improved by my efforts. A shoulder would often be formed half way to the foramen, against which the filling would lodge, and all attempts to get a plugger further were useless. If a fine broach, such as would go into those small, crooked canals, were used, it must first be annealed, otherwise a few revolutions would fracture it, and when thus annealed it would not cut; hence I have given up all attempts at enlarging the canals, except in a few rare cases where I enlarge the foramen for the treatment of alveolar abscess.
Cita que ocorrem perfurações, dificuldades de avançar, formação de ombros a meio caminho, e, ainda, fratura de instrumento no interior do canal.
I do not belong to that class who believe that cotton is the best material for filling pulp cavities.
Não acredita que algodão seja o melhor material obturador.
It is true, my experience has not been extensive in this direction, but I have taken out a few cotton fillings from the roots of ulcerated teeth, the odor of which has constrained me to rejoice that my experience was thus limited. I cannot say whether the cotton was put in with the mallet in these cases or not. Other operators may have a different class of teeth to work upon from those which come to me; indeed, I am frequently inclined to think so when I hear first-class authority talk about malleting gold to the apex of the root, or when I see the immense nerve broaches and pluggers in the market, and which are so favorably spoken of by everybody.
Descreve o estado repugnante de algodão removido de dentes tratados. E ironiza que os canais que chegam aos outros dentistas devem ser muito diferentes do que chegam no consultório dele, visto as dimensões enormes dos instrumentos utilizados.
My present plan is as follows: after having used the Nos. 2 and 3 Swiss broaches for removing the nerves from teeth as directed by my brother, Dr. J. S. Latimer, in the DENTAL COSMOS a few months ago, I prepare them for use by burnishing them upon a hard surface until they are rendered sufficiently stiff and elastic. This should smooth down the barbs and leave them straight.
Utiliza sonda 2 e 3 para remover o "nervo", após o que aplica um polimento sobre uma superfície dura para que tornem alisadas e elásticas e retas.
I now cut a strip of gold foil (Nos. 4 or 5 preferred) from one-fourth to half an inch wide, depending upon the size of the foramen; this is firmly rolled upon the broach, being sure that the point is covered.
Corta uma fita de ouro e cobre a sonda (enrolando).
It may now be clipped off of suitable lengths for filling the root, dipped in creosote, and forced. into the canal. In many cases the mallet may be employed to advantage by using a plugger with a slight concavity in the working end, which will prevent. the end of the broach from slipping, and drive it firmly into the foramen, thereby closing it pretty effectually.
Mergulha em creosote e força no canal para obturá-lo. Utiliza materlo para forçá-lo até o forame.
If the canal will permit it, other broaches similarly prepared may be forced in around this until the root shall be filled; or, if large, gold foil may be packed in around the broaches, a part of the distance.
Se for necessário, indica a inserção de outras sondas (preparadas da mesma forma) ao redor da sonda principal, ou, a inserção de folha de ouro.
I feel confident that after a fair trial this method will be highly prized by many, and especially for small tortuous canals, or in cases where the cavity of decay is almost at a right angle with the canals. It is really gratifying to know how little space is requisite to enable a careful operator to remove a pulp and fill a canal with these broaches
Sente-se confiante em relação a aceitação desta abordagem e de seu sucesso, especialmente em casos de canais curtos e tortuosos e quando a cavidade da cárie está em ângulo reto com o canal.
Nenhum comentário:
Postar um comentário