Simple Cavities upon Exposed Surfaces - Part 1
This class of cavities presents the most simple forms of fillings in the whole range of operative procedures upon the teeth.
Cavities which are situated upon the labial surfaces incisors and cuspids, especially when they have involved the cervix and extended beneath the margin of the gum, often present serious difficulties to the introduction of gold, which test the ingenuity, skill, and patience of the operator, as well as the fortitude of the patient.
One of the most formidable difficulties to be overcome is the adjustment of the rubber dam to those cases in which the cavity extends beneath the free margin of the gum. This may sometimes be accomplished by passing a ligature around the cervix of the tooth and forcibly carrying it towards the apex, until the dam passes beyond the border of the cavity, or the gum may be held away by the aid of the gum retractor.
It is always best to include in the rubber dam not only the tooth to be operated upon, but at least one upon either side of it. The How cervix clamp, often serves a good purpose in retaining the rubber dam in position, as do also the Libby-clamp, the Johnson lever clamp, and the Dunn clamp.
It is sometimes necessary to slit the edge of the gum above the cavity in order to gain a clear view of the gingival margin and to permit the rubber dam to go above it.
Cavities occurring in the labial surfaces of the incisors and cuspids are 'generally located either at the cervix or in the frequent imperfections of the enamel, due to developmental defects.
As a rule they are shallow, and therefore need to be given a good retentive form, either by slightly enlarging the cavity at the bottom or by forming small retaining-pits in the extremities. Cohesive foil or crystal gold are the best for filling this class of cavities. The filling should be started in one of the extremities, care being taken that the first piece of gold is securely anchored and the balance of the filling built upon this. Many operators finish such fillings with platinum-gold foil, as the color is less conspicuous than pure gold.
Cavities occurring upon the lingual surface of the incisors are generally confined to the laterals, and are the result of developmental defects, as shown in the imperfect closure of the pit or fissure at the base of the cingulum. These cavities are usually small, and are readily filled with a narrow ribbon of non-cohesive foil and finished with cohesive; or the entire cavity may be filled with a narrow ribbon of cohesive foil.
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