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Bands or crowns for temporary molars
finishing March 3rd, giving the appearance as shown in Fig. 2. One of the central incisors was broken off, the lateral incisors wre undersized, and it necessarily made a very unpleasing type of malocclusion, which is sho1f-n in Fig. 3. Fig. 3 shows the appearance of the patient’s face and lips in repose after the case \vas treated, while Fig. 5 sho\vs the appearance of the patient’s face \vhile smiling. In my opinion it was the correct solution of the case regardless of her aljility to pay more or less. \\.c arc aware of the fact that i.he extraction of an anterior tooth in the correction of malocclusion is to be avoided, but here was a case where the centrals \vcre deformed by being over&cd, one of them was broken off, the lateral incisors were small, even if the strictly orthodox plan of orthodontic treatment \vas followed bridge-work and restoration would have klecn necessary. This meant time :tntl money as a decided factor, consequently, the method of extracting the t\vo large incisors, and adjusting a four-tooth bridge by using the small lateral incisors as abutment, was decided upon. In iact I -ani very much in doubt if a Iletter appearance could have been accomplished considering the patient we had to I\-ork on, and the condition in the beginning, if a different plan had been follo\ve i However, in the use and the construction of the bridges for the correction of malocclusion, they must be constructed according to anatomical laws, the force of the occlusion must be observed, the operator must be positive that the constructed hridgc \vill he better in appearance than the deformed and mutilated teeth I\-hich arc extracted. I get good results many times by cstractin, rr theblo\ver central in hat11y cro\vdetl conditions rather than torturing the patient by trying to widen the arch. or by extracting the first bicuspid and trying to move several teeth owr. I!y extracting the central. the teeth vill straighten themselves out, and it is good lxactice for poor patients, \vho othcr\vise ivould have crolvded teeth all theit liws. I extracted a lower lateral tooth for a man. 37 years old, and the teeth straightened, without any appliances. in a year’s time.
BANDS
T
OR CROWNS
FOR
TEMPORARY
MOLARS
HI: difficulties-discomfort and sometimes pain attending the proper fitting and adjusting of anchor bands on molars, especially the temporary molars, is sometimes quite annoying to both the little patient and the dentist, and the fact that they sometimes do not stay oil- that they loosen, come off, or are driven into the soft tissue by the force of occlusion, and cause inflammation of the ginxivre, if not the peridcntal membratw, or sometimes cause etching of the enamel, is also quite annoying. Al1 of these things happen to the “busy dentist,” and the following method, \vhich has proved \-cry satisiactory to the author, is suggestetl f& the relief and the comfort of the little patient. ‘1%~ indirect method of making various restorations has been a great benefaction to dentists--especially the general practitioner, and a great factor in all
any other purpose. Aitcr thr necc+:q band, an impression of the individual tooth copper band, trimmed to the festoon of the to pass into the approximal SIKIW without modelling compoundz and forced to place on
separation ir; taken, gum (I:ig. cro\vding, the tooth.
for tlw application of ;L using a thin loosely fitting 1 ), and made thin enough ivhich i,G filled lvith soft \\‘hcn c,hilled it iq r<2ilovctl
Bands
OY
CYOKWSfor
Temporary
Mo1nr.s
707
(Fig. 2), encompassed with a celluloid strip (1:ig. 3)) and sunk into thin plaster (Fig. 4:) IVhen the plaster is set the impression is filled with copper amalgam, mixed to a soft consistency as in indirect work. UThen the amalgam has set, the plaster containing the model is slightly warmed (for safety), broken open, and the amalgam model cleaned, using chloroform to remove any traces of modelling compound. \\.e now have a practical duplicate of the crown of the tooth in amalgam (Fig. 5) upon which a band of any description may bc fitted with facility. In the method suggested, band material of a suitable gauge is cut from a tin foil pattern, and soldered, with lap joint (Fig. 6), and fitted to the model (joint on opposite side from the tube or other attachment), trimmed cusp-high or sometimes overlapping the cusps and marginal ridges a little. If necessary the band is slit a little and lightly burnished over and into the developmental grooves and margins to prevent displacement, and is then wedged to place in cylindrical s\vcdgc with vulcanite rubber. The band is then removed and the cusps trimmed high, allowing the band to lap over the occlusal surface at any place where it \vill not conflict with occlusion as in the buccal and lingual developmental groove (Fig. 7j. This can now be reinforced with solder and used as a plain band, if desired, or, a thin piece of metal can be cut and annealed and swedged right over the band and model which will be forced down into the fissures and sulci and over the edge of the band (Fig. 8) ; then remove and solder to the band and finish. The crown, for such it is, will slip into place on the tooth, many times with a spring, and will interfere very slightly with occlusion, which interference can be remedied by grinding or cutting away the interfering metal from the occlusal surface, leaving enough overlapping the occlusal surface to prevent the band being forced gingivally into the tissue, should it loosen (Fig. 9). The tubes or attachments can be soldered (Fig. lo), the band electroplated, and cemented to place with thin well-mixed cement, which causes it to stay on. that is, reasonably well, without any chance of gingival inflammation, if the cement is all cleaned off as it should be. The band can be any gauge desired for strength, but 34-gauge is surely thick enough. The cusp can he much thinner and in cementing the pressure should be on the band-or attachment thereto, and even a little lug can be soldered to the lingual for the purpose, as shown on Figs. 0 and 10, but pressure should not be on the soft and thin cusp. If in the opinion of the operator the band wedged directly in the model fits too closely, first wedge and burnish tin foil, No. 60. over the model and then proceed as before mentioned-the result is accurate but loosely fitting.
BANDS
T
OR CROWNS
FOR
TEMPORARY
MOLARS
HI: difficulties-discomfort and sometimes pain attending the proper fitting and adjusting of anchor bands on molars, especially the temporary molars, is sometimes quite annoying to both the little patient and the dentist, and the fact that they sometimes do not stay oil- that they loosen, come off, or are driven into the soft tissue by the force of occlusion, and cause inflammation of the ginxivre, if not the peridcntal membratw, or sometimes cause etching of the enamel, is also quite annoying. Al1 of these things happen to the “busy dentist,” and the following method, \vhich has proved \-cry satisiactory to the author, is suggestetl f& the relief and the comfort of the little patient. ‘1%~ indirect method of making various restorations has been a great benefaction to dentists--especially the general practitioner, and a great factor in all
any other purpose. Aitcr thr necc+:q band, an impression of the individual tooth copper band, trimmed to the festoon of the to pass into the approximal SIKIW without modelling compoundz and forced to place on
separation ir; taken, gum (I:ig. cro\vding, the tooth.
for tlw application of ;L using a thin loosely fitting 1 ), and made thin enough ivhich i,G filled lvith soft \\‘hcn c,hilled it iq r<2ilovctl
Bands
OY
CYOKWSfor
Temporary
Mo1nr.s
707
(Fig. 2), encompassed with a celluloid strip (1:ig. 3)) and sunk into thin plaster (Fig. 4:) IVhen the plaster is set the impression is filled with copper amalgam, mixed to a soft consistency as in indirect work. UThen the amalgam has set, the plaster containing the model is slightly warmed (for safety), broken open, and the amalgam model cleaned, using chloroform to remove any traces of modelling compound. \\.e now have a practical duplicate of the crown of the tooth in amalgam (Fig. 5) upon which a band of any description may bc fitted with facility. In the method suggested, band material of a suitable gauge is cut from a tin foil pattern, and soldered, with lap joint (Fig. 6), and fitted to the model (joint on opposite side from the tube or other attachment), trimmed cusp-high or sometimes overlapping the cusps and marginal ridges a little. If necessary the band is slit a little and lightly burnished over and into the developmental grooves and margins to prevent displacement, and is then wedged to place in cylindrical s\vcdgc with vulcanite rubber. The band is then removed and the cusps trimmed high, allowing the band to lap over the occlusal surface at any place where it \vill not conflict with occlusion as in the buccal and lingual developmental groove (Fig. 7j. This can now be reinforced with solder and used as a plain band, if desired, or, a thin piece of metal can be cut and annealed and swedged right over the band and model which will be forced down into the fissures and sulci and over the edge of the band (Fig. 8) ; then remove and solder to the band and finish. The crown, for such it is, will slip into place on the tooth, many times with a spring, and will interfere very slightly with occlusion, which interference can be remedied by grinding or cutting away the interfering metal from the occlusal surface, leaving enough overlapping the occlusal surface to prevent the band being forced gingivally into the tissue, should it loosen (Fig. 9). The tubes or attachments can be soldered (Fig. lo), the band electroplated, and cemented to place with thin well-mixed cement, which causes it to stay on. that is, reasonably well, without any chance of gingival inflammation, if the cement is all cleaned off as it should be. The band can be any gauge desired for strength, but 34-gauge is surely thick enough. The cusp can he much thinner and in cementing the pressure should be on the band-or attachment thereto, and even a little lug can be soldered to the lingual for the purpose, as shown on Figs. 0 and 10, but pressure should not be on the soft and thin cusp. If in the opinion of the operator the band wedged directly in the model fits too closely, first wedge and burnish tin foil, No. 60. over the model and then proceed as before mentioned-the result is accurate but loosely fitting.