[12] Translated from the _Revue Odontologique_, for the _Dental Cosmos_.
At the July meeting of the Odontological Society of France, Dr.
Cludius, from Grenoble, made the following demonstration of a new
method of gold filling, saying:
We feel the necessity of making the operation of filling teeth with
gold easier, if possible, especially in difficult cases, in order to
lessen the fatigue of the operator, as well as to prevent the suffering
of the patient, during hours without interruption, under the ceaseless
blows of the mallet. The remedy has been sought in new forms of
material, like sponge and crystal gold. These have not given any help
in the performance of good operations, but have rather facilitated poor
work. We are not in need of varieties in the forms of gold, but we
ought to try and improve its manipulation, and this has recently been
done in a novel manner by Dr. Herbst, whose rotation method has been
mentioned in the dental journals within only a few months; and yet it
seemed necessary that this great invention, made in Bremen, should take
its way by America to come to us.
In the January meeting of the Odontological Society of New York, Dr.
Bödecker mentioned it for the first time, describing the excellence of
fillings made by Dr. Herbst in less than half the time that any mallet
work would have required, and he expressed his intention of going to
study the method with the inventor. Thinking that I was yet nearer to
Bremen, I went thither, and found there Dr. W. D. Miller, who had come
on the same errand. Mr. Brasseur had also written to Dr. Herbst, and it
is by his (Mr. B.'s) invitation that I came to Paris to show you what
I have learned in Bremen. To-morrow morning I shall show the method in
the mouths of patients at the Dental College of France. Dr. Herbst did
not patent his new method, to which may be given the name of "rotation
gold filling." All he desires is that every one may try the system,
and he feels himself already largely paid by the acknowledgments he is
daily receiving.
He proves that by his way of rotation one is able to adapt the gold
more perfectly to the walls of the cavity than by any other means
hitherto employed. One can thus work gold in the very weakest teeth,
because there is no force employed, yet the gold is as much condensed
as by any mallet known.
[Illustration]
The new instruments are very simple, and you may find them in the
dental depots. One can easily prepare them for himself--at least the
principal one, No. 5--by putting a broken burr in the hand-piece and
holding it like a pen for writing until the rotating end of the burr is
ground to a roof-like shape, on a dry Arkansas stone. Nos. 1, 2, 3, and
4 are smooth burnishers, and help to fix the first layers of gold in
large fillings. They are afterward used as finishers, Nos. 9 to 17 are
finishing burnishers, and No. 18 is a needle-point finisher.
The cavity is to be prepared in the usual way, but retaining points are
very much less needed than for other methods. Take, for instance, a
central cavity in a molar--and, moreover, the fundamental idea of this
system is to transform all cavities to be filled into central cavities.
Now fix several cylinders, of a size proportioned to the cavity, with a
common plugger, and then take No. 2, or 3, or 4, and by a slow rotation
polish the gold against the walls. If the gold does not stick directly,
put in more cylinders with the plugger, and recommence the condensation
with the burnisher. On this first layer of gold a second one is to be
made to adhere; but the polished surface prevents, and here No. 5 finds
employment in quick rotation and interrupted touches until the polish
is gone. (I may here remark that the gold is condensed by this rotation
and without pressure in a very remarkable way.) For large fillings, No.
5 is to have proportionate points,[13] which, if too fine, will make
holes in the gold, and the pressure is to be intermittent, in order to
avoid the development of heat, which would be painful and irritating to
the pulp.
[13] In the cuts, Nos. 6, 7, and 8 are proportionate modifications of
No. 5.
All the instruments by use get gilded, and will not work longer without
tearing out the gold; but this inconvenience may be prevented by
occasionally rubbing them while in rotation upon a piece of tin.
The filling of the cavity is continued in the way above described.
Let us now take the case of two incisors with lateral cavities
approximating one another. The two cavities, prepared as usual, are
treated as if one, and the gold is at the same time introduced into
both cavities, fixing some cylinders in the four corners by rotation
of the proper burnishers, and condensation with No. 5, until they are
filled, so that there appears to be a single mass of gold. No. 18 is
then pushed with regular rotation between the teeth until the mass
is quite separated, so that thin files, and disks, and tapes may be
employed in finishing the fillings.
In filling similar cavities between the second bicuspid and first
molar, after they are properly prepared, place a matrix and fill
one cavity with shellac to retain the matrix, and distribute the
resistance, and then fill the other like a central cavity, beginning at
the cervical border, and pressing especially against the matrix at that
point, work toward and finish at the middle of the crown. Having filled
the first one, remove the shellac and fill the other in the same way.
The rotation and the pressure, _if intermittent_, do not produce
heat--at least, not more than will render the gold cohesive.
Dr. Herbst filled for me two molars, carious to the cervical border,
and very sensitive there, for which reason they had for years been
filled with plastics, because I was afraid of perforation if retaining
points were made, without which gold filling by malleting would not
have been possible; and I was too nervous to sit three or four hours in
the chair. Dr. Herbst filled both teeth by rotation, without retaining
points, in a little more than one hour. Several gentlemen present have
seen them and observed the severe tests to which Mr. Brasseur subjected
them, and I may add that notwithstanding the great sensitiveness of
the dentine and the proximity of the pulps, I felt not the least
inconvenience from heat, and my own patients bear like testimony.
We will now split a crown filled in the hand, and you see that the
gold is pressed into the smallest depressions of the interior surface,
and is so uniformly condensed as to resemble an ingot, impossible
to separate in pieces, yet you may note the different stages of the
rotation.
I saw Dr. Herbst fill six cavities--some of them large ones--in front
teeth, taking altogether at the same sitting about one hour.
It would be difficult to precisely describe the manipulation requisite
for the great variety of cases presenting in practice, but I have
explained to you in theory the typical ones in the hope of stimulating
you to try this method of filling by rotation, which I look upon as one
of the most ingenious modes yet given to our profession. The results
are splendid, and the operator will thereby save much time and prevent
great suffering on the part of the patient.