Cdunibta ^mbetjsittj) i ^^j. (UnUpgp of piijjBtrtanH anii ^urgpona \ (&iven bg ^. Digitized by tine Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/practicaltreatis1880rich A PRACTICAL TREATISE MECHANICAL DENTISTRY. Valuable Works Connected with Dentistry PUBLISHED BY LINDSAY & BLAKISTON, PHILADELPHIA. HARRIS (CHAPIN A.), M.D., D.D.S. The Principles and Practice of Dentistry. Tenth Eevised Edition. In great part Eevvritten, Rearranged, and with many new and important Illustrations. Edited by P. H. Austen, M.D., Professor of Dental Science and Meclianism in the Baltimore College of Dental Surgery. With nearly 400 Illustrations. Royal octavo. Price, in cloth, 6.50 ; in leather, 7.50 HARRIS (CHAPIN A.), M.D., D.D.S. A Dictionary of Medical Terminology, Dental Sur- gery, and the Collateral Sciences. Fourth Edition, Carefully Revised and Enlarged. By Ferdinand J. S. Gorgas, M.D., D.D.S., Professor of Dental Surgery in the Baltimore College, etc. Royal octavo. Price, in cloth, 6.50 ; in leather, 7.50 RICHARDSON (JOSEPH), D.D.S. A Practical Treatise on Mechanical Dentistry. Third Edition, much Enlarged. With 185 Illustrations. Octavo. Price, in cloth, 4.00; in leather, 4.75 TAFT (JONATHAN), D.D.S. A Practical Treatise on Operative Dentistry. Third Edition, thoroughly Revised, with Additions. Over 100 Illustrations. Octavo. Price, in cloth, 4.25 ; in leather, 5.00 WEDL (CARL), M.D. Dental Pathology. With Special Reference to the Anatomy and Physiology of the teeth, and notes by Thos. B. Hitchcock, M.D., Prof, of Dental Pathology, Harvard University. 105 Illustrations. Price, in cloth, 3.50 ; in leather, 4.50 HANDY (WASHINGTON R.), M.D. Handy's Text-Book of Anatomy and Guide to Dis- sections. For the use of Students. 312 Illustrations. Octavo. Price, cloth, 3.00 LEBER AND ROTTBNSTEIN (Drs.) Dental Caries and Its Causes. An Investigation into the Inlluaice of Fungi in the destruction of the Teeth. With Illustra- tions. Price, cloth, 1.25 SEWILL (H. E.), M.R.C.S., Eng., L.D.S. The Student's Guide to Dental Anatomy and Sur- gery. With 77 Illustrations. Price, cloth, 1.50 SANSOM (ARTHUR ERNEST), M.B. Chloroform. Its Action and Administration. Price, cloth, 1.50 TURNBULL (LAURENCE), M.D. The Advantages and Accidents of Artificial Anaes- thesia. A Manual of Ansesthetic Agents, Modes of Administration, etc. Second Edition, Enlarged. 25 Illustrations. Price, cloth, 1.50 A PRACTICAL TREATISE MECHANICAL DENTISTRY. JOSEPH RICHARDSON, D.D.S., M.D., PROFESSOR OF THE PRIXCIPLES OF PROSTHETIC DENTISTRY K THE INDIANA DENTAL COLLEGE; FORMERLY PROFESSOR OF MECHANICAL DENTISTRY AND METALLURGY IN THE OHIO COLLEGE OF DENTAL SURGERY. THIRD EDITION, REVISED AND ENLARGED, WITH ONE HUNDRED AND EIGHTY-FIVE ILLUSTRATIONS. PHILADELPHIA: LINDSAY & BLAKISTON. 18 80. Entered according to Act of Congress, in the year 1880, By LINDSAY & BLAKISTON, lu the Office of the Librarian of Congress, at Washington, D. C. €n JAMES TAYLOR, M.D., D.D.S., KMEBITUS PEOFESSOR OF THE INSTITUTES OF DENTAL SCIENCE IN THE OHIO COLLEGE OF DENTAL SURGERY, ACKNOWLEDGMENT OF PROFESSIONAL EMINENCE AND PRIVATE WORTH, €^u Mmu is grntrfnllt[ instrih^^; HIS FEIEND AND FORMER PUPIL, THE AUTHOR. PREFACE TO THIRD EDITION. In responding to the demand made for a third edition of the presf nt work, the author has subjected the preceding one to a careful and thorough revision, and has endeavored to make it, as nearly as practicable, a faithful reflex of the ad- vanced thought and experience of the profession in all essen- tial matters relating to the facts, appliances, methods, and principles appertaining to the department of prosthetic dent- istry. In this endeavor no attempt has been made to incorporate the almost limitless shades of opinion which prevail among members of the profession concerning methods and appliances, or the almost equal diversity of the latter themselves. Much, therefore, of individual thought, experience, and modes of operating, differing chiefly in the manipulative details by which similar objects and results are sought to be obtained by different practitioners, are necessarily excluded. While there are undoubtedly many appliances and methods of procedure which are approved and meritorious, the limits of the work can admit only those which, in the judgment of the author, are esteemed typical of the best. In addition to the consideration of new and improved meth- ods and ai)pliances of more recent introduction, as well, also, as conspicuous supplementary matters in connection with the older on(!S, the reader will find throughout the body of the present work not only interpolations of important facts relat- ing to the minor details of practice, but also careful elimination of Biicli ])ortions of the original text as are believed, on more matured reflection, to be at variance with accepted facts and Vlll PEEFACE. theories. This is done under the conviction that it is the province of a work like the present to preserve and perpetu- ate only that which survives the ordeal of experience, and to teach only that which has the sanction and approval of the en- lightened judgment of the profession. As still occupying somewhat middle ground between con- demnation and approval, the chapter on Vulcanite Base, with some modifications, has been retained in deference to many who continue to claim for it important advantages as a cheap and convenient base. The growing distrust of its fitness, how- ever, for this purpose, points to . the conclusion that, at no distant day, it will be classified among the obsolete processes. While the reader will share the author's regret that nothing additional appears from the pen of Dr. John Allen in connec- tion with the subject of Continuous Gum Work, by reason of afflictive surroundings which rendered it impossible for him to farther enrich this chapter with the results of his added ex- perience, yet, with the additional practical details relating to this unequalled process obtained from other sources, it is be- lieved the descriptions found embodied in the present volume are exceptionally full and complete. An additional chapter relating to Celluloid as a base has been introduced, embracing a full and particular account of the most approved appliances and methods of manipulating this ma- terial. A new chapter is also introduced relating to an approved method of recent introduction entitled " Gold Alloy Cast Base," of which Dr. Reese, of Brooklyn, N. Y., is the inven- tor, and to whom the author is indebted for detailed descrip- tions and illustrative models. A distinct chapter has also been assigned to the subject of Porcelain Teeth in connection with Carved Block-work, em- bracing an interesting account of their composition and manu- facture, with reflections upon the aesthetic requirements of prosthetic practice. A separate chapter has also been given to an account of the method of attaching teeth to a metallic plate base by means of PREFACE. IX rubber or celluloid, a process of constructing dentures scarcely- inferior to that of continuous gum work itself. The author would especially direct attention to the chapter on Pivoting Artificial Crowns. The conceded importance and superior excellence of this method of substitution will fully justify, it is believed, the large space devoted to its considera- tion. To the members of the profession whose names appear in connection with the several methods, the author is under peculiar obligations for personal courtesies and indispensable aid in the preparation of descriptive material and accompany- ing illustrations. While much valuable matter has thus been added to the present volume, the author has not hesitated to exclude what- ever, in his judgment, the common experience of the profession has demonstrated to be impracticable, and therefore useless. Among the omitted matter is the consideration of cast alumi- num plate base and other forms of this metal requiring the use of solder as a uniting medium for the attachment of teeth. Long-continued, patient, and intelligent experimentation with this metal as a base has demonstrated its practical inutility, its only exceptional use as such being confined to the process in which the attachment is secured in the manner described in Chapter XVI. For fuller information on the subject treated of in the con- cluding chapter, and which could not be extended consistently with the proper limits of a work like the present, the reader is referred to a recently publislied treatise by Professor Norman W. Kingsley, entitled Oral Deformities, a comprehensive work, embracing, among other important matters, an exhaustive con- sideration of Palatal Defects and their Treatment. The au- thor would commend this invaluable work as the embodied thought and experience of the foremost and most successful practitioner in this department of prosthetic dental surgery in this country or elsewhere ; a work which not only enriches, in an eminent degree, the special literature of the dental profes- sion, but adds fame and lustre to American authorship. In closing, the author desires to express his sense of obliga- X PREFACE. tion to those members of the profession who have freely and generously assisted in placing their special methods of operat- ing before the profession through the medium of this work, and also to the representatives of the late Dr. S. S. White, the members of the Celluloid and Buffalo Dental Manufacturing Companies, and others, for needful illustrations and essential information respecting appliances, etc. ,, Remembering gratefully the many valuable suggestions received .during a somewhat extended correspondence with representative members of the profession, and cordially appre- ciating the many substantial and essential favors voluntarily proffered by individual practitioners, the author, in conclusion, trusts that the present volume, thus enhanced in value by the friendly and helpful assistance of others, will continue to merit the same consideration and approval that have been accorded to former editions. Teree Haute, Ind., September, 18S0. PREFACE TO FIRST EDITION. In the preparatioD of the following treatise, the author has endeavored to present, in as concise and methodical a form as possible, the material facts and principles which relate to the Mechanical Department of Dental Practice in its present ad- vanced condition. In the accomplishment of this undertaking, the primary and leading purpose has been to furnish the stu- dent and more inexperienced practitioner with a practical guide to the manipulations of the laboratory, with accompanying elucidations of the elementary principles which underlie the practice of this important specialty. In furtherance of this design, all matters, discussions, and commentaries, not strictly material, have been carefully excluded. The arrangement and treatment of the various subjects em- braced are such, it is believed, as will best facilitate the student in the acquisition of a knowledge of the department alluded to, and the practitioner in the intelligent and successful con- duction of the manipulations which appertain to this branch of Practical Dentistry. In the belief that these objects have been mainly accom- plished, the work is respectfully submitted to the profession. J. Richardson. Cincinnati. CONTENTS. PAGE Dedication, 5 Preface, 7 PAKT FIKST. METALS EMPLOYED IN DENTAL LABORATORY OPERATIONS, WITH PRE- LIMINARY OBSERVATIONS ON THE DIFFERENT MODES OF APPLYING HEAT. • CHAPTER I. DiFFEREXT Modes of Applying Heat, 17-40 Blowpipes 17 Mouth Blowpipe, 18 Bellows Blowpipe 22 Lamps 26 Oil Lamp 26 Spirit Lamp, 27 Furnaces, 28 Draft or Wind Furnace, 28 Baking Furnace 29 Gas Furnace without Blast, . . • 31 Blast Furnace, 32 Fuel 35 Supports 38 Crucibles, 40 CHAPTER 11. Gold, 41-47 Geological Situations 41 Geographical Distribution, 42 Properties of Gold, 42 Influence of Alloying on the Properties of Gold, 43 ProperticH of Particular Alloys of Gold 45 XIV CONTENTS. CHAPTEE III. PAGE Repining Gold, . 48-53 EJements Employed, 48 Separation of Foreign Metals from Gold 49 CHAPTEE IV. Alloys of Gold for Dental Purposes 54-67 Reducing Metals, 54 Required fineness of Gold Plate,- 54 Formulas for Gold Plate used as a Base for Artificial Dentures, .... 55 Formulas for Gold Plate used for Clasps, Wire, Stays, Metallic Pivots, etc., . 57 Gold Solders 57 Method of reducing Gold to a Lower or Higher Standard of Fineness, and of Determining the Carat of any given Alloy, 59 Table of Gold Coinage of Difi'erent Nations 63 CHAPTEE V. Method of Converting Gold Alloys into the Required Forms for Dental Purposes 68-75 Manner of Procuring an Ingot, 68 Forging, ' 70 Laminating or Rolling, '. . 70 Thickness of Gold Plate required as a Base for Artificial Dentures, ... 72 Thickness of Plate for Clasps, Stays, etc., 73 Reduction of Gold Solders into Proper Forms for Use, 73 Method of obtaining Gold Wire, 73 Method of constructing Spiral Springs 74 CHAPTEE VI. Silver, 76-78 General Properties of Silver, 76 Alloys of Silver 76 Reduction of Silver to the required forms for Dental Purposes, .... 77 Formulas for Silver Solders, 78 CHAPTEE VII. Platinum and the Platinoid Metals 79-82 Alloys of Platinum, 81 Platinoid Metals, . 81 CHAPTEE VIII. Aluminum, 83-86 General Properties of Aluminum, • . 83 Alloys, ■ . 85 CONTENTS. XV CHAPTER IX. PAGE Copper, Zinc, Lead, Tin, Aktimoxy, and Bismuth, 87-92 Copper, 87 Alloys of Copper, 87 Zinc, 88 Lead, 89 Alloys of Lead, 89 Tin, 90 Antimony, 91 Bismuth 91 CHAPTER X. General Propertiesof Alloys, and their Treatment and Behavior in the Process of Compounding 93-96 PART SECOND. ARTIFICIAL DEKTURES. CHAPTER I. Treatment of the Mouth Preparatory to the Insertion of Artificial Dentures, 97-104 Useless and Diseased Remains of Teeth 98 Removal of Salivary Calculus or Tartar, 101 Diseased Conditions of the Mucous Membrane and Gums, .... 102 Caries or Decay of the Remaiuing Teeth, 102 Surgical Treatment of the Mouth after the Extraction of Teeth, . . . 102 Time Necessary to Elapse after the Extraction of Teeth before Inserting Artificial Dentures, 103 CHAPTER 11. Materials and Methods Employed in Obtaininu Impressions of the Mouth 105-1'20 Wax, 105 Manner of Obtaining an Impression of the Mouth in Wax for Partial Upper Dentures, 106 Manner of Obtaining an Impression of tlie Lower Jaw in Wax for Partial Dentures, 109 Manner of Obtaining an Impression of the Mouth in Wax for Entire Upper Dentures, 110 Manner of Obtaitiing an Impression of the Lower Jaw in Wax for Entire I^entures, 112 Gutta-percha, 112 Plaster of Paris, 113 Manner of Obtaining an Impression of the Mouth in Plaster for Partial Upper Dentures, 115 Manner of Obtaining an Impression of the Mouth in Plaster for Entire Upper Dentures 118 Manner of Obtaining an Impression of the Mouth in Plaster for ICutire Lower Dentures 120 XVI CONTENTS. CHAPTER III. PAGK Plaster Models, 121-127 Manner of Obtaining a Plaster Model from an Impression in Wax for Par- tial Dentures, 121 Manner of Obtaining a Plaster Model from an Impression in Wax for En- tire Dentures, 123 Manner of Obtaining a Plaster Model from an Impression in Plaster for Partial Dentures, 125 Manner of Obtaining a Plaster Model from an Impression in Plaster for En- tire Dentures, 127 CHAPTER IV. Metallic Dies and Counter-dies, 128-144 Manner of Obtaining a Metallic Die, 128 Moulding, 128 Dipping, . „ 134 Counter-die, 135 Essential Properties of a Die, 136 Table of Fusible Alloys, 143 CHAPTER V. Partial Dentures 145-199 Means Employed in Retaining Partial Sets of Teeth in the Mouth, . . 145 Pivoting Artificial Crowns 145 Circumstances Modifying the Success of the Operation, 146 The Condition of the Roots, etc., . 146 Diathesis of the Patient, 147 Manner of Performing the Operation, 147 Preparation of the Root 147 Fitting the Crown, 151 Attaching Crowns with Wood Pivots, 152 Pivots of Metal and Wood, 155 Pivot Plate, 158 Dr. E. T. Darby's Method, 159 Dr. M. H. Webb's Method, 161 ' Gold Crown faced with Porcelain, 164 Dr. M. H. Webb's Method .164 Attaching Porcelain Crowns with Steel Screws, 166 Dr. E. W. Foster's Method, 166 Substituting an All-porcelain Crown upon any Root in either Denture, . 172 Dr. Bonwill's Method, 172 Dr. Richmond's Method of Attaching Artificial Crowns, 185 Dr. M. H. Chappell's Method 187 Substitution of an Artificial Crown by Pivoting in the Absence of the Nat- ural Root, 189 Dr. M..H. Webb's Method, 189 Dr. E. T. Darby's Method, , . . . 197 205 209 CONTENTS. XVll CHAPTER VI. PAGE Partial Dentures Retained in the Mouth by means of Clasps attached TO THE Natural Teeth 200-220 Eeinarks on the Use of Clasps 200 The Teeth to which it is Most Proper to Attach Clasps, 202 Separation of the Teeth, by Filing, for the Reception of Clasps, ... 204 Modifications in the Form of Clasps Modifications in the Form of Plates for Partial Dentures Supported in the Mouth by Clasps, Swaging or Stamping the Plate 214 Uniting the Plate and Clasps, ^^^ CHAPTER VII. Partial Dentures Supported in the Mouth by means of Cylinders of Wood attached to Tubed Plates, 221-223 CHAPTER VIII. Partial Dentures Supported in the Mouth by Pivoting the Plate to THE Roots of the Natural Teeth, 224-226 CHAPTER IX. Partial Dentures Supported in the Mouth by Atmospheric Pressure, . 227-230 Modifications in the Form of the Base, 227 Manner of Forming an Air-chamber 229 CHAPTER X. Method OF Obtaining an Antagonizing Model for Partial Dentures; Selecting, Arranging, and Antagonizing the Teeth; Investing, Adjusting Stays, Soldering, Etc. 231-245 CHAPTER XI. Entire Dentures 246-275 Method of Constructing a Plate Base for an Entire Denture for the Upper Jaw 246 . Mfxlifications in the Form of Plates for Entire Upper Dentures, ... 249 Method of Constructing a Plate Base for an Entire Denture for the Under Jaw, , 253 Antagonizing Model for an Entire Upper and Lower Denture, . . . 255 Antagonizing Model for an Entire Upper Denture with the Natural Teeth of the Ixjwer Jaw Ri-maiiiiiig, 258 Dr. Bonwill's Anatomical Articulator 260 Selecting, Arranging, and Antagonizing the Teeth ; Rimming the Plate; At- taching Spiral .Springs ; Investing, Ivining, Soldering, and Finishing, . 265 XVlll CONTENTS. CHAPTER XII. PAGE Porcelain Teeth, 27G-306 Components of Dental Porcelain, 277 Manufacture of Porcelain Teeth 279 Comments on the iEsthetic Requirements of Prosthetic Practice, . . . 282 Carved Block-Teeth, 285 Composition and Preparation of the Body, 285 Composition and Preparation of Crown Enamels, ..,.., 287 Composition and Preparation of Gum Enamels, 288 Antagonizing Model for an Entire Upper and Lower Denture, . . . 292 Antagonizing Model for an Entire Upper Denture, 292 Forming a Matrix for Moulding the Body preparatory to Carving the Teeth, 294 Moulding the Porcelain Paste preparatory to Carving the Teeth, . . . 296 Carving the Teeth, 298 Crucing, or Bisciiiting, 298 Application of the Crown and Gum Enamels, 300 Final Bating, 301 Fitting and Attaching the Blocks to the Metallic Base 301 Dr. Calvert's Method, 303 CHAPTER XIII. Uniting Single Porcelain Teeth to Each Other and to a Metallic Base WITH A Fusible Silicious Compound, Forming a Continuous Artifi- cial Gum, 307-335 Introductory Remarks 307 Dr. Allen's Methods, • . . . . 311 Dr. Hunter's Formulas and Methods, 318 Dr. Haskell's Methods, 325 Dr. Field's Methods, 330 Application of Continuous Gum to Partial Sets, 333 CHAPTER XIV. Vulcanite Base, . 336-376 General Properties of India-rubber, 336 Compounding Rubber for Dental Purposes, 338 Method of Constructing an Entire Denture in a Base of Rubber, . . . 338 Arranging the Teeth, 339 Formation of the Mould or Matrix, 342 Packing the Mould, 347 Vulcanizing, 354 Finishing 367 Partial Dentures constructed in a Base of Rubber, 368 Metallic Clasps attached to Rubber Plates, 369 Substitution of Plate for Rubber Teeth 370 Repairing 371 Reiitting Gold or Rubber Plates with Rubber Lining 372 Manner of Obtaining an Exact Duplicate of a Set of Teeth on Rubber, . .374 CONTENTS. xix CHAPTER XV. PAGE Celluloid Base, 377-399 Introductory Remarks 377 Composition and Manufacture, 378 Processes Preliminary to Moulding, 380 Selection and Preparation of the Celluloid Blank, 384 Moulding, 386 Hot Moist Air (so-called "Dry Heat ") Machines, 387 Moulding in Glycerin, 39O Moulding in Steam, 392 Repairing 396 Finishing, 399 CHAPTER XVI. Attaching Porcelain Teeth to a Metallic Base with Rubber or Cellu- loid 400-406 CHAPTER XVII. Gold Alloy Cast Base, 407-415 CHAPTER XVIII. Defects op the Palatal Organs and their Treatment by Artificial Means 416-438 Dr. Kingsley's Artificial Velum and Palate 416 Palatine Defects, 416 Obturators, 417 Artificial Palates 420 Artificial Palates for Congenital Fissure, 426 Method of Making an Artificial Palate 429 MECHANICAL DENTISTRY. PART FIRST. METALS EMPLOYED IX DENTAL LABOKATORY OPERATIONS, WITH PRELIMINARY OBSERVATIONS ON THE DIF- FERENT MODES OF APPLYING HEAT. CHAPTER I. Different Modes of Applying Heat. The application of heat to the various mechanical processes of the dental laboratory would seem to require a brief descrip- tion of some of the agencies employed for the purpose. As full a description of the appliances used will be introduced as is compatible with the scope of the present work. BLOWPIPES. Various modifications in the form of the blowpipe have been introduced from time to time, and are named according to the means used to produce the blast, as mouth, bellows, self-OAitinr/ or spirit, and hydrostatic blowpipe. In addition to the varieties mentioned, there are others used in producing extreme degrees of heat, as the " oxygen blowpipe" with which the flame is blown with a jet of oxygen ; and another, with which the two gases, oxygen and hydrogen, are burned, called the " oxy-hydrogen blowpipe." The latter is 2 18 MECHANICAL DENTISTRY. , capable of producing a heat that immediately fuses the most refractory substances^ as quartz, flint, rock-crystal, plumbago, etc. With it, gold is volatilized, and iron rapidly consumed when placed in the flame ; while platinum, next to iridium, the most infusible of all known metals, has been melted in quantities exceeding one hundred ounces by means of this powerful instrument. As, however, these blowpipes are of no special practical utility in the dental laboratory, any further reference to them will be omitted. Nor is it deemed neces- sary to embrace descriptions of either spirit or hydrostatic blowpipes, as they have fallen of late years almost wholly into disuse. Month Blowpipe, — This instrument has been long in use, is simple in its form and construction, and, for general use in the application of moderate degrees of heat, is both conve- nient and economical. Those accustomed to its use are enabled to produce a continuous blast of considerable force, and soon acquire the facility of regulating the heat produced with equal if not greater precision than can be readily attained in any other way. The most simple form of the mouth blowpipe is shown in Fig. 1. It consists usually of a plain tube of brass, larger at Fig. 1. the end applied to the mouth, and tapering gradually to a point at its other extremity, the latter being curved and tipped at the point with a conical-shaped, raised margin, to protect it from the action of the flame ; the calibre of the instrument terminates here in a very small orifice. The point of the in- strument, as well as that part of it received into the mouth, is sometimes plated with a less oxidable metal than brass, as silver or platinum. The stem is generally from twelve to BLOWPIPES, 19 twentv inches in length, and the mouth extremity from one- half to three-fourths of an inch in diameter. In operations requiring protracted blowing, a somewhat dif- ferent form of the instrument will be required, owing to the accumulation of moisture within the tube, which, being forcibly expelled from the orifice, spirts upon whatever is being heated and interrupts the blast ; also, on account of the fatigue which in process of time renders the muscles of the mouth and face engaged in the act to a great extent powerless. The difficulties mentioned may be obviated, in a great meas- ure, by applying the form of blowpipe represented in Fig. 2. To the mouth extremity is attached a circular concave flange or collar which receives and supports the lips. To the shaft, near its curved extremity, is adjusted either a spherical or Fig. 2. cylindrical chamber which collects and retains the moisture as it forms within the pipe. By allowing that part of the tube connected with the curved end to pass part way into thecham- Vx;r, a basin is formed at the depending portion of the latter, which, by collecting the fluids, will eifectually prevent them from overflowing and passing into the tube beyond. Thoma.s Fletcher, of Warrington, England, has introduced modifications in the construction of mouth blowpipes, which are unquestionably improvements upon the simpler forms just described.* One form, styled the hot-blast mouth blowpipe. * The several appliances embraced in the above chapter, and designated by the FiKnres 3,4, 5, 6,8, 9, 11, lo, 16, 17, 18, 19, are such jwrtions of Flet'her's heating apparatus as are more especially adapted to the work of the dental lalK)ratory, and are l)elieved to possess peculiar and unequalled advantages in the application of heat for — - just described, but burning refined petroleum instead of gas as fuel, and is claimed to be equally as efficient as the gas furnace. The burner for this furnace is constructed upon the prin- ciple of an atomizer ; and this of course dispenses with a wick. This method has proved the most efficient of any that has been experimented with. The recent improvements consist in a device for regulating the supply of oil, which is operated by the milled nut (marked A) shown on top of the reservoir in the cut, and the addition of an annular jet of air, which is regulated by turning the sleeve (marked B). This burner is so made that it can be taken apart and cleansed, in case there should be any obstruction to its proper working. Remove the burner from the reservoir, by unscrew- ing the small screws ; draw out the oil tube, which is operated by the milled nut A, take off the sleeve B, and remove the inside tube. FUEL. 35 The same furnace and stand are used for either gas or petro- leum, the lamp being fitted for adjustment in place of the gas burner, so that the same apparatus can be furnished for burn- ing either gas or refined petroleum. There is no doubt that these furnaces in one or both forms will become a necessity in every workshop, as they fill a place intermediate between a blowpipe and a large furnace — which has never yet been filled ; whilst their strength, cheapness, simplicity, and general usefulness recommend them to all. A very useful and almost indispensable heating apparatus in the dental laboratory, suitable for drying, boiling, melting metals requiring: a moderate tempera- , , . Fig. 20. ture, as zinc, tin, lead, etc., heating ^ flasks preparatory to packing with rub- ^i^fel" vZj^ ber, and a variety of other purposes, ■SSHHSfflSH is exhibited in Fig. 20. ll,.,a^JII9lliB^^^ The burner, consisting, as will be ^i^^^^«'|l seen, of a circular perforated gas tube, '^tIi^^^'— s--[iil| ^ ,i.. with a central air-jet, gives a complete ^^^^^^I^^^^kW range of temperature, from a gentle ^^^^far^ "-^^^s^ current of warm air to a clear red heat, and is so perfectly under control, that a common glass bottle may be placed on the tripod and heated to any required tem- perature without the slightest risk of fracture. For veiy low temperatures the ring must be lighted through the opening B. This gives a steady current of heated air through the gauze above. For boiling, melting, etc., the light must be applied on the surface of the gauze, thereby providing a large body of blue flame, which can be urged by the blast-pipe C. This is one of the most generally useful burners, and stands hard dirty work without injury. The gauze if choked up with dirt can be replaced in a few seconds. FUEL. Under this head are comprehended such combustible sub- stances as are used for fires or furnaces, as v)ood, coal, charcoal, 36 MECHANICAL, DENTISTRY. and Gohe. For dental furnace operations only the latter two are, as a general thing, admissible. Bituminous, or pit coal, is unfit for the uses required of fuel by the dentist, and is therefore seldom used. Anthracite coal, if carefully selected, may be employed, pro- vided it is clean, free from slate, and does not yield a fusible ash. As charcoal and coke are the fuels chiefly used in the processes of the laboratory, these substances will be more par- ticularly described. Charcoal. — Charcoal is obtained by igniting wood and then excluding it from the air while burning; the volatile products are thus driven off while the carbon remains. When com- bustion has proceeded slowly for a certain length of time, the openings to the bed or mound are closed, and the wood allowed to char. When it is desired to maintain a high heat in a small com- pass, the charcoal best adapted to the purpose is that obtained from what is termed hard wood, as the beech, the oak, the alder, the birch, the elm, etc. A cubic foot of charcoal derived from these woods weighs, upon an average, from twelve to thirteen pounds ; while a similar bulk obtained from soft wood, as the fir, the different kinds of pine, the larch, the linden, the willow, and the poplar, averages only from eight to nine pounds.* There is, therefore, economy in the use of the for- mer when purchased by the bulk ; and of this class the beech- wood charcoal is the best, on account of its greater specific gravity. The more heavy charcoals require a stronger draught than those of a lighter character, as a more generous supply of oxygen is necessary to their perfect combustion. Charcoal should be kept as dry as practicable, since it rapidly absorbs moisture from the atmosphere, by which its calorific energy is materially impaired. Cohe. — This substance, like charcoal, is a carbonaceous resi- duum obtained from pit coal that has been exposed to ignition for some time, excluded from the contact of air, the volatile * Ure. FUEL. 37 products of the coal, like those of wood, having been driven off bv the heat. Coke differs in appearance as well as in quality. The principal part of that obtained from gas houses is of a dull, iron-black color, very spongy and friable, and is more rapidly consumed, and produces less heat than the harder and more compact kinds. The best coke for furnace use is that used by brassfounders, and has a steel-gray color, with a somewhat metallic lustre ; is compact in its structure, and splits into pieces having a longitudinal fracture. Coke does not readily ignite, and at first generally requires the admixture of charcoal to effect its combustion ; it also re- quires a strong draught to burn it, but when thoroughly ignited it produces an intense and persistent heat. It is the principal fuel used in baking mineral teeth, porcelain blocks, and the silicious compounds employed in the fabrication of continuous gum work. Professor Piggot, in his remarks on the comparative value of fuels, observes: "Practically, for the purposes of the chemist, the best fuel is charcoal or coke, or a mixture of the two. The ash of charcoal being infusible it passes through the bars of the grate as a white powder. Should potash, however, be in large exce&s it corrodes the bricks, by forming with them a silicate of potash, which runs down the walls and chokes the bars. In small quantities this action is beneficial, as it fur- nishes a protective varnish, and unites the bricks and lutes, by forming a sort of cement, which intimately combines with them. " Coke contains a very variable amount of ash, which is composed chiefly of oxide of iron and clay. The latter is not fusible by itself, but may soften. When pure it forms a harm- less slag, which injures neither the furnace nor the crucibles. Usually, however, the oxide of iron predominates. In this case the ash is very injurious, for it is reduced to a protoxide, which is not only fusible, but powerfully corrosive to all argillaceous matters, so that both the crucibles and furnaces suffer." * * Dental Chemistry and Metallurgy, p. 274. 38 MECHANICAL DENTISTRY. In order that the greatest amount of heat may be evolved from these fuels, it is necessary that the conditions necessary to secure their perfect ignition should be strictly observed ; these have reference to an unobstructed circulation of air, that oxygen may be freely supplied to them. To this end the fur- nace should be kept clean, the bars of the grate unbroken, and a good draught obtained. The condition in which the fuel is applied will also modify the results : thus, for example, if the lumps are too large they will absorb heat, and caloric will be lost; if too small they Avill be too rapidly consumed. It is essential, also, to have the fuel as free as possible from dust and dirt, as these fine particles, in any considerable quantities, ob- struct the draught, and prevent a thorough ignition of the mass. Coke, especially, should be preserved clean, and should be broken into fragments not larger than an inch or an inch and a half in diameter, and, as nearly as possible, in the form of blocks or cubes, as these leave more open spaces for the free circulation of the air. SUPPORTS. There are many processes in the dental laboratory requiring the application of heat, for which a suitable holder or support should be provided. A very convenient form of holder, used in soldering, may be made of a circular or semi-el iptical piece of heavy sheet iron, the margin being serrated and turned at right angles, forming a cup. To the under side and centre of this an iron rod, ten or twelve inches long, may be permanently riveted ; or it may be made to revolve on the handle, so that the heat may be thrown directly upon any particular part of the piece to be soldered without disturbing the latter. A small hand-furnace (Fig. 21) is sometimes used, and will be found a very convenient and useful apparatus, not only for soldering, but for preparatory heating. It consists of a funnel- shaped receptacle made of sheet iron, with a light grate or per- forated plate of the same material adjusted near the bottom, and an opening on one side, underneath the grate, for the ad- mission of air. The upper part of the holder is surmounted SUPPORTS. 39 by a cone-shaped top, whicli may be readily removed by a handle attached to it ; while to the bottom of the furnace is attached an iron rod, five or six inches long, and terminating in a wooden handle. The piece to be soldered is to be placed inside on a bed of charcoal, the top adjusted to its place, and the fuel ignited ; when the operation is sufficiently heated the top may be lifted off, and the piece remaining in the furnace Fig. 21, soldered with the blowpipe in the usual manner, the furnace thus serving the purpose of a holder. A support in very common use consists simply of a large close-grained piece of charcoal, invested in plaster one-half or three-fourths of an inch thick, one end or side being left open and scooped out to receive whatever is being heated. Or a plaster cup two or three inches deep may be made, and its interior partly filled with a mixture of plaster, sand, asbestos, and pulverized cliarcf)al. Carbon blocks, suitably moulded, may also be used. They are cleanly, perfect non-conductors, and imperishable. 40 MECHANICAL DENTISTRY. CRUCIBLES. Crucibles are small conical -shaped vessels used by the dent- ist principally for the purposes of melting and refining metals used for plates, compounding metallic alloys, preparing and compounding the various ingredients employed in the manu- facture of porcelain teeth and continuous gum work, etc. They combine in a high degree the properties of infusibility, exemption from the attack of substances fused in them, the power of resisting sudden alternations of temperature, and impermeability to fluids and gases. The Hessian crucibles, which are in most common use among dentists, are composed of silica, alumina, and oxide of iron. Plumbago crucibles are also made from special patterns, and expressly designed for Fletcher's furnaces. For a more particular description of the various components entering into the structure of crucibles, as well as the manner of manufacturing them, the reader is refer- red to Piggot's Dental Chemistry and Metallurgy, and other works treating more fully of the subject. GOLD. 41 CHAPTER 11. Gold. Gold has been known from a period of great, antiquity? has'ing, according to the writings of Moses, been wrought into articles of jewelry more than three thousand years ago. As a base or support for artificial dentures, it has entirely superseded the use of the various animal substances formerly employed, and, by the mass of practitioners at the present time, it continues to be the most highly esteemed metal for the purpose mentioned, notwithstanding the more recent in- troduction of approved processes in which, as a base, this metal is wholly discarded. Gold is found only in the metallic state, and occurs either crystallized in the cube, and its allied forms, or in threads of various sizes, twisted and interlaced into a chain of minute octahedral crystals; also in spangles or roundish grains. Ihese latter, when they occur of a certain magnitude, are called pepitas, some specimens of which have been obtained of great size. In 1810 a mass of alluvial gold weighing twenty-eight pounds was found in the gravel pits of the creeks of Rockhole, in North Carolina. A lump of gold ore •weighing three cwt., was forwarded from Chili, South Ame- rica, as a contribution to the World's Exhibition in London. New Granada, California, Russia, and Australia, have each produced pepitas or masses of gold Aveighing respectively twenty-seven and a half, twenty-eight, seventy, and one hun- dred and six pounds. Geological Situations. — The crystalline primitive rocks, the compact transition rocks, the trachytic and trap rocks, and alluvial grounds, are the formation in which gold occurs. Unlike many other metals, it is never in such large quantities 42 MECHANICAL DENTISTEY, as to constitute veins by itself, but is either disseminated through the rocky masses, or spread out in thin plates or grains on their surface, or confined in their cavities in the shape of filaments or crystallized twigs. The minerals com- posing the veins are either quartz, calcspar, or sulphate of baryta. The ores associated with the gold in these veins are principally iron, copper, arsenical pyrites, galena, and blende. The most abundant sources of gold, however, are in alluvial grounds, where it is found distributed in the form of spangles in the sands of certain plains and rivers, especially at their re-entering angles, at the season of low water, and after storms and temporary floods. Sufficient reasons have been advanced in sup2)ort of the belief that gold, found in alluvial situations, belongs to the grounds traversed by these rivers, instead of being washed, as was formerly supposed, from the mountains in which their waters have their origin. Geographical Distribution. — The European mines, more particularly distinguished for their richness, are in Hungary and Transylvania, especially the former. Gold also occurs, but more sparingly, in Ireland, Sweden, Siberia, Germany, Russia, and Spain. In Asia and Africa, the mines which yield most abundantly, are situated in the southern portions of these continents. From the latter, the ancients derived the greater portion of their gold. Several of the South American provinces yield this metal in considerable quanti- ties. Washings are also common in several States of the Union, but California stands unrivalled, except by Australia, in the immense productiveness of its mines, and its resources in respect to this rare and valuable metal are reckoned inex- haustible. Properties of Gold. — Pure gold is distinguished from all other metals by its brilliant orange-red or yellow color, being the only simple metal that possesses this complexion. It is susceptible of a high polish, but is inferior in brilliancy to steel, silver, or mercury. Its specific gravity varies some- what, according as it is fused or hammered; the former having a density of 19.26; the latter ranging from 19.4 to GOLD. 43 19.65. It is only excelled in density, therefore, by platinum, the specific gravity of which is 21.25. Gold surpasses all other metals in malleability. The aver- age thickness of ordinary gold leaf is ^go'ij??^ of an inch, but the ultimate degree of attenuation of which pure gold is susceptible exceeds considerably this estimate. It is also distinguished for its ductility. A single grain of gold may be drawn into wire 500 feet in length, while an ounce may be made to extend 1300 miles. It is somewhat softer than silver, and possesses great tenacity, though inferior in this quality to iron, copper, platinum, or silver. A thread of gold i-jf-Q of an inch in diameter will sustain a weight of 150 pounds. Gold fuses at 2016° with considerable expansion, and, on cooling, contracts more than any other metal. On account of the want of affinity of gold for oxygen, it remains unaltered in the longest exposure ; it is incapable of being oxidized in any heat that may be applied to it, and is only volatilized with great difficulty in the resistless heat of the oxy-hydrogen blowpipe. It is unaffected by the most concentrated of the simple acids, but is readily soluble in aqua ref/ia or nitro-muriatic acid, and nitro-fluoric acid. It will thus be seen that gold possesses, in an eminent degree, those general properties which render it peculiarly fit for the purposes to which it is applied in the practice of dental prosthesis. Influence of Alloying on the Properties of Gold. — The term al/oy signifies a compound of any two or more metals, as brass, which is an alloy of copper and zinc. Alloys, in respect to their uses, are practically new metals, and edded in the two pieces of charcoal, and the latter secured by binding them together with wire. Moulds made from this material do not require to be either heated or oiled. It not unfrequently happens that, at the first pouring, the metals arrange themselves in the ingot in accordance with the density of the several components ; those of greater specific gravity passing to the bottom, and the lighter metals remain- ing above. Whenever this occurs the ingot must be broken 70 MECHANICAL DENTISTEY. into pieces and remelted ; this should be repeated, if necessary, until the alloy assumes a perfectly homogeneous appearance. It should then be annealed in hot ashes, which softens the gold and removes the adhering grease. Forging. — Before laminating the ingot it should be reduced somewhat in thickness by placing it on an even-faced anvil or other equally smooth and resistant surface, and subjecting it to repeated blows with a tolerably heavy hammer. It should be frequently annealed, and the process of forging continued, alternately hammering and annealing, until the ingot is reduced one-half or more in thickness. Laminating or Rolling. — The reduced ingot, well annealed, is next laminated or spread out into a sheet of greater or less thinness by passing it repeatedly between two strong, highly- Fltt. 25. polished, cylindrical steel rollers. The mills used for the pur- pose are variously constructed, the plainest forms (Fig. 24) be- ing very simple in their mechanism, while others, or geared mills, are more complicated, and are constructed with a view to a greater augmentation of power, and precision, and cer- tainty of action. The latter (Figs. 25, 26), if of approved pat- tern, materials, and manufacture, are, upon the whole, more economical and reliable than the cheaper varieties. The rollers, for the purposes of the dentist, should be from three to four inches in length. COXVERTING GOLD ALLOYS INTO REQUIRED FORMS. 71 In laminating, the rollers should first be adjusted equidis- tant at both ends, and this uniformity, as they are approxi- mated from time to time, should be preserved throughout. At every passage of the gold bar between the rollers the dis- tance between the latter should be diminished, care being taken that the approximation be not sufficient to clog or impede the Fig. 26. free action of the mills. The gold, which, in time, becomes hard, and brittle, and liable to crack in the mills, should be frequently and well annealed by bringing it to a full red heat; this restores the pliancy of the gold and facilitates the opera- tion in the press. When the ingot has been extended in one direction as far as may be desired, it should always be re-annealcd before 72 MECHAlvICAL PENTTIBTEY. FiG- 27. tamino:: it in the mills ; a neglect of this precaution will seri- ously interfere with the working of the gold by twisting or doubling the plate upon itself; and in some instances, pro- vided the gold has not been well annealed throughout the operation, or is in any considerable degree unmalleable, the plate wiD be torn across and rendered unfit for use. A thin or retreating edge may be given to the plate at any desired point or points by passing such portions part way between the rollers and withdrawing ; repeating this, with the rolleis brought a little nearer to each other every time the plate is introduced between them, and decreasing the distance the plate passes each time until it is reduced to as thin an edge as may be d^ired. The degree of attenuation obtained by rolling is determined by what is called a gauge-plate, (Fig. 27.) Tills instrument is usually circular or oblong in form, and is marked at intervals on its edge by cross-cut grooves or fis- '^-i sures, which successively dimin- ish in size and are indexed by numbers ranging from 6 to 40. The size of the grooves diminish with the ascending numbers. During the operation of rolling, the plate should be tested, from time to time, by the gauge, to determine when it has undergone sufficient attenuation. Thichiess of Gold Plate required as a Base for Artificial BaitureB. — ^In prescribing the thickness of plate proper for the puq>ose indicated, no estimate can be given that will apply to all cases, as certain conditions of the mouth, to be mentioned hereafter, will suggest some modifications in this lespect. Usually, however, plate for entire upper sets should correspond in thickness with number 26 of the gauge-plate ; for the under jaw, number 24 may be used ; while for partial upper pieces, an intermediate number may be chosen, unless CONVERTING GOLD ALLOYS INTO REQUIRED FORMS. 73 atmospheric-pressure plates are used, when the number recom- mended for full upper sets may be employed. Thickness of Plate for Clasps, Stays, etc. — Plate for these purposes should correspond with from 20 to 22 of the gauge ; a less amount of substance, as before stated, being required when the alloy has incorporated with it a small proportion of platinum. lied action of Gold Solders into Proper Form for Use. — The method of converting gold solders into the form of plate, does not differ from that already described in the manufacture of plate as a base, except that when zinc or brass is used, the latter should be added after the other constituents are com- pletely fused, and then instantly poured to prevent undue wasting of the base metals by a too protracted heat. The solder should be reduced to plate somewhat thinner than that used for upper sets, 28 of the gauge-plate. It is customary sometimes to roll the solder into very thin rib- bons, but this is objectionable for the reason that a greater amount of the alloying metals being exposed in a given sur- face to the action of the heat in soldering, are burnt out or oxidated, whicli interrupts the flow and weakens the attach- ment between the solder and plate. / Method of Obtaining Gold Wire. — To convert gold or its alloys into the form of wire, the operator should be provided with a draw-plate, a vice, and a pair of hand-pincers. A draw-plate (Fig. 28) is an oblong piece of steel pierced with a regular gradation of holes, or a series of progressively dimin- ishing apertures, through which the gold bar, reduced to a rod, is forced and made to assume the form and dimensions of the hole through which it is last drawn. The holes are formed with a steel punch, and are enlarged on the side where tlie wire enters and diminish with a gradual taper to the other side. A draw-bench is sometimes employed in ex- tending the wire, the power being applied by a toothed wheel, pini<;n, and rack-worK, and is moved by the hands of one or two persons. For the purposes of tlie dentist, however, it will be sufficient to fix the draw-plate securely between the 74 MECHANICAL, DENTISTRY. jaws of a bench-vice, and, by seizing hold of one end of the gold rod with a strong pair of clamps or hand-pincers, serrated or cut like a file on the inside of the jaws, the wire may be drawn steadily through the plate, passing from the larger to the smaller holes until a wire of the required size is obtained. Fig. 28. 6'.v 5^ VV fc-^^ ^,^ .) c) Cv 0O • ^) '<.•) I • k)© <^ ^ (!J>C '^^ «® ■d^gss- In drawing the wire, the motion should be steady and uni- form, for if drawn interruptedly or by jerks, the wire will be marked by corresponding inequalities. The gold rod should also be annealed from time to time, and the holes kept well greased or waxed. The process described above will answer equally well in re- ducing any of the ductile metals to wire, as silver, copper, platinum, etc., so that any further description of the method, in connection with these metals, will be unnecessary. Method of Constructing Spiral Springs. — Inasmuch as spiral springs have been, to a great extent, superseded by more ap- proved agencies employed in the retention of artificial teeth in the mouth, and as all the principal dental furnishing houses are suppled with these appliances already prepared for use, the author does not deem it necessary to enter into a descrip- tion of the various apparatuses used in making them. The following simple contrivance will meet the limited re- quirements of those who are obliged or prefer to manufacture CONVERTING GOLD ALLOYS INTO REQUIRED FORMS. 75 their own springs. The wire, obtained as already described, is held between two blocks of wood fastened between the jaws of a bench-vice. By means of a small hand-vice, one end of the wire is clamjied to a uniformly cylindrical and well-tem- pered steel rod or wire four or six inches long, and about the size of a small knitting needle, and which being made to re- volve while resting on the blocks of wood, the wire is wound firmly and compactly around it, producing a uniform coil. 76 MECHANICAL DENTISTRY. CHAPTER yi. Silver. General Properties of Silver. — Pure silver, when planished, is the brightest of the metals. Fused, or in the form of ingot, its specific gravity is 10.47 ; but when hammered or condensed in the coining press, its density is increased, and its specific gravity becomes 10.6. It fuses at an extreme red heat, gener- ally estimated at 1.873° Fahrenheit. It is remarkably lamin- able and ductile; yielding leaves not more than _-j_'__^ of an inch thick, and wire 400 feet of which may be drawn weighing but a single grain. It exceeds gold in tenacity or cohesion, but is inferior to platinum in this respect. A silver wire .078 of an inch in diameter will sustain a weight of 187.13 pounds. Fine silver is unaffected by moisture or pure atmospheric air, but is readily tarnished with a film of brown sulphuret by ex- posure to sulphuretted hydrogen. The sulphuret of silver thus formed may be easily removed by rubbing the metal with a solution of cameleon mineral, prepared by calcining equal parts of black or peroxide of manganese and nitre. Unlike gold and platinum, it is readily soluble in nitric acid ; this and sulphuric acid being the only simple ones that dissolve it. Silver becomes very brilliant when heated ; boils and vaporizes above its fusing-point ; and when cooled slowly, its surface presents a crystalline appearance. Alloys of Silver. — Silver combines readily with most metals, forming compounds of variable degrees of malleability, duc- tility, density, etc. Tin, zinc, antimony, lead, bismuth and arsenic, render it brittle. A very minute quantity of tin is fatal to the ductility of silver. Silver does not easily combine with iron, although the two metals may be united by fusion. Gold, copper, SILVER. 77 platinum, iridium, steel, manganese, and mercury, also form alloys with silver. An alloy of nine parts of silver and one of copper is the Government standard of the United States coinage since 1837. To this, three-cent pieces form an exception; these being com- posed of three parts silver and two of copper. The coins of silver having a greater average fineness than those of s of oil or wax cloth, etc. Before pouring the plaster, if it is desired to strengthen any of the plaster teeth — as those adjoining the vacuities in the jaw, or such as are to be used in adjusting clasps, and thus secure them against accident in handling — adequate support may Vxi im))arteartial f^s^-s. The general form of thfise p'lecjiH is represented in Figs. 37 and 38. li' it is desired to swage a rim to the plate, forming a groove 124 MECHANICAL. DENTISTRY. or socket into which the plate extremities of the teeth are received, the model should be formed in the manner repre- sented in the annexed cuts ; in which it will be seen that an abrupt shoulder is formed on the external border of the model of the upper jaw (Fig. 37), but which on the lower (Fig. 38), is extended round the inner border also, as it is desirable, in the latter case, to give a rounded edge to the lingual border of the plate, and which is accomplished in part by swaging in the fii"«t instance and afterwards by turning the edge down upon the plate with pliers or by other means. The model is prepared by adjusting a strip of softened wax around the bor- der and cutting away from its upper surface in such a way as to form a groove, the bottom of which shall be on a line with the extreme edge of the base or plate, and which should be in- dicated upon the model with a pencil-mark before applying the roll of wax. Plaster may be substituted for wax, and should always be used whenever heat is applied to the model in the process of obtaining a metallic swage, as by the " dip- ping" method. If the model is to be used in moulding, the groove should be sufficiently open to permit the ready withdrawal of the sand, otherwise the die at this part will be imperfect ; if, how- ever, the face of the model is to be immersed in molten metal, securing first the counter-die, any form may be given to the groove that will best facilitate the operation of overturning the margins of the plate. Rimmed plates are only required when single gum teeth or sectional or entire blocks are employed, or when plate teeth are mounted on a platinum base with continuous gum. Whenever an air-chamber is to be stamped in the base, the model should be prepared for the purpose before casting the metallic swages. The general form and position of the central cavity or chamber in the arch is represented in Fig. 37. The model may be prepared in either the following ways : 1. The form of the chamber may be cut from the wax or plaster impression ; in which case the plaster will be raised at a cor- responding point or points upon the model, and will have ex- actly the same form and depth as the cavity in the impression. PLASTER MODELvS. 125 2. Cover the palatal face of the model with a sheet of wax equal in thickness to the required depth of the chamber, and cut out from this, at the desired point, the form of the cavity ; fill the latter with plaster, and when hard remove the wax and trim the raised portion to the proper form. 3. Cut a pat- tern chamber, of the required form and thickness, from sheet wax or lead ; place it in proper position in the arch and press down with the fingers or burnisher until it conforms to the contour of the palate; it is then fixed in place either by con- fining it with a small piece of wire or tack driven through it into the plaster, or by interposing softened wax or other adhe- sive material between the chamber and model. A small brush loaded with a varnish mixture passed round the edge of the chamber will insure sufficient adhesion of the latter. The same general method as that when central chambers are formed is pursued in the preparation of the model when it is desired to construct lateral cavities in the plate. The form and position of these on the model will be indicated by inspec- tion of the form of " lateral cavity " plates as exhibited in the chapter on " Entire Dentures." There are other modifications in the form of cavity plates, some of which are obsolete; that known as "Cleveland's chamber" is still in limited use, and will be described in a subsequent chapter, but does not require a model differing in form from the one described in connection with full dentures wdth central chambers. Manner of Obtaining a Plaster 3Iodel from an Impression in Plaster for Partial Dentures. — The surface of the impres- sion in plaster should first be rendered hard by applying to it, with a camel's-hair brush, a uniform coating of varnish to prevent adhesion of the model. Two kinds of varnish are in common use — a transparent and colored. Tlie former is pre- ferred for the reason that it penetrates the plaster more thor- oughly, giving to it a greater depth of surface hardness, while the latter, if not sufficiently fluid, forms a somewhat sui)erticial incrustation, which is liable to peel off in handling, leaving 126 MECHANICAL DENTISTRY. portions of the model unprotected. Either, however, if prop- erly prepared and applied, may be employed. Formula No. 1, Formula No. 2. Transparent Varnish. Colored Varnish. Gum sandarach, . 5 oz. Gum shellac, . . 5 oz. Alcohol, . . .1 quart. Alcohol, . . .1 quart. The sandarach and shellac should first be freed from all impurities by careful jjicking and washing ; they are then added to the alcohol and digested over a moderate heat until thoroughly dissolved. Other substances, as gum elemi, Ve- nice turpentine, etc., have been recommended as additional ingredients, but they are not indispensable, and may be 'omitted without sensibly impairing the properties of the varnish. After glazing the surface of the plaster impression with var- nish a thin and uniform coat of oil should be applied ; it is then enveloped, and the model procured in the same manner as when wax is used. The following method of preparing the plaster impression before it is filled in for the model is recommended by Dr. C. W. Spalding : " After the impression has become hard, coat the surface with a lather of soap and water ; wash this off and immerse the model in water. This expels air and avoids lia- bility to porosity of the surface of the model. Again coat the surface with a strong lather of soap and water, and wash off as before, when the impression is ready to receive the plaster for the model. I prefer this method to varnishing for the reason that the varnish used is not always of uniform consistenc.e." In separating the model from a plaster impression, for par- tial cases, it will be necessary to cut the latter away in pieces, as any attempt to separate the two in the ordinary manner would inevitably break away the plaster teeth from the model. The impression should be chipped away with great care, to avoid defacing the model. To provide more perfectly against this accident, it is better to coat the impression with colored PLASTER MODELS. 127 varnish,* as this will indicate with greater certainty the line of contact or union between the two pieces. When separated, the model should be trimmed and formed in the manner here- tofore described. Manner of Obtaining a Plaster 3Iodel from an Impression in Plaster for Entire Dentures. — -The preparation of a plaster impression of either the upper or lower jaw for full dentures, and the method of procuring a model therefrom, differ in no essential respect, except in the mode of separation, from the manipulations required when the impression has been taken in plaster for partial pieces. A model can, ordinarily, be readily detached from an impression of the lower jaw, but is not always so easily effected in the case of the upper. To accomplish this in the latter case, the model may be taken in the hand and the back of the handle of the cup tapped lightly with an instru- ment; or, a small, wedge-shaped instrument may be carefully forced between the model and impression at the posterior bor- der of the latter until they part slightly, when they may be easily detached ; before doing which, however, any overlap- ping portions of the model which may tend to bind the two pieces together should be trimmed away. If any portion of the heel of the model is defaced by the introduction of the wedge, it may be afterwards remedied by restoring the con- tour of the parts with either wax or plaster. After obtaining a model in either of the ways mentioned, the entire body of it should be glazed and hardened by apply- ing to it a uniform coat of varnish. This protective covering will prevent the surface from wearing, render it more pleasant to the touch, facilitate its withdrawal from the sand, and give a more perfect mould. A model may be better prepared for permanent preservation by immersing it for a short time in a solution of carbonate of soda, by which its surface is con- verted into carbonate of lime, and thereby rendered hard and durable; care must be taken not to introduce any of the bicar- bonate of soda into the solution. * The author is indebted to Dr. Spalding for a simple and admirable de- vice for the Hame purjjoso, wliicli consists in coloring the water used to mix plas'er for the impression with aniline red. 128 MECHANICAL DENTISTRY. CHAPTER ly. Metallic Dies and Counter-Dies.' A metallic die is a fae simile or transcript of the mouth in metal, and is also a copy or likeness of the plaster model. A metallic counter-die is a copy of the impression, and is a reversed image of the die and plaster model. Manner of Obtaining a Metallic Die. — Two general methods are employed in procuring a metallic counterpart of the model ; first, by moulding; secondly, by a process termed "dipping." Moulding. — For this purpose the best material is marble- dust, though other substances — as sand, Spanish whiting, etc. — have been recommended. Marble-dust has the advantage of being always ready for use, as it absorbs sufficient moisture from the atmosphere to render it cohesive, is cleanly, and gives a smooth and uniform surface to the die. When sand is used it should be fine and even-grained, the best for the purpose being that used by brassfounders. It is prepared by mixing with it sufficient water to render its particles somewhat adhe- rent, so that when portions of it are pressed in the hand and then parted with the fingers it will break away in well-defined fragments. Excess of water should be avoided, as the vapor formed by the molten metal, when poured upon it, will dis- place portions of the latter, and form cavities or blisters in the face of the die ; nor should the sand used be too dry, as in that case it will crumble away in detaching the model. Oil has been proposed as a substitute for water, in which case it is recommended to add one quart of the former to a peck of sand. It is claimed that the sand so prepared is always in immediate readiness for use. The moulding material properly prepared, the model is next placed with its face uppermost, on the moulding-board, and METALLIC DIES AND COUNTER-DIES. 129 surrounded with a metallic ring. A common " wagon-box," of which two or three sizes should be had, will answer every purpose. If sand is used it should first be well sifted to remove the coarser particles, and then filled into the ring, packing it closely with the fingers around and over the model until even with the upper edge of the box. Some care must be observed in the management of the moulding material when packing it, for, if made too compact, the vapor formed in pouring hot metal, failing to pass out readily, will be confined within the cavity, and form imperfections in the face of the die; or, if too loosely packed, the fluid metal, when poured into the mould, will, to some extent, permeate the pores of the sand or other material, and render the face of the die rough and imperfect. The box, with the model encased, is then lifted above the board and the model dislodged by tapping it gently under- neath Avith a small mallet or hammer until it parts from the mould. The uncertain and hazardous method, sometimes re- sorted to, of detacliing the model by pressing it alternately backward and forward until loosened, and then lifting it out, should never be practiced, as more or less deformity of the mould is unavoidably produced thereby. It not unfrequently happens that the ridge on the plaster model of the upper jaw overhangs, forming corresponding depressioas above, the excavations occurring more commonly in front and on each side of the mesial line. Whenever this form of the model exists, it will be impracticable to obtain a correct mould in the manner just described, since the sand becoming impacted in these excavations will be broken away and remain with the model when the latter is dislodged. The difficulty mentioned, however, may be readily over- come in all cases by employing the sectional moulding flask iiivented by Dr. G. W. Hawes, the several parts of which are representa<'k upon 154 MECHANICAL DENTISTEY. the rod, and thus ijidicate with certainty the depth of the canal. The pivot being cut off at a point distant from the crown equal to the length of the uncovered end of the wire, is then dressed to the size of the orifice in the root. The pivot should be accurately fitted to the canal in the root, but not so tightly as to require any greater force in adjusting the crown to the root than may be readily applied with the fingers. A pivot thus easily applied will, when enlarged by the absorption of fluids, be so firmly retained as to render its removal difficult ; and even when moisture is excluded, adequate stability will be imparted to the attachment, provided sufficient depth is given to the cavity in the root. It may be observed, however, that any method of pivoting which does not effectually exclude the secretions of the mouth is objectionable. The too frequent method of fixing artificial crowns Avith pivots of wood, without providing for the exclu- sion of the oral secretions and pulpy portions of food, not only hastens the destruction of the root, but, in addition to being positively harmful, cannot fail to bring a desirable method of replacement into general and merited disrepute by reason of the offensive odors accompanying the animal decomposition in- separably associated with such a mode of procedure. To provide against the intrusion of the secretions or portions of alimentary substances, either of the following expedients may be adopted : If the coaptation of the prepared surfaces of crown and root in contact is accurate and uniform, one or two thicknesses of No. 4 or 6 gold foil, or corresponding thickness of tin foil, interposed when the crown is forced to its place, will exclude the secretions with tolerable certainty. Such plastic substances, however, as are impervious and in- soluble will more certainly accomplish the object in view, and among these, Hill's stopping is generally esteemed the best. Amalgam may also be used for the same purpose, in which case the central portion of the articulating surface of the root should be somewhat countersunk. It not unfrequently happens that a cone or funnel-shaped PIVOTIXG ARTIFICIAL CROWNS. 155 enlargement exists at the orifice of the root-canal as the result of decay. In such cases it will be difficult and often imprac- ticable to adjust a pivot crown securely without preliminary treatment of the root. Firmness of attachment, in these cases, may be secured in either of the following ways : 1. Having removed all softened or decayed material from around the orifice of the canal and enlarged the latter to the required depth for a ])ivot of ordi- nary length, the canal so prepared, together with the carious excavation, may be filled compactly with gold flush with the margins of the dressed end of the root. Through this a cen- tral passage is made with suitable drills for the admission of a pivot. 2. A highly polished and uniformly cylindrical steel wire, somewhat smaller than the prepared opening in the root, may be introduced into the latter and gold packed around it and into the excavation, flush, as in the former case, with the margins of the root, after which the steel wire is carefully withdrawn. In either of the above cases the gold should be securely fixed in place in the first instance by forming small pits or circular grooves in the walls of the enlarged canal, and by retaining-points in the sides of the excavation. Pivots of Metal and Wood. — Pivots are sometimes formed of gold wire encased in wood. These impart additional strength to the attachment, and, at the same time, enable the operator to change the direction of the crown by bending the pivot whenever the root stands irregularly in the arch. A hole, somewhat smaller than that in the root, is drilled into a block of pivot wood, and into this is forced a gold wire — that formed of gold and platinum being the best, as it possesses greater stiffness and elasticity. The wood is then dressed down to a size a little larger than the canal in the root, and then com- pressed. One end being fitted to the hole in the crown, the projecting portion of the pivot, cut to the jtroper length, is trimmestituting a porcelain plate tooth for the pivot crown in connection with the use of rubber the following method may be j)ursued : Fit a metallic pivot, composed of gold and pla- tinum, accurately to the enlarged opening in the root, but not HO tiglitly but that it may be readily withdrawn. Select and fit a suitable plate tooth, and solder to this a moderately thin 158 MECHANICAL DENTISTRY. gold backing. If, on reapplying the crown, with the pivot in place, the former is crowded forward out of proper position by the pivot, cut a slot in the latter, and, if necessary, groove the gold backing and crown at the base of the latter until the crown will take its required place, and the projecting portion of the. pivot lies in close contact with the gold backing for a distance sufficient to insure adequate strength of attachment when the two are united by solder. When the crown is thus adjusted to the pivot, secure them in this relation with wax or plaster and remove them carefully ; imbed in plaster and unite them securely with solder, and then proceed to take an accurate impression of the end of the root in connection with the united crown and pivot. This may be done by first filling in over the dressed end of the root with a sufficient quantity of soft- ened wax, forcing the crown and pivot into place, and then moulding the wax with the finger to the end of the root and over the backing. Trim away superfluous portions of wax, remove carefully, imbed in plaster in the same manner as de- scribed in connection with pivot crown, form matrix in plaster, pack with rubber, vulcanize, dress down to the form of adjoin- ing crowns, and polish. To secure more perfectly the attachment of the rubber, the porcelain crown may be sufficiently undercut with a corundum disk along the sides of the gold backing, to bind the rubber, and this should be done either before or immediately after soldering the pivot to the crown. AVhen employing either of the foregoing methods, the wire pivot should be well barbed, and the joint between the crown and root sealed either by interposing folds of soft foil, or by some durable and impervious plastic material when the crown is finally and permanently adjusted. Pivot Plate. — The following methods of pivoting an arti- ficial crown are applicable to all cases admitting of this mode of substitution, but will be found of especial utility under certain circumstances or conditions which exclude the use of the simple pivot crown, or which at least render their employ- ment difficult and unsatisfactorv. PIVOTING ARTIFICIAL CROAVNS. 159 It frequently occurs that the root to be used occupies a posi- tion in the arch inconsistent with a harmonious arrangement of the tooth of replacement by the usual method of attaching an ordinary pivot-crown. Thus it may lie closely against one or other of the adjoining teeth, distant from the centre of the space ; or it may have too great an anterior or posterior ob- liquity, or too great a lateral inclination; or, again, it may range with the other teeth with respect to its direction, but may occupy a position entirely within the circle ; in either case it will be difficult or impracticable to give a proper relative posi- tion to the crown in the usual way. It is true that any slight deviation from a just position or inclination of the root may be compensated for by a corresponding inflection of the pivot, or by forming an abrupt angle to it where the crown and root unite, or by placing the pivot on one side of the hole in the crown ; but when the irregularities spoken of exist to any con- siderable extent, it will become necessary to adjust a pivot-plate to the root, and attach to the base an ordinary plate tooth, to which any desired position may be assigned. One of the simplest and most practicable methods of per- forming this operation is thus described by Professor Edwin T. Darby: " After this (the proper preparation of the root) has been thoroughly done, select a piece of gold or platinum wire («), Fig. 40, of the diameter of the opening in root, and fit nicely Fig. 4G I © tt to the opening, letting it project one-eighth inch beyond the end of the root, that it may be readily removed and inserted in the root during the operation. Next select a thin piece of platinum, of which make a cap with hole to fit around the wire pivot snugly, and over the whole end of the root (6). 162 MECHANICAL DENTISTEY. is here given (Fig. 47, o). When this is done and the wire and plate taken from the root and put in place in the impres- sion, a correct model of the teeth and parts adjoining can be made with the gold in the same relative position as when in the mouth. After the model is made, the gold removed from it, the end of the wire which extended outside the root to aid in marking the position of the wire and plate in the impres- sion cut off and filed down to the surface of the plate, a thick, narrow gold backing should be fitted and riveted to a suitable crown (plain 'plate tooth' with 'straight pins') and a groove be cut along each side, and, in some cases, near the cutting edge of the porcelain, as illustrated in Figs. 47 6, and 48. This is done that the parts may then be built out and the por- celain more perfectly secured, and the contour of the palatal Fig. 47. Fig. 48. portion restored with pure gold, as shown in the cut with crown in place (Fig. 48). After the backing is placed upon the porcelain, it should be attached to the plate with wax and the whole carefully removed from the model, encased in plas- ter and sand, gradually heated, and soldered. The parts, pre- pared as described and illustrated, may be held by screwing the wire in a hand-vice while the gold foil is being built in place. This can be nicely done with the electro-magnetic mallet, and the crown made ready for insertion by the time of the next appointment with the patient. " A very good and less difficult method of preparing crowns is to back the whole of the porcelain and restore the contour of the palatal portion with fine gold plate (18 to 22 k.), united with correspondingly fine solder. " The apical foramen should be closed with gold. If gutta- percha or oxychloride of zinc be used for this purpose, some of PIVOTING ARTIFICIAL CROWNS. 163 the material may be pressed through the foramen, but with gold the operation can be made more certain and satisfactory. To avoid any exposure of gold should recession of the gum take place, the edge of the plate ought to be so cut away that the porcelain may be accurately fitted upon the labial portion of the root. " When all is in readiness for placing the crown upon the root, fine barbs should be made with a knife or lancet along the entire surface of the gold wire, a thin layer of white gutta- percha (such as requires little heat) placed around the wires and against the plate ; the metallic parts should be heated suf- ficiently to just soften the gutta-percha, and, with the root dried, the whole must be immediately pressed and carefully malleted to place. The surplus stopping should be trimmed oif with a lancet a few hours or the day after the crown is placed upon the root, or when the gutta-percha shall be thor- oughly cooled ; the gum will then have been so pressed away that the boundary-line between the crown and root can be seen and the edge of the gutta-percha smoothly finished with pellets of Japanese bibulous paper, lint, or cotton saturated with chlo- roform. " There is a still less difficult and yet good method of plac- ing crowns upon roots of teeth, and one, too, that does not re- quire so much time as that just described ; but the root should be prepared and a gold wire fitted in it in the same manner. A suitable plain 'pivot' crown, having a hole in it a little larger than the gold wire, should be selected and fitted to the surface of the root as perfectly as possible, and the opening in the porcelain filled with fine, well-seasoned hickory wood, which must then be cut off even with the base of the crown, and a hole drilled in the centre and entirely through it large enough to insert one end of the wire. The surface of the wire should l)c roughened or finely barbed along its whole length, one end })]aced (not malleted) tightly in the opening made for it in the wood in the crown, and the whole then placed upon the root and finished Jis above descril)ed. "An artificial crown, l)y whatever method mounted, can be 164 MECHANICAL DENTISTEY. ■ more successfully placed upon a root, and all operations better performed, when the rubber dam is applied than where it is not used, and it should, therefore, be secured, if the operator can apply it, to the adjoiniug teeth, and then to the root, be- fore the final fitting and mounting of the crown." Gold Crown Faced with Porcelain. — The subjoined method of attaching an artificial crown to a root was originally intro- duced to the notice of the profession, in 1872, by Dr. Marshall H. Webb. The following is a description of his more recent and perfected method of operating, which, while it necessitates great care, dexterity, and delicacy of manipulation, unquestion- ably possesses, in aa exceptional degree, the important advan- tages not only of security of attachment, but of indestructi- bility, the union with the prepared surface of the root being effected by direct contact of impacted gold. " Building crowns of gold upon roots of teeth and facing them with porcelain makes the most secure and satisfactory though difficult operation. After preparing the root, closing the foramen with gold, and cutting away the irregular or pro- jecting edges to within about a half line of the margin of the gum (leaving this much to aid in applying the rubber dam), a gold wire, No. 13 or 14, with a fine, sharp thread cut upon it, should be accurately fitted in the pulp-chamber to near the apical foramen. To the platinum pins of the porcelain selected for the case a cylinder or tube made of gold plate should be fitted, and, after it is opened (Fig. 49), riveted and then closed, placed in plaster and fine sand, and carefully heated and sol- dered. A thread must then be cut in the cylinder correspond- PIVOTIXG ARTIFICIAL CROWNS. 165 ing to that upon the wire to which it is to be attached. This is done that the crown may be more securely placed upon the root than by the method described by the writer in the Dental Cosmos, June, 1873. The end of the gold tube next the cut- ting edge of the crown may be bevelled and a slot made in the wire at that part, so that the cylinder will be prevented from turning, while still greater strength is added by impacting gold into the open part, thus spreading the end of the wire. A groove should be cut with a corundum disk in each side (6), and sometimes along the cutting edge of the porcelain, into which gold foil is to be placed, to secure greater strength and permanency. " When all is in readiness for the operation, the rubber dam should be applied to two teeth each side of the root and to the root itself. The ligature of waxed floss silk should be placed twice around the root, tightened, and pressed well to place with a burnisher, the ends of the silk wrapped twice, as in tying a surgeon's knot, and the ligature then attached to the ring at the end of an elastic rubber dam holder and held just below the edge of the slightly upraised lip, so that, when the holder is fixed to a tie put around the patient's neck, there shall be constant tension upon the ligature. After this has been done the root should be trimmed down with corundum wheels or cones to the ligature, although not close enough to displace it. The porcelain should then be so fitted as to leave a half line of space to be filled with gold (as at c) between it and the root, after the wire has been placed in the cylinder and screwed into the root. In placing the parts in position a little oxychloride of zinc, nearly the consistency of cream, should be placed in the root next the gold that closes the foramen, and the gold wire at once put in this and screwed securely to place. After the oxychloride of zinc has crystallized, sufficient of it and of the dentine should be cut away with small burs to secure good anchorage for the gold now to be placed as perfectly and solidly as possible around the wire, to and over the margin of the root, along the gold tube, into the grooves made in the porcelain, and betwficn it and the labial margin of the root (c). This 166 MECHANICAL DENTISTEY. narrow line of gold need not be made visible when the oper- ation is completed. The gum should cover it. While the gold is being placed around the wire in the root the porcelain can be turned a little to one side upon the gold wire till the cylinder is reached and restoration of the contour of the parts commenced. All the gold should be cohesive and impacted by the aid of the electro-magnetic mallet, with which the surplus foil can easily be trimmed away from the margin of the root as placed upon it, and the form of the crown so nicely carried forward that but little dressing is afterwards necessary. The gold should be filed even with the margin of the root, and finished with narrow strips of fine emery cloth at and near that point, while the rubber dam is yet in place; after this is re- moved the gold should be so cut away as to allow proper occlu- sion of the teeth, and a little space should afterwards be gained by very careful wedging for the trimming and finishing of the gold along each proximate surface separately." The form and relations of the several parts entering into the construction of a crown by Dr. Webb's method are shown in Fig. 49. A process of attaching porcelain crowns to the roots of teeth by the use of steel screws, originally introduced to the notice of the profession by Dr. George T. Moffat, of Boston, Mass., but more recently and particularly described by Dr. E. W. Foster of the same city, is worthy of a place among the best operations of this kind by reason of its simplicity, security of attachment, comparative inexpensiveness, and its practicable application to other than the single-rooted teeth. Dr. F. thus describes the method : " Among the principal features of this method is the steel screw in place of the steel pin, as first applied, and which unites the crown to the root in the most perfect and absolute manner. The inner head of the screw (Fig. 50 a) is a concave or half globular, and completes the principle of a ball-and- socket joint between itself and the circular cavity in the poste- rior part of the crown, seen at b, in a vertical section of the same. This, it will be observed, permits of an automatic ad- PIVOTING ARTIFICIAL CROWNS. 167 justment to the root, but more so in lateral directions, a fact of great importance and convenience where the root is out of its normal position, as is frequently the case, especially as regards the anterior teeth. Where the root is sound and the joint close, a few layers of soft gold foil are placed between the crown and the root. After a careful and final setting of the screw, an impervious joint is thereby obtained — one perfectly odorless and highly antiseptic to the root for an indefinite period of time. " The prejudice against the old and odorous varieties of crowns is well sustained by all persons of intelligence and re- finement. " The front view of an incisor crown thus set is shown at a (Fig. 51). The posterior cavity in the crown, over the screw- FiG. 50. Fig. 51. head at 6, is filled with gold, or other material, and finished flush and smooth with the surfaee. Where gold is u.sed, which is generally preferable, the retention of the first pellets is greatly facilitated by the previous arrangement of a few layers of adhesive gold foil under the head of the screw, whose over- lapping edges serve admirably the purpose intended. " Oxychloride of zinc or gutta-percha would be indicated in cases where the root was hypersensitive. In the place of the layer or layers of foil in the joint, a drop of gum sandarac varnish — quite thick — will often be all that is required to ac- complish the same results. Where the end of the root is ex- tensively decayed, the jagged interval in adjustment may be filled with gold or gutta-percha according to the judgment of the operator. The screws should be made of the best watch- 168 MECHANICAL DENTISTRY. steel wire, and in the main shaft do not require to be larger in diameter than a small knitting or common-sized darning-needle. The screws may be also slightly washed in a nickel bath to suit a whim or fancy, but practically they have no advantage what- ever over plain screws, for the obvious reasons of their seclu- sion and dryness when in position. Most of the anterior roots will, for a sufficient distance, permit the use of a drill which is three or four, or even five times the diameter of the screw. A plug of hickory in such cases is firmly set in the hole thus drilled in the root, and the end of the wood neatly finished with the outer surface. The tooth crown, now firmly held in the desired position on the end of the prepared root, will act as a guide in drilling for the screw, the drill passing up through the posterior cavity of the crown. Presuming, of course, that the nerve cavity is filled to the screw with gold, a vertical half section of the root and crown with the inserted wood for the attachment of the screw would appear as in Fig. 52. At a Fig. 52. Fig. 53. appears the wood, and at b the external gold plug. The final attachment is facilitated by having previously run the screw once through the wood before the crown is put on. A tap for the screw is easily made from a broken excavator or other in- strument of like dimensions by drawing the temper and cutting the same thread as the screw for a suitable distance upon the end. After the end is slightly rounded, three grooves, equi- distant from each other, should be filed rather deeply, length- wise of the tap, then the whole tempered and drawn back to straw color. The screws themselves will run better by being grooved likewise, but should not be tempered. However, if a PIVOTING ARTIFICIAL CROWNS. 169 tap is necessary, and a regular one is not at hand, from acci- dent or otherwise, the screw, already grooved, needs simply to be tempered to act admirably in a double capacity. "We have spoken principally of the anterior teeth. We will now refer to this method as applied to those teeth, in either arch, that are posterior to the canines. " It will be evident from the principles involved, that bicus- pid and molar crowns can be applied with the same facility, especially whenever their situation in the arch will permit the use of the drill. Bicuspids are treated in the same manner as the anterior teeth, save that in the strong, broad, and frequently bifid roots of second bicuspids, two screws may attach the crown, especially where extra strength will be required from their situation in mastication. "Fig. 53 will illustrate a second upper bicuspid, in part sec- tion vv-ith two screW'S. Upper and lower molars will require two, three, or more screws as the operator may determine, ]Many more layers of foil will be required for molar crowns than for others, in order to secure an equal perfection of their joints. Where many crowns may be called for in a case, the carver is indispensable. In cities, and in offices, even, where good carvers may be had, nearly, if not every tooth may be carved by him to suit each place precisely, and little or no fitting will be required. More diversified and desirable results are thus obtained. In the country, and places too remote for such ad- vantages, the anterior and bicuspid crowns may be furnished in various colors and shapes after the ordinary patterns. Excel- lent crowns of the above description have been furnished us by the enterprise and accommodation of S. S. White from moulds made expressly for such. " In the matter of screws we will merely remark that, as no town furnishes a dentist without at the same time furnishing him with a neighbor equally constant, omnipresent, and inde- fatigable, — the jeweller, — the facility of obtaining screws made to a desirable j)attorn will be abundant and satisfactory. Where it is decided to give the carver an opportunity to dis- play his skill, whether it be upon one crown or a dozen, an 170 MECHANICAL DENTISTEY. impression in plaster will be necessary. Preceding this, all the crown-bearing roots should be prepared, dressed, and drilled the same as for setting, but not tapped. Bits of wire of any- kind, the diameter of the drill, are now set in each place in- tended for a screw, and rising to the height of the future crown. These pins should sit in their places easily enough to come away readily with the impression when it is withdrawn. The removal of the impression from about the other teeth may be facilitated by the use of a slight portion of glycerin applied with a small camel's-hair brush about their necks and crowns. Glycerin, though agreeable of itself to most people, may be rendered quite so by perfuming it with some generally accept- able odor. The impression being now removed is carefully varnished and oiled, the pin or pins remaining in situ. From this the true cast is made, the pins now being transferred to this one in turn. By careful manipulation and cutting the pins will part with the old cast or impression with little or no difficulty. The purpose of these pins is to serve the carver for attachment of the ' body ' in its first moulding, and give, at the same time, the direction and diameter of the screws in the crown, the heads of which should finally occupy the posi- tion of about a sixteenth of an inch from the joint. A plaster bite of the antagonizing teeth should also accompany the final cast. If shrinkage in baking of the crown will not permit the passage of the screw freely, a small, soft steel mandril in the lathe, with the use of oil and the flour of emery, will be efficient. " Fig. 54 represents a case where eight crowns have been set by this method. The black dots represent the gold fillings over the screws — two in the second bicuspid and three in each of the two molars. " In conclusion, with regard to the above method of crowning roots, and its application, we may be permitted to offer for consideration a summary of its characteristics ; " 1st. Its simplicity, neatness, and permanency. " 2d. The impervious and antiseptic character of the union of crown and root. PIVOTING ARTIFICIAL CROWNS. 171 " 3d. The practical application of these crowns to bicuspids and molars, as well as to the anterior teeth, which have been chiefly concerned in this matter hitherto. "4th. The use of the screw, which is one of the most pow- erful adjuncts in mechanics; and this screw of steel, uniting the minimum of size with the maximum of strength. " 5th. The application of an entire crown of porcelain, ivory, or gold and porcelain, as set forth. Fig. 54. "6th. The ball-and-socket principle of the screw-head and its cavity of reception in the crown, permitting of automatic adjustment to the root, whether in its normal position or other- wise. " 7th. The facility with which the carver may adapt one or many crowns in cither dental arch. " 8th. The final filling and finish of gold or other material in the posterior cavity over the screw, sealing the whole imper- viou.sly, and at the same time permitting of the speedy and safe removal of the crown, when necessary from its fracture, or from other causes. " *Jth. The many objections it refutes witii regard to the 172 MECHANICAL DENTISTEY. popular notion of 'pivoting' teeth in general. Among the raost j)rominent of which are not only the oifensive odor and other imperfections of the older forms, but the costliness and tediousness of some of the later ones." The author is indebted to the obliging courtesy of Dr. W. G. A. Bonwill, of Philadelphia, Pennsylvania, for advance proof-sheets of an article descriptive of a " New Method of Substituting an All-poecelain Crown upon any Koot IN Either Denture/' prepared for August number (1880) of the Dental Cosmos. Dr. Bonwill's long-continued, intelli- gent, and successful experimentation in this sj)ecial department of practice is well known to the profession, and the following may be accepted as embodying his best and latest experiences. He writes : "No argument is needed to convince the advanced practi- tioner that some method is demanded whereby the thousands of good roots now sacrificed can be made permanently useful. Notwithstanding the great revolution wrought by machinery and improved appliances for filling teeth, so few are the suc- cesses that, unless some plan is brought to our aid to save the remaining roots from the ravages of decay and from a want of skill and judgment by three-fourths of the dentists, we shall have little else than plates with which to meet the issue. Teeth can be saved without filling as well as by filling by some operators, but by a few only. Most of the dilemmas which all of us encounter every day are the results of bad dentistry. The plan to meet the difficulty must be one which is founded on such mechanical and physical laws that it can be safely relied upon for resisting both time and the various surrounding cir- cumstances; one which any ordinary operator can follow, and which will be so cheap as to bring it within the reach of all; one which, if by accident the porcelain crown has been frac- tured, will allow of easy substitution in a few minutes without interfering again with the operation performed on the root. A crown is needed which can be obtained by every operator as easily as porcelain teeth for plate work, and kept in stock by him ready for any emergency, and costing but a trifle to replace; PIYOTIXG ARTIFICIAL CROWXS. 173 a method by which we can take any case of great irregularity, of any age and standing, and, without disturbing the root, cut oiF the crown and place the porcelain one in the proper curve in the arch ; a result which is absolutely clean, and which will make the patient feel safer from accident than any other pro- cess of restoration. " Has any such plan been generally practiced? A few have been successful by certain elaborate methods which only the exceptionally skilful could perform, and even then, when a ' break-do^v•n ' came, there was no alternative but to do it all over again, either at the cost of patient or operator. " Since 1871 I have been experimenting in this direction. The grand object in view was to give to the dentist at large such a made-up all-porcelain tooth as would meet almost any requirement. "My first jilan (see Dental Cosmos, September, 1877) of a bolt and nut planted in the root by gold foil did not succeed, as the safety of the whole depended on the perfect rigidity of the bolt. Gold could not be so packed, save in a few cases. Amalgam overcame this difficulty, a platinum bolt being used instead of a gold one ; but this operation was practicable only to skilled mechanicians ; the average dentist was unable to per- form it. " To meet this issue, the all-porcelain crown, without nut, was devised. In looking at the incisor crowns, superior and inferior, one might suppose that with so much cut away from their base, and with the pin-hole running entirely through the crown, the strength would be impaired. So I feared when the idea was first suggested to my mind. But upon trial the strength was found entirely sufficient. The experiments were made Ijy drilling out old-style pivot teeth with a diamond. They are now made by the Trustees of S. S. White in special moulds. With these still greater strength is attained. The in- cisors are so shaped as to form a dovetail, which allows the strain outward te ob- served that the incisors, lx)th as regards form and situation, are inadmissible for clasping, and are, therefore, never used for this purpose. The cuspidati, likewise, being placed con- spicuously in the front part of the mouth, cannot be securely embraced without manifest exposure of the clasp ; besides, the conical form of these teeth makes the use of a very slender clasp indispensable ; henc-e, these teeth are rarely employed, and may only be used when, in the judgment of the operator, the necessities of the patient for the time Ijeing s^-em to require it. Either the anterior or the posterior molars, when sound and firm, offer, in respect to their general conformation and posi- tion in the arch, the most desirable and efficient support for parts of sets of teeth. The crowns of these teeth generally afford ample breadth to the clasp ; have nearly parallel walls ; and furnish, by the strength and immobility of their attach- ments to the Jaw, the greatest security' to the artificial appli- ance. The anterior molars are preferable where these are remaining in good condition, or are sasc-eptible of being prop- erly restored and preserved if diseased or carioiK. Of the bicuspids, the posterior are to be selected, if practi- cable, as these better favor the concealment of the clasps ; to effect which more perfectly, in the use of either the first or second bicuspids, it will be sufficient in many cases to embrace only the posterior half of the crown. The denies sapientite, or wisdom teeth, will seldom admit of the application of clasps, as the crowns of these teeth are usually very short and cone-shaped, the walls converging abruptly from the gum ; Ix-sides, the retractive forces applied to the anterior teeth of the substitute, would, on account of the increased leverage consequent upon the extension of the plate back to these teeth, tend either to disengage the clasps or pro- duce displacement of the teeth to which they are applied. 204 MECHANICAL DENTISTRY. In supplying the loss of one or more of the inferior incisors, the appliance should, as a general thing, be attached either to the anterior or posterior bicuspids, as these teeth stand more nearly vertical in the arch. In fixing partial lower dentures^ it will be sufficient to simply provide against mobility of the base, as they are favored rather than opposed, as above, by gravitation. The replacement of the inferior teeth posterior to one or both bicuspids, however, are more frequently demanded ; in which case it is customary to attach the clasps to the teeth immediately in front of and adjoining the vacuities on each side. It will not, however, be necessary to attach clasps in these cases whenever the edentated portions of the jaw present a distinctly scooped form, or marked concavity of outline, forming a kind of bed for the plate. If, on the other hand, the ridge falls back with a tolerably uniform inclination from the teeth in front, with no sufficient elevation at the base of the coronoid process, it may become necessary to provide against backward displacement of the substitute by attaching clasps, as before stated, to the teeth immediately in front. In any case, if the dentes sapientise remain, partial or stay clasps may be attached to each heel of the plate, and so adjusted as to rest against the anterior face of these teeth, obviating entirely the necessity of clasps in front. Separation of the Teeth, by Filing, for the reception of Clasps. — The practice of separating the teeth with the file to provide for the application of clasps should always be avoided if practicable, since the liability of the teeth thus denuded of enamel to decay is greatly increased under circumstances so favorable to their disintegration. In the case of young sub- jects, especially, where the teeth are but imperfectly consoli- dated, and in adults whose teeth are defectively organized, pre- senting but a feeble resistance to the disorganizing agents usually present in the mouth, the use of the file, for the pur- pose indicated, is eminently pernicious, and should never be resorted to until every other means of supporting the artificial appliance have been fairly and patiently tried. Whenever a plain necessity for this operation exists, a care- CLASPS. 205 ful examination of all the teeth to which it is proper to ap- ply clasps should be made, and if decay is found upon their proximate surfaces, the separation should be made between the teeth so affected ; and this circumstance should, in most cases, determine the selection, though the affected tooth or the one ad- joining may not be esteemed, in other respects, the best for the purposes of support. If decay exists on the proximate surface of only one of the teeth to be separated, a safe-sided file should be employed, and the filing confined entirely to the carious tooth, leaving the enamel of the one adjoining unbroken. The cavity of decay should be well filled, and the filed surface thoroughly condensed and polished with a burnisher. Modifications in the Form of Clasps. — 1. Plain Band. The most usual form of clasp is that shown in Fig. 73. It consists of a plain metallic band of greater or less width and thickness, and is made to embrace the larger portion of the circumfer- ence of tiie tooth. In respect to the general properties of metal- lic clitsi)s, it may be said that they should be, as nearly as prac- ticable, of the same quality or fineness as the plate or base to which they are united ; they should be heavy enough to impart adequate security to the attachment, say twice the thickness of the base, and exceeding this in some cases; and sufficiently elastic to embrace accurately the more contracted parts of the teeth after having been temporarily forced apart in passing over the enlarged portions of the crowns. In constructing a plain band or clasp, a strip of sheet lead or other pliable sub- stance may first be fitted accurately to the plaster tooth, mak- ing it of tiie rerpiired width, and shaj)ing the edge next the gum in conformity with the irregularities in the latter around 206 MECHANICAL DENTISTRY. the neck of the tooth ; the exact counterpart of the pattern thus obtained is then cut from the plate to be used in the formation of the clasp. The strip thus obtained is then bent with round-nosed or grooved pliers (Fig. 74), until conformed as perfectly as possible to every portion of the surface of the tooth embraced by it. This coaptation should be sufficiently accurate to exclude perfectly all solid substances from between the clasp and the tooth. A more accurate adaptation of the clasp may be secured in the following manner : First secure a pattern, as before described, and by this cut from a thin strip of platinum, say ISTo. 30 or 32 of the gauge-plate, a band of the required size and form, and press or burnish it accurately to the form of the plaster tooth. The soft and pliant condi- FlG. 74. tion of this metal will admit of its being easily adapted to any irregularities upon the lateral walls of the tooth. The band thus moulded to the tooth is then carefully removed from the model, or the mouth, if fitted to the tooth in the latter, and its central portion filled with a mixture of plaster and sand with a small metallic wire or bar passing through the centre to sup- port it while soldering. The outer or exposed surface is then smeared with a mixture of borax, and small scraps or frag- ments of gold plate of equal fineness with the main plate, are placed at intervals and fused with the blowpipe until diffiised uniformly over the surface. Small pieces may be added from CLASPS. 207 time to time, until the required thickness of the clasp is ol> tained. The piece should be heated uniformly throughout to induce an even flow of the gold over the exterior surface of the platinum ring. By this method a faultless adaptation of the clasp to the tooth may be secured, provided the form of the latter is correctly represented on the model. In all cases where the plain band is used, it should be made as broad as the tooth will admit of, as a clasp so formed gives greater sta- bility to the plate, and does not endanger the tooth clasped in any greater degree than a narrow one. 2. Standard Clasp. — To guard more perfectly against the retention of vitiated secretions and particles of food around the neck of the tooth, a method of constructing clasps has been devised and introduced to the notice of the i>rofession by Dr. Fig. 75. C W. Spalding, which, by leaving the cervical portion of the tooth in a great degree uncovered, permits the action of the tongue and the natural circulation of the fluids of the mouth to wjish or cleanse that portion of the tooth most liable to be injuriously aflected. In commenting on this method, Dr. S. remarks : " The writer has for many years been in the habit of employing narrow clasps for the pur- poses of support, making them of sufficient thickness to give the required strength, and attaching them to the plate by means of standards, so arranged as to induce tlie removal of accumulations between the clasp and tooth, by the circulation of the saliva (Fig. 75). The use of one or more standards as a means of attachment, also provides, by a variation of their lengtli, for the grasping of the tooth at any desired point. If the tooth Ls long, and particularly if it is at the same time bell- 208 MECHANICAL DENTISTEY. crowned, the point selected should be toward the grinding sur- face, as far from the gum as is found practicable. If the tooth is short and of such form that it can be successfully clasped at no other point than that near the gum, the plate should be cut away at least one or one and a half lines from the tooth, and standards introduced for the purpuse of promoting circu- lation, by affording a free passage for the ingress and egress of fluids. These standards should also be narroto, no wider than the clasp itself, and should constitute the only point of union between the clasp and plate. Haf-round wire will be found to be a very convenient article for making clasps. The par- ticular form of the clasp is, however, immaterial, if it is both narrow and strong,"* 3. Scalloped Clasp. — Somewhat analogous in form to the clasp just described, and constructed with a similar design, is the one recommended by Dr. B. T. Whitney. A plain band of gold is fitted to the tooth in the manner first described, when that portion of it next the gum on the lingual side of the tooth is scalloped or cut away in the form of a semicircle or arch, the ends of the clasp being in like manner narrowed sufficiently to relieve them from contact with the neck of the tooth. The intermediate points of the clasp which serve to unite the latter to the base may be two or more in number, and should be wide enough to impart adequate strength to the attachment. A clasp so formed and applied to the base will present very nearly the appearance of the standard clasp as represented in Fig. 75. Dr. W. recommends soldering but a single point at first, and then having tried the plate in the mouth and adjusted the clasp properly to the tooth, remove and solder the remaining point or points. 4. Partial or Stay Clasp. — This form of clasp, instead of embracing the tooth, is designed to steady or fix the substitute in place by simply resting against one side of the tooth to which it is applied. (Fig. 76.) They should be so connected to the plate that when pressed over the enlarged portions of the * American Dental Review, vol. i, p. 12. CLASPS. 209 crowns of the teeth, they will spring readily into place and adapt themselves closely to the more contracted parts near the gum. In cases where there is no adequate opposing force to that exerted by the clasp, care should be taken that no more pressure is produced than is necessary to keep the substitute in Fig. 76. place, as, without this precaution, outward displacement of the teeth is liable to occur, and the appliance, losing its bearing upon the teeth, soon becomes loosened and insecure in the mouth. The result alluded to should be particularly guarded against in the case of young subjects, whose teeth are easily moved by the application of very slight forces. Modification in the Form of Plates for Partial Dentures supported in the 3fouth by Clasps. — The particular form and dimensions of a plate, when clasps are used, will be mainly determined by the number and position of the teeth to be replaa;d, and by tiie location of the natural organs to which the clasps are attached. It will be sufficient in this place to indicate the leading forms as they relate to the substitution 14 210 MECHANICAL DENTISTRY. of the several classes of teeth. In supplying the loss of a superior central or lateral incisior, it will be sufficient in many cases to attach the plate to either a bicuspid or molar on the same side, as in Fig. 77. If two or more of the front teeth, however, are to be replaced, it is better to extend the plate on each side of the palatal arch, and attach to a bicuspid or molar Fig. 78. Fig. 79. Ij>r— £|^> (Fig. 78) ; or to a bicuspid on one side, and a molar on the other; unless two firm and well-formed teeth on the same or the opposite side can be commanded (Fig. 79), while those upon the other could hot be employed without a separation. In all cases where it is necessary to extend a narrow plate from the extreme front part of the mouth to a single tooth situated pos- teriorly in the arch, the former should be strengthened by soldering a narrow rim of plate or half-round wire along the CLASPS. 211 border next the teeth, and the clasp should, Avhenever prac- ticable, pass in front of, and embrace, the anterior face of the tooth to which it is applied. If an anterior bicuspid is to be replaced, the plate may be attached to the adjoining bicuspid (Fig. 80, right side), or if both are absent, then to the first molar (Fig. 80, left side), or the clasp may embrace both of the latter if remaining and no separation between them exists. Fig. 81 represents the form of a plate supplying the loss of teeth at intervals; the clasp on one side embracing the posterior bicuspid in front and extending round the back part of the adjoining molar. Fig. 82 represents the form of plate supplying the loss of the two bicuspids on one side, and the anterior bicuspid and Fig. 82. Fig. 83. molar on the opposite, the plate being attached to an anterior molar and second bicuspid. The antero-posterior extension of the plate, as exhibited in connection with the bicuspid tooth, greatly favors the stability of the substitute, and, pro- vided the plate and clasp are accurately fitted to the parts, the support afforded by a bicuspid tooth under such circumstances Is equivalent to that furnished by a firm and well-formed molar clasped as shown on the opposite side. A base so sup- ported may be made to sustain any number of teeth with the greatest security. Either the anterior or posterior molars, if firm and securely attached to the jaw, will afford adequate support to a ])late replacing all of tlie teeth anterior to them. (Fig. 83.) Even 212 MECHANICAL DENTISTRY. a single molar situated on either side of the arch, if similarly circumstanced, may be made to sustain, with tolerable firm- ness, a base supplying the loss of all the remaining teeth, — though, ordinarily, it is better to extract such a tooth and substitute an entire upper denture. In all cases, where any considerable number of teeth anterior to those clasped are to be replaced, and a vacuity on the ridge exists posterior to the latter, the plate should be extended back and overlap the ridge (Fig. 84), the latter affording a counter-point of resist- ance when traction is made upon the anterior teeth, thus di- recting the forces applied more on a line with the long axes of the teeth that sustain the appliance. In supplying the loss of the inferior molars and bicuspids, or any number of these teeth, the form of plate represented in Fig. 84. Fig. 85 is generally employed. The parts of the plate over- lapping and resting upon the ridge behind, are connected with each other by a narrow strip of plate extending round the ridge in front on the lingual side of the anterior teeth. This latter portion of the plate should be accurately swaged to the form of the gum on which it rests, and should be made narrow enough to avoid encroaching upon the reflected portion of mucous membrane, the glands beneath the tongue or the frse- nura linguae. To avoid wounding these parts, and to allow them unobstructed play, it will be necessary to make this por- tion of the plate quite narrow ; and as a single thickness of CLASPS. 213 plate would not impart adequate strength, it is customary to double this connecting baud — the duplicate band extending back to the lateral wings of the plate, and crossing them ob- liquely, as indicated by the dotted lines in Fig. 85. Addi- tional strength will be given by doubling the entire plate, but this is not generally required. The outer border of those portions of the plate overlapping the ridge may be turned up to the depth of from half a line to a line to form a groove or socket for the reception of the ends of gum teeth, or blocks, if such are used ; while the inner margins should terminate iu a rounded edge, extending from heel to heel of the plate, this form being given to it either by turning the edge over and filling iu the groove with solder, or by soldering a narrow Fig. 86. strip of plate or half-round ware along the border. The cir- cumstances or conditions which make the use of clas2>s neces- sary in these cases, as well as those, also, which contraindicate their employment, have already been noticed. The practice of extending a narrow band or wire from the sides of the plate round the outer border of the ridge in front of the anterior teeth, to prevent a backward displacement of the base, is liable to produce irritation and tenderness of tlie mucous membrane immediately over the roots of the anterior teeth, and should, therefore, never be resorted to, unless there are no teeth re- maining to which clasps may be applied. If tiie appliance is designed to restore the loss of teeth re- cently extracted, and where but little or no change has occurred from ab.sorj)tion of the parts, the portions of the j^late which 214 MECHANICAL, DENTISTRY. pass in between the adjoining teeth should terminate a line or more within the outer circle of the remaining teeth ; and where the space, if it happens in the front part of the mouth, admits of two or more teeth, the edges of the extended portion of plate should be scalloped in correspondence with the fes- toons of the gum, as seen in Fig. S6. In such cases, plain or plate teeth, by which is meant those which represent only the crowns of the natural organs, should be employed ; these, rest- ing on the edge of the plate, will overlap somewhat, with their anterior edges resting directly upon the gum in front, taking the place occupied by the crowns of the extracted teeth. On the other hand, if sufficient time has elapsed after the ex- traction of the teeth to permit the changes in the form of the ridge to occur incident to partial or complete absorption of the parts, and a greater or less concavity exists between and above the teeth on the outside of the jaw, the plate, where it passes into the interspace, should extend some distance over the border of the ridge. Swaging or Stcimping the Plate. — Haying determined upon the proper form and dimensions of the plate for any given case, its outlines may first be traced upon the model; from this an exact pattern in lead may be obtained, or the pattern may be sufficiently ample to partially overlap the cut extremities of the teeth when the latter are not represented upon the die, having been previously cut from the model. The outlines of the pattern are then traced upon the plate of gold or other metal to be used for the base. The redundant portions of plate are then cut away with plate shears and forceps, and the edges trimmed smooth with a file. A very convenient and almost indispensable instrument for cutting away the plate where it describes the palatal curvature of the teeth, is a plate forceps, as exhibited in Fig. 87. The plate cut to the proper form is now placed upon the die and brought as nearly as possible into adaptation with a wooden or horn mallet ; it is then placed between the die and counter, the latter resting on an anvil or other equally resist- ing surface, when the two metallic pieces are brought forcibly CLASPS. 215 together with a few stearly and well-directed blows of a heavy hammer. Tilting of the die, resulting sometimes unavoidably from a one-sided blow, may be obviated by placing a cone- shaped piece of cast iron, brass, or zinc over the die, the base of the cone resting on the back of the die ; by this expedient the force of the blow is equalized and concentrated more directly over the die. The metallic swages should at first be brought cautiously together, and should be separated after the first blow or two to enable the manipulator to detect and remedy any malposition of the plate before it becomes intractable from continued swaging. If, in the process of stamping, any portion of the plate is found cracking or part- ing, its further extension at that point may be prevented by Fig. 87. flowing a little solder at the termination of the fissure. Dur- ing the progress of swaging, the plate should be frequently annealed, which is done by bringing it to a full red heat under the blowpipe, or by j)lacing it in the furnace; the plate is thus rendered more pliant and can be more readily and per- fectly forced into adaptation to the irregularities on the face of the die. If, after somewhat protracted swaging, the plate is not con- formed perfectly to the face of the die, another and unused counter should be substituted for that in use; and, indeed, it is better in all cases to have duj)licate copies both of the die and counter in reserve with whit^h to complete the swaging, inasmuch as more or less deformity of both swages unavoid- ably occurs before the plate is brouglit into very accurate 216 MECHANICAL DENTISTRY. coaptation with the die. The stamping conducted thus far, the plate may be applied to the plaster model, and if found too full at any points, it should be trimmed with a file to the exact dimensions required. The margins of the plate adjoining the necks of the teeth should be permitted either to lie closely to them, or should be cut away, leaving a space equal to a line or more between the plate and the teeth ; for if but a very nar- row line of uncovered gum remains at these points, injury to the parts immediately surrounding the necks of the teeth is more liable to occur from strangulation of the interposed gum than if the plate were further removed from the teeth or rested directly against them. If the portion of the plate which passes in between the re- maining teeth is quite narrow, as where but a single tooth is to be supplied, it should be strengthened by wiring the edges or doubling the plate at such point. It is also advisable in many cases, in order to provide more perfectly against fracture or distortion of the base in mastication, to wire or double the entire border of the plate adjoining the necks of the teeth. Narrow bands of gold resting against the necks of the teeth, constructed and adjusted after the manner of stay clasps, are sometimes soldered to the edge of the plate next the teeth ; but unless the substitute is frequently removed from the mouth and cleansed, as well, also, as the teeth to which they are ap- plied, serious injury is likely to be inflicted upon the teeth im- plicated. The edges of those parts of the plate occupying the vacuities on the ridge should be filed thin to admit of a more accurate adaptation of the artificial with the natural gum, and should not, as before observed, ordinarily extend beyond the outer circle of the contiguous teeth, allowing the gum extremity of the artificial tooth to overlap and rest directly on the natural gum above. If, however, the concavity between and above the teeth on the external border of the ridge is considerable, the interdentinal portions of plate should overlap the border completely and underlie the porcelain gum. Uniting the Plate and Clasps. — Having proceeded thus far CLASPS. 217 in the operation, the plate and clasps should next be united to each other, and the utility and comfort of the appliance in the mouth, as well as the safety of the natural organs used for the purpose of support, will depend, in a great measure, upon the accurateness of the relation of the several parts of the appli- ance to the organs of the mouth ; it being a matter of primary importance that the various parts of the substitute should be so adjusted to the remaining teeth, — especially those to which the clasps are applied, — and the ridge and palate, that it shall not, in any material degree, act as a retractor upon the organs of support, or furnish interspaces for the lodgment of food, Avhile at the same time it should be so fitted as to be easily removed and applied by the patient. The clasps having been fitted to the plaster teeth and the base swaged to the form of the palatal arch and ridge, the plate is placed in its proper position in the mouth and an impression in wax taken of the latter with the plate in place. The im- pression with the plate adhering, is then removed from the mouth, its surface oiled and a model obtained in the manner heretofore described. If, in separating the model and im- pression, the plate adheres to the latter, it should be detached and adjusted to the model and the clasps arranged upon the plaster teeth. The plate and clasps may now be bound to the model with annealed wire, and united to each other with solder ; V)ut the better way is to attach them to each other tem- porarily, with adhesive wax, in the relation they occupy on the model, and then remove them carefully and imbed the clasps and i)alatal face of the plate in a mixture of nearly equal parts of plaster, sand, and asbestos. Before uniting the two •pieces on the model with wax, however, the ends of the clasps should be straightened out or spread apart, in order that they may part readily from the plaster teeth, without, in any de- gree, changing their exact relation to the plate ; in doing which, it should be observed that all parts of the clasps which are to be united to the })late should remain in close contact with the plaster teeth. After the plaster mixture, in which the plate and clasps are imbedded, has become sufficiently 218 MECHANICAL DENTISTRY. hard, the portions of wax which temporarily united the latter should be removed, and the surfaces of the clasps and plate, where they unite with each other, smeared with borax ground in water to the consistence of cream ; small pieces of solder are then placed along the lines of contact, the investient heated in the furnace until the plate acquires a full red heat, when it is removed, placed upon a suitable holder, and the solder fused with the blowpipe. Whenever the form and inclination of the teeth to be clasped are not fairly represented on the model, owing to dragging or displacement of the wax in withdrawing the impression, the difficulties of securing a proper relative adjustment of the sev- eral parts of the appliance will be increased ; but either of the following methods, if carefully and accurately manipulated, will secure accurate results. 1. Gutta-percha may be substituted for wax when taking an impression with the plate in the mouth. With the proper use of this material, the exact form and inclination of the teeth will be preserved ; and when employed, it should be filled in Avith plaster for the model immediately after removing it from the mouth. The subsequent steps in the operation are precisely similar to those described when wax is used. 2. Another method is to adjust the clasps and plate to the parts in the mouth, attach them temporarily in their proper relation, and remove, invest, and solder in the usual way. This may be accomplished in the following manner : First, spread apart the ends of the clasp somewhat to permit it to be easily removed from the tooth ; place this upon the tooth in the mouth to be clasped ; then adjust the plate in the mouth, and attacli the two to each other by pressing a piece of stiif, adhesive wax in against the clasp and plate where they unite ; harden the wax by placing against it, for a few minutes, the end of a napkin moist with cold water ; then remove the plate and clasp carefully from the mouth, and invest and solder as before. The plate, with one clasp permanently attached, is now placed back in the mouth, and the second clasp adjusted to the tooth on the opposite side in the manner before alluded CLASPS. 219 to; this is tlien temporarily fastened to the plate and other- wise treated in like manner as the one first described. If the teeth to be clasped are favorably formed and regularly ar- ranged in the arch, both clasps may, at the same time, be tem- porarily attached to the plate in the fii*st instance ; if not, it will be impracticable to remove them from the teeth without disturbing the wax and changing their relation to the base and the teeth clasped. The additional labor and consumption of time incident to a separate attachment of the clasps, Avill, in proportion as they secure better results, amply reward the op- erator for his painstaking. Plaster is sometimes substituted for wax in this process ; in which case it is introduced into the mouth on a small piece of wax or sheet lead and pressed gently against the uniting por- tions of the plate and clasp, and allowed to remain until suf- ficiently hard. Any superfluous portions around the tooth that may hinder the easy removal of the clasp should now be cut away, when the pieces so attached to each other are re- moved from the mouth. A separation of the plaster from the clasp or plate, or both, may occur when removing the latter ; in this case the several parts may be readily and accurately adjusted to each other again in their exact relation when out of the mouth ; as the latter will be plainly indicated by the impression made by the plate and clasp in the plaster. Being readjusted, they may be further secured by sticking them to- gether with a little softened wax, when they are invested, the temporary fastenings of plaster removed, and the pieces united l)y soldering. The use of plaster in these cases is due to Dr. Lester Xoble, and unquestionably possesses many advantages over wax for the purpose, as the latter is liable even with the most skilful manipulation, to become displaced in removing it from the mouth; and this change, when it occurs, not being indicated by inspection of the m ax, is incapable of timely cor- rection. 3. Still another method is that contrived by Dr. Fogle and describcrcscrve the several pieces in situ more perfectly, the projecting end of the pivot may be flexed, or a head formed on it with the file before applying the plaster; the pivot thus secured will bring all f)arts together if traction is made on the plate in the act of withdrawing the pivot. The plate being removed from the mouth, its palatal por- tion is imbedded in the plaster mixture, and when the latter 15 226 MECHANICAL DENTISTEY. is hard, the plaster is removed from around the pivot on the opposite side of the plate, and the pivot permanently united by flowing solder at its point of contact with the plate. The redundant portion of the pivot on the lingual side of the base is then cut and filed away even with the surface of the latter. If the manipulations have been accurately conducted, the plate and pivot, on being reapplied to the parts in the mouth, will be found to adapt themselves perfectly to the palatal arch and roots. It is better, unless the roots to be pivoted stand nearly or quite parallel, to adjust and solder but a single pivot at a time, as but a very slight variation in the direction of the roots would render the withdrawal of both pivots at the same time difficult or impracticable without more or less change of relation. The same may be remarked of those cases where a clasp is used in conjunction with the pivot. The most efficient method of rendering the appliance sta- tionary when applied to the roots, and at the same time of enabling the patient to readily apply and remove it at will, is that recommended by Dr. Dwindle, and which consists in splitting the pivot with a fine saw, and spreading the sections apart somewhat, thus giving them an increased lateral bearing. Gold used for pivots in these cases should be alloyed with platinum, as that ordinarily employed for plate is too inelastic for the purpose. ATMOSPHERIC PRESSURE. 227 CHAPTER IX. Partial Dentures Supported in the Mouth by Atmospheric Pressure. The method of attaching partial sets of teeth to the superior jaw by means of atmospheric pressure, is much more generally practiced now than formerly, and whenever the condition of the soft parts of the mouth, the general configuration of tlie palatal arcli, and the antagonism or occlusion of the artificial witli the natural teeth favor its adoption, there are good and sufficient reasons why it should be preferred, in all practicable cases, to either of the other methods heretofore described. Modifications in the Form of the Base. — If vacuities exist at various points on the ridge, the plate on which the teeth of re- placement are mounted, should be ample in its dimensions, covering nearly or quite all Fig. 92. of the hard palate. The gen- eral form of the base wher- several teeth scattered through- out the arch are required, is shown in Fig. 92. In most cases, whether but one or a greater number of teeth are to be replaced, increased adhe- rence and stability of the sub- stitute will be better secured by permitting the plate to cover the larger portion of the roof of the mouth ; though, in cases that present the best form of the vault, a diminished surface may be given to the base with cfjually satisfactory results. In the substitution of a single incisor, for example, it will frequently be sufficient to employ a very small plate, covering only a part of the anterior sloping 228 MECHANICAL DENTISTRY. wall of the palate. (Fig. 93.) lu the latter case, the plate used may be very thin, say No. 30 of the gauge ; it will thus impede the movements of the tongue less, and may be swaged more accurately to the parts. If constructed with an air-cham- ber, the latter should be quite shallow. A somewhat anomalous form of atmospheric pressure plate employed in the substitution of one or two bicuspid teeth on each side is described by Professor Taft,* the design of which Fig. 94. is to secure, in such cases, increased stability of the substitute, while much of the palatal arch is left uncovered. It consists, as will be seen by reference to Fig. 94, of two lateral cavity plates accurately adjusted to the sloping walls of the palate on each side, immediately adjoining and partly occupying the spaces to be supplied. These lateral plates may be made as large as a dime, or somewhat larger, and of an elliptical shape, if both bicuspids on the same side are to be replaced, and are connected with each other by a narrow band of gold plate, two lines or more in width, having an anterior curvature, and resting on the front wall of the palate, two or three lines behind the anterior teeth. The entire appliance may be constructed from a single piece of gold plate swaged accurately to the parts ; or the lateral plates and connecting band may be sepa- rately swaged and secured in their proper relation to each other in the mouth with wax or plaster, when they are care- * Dental Register of the West, vol. xiii, p. 112. ATMOSPHERIC PEESSUEE. 229 fullv removed, invested, and soldered together; it should then be re-swaged to correct any change of relation that may have happened during the concluding manipulations. The liability of the plate to ride upon the central and raised portion of the palate, when pressure is made upon one side, throwing the plate off from the ridge on the other, as in the case of a base extending across the arch, is in a great degree obviated by the method just described. Manner of Forming an Air-chamber. — Atmospheric pres- sure plates for partial cases are usually constructed with a central air-chamber; in which case, the part of the model representing the chamber may be formed in either of the ways mentioned in the. chapter on " Plaster Models." The model prepared, the form of the plate to be used is first indicated thereon, and from this a pattern in sheet lead is obtained, which is placed on the plate of gold or other metal, and its outlines traced with a pointed instrument; the redundant por- tions are then cut away with plate-shears and forceps. The plate is now placed on the die, and brought as nearly as possi- ble into adaptation to the latter with the mallet and pliers ; it is tlien interposed between the die and counter, and swaged until it conforms perfectly to the face of the former ; annealing the plate frequently to render it more pliant and manageable under the hammer. Unless the plate used is purer and thin- ner than is generally employed, or than is consistent with the required strength, it will fail to be forced perfectly into the groove around the chamber by the process of swaging alone ; a more definite border, ho\v'ever, may be formed by forcing the j)late in at this place with a small, smooth-faced stamp, shaped to the angle of the groove, passing round the chamber and carefully forcing the plate in with the stamp and a small hammer or mallet until a somewhat sharp and abru])t angle is obtained to the palatal edge of the chamber. After the cham- ber is as perfectly formed as possible in this way, the plate should l>e well annealed and again swaged to correct any par- tial deformity occasioned by stamping the chamber. A still more perfectly defined angle may be given to the 230 MECHANICAL DENTISTRY. borders of the chamber in the following manner : After SM^ao;- ing the plate sufficiently to indicate the exact position and form of the chamber, the portion forming the latter should be separated from the main plate by completely dividing it with a small, sharp, chisel-shaped instrument, cutting on a line with the groove around the chamber until the latter is entirely sepa- rated. The cut portion of the main plate is then trimmed evenly with a file, being -careful not to enlarge the opening more than is required to remove the irregularities of the edge formed in cutting. The plate, with its central portion removed, is then placed upon the die, when a separate piece of gold cut to the general form of a chamber, but somewhat larger than the opening in the main plate, is adjusted over the chamber, and struck up with the plate until the overlapping portions of the central piece are forced down upon the plate around the margins of the chamber. It is not, however, always necessary to employ a separate piece of gold for the chamber, as the cen- tral portion cut from the plate in the first instance may be suf- ficiently enlarged for the purpose. This is accomplished by first flattening out the detached portion, annealing it, and then passing successive portions of its edges a sixteenth of an inch or more between the rollers, the latter being sufficiently ap- proximated to produce a perceptible thinning of the margins. When the entire border of the chamber piece has been thus attenuated and extended, it will be found so much enlarged that when adjusted to the die and swaged in connection with the main plate, its borders will overlap and rest upon the mar- gins of the opening in the base, as in the other case. The portions of the plate and cut chamber lying in contact are now coated with borax and pieces of solder placed along the line of union on the lingual side of the plate, when the two pieces, being transferred to a bed of charcoal, are permanently united by flowing the solder with a blowpipe. Sufficient heat should be applied to induce an extension of the solder between the two portions of plate, filling up completely the gap between them to the edge of the orifice in the main plate, forming, at this point, a square and well-defined angle to the margins of the chamber. SELECTIXG AND AERAXGIXG THE TEETH. 231 CHAPTER X. Method of Obtaining an Antagonizing Model for Partial Dentures; Selecting, Arranging, and Antagonizing the Teeth ; Investing, Adjusting Stays, Soldering, Etc. Haying constructed the plate or base to be used as a sup- port for partial sets of teeth in either of the ways described in the preceding chapter, it will be necessary, before arranging the teeth on the plate, to secure an accurate representation of all the remaining natural teeth of both jaws in plaster, pre- serving accurately the relation which these organs bear to each other in the mouth. This is effected by what is called an antagonizing model, and may be secured in the following manner : . A roll or strip of adhesive wax is first attached to the lin- gual border of the plate, and its adhesion secured by holding the opposite side of the plate for a moment over the flame of a spirit-lamp. The wax used for articulating purposes should be harder and more tenacious than plain beeswax, and may be compounded from the following formula: Beeswax, 1 pound Guru inastich, 2 ounces Spanish wliiting, 1 ounce The wax is first melted in a shallow vessel, and the mastich, finely pulverized, gradually added, and then the whiting, stir- ring constantly until thoroughly incorporated. The rim of wax being arranged on the plate, all superfluous portions over- hanging the margins occupied by the remaining teeth are cut away ; the plate may then be placed on the model and the wax again trimmed, leaving it somewhat fuller than the outer 232 MECHANICAL DENTISTRY. circle of the teeth, and from one to three lines longer than those immediately adjoining the spaces. The plate, with the wax attached, is then placed in its proper position in the mouth, and the patient instructed to close the jaws naturally until the remaining; teeth meet : one-third or more of the crowais of the opposing teeth opposite the spaces will thus be imbedded in the wax. A still fuller impression of the opposing teeth may be obtained, if desired, by pressing the edges of the wax down upon the crowns with the finger. If a series of anterior teeth are to be replaced, the mesial line of the mouth in front should be indicated upon the wax by drawing a line vertically across the latter to serve as a guide in the arrangement of the Fig. 95. central incisors and adjoining teeth. The plate and wax are then carefully removed from the mouth and again placed upon the plaster model, the latter having been previously obtained from an impression of the parts with the plate in the mouth. The model is then placed on a slip of paper with the plate and wax upward, and the heel of the model extended from one to two inches posteriorly to form an articulating surface for the remaining portion of the antagonizing model. The added portion of plaster may be confined by a narrow strip of wax or sheet-lead extending back upon each side of the model, into which a batter of plaster is poured to the depth of half or SELECTING AND ARRANGING THE TEETH. 233 thrcc-fonrths of an inch. When hard, the edges and upper surface of the added phister should be trimmed smooth, and a crucial groove, or two or three conicaI-shai)ed holes, cut in the surface of tiie latter to secure a fixed and definite relation of the two parts of the model. The articulating surface is then varnished and oiled to prevent the next portion of })iaster from adhering ; the imprints of the teeth in the wax are also oiled. This portion of the antagonizing model, with the plate and wax attached, is exhibited in Fig. 95. The open sj)ace look- ing into the ])alatal vault should be closed with a sheet of softened wax to prevent the next portion of plaster from flow- ing into the cavity underneath. A batter of plaster is now poured carefully upon the exposed surface of the wax, filling the imprints of the teeth perfectly, and extending back upon Fig. 96. the heel of the model until it acquires a depth of half an inch or more. When sufficiently hard, the two sections of the model are sejjarated, superfluous portions triuinied away, and the entire surface of both pieces glazed with varnish. The model complete, with the plate in place, and the wax (retained as a tem^jorary support, whilst adju.sting the artificial teeth) trimmed as required, are shown in Fig. 96, and if the manip- ulations have been accurate this simple contrivance will ex- hibit all the parts represented in plaster in precisely the same relative position which they occupy in the mouth when the teeth are closed upon each other. It will be seen, by reference to Fig. 9o, that only those teeth of the opposing jaw which 234 MECHANICAL DEXTISTEY. Fig. 97. present to the spaces, are represented in plaster, as these are all that are required in arranging the teeth of replacement. Selecting, Arranging, and Antagonizing the Teeth. — The teeth of replacement should harmonize, as nearly as possible, in size, configuration, and color, with those remaining in the mouth ; and when selecting teeth for any given case, the operator should be provided with a sufficient number of sample teeth to meet every require- ment, by comparison, in respect to the various tints or delicate shades of color characteristic of the natural teeth and gums. The required size and form of the artificial teeth may be determined with tolerable accuracy by a compari- son with those on the plaster model, but the form or figure more certainly by a careful inspection of those in the mouth. A greater or less change in the form of porcelain teeth will be required, in nearly all cases, in arranging and fit- ting them to the vacuities in the jaw ; and this is more particularly so in those cases requiring the use of gum teeth. This alteration of form is effected by grind- ing away portions of the tooth upon an emery or corundum wheel, attached, as will be seen in Fig. 97, to a foot-lathe. If the edentated portions of the ridge have suffered but little change of form by absorption, as w^here the teeth have been recently extracted, and plate teeth (those representing only the crowns of the natural organs) are used, the posterior portions of the base of the latter resting upon the margins of the plate will only require to be conformed to the irregularities on the surface of the base, grinding sufficiently to give to them the proper length and relative position, while their anterior cer- vical portion is permitted to overlap the edge of the plate and rest directly upon the gum in front on a line with the adjoin- SELECTING AXD ARRANGING THE TEETH. 235 ing teeth. AVhen, however, a considerable concavity exists in the ridge and external border, and single gum teeth are em- ployed to restore the customary fulness and contour of the parts, the gum portion of the tooth should be ground away on its posterior face sufficiently to restore the circle of the gum on the external border of the alveolus, and from the base of the tooth where it rests upon the plate, to admit of a proper rela- tive position of the artificial crown ; while those portions of the porcelain gum terminating at, and adjoining the remain- ing teeth, next the spaces, should be formed with a thin, re- treating edge, where it laps upon the natural gum, giving to the parts, when the substitute is adjusted to the mouth, the appearance of an unbroken denture and a continuous gum. When the space to be supplied requires a series of two or more single gum teeth, the latter should be united to each other with the greatest care and exactness by grinding the proximate edges of the gum portions until the coaptation is such as to render the seams imperceptible in the mouth. In adjusting the porcelain teeth to the plate, the base of each tooth should be ground to rest as directly and uniformly on the plate as possible; for if thrown, in any degree, from the plate, the whole strain in mastication will come upon the platinum rivets, and, in a comparatively short time, the latter will either be entirely worn or cut off, or the artificial crown will be fractured on a line with the pins. In antagonizing partial sets of teeth, the indications pointed out by the customary closure of the natural organs should be followed as nearly as the form and position of the op- posing teeth will permit. A changed or abnormal relation of the teeth of both jaws, however, frequently renders it diffi- cult tf» effect a satisfactory adjustment of the teeth of replace- ment. If, in the case of the bicuspids, for example, one or more teeth in the under jaw project into a vacuity above to the extent of one-third or more of its depth, a direct closure of the substituted organs ujjon these, in the ordinary manner, would be impracticable without a corresponding shortening of the porcelain teeth, enforcing, in such cases, an inharmonious 236 MECHANICAL DENTISTRY. arrangement, entirely inconsistent with the just requirements of the case. The difficulty cited, Or any of the various modi- fications of it, may be overcome wholly or in part in one of two or three ways. If the teeth encroaching upon the opposite space are very loose, as is frequently the case with those that have become elongated from the long-continued want of an adequate opposing force, or are hopelessly carious or otherwise diseased, they should be at once removed. If they remain firm and sound, and stand slightly within the circle of the teeth of the opposite jaw, or if they have somewhat of an in- ward inclination in the arch, the vacuity opposite may be filled with non-masticating teeth, as a canine, on the lingual side of which an antagonizing cusp of gold may be constructed, allowing the point of the cuspid to lap over upon the labial face of the encroaching tooth or teeth ; or a bicsupid, manufac- tured for the purpose, with the inner cusp near the base of the tooth, may be used instead. Additional room may be pro- vided, in such cases, for the overlapping portion by filing away from a corresponding point on the opposing tooth. If, however, taking the most impracticable case, the intruding teeth are sound and firm, and stand vertically in the arch, closing between the opposing teeth on a line with, or some- what outside of, the outer circle of the latter (the elongation of such teeth being rather relative than absolute, as where it results from a mechanical wearing away of the remaining an- tagonizing teeth and a corresponding approximation of the jaws), the practitioner will be compelled either to submit to a mal-arrangement of the teeth of replacement by grinding away sufficiently from their grinding surfaces to permit an unob- structed closure of the natural organs, or decline the operation altogether. The undue projection of the teeth of one jaw into a vacuity occurring in the one opposite more frequently happens, how- ever, in connection with tlie loss of the superior incisors. In such cases, the points of the lower incisors very frequently encroach upon the circle of the upper teeth, so that when the artificial teeth are arranged above in correspondence with the SELECTING AND ARRANGING THE TEETH. 237 circle of the adjoining teeth, antl the jaws are approximated, the points of the inferior teeth will strike prematurely either upon the cutting edges of those above or will close upon their inner surfaces, — impeding thereby, or entirely preventing, the Qi^clusion of the teeth posterior to them. For such cases thin teeth should be selected, and whenever necessary the lower teeth may be filed away sufficiently, while those of replacement should, at the same time, be arranged as prominently as the circle will admit of. If these expedients fail, and a sufficient number of teeth posterior to the incisors require to be substi- tuted in connection with the same appliance, it will be better, in cases not susceptible of satisfactory correction by the means already suggested, to change the bite by substituting an entirely new antagonism with the artificial teeth, — spreading the jaws sufficiently apart to relieve the artificial incisors in front. In no case, except that last described, should the artificial teeth come in contact with the oi)posing teeth before the occlu- sion of the remaining natural organs when the jaws are closed. The contact of all the teeth of one jaw, artificial and natural, with those of the opposite, should either be simultaneous, or the natural teeth should be permitted to strike first. In view of the difficulties which so frequently present them- selves in connection with the arrangement of artificial teeth in partial cases, it may not be amiss to observe that, however essential to the natural and agreeable expression of the indi- vidual an exact and harmonious arrangement of the teeth of replacement may be, this requirement should, in some degree, be disregarded whenever the necessities of the patient, in re- spect to the comfort and utility of the appliance or the safety of the natural organs, demand it ; — to what extent appearances should he sacrificed to these considerations will dejjend upon the ])eculiar exigencies of the case, and cannot, therefore, be specifically stated. On the other hand, it may be observed that, if a sufficient numl)cr of the natural teeth are remaininjj in both jaws to enable th(! patient to ]X'rform, with tolerable effi- ciency, the act of mastication, the mere utility of the substitute in regard to the performance of this function may l)e partly or 238 MECHANICAL DENTISTEY. wholly disregarded whenever there is sufficient reason to appre- hend that the substituted organs cannot be antagonized with a view to the comminution of food without endangering the per- manency and usefulness of the appliance by necessitating the application of forces unfavorably directed. Investing, Adjusting Stays, Soldei^ing, and Finishing. — Hav- ing arranged and antagonized the teeth as accurately as possible on the plaster model, the piece should be placed in the mouth to detect and remedy any faultiness that may be found to exist either in the adaptation, position, or antagonism of the artificial teeth. It is then removed and imbedded in a mixture of plaster, sand, and asbestos, in the proportion of about two parts of the former and one part each of the latter. The body of the investient may be surrounded by a copper or sheet-iron band to prevent the plaster from breaking away whilst adjust- ing the stays or linings to the teeth. All parts of the plate and teeth, except the lingual side of the former and the backs of the latter, should be incased in plaster to the depth of half an inch or more, and when the latter is sufficiently hard all traces of wax from the inside should be carefully detached with suitable instruments. The piece is now ready for the adjustment of stays or back- ings, which, when permamently united by soldering to the base and teeth, are designed to sustain the latter in position. These supports are formed from plate somewhat thicker than that used for the base; a heavier and stronger stay being necessary when they are not united laterally, as when plate teeth are used. If, however, single gum or block teeth are employed, and the stays are joined, forming a continuous band, plate one-half thicker than that used for the base will, ordi- narily, impart adequate security to the attachment. A plain strip, corresponding in width with the tooth to be lined, is cut, and the end resting on the main plate conformed accurately with the file to the irregularities on the surface of the latter, and in such a manner as to permit the strip to take the direc- tion of the tooth. The general form of the stay may, in the first place, be obtained by cutting a strip from a piece of gold SELECTING AND AERANGING THE TEETH. 239 with a pair of plate forceps. (Fig. 98.) The points upon the stay to be pierced for the admission of the platinum pins may be ascertained by coating the surface of the former with wax Fig 98 softened in the flame of a spirit-lamp, and pressing it first against the lower pin, the point of which will be indicated by an indentation of the wax. The backing is then perforated Fig. 99. at this point with a plate punch, two forms of which are ex- hibited in Fig. 99, one armed with a tongue, which, when the plate is pierced, forces the latter from the punch. The strip 240 MECHANICAL DENTISTRY. is then reapplied to the upper pin, and the second hole obtained in like manner as the first. Instead of using- wax, the ends of the rivets may be stained with some pigment, which will show the points to be pierced in the lining. Fig. 100 represents an ingeniously contrived instrumentj invented by Dr. Samuel Mallet, and designed to secure an accurate relation of the two holes. After straightening the pins, one is placed in the hole i, at the head of the punch, the other pin pressing out the movable punch e (which works Fig. KO. by the spring g), until it slips into the slot h ; the two punches, /, e, then make the holes at the exact distances apart to receive the pins. The stay should be adapted accurately to the face of the tooth; it is then cut to the proper length, reaching nearly or quite to the point of the tooth, and then shaped with a file to the general form of the crown. When the stays are to be united they should be formed with a shoulder at a point cor- responding with the neck of the tooth, and the proximate edges below united closely by square edges, or the latter may be bevelled and made to lap upon each other. The process of soldering will be greatly facilitated and the piece will be more easily and artistically finished, by securing, in the first in- stance, a perfect coaptation of all the parts which are ulti- mately to be united. The sides of the holes in the stays facing the plate should now be enlarged or countersunk with a spear- shaped or conical burr drill, and when applied to the teeth the SELECTING AND ARRANGING THE TEETH. 241 projecting ends of the platinum pins are cut off even with the backings and then split and spread apart with a small chisel- shaped instrument; a head will thus be formed to the rivets when solder is fused upon them, and which will prevent them from drawing from the linings. All the lines of union between the several pieces should next be well scraped, exposing a clean, bright, metallic surface to the solder ; the seams are then smeared with borax, ground or rubbed in clean, soft water to about the consistence of cream ;* after which small j^ieces of solder are placed along the joints and over the points of the platinum pins. The piece thus prepared is now placed in the furnace or ordinary fireplace, in order to heat the entire mass throughout preparatory to soldering. The fuel most proper for this purpose is charcoal, either alone or combined with coke ; the latter being preferable for the reason that charcoal alone is more quickly consumed, and burning away more rapidly underneath, the piece is liable to drop to the bottom of the furnace. The fuel should be broken into small pieces and built up around the borders of the investient, in order that all parts of the latter may be uniformly heated. The heating process should be conducted gradually, for if the piece to be soldered is subjected suddenly to a high heat, the plaster will be displaced by the too rapid evolution of vapor, and the in- tegrity of the porcelain teeth will be endangered. The piece may be allowed to remain in the fire until the plate acquires a visible red heat, when it should be removed, placed ou a suit- able holder, and the solder fused with the blowpipe. A broad, spreading flame should first be thrown over the entire surface of the plate and border of the plaster until the temperature of the entire mass is nearly that required to fuse the solder, and which is indicated by the latter settling and contracting upon itself; the flame may then be concentrated upon a particular point, as at the heel of the plate on one side, passing round * Slate is often used for this purpose, but is unfit, as in rubbing the borax, loosened particles of the former become mixed with the latter and impede the flow of the solder, and becoming entangled render it unclean and porous. Ground glass or a porcelain slab is the best for the purpose. 16 242 MECHANICAL DENTISTRY. from tooth to tooth until all parts are completely united and the solder is well and uniformly diffused. Having united the teeth to the plate, the piece may be allowed to cool gradually, or it may be plunged after the lapse of a few minutes into boiling water without risk of injury to the teeth. When cool, the plaster is removed and the plate placed in a solution of equal parts of sulphuric acid and water, where it may be allowed to remain until the discoloration of the plate and the remains of the vitrified borax, incident to soldering, are removed ; or it may be put into a small copper vessel, partly filled with the same solution and boiled for a few Fig. 101. minutes. After removing the plate from the acid, it should be boiled for five or ten minutes in a solution of chloride of soda or common salt and water to remove thoroughly all traces of the former. Superfluous portions of solder are now to be removed, and this at first may be more quickly accomplished by the use of burrs of various forms and sizes attached to a lathe. After the rougher and more redundant parts are thus cut away, any remaining irregularities upon the surface may be further reduced with properly formed files, scrapers, and cutting instruments. Flat and half-round curved files, and scrapers having a right and left curvature to their cutting edges, and chisel-shaped cutting instruments for paring or chipping away (Fig. 101), are the implements usually employed for this purpose, and with which a comparatively smooth sur- SELECTING AND ARRANGING THE TEETH. 243 face may be obtained ; after whicli, the filed portions should be well rubbed with Scotch stone until all traces of file-marks or other scratches are completely removed. With a rapidly revolving brush attached to a foot-lathe, the final polish or lustre may be imparted by the use, first, of Spanish whiting, or prepared chalk, and then rouge mixed with water or alcohol. The following method of finishing plate-work communi- cated by Professor J. L. Suesserott,* embodies some practical suggestions in reference to this process : " The first step is to procure and attach to the lathe a three- or four-pronged fork, or a screw such as is used for withdrawing a load from a gun ; upon this a good smooth cork is fixed, and, with a sharp knife, turned to any desired shape. The cork is saturated with water as well as it can be, and powdered pumice placed upon it. If we have been careful to remove all excess of solder from our work, which can easily be done by a burr attached to the lathe, we can, with the cork and pumice, make a very smooth sur- face, and this can be still more perfectly accomplished by sub- stituting a very finely powdered spar for the pumice, after we have removed the largest scratches with tlie latter. By con- tinuing the cork for a little while after the above-named pow- ders have been used oif, we avoid the use of the Scotch stone ; and finally we dispense with the burnisher, by taking a new cork with a piece of chamois or buckskin stretched upon it, and going over the plate in the same manner as before, with the lathe revolving very rapidly. " A higher color can be given to the plate by the use of the burnisher after the above proceeding, but we can certainly not produce a smoother surface. " Some precaution is necessary by those who have never used the lathe in finishing the j)late ; in the first place the careless use of the burr, in removing the excess of solder, might result in the weakening of the piece by removing more than neces.sary, or, what would .be still worse, holes might be cut * Erroneously aHcribod in tlie fii-st edition to Professor T. L. Buck- ingham. 244 MECHANICAL DENTISTRY. entirely through the plate. Again, in polishing, if a little care is not taken, the fork or screw, whichever is used, may pass through the cork, and before the operator is aware he will have inflicted an injury that will be difficult to repair. A small amount of experience — that which is essential in the proper performance of every nice operation — will enable almost any one, even those, to use a common expression, ' whose fingers are all thumbs,' to finish their work in about one-eighth of the time that the most expert workman would require for the accomplishment of the same by the old method."* In the final adjustment of the finished piece to the mouth, and after any additional change in the form of the teeth neces- sary to secure the most perfect antagonism has been made, the patient should, in all cases of partial dentures, receive explicit directions in regard to the general care and management of the appliance and the remaining natural teeth. Ordinarily, there will be but little difficulty experienced by the patient in the immediate and successful use of a substitute supported in the mouth by clasps, or any equivalent means, but in the case of atmospheric pressure plates, the patient should be candidly advised of the probable want of stability incident to the first use of the appliance, and the consequent annoyance which in many cases follows its occasional displacement in mastication until such time as the adaptation of the several parts to each other are perfected, and the patient has acquired a habit of controlling and directing the forces applied to the substitute. The time necessary to accomplish these results will depend much upon the form and condition of the mouth, a favorable or unfavorable antagonism, the adaptation of the plate, and the aptitude and temper of the patient. It will be prudent and but just to the patient to state that the complete utility of an appliance sustained by atmospheric pressure will not, probably, be realized in less time than from four to six weeks ; and this estimate of time, in a majority of cases, will be fully justified by experience in the cases under consideration. * Dental Cosmos, vol. i, p. 330. SELECTING AND ARRANGING THE TEETH. 245 The importance of thorough and absolute cleanliness of the substitute and natural teeth, and the reasons therefor, should be clearly stated ; and the comfort, utility, and durability of the artificial fixture as well as the safety of all the remaining natural organs will depend, in a great measure, upon the fidelity of the patient with respect to the observance of these injunctions. In those cases especially where clasps are used, the substitute should invariably be removed after each meal and cleansed, while the teeth clasped should, at the same time, be freed from deposits of food or other foreign substances with a brush, or any of the means usually recommended for the purpose. 246 MECHANICAL DENTISTRY. CHAPTER XI. Entiee Dentures. Method of Constructing a Plate Base for a,n Entire Denture for the Upper Jaio. — The general form and dimensions of the required base to be used as a support for a complete denture for the upper jaw may first be indicated by drawn lines upon the plaster model, and a sheet-lead pattern obtained from this to serve as a guide in securing the form of the plate to be swaged. Whenever the substitute for the upper jaw is de- signed to be retained in situ by the external pressure of the atmosphere, and especially where a central air-chamber is employed, the plate should be made sufficiently ample in its dimensions to cover all the hard palate, the alveolar ridge, and all portions of the external borders of the latter not directly encroached upon by the muscles and reflected portions of the mucous membrane of the lips and cheeks. Before swaging, the plate should be well annealed, and its central portion brought as nearly as possible to the form of the palatal face of the die with the mallet, forcing the heel of the plate down in advance of the portion covering the more anterior concavity of the arch, preventing thereby a doubling of the posterior edge of the plate upon itself. This central portion may also be forced more perfectly into adaptation with a partial counter before swaging in the ordinary manner, and this is advisable in all cases when the palatal arch is very deep ; but as this is very liable to be drawn from the arch in the process of turning the borders of the plate over upon the ridge, a useful contrivance has been invented by Dr. Rurras, of Xew York, to prevent the displacement. Fig. 102 shows the form of this instrument. The die and plate are placed near the edge of the bench, and the upper part of the clamp adjusted ENTIRE DENTURES. 247 over the central portion of the plate ; the two pieces are then bound firmly to the bench by tightening the screw underneath. A protective piece of buckskin, cloth, or paper, should be placed between the plate and clamp, to prevent the former from being bruised or indented. The margins of the plate are now turned over upon the ridge, and if the external borders of the latter are undercut or stand even verti- cally, the edges of the former will tend to double upon themselves at such points, and hence it will be necessary, before swaging, to split the plate in front, and, in some cases, on each side, and wherever divided, a V-shaped piece may be cut out of sufficient "svidth to allow the divided edges to overlap slightly when approxi- mated in the process of swaging. The proximate edges of the divided sections should be filed to a thin edge before swaging, so that when brought together and soldered there will be but little additional thickness of the plate at such points. The cut portions should not be soldered until after a partial or complete swaging. Having conformed the plate as nearly as practicable to the die with the mallet and pliers (Fig. 103), or with plate forceps constructed for the purpose (Fig. 104), it should be placed between the die and counter, and the latter forced together with a heavy hammer until a tolerably accurate coaptation of the plate is obtained, the latter being frequently annealed during the process of stam])ing to render it more pliable. At first considerable yielding and consequent deformity of the counter-die will occur ; hence, after partial swaging, another should be substituted and the process continued until the greatest possible accuracy of adaptation is secured. If the face of the die is marked by prominent and sharply defined rugie, or other irregularities, such points will, to some extent, be bruised or flattened; it will therefore be expedient in such cases, and better perhaps in all, to finish the swaging with a 248 MECHANICAL DENTISTEY. new and unused die and counter, in which case two or three moderate, steady, and well-directed blows of the hammer will be sufficient. If the plate is brought into uniform contact with all parts of the face of the die, this conformity is the only reliable test Fig. 103. of its adaptation out of the mouth. In no case will the swaged plate fit the plaster model perfectly, inasmuch as the unavoid- able contraction of the die, however slight, will, especially in deep-arched mouths, cause the plate to bind on the posterior Fig. 104. and external borders of the ridge, preventing it from touching the floor of the palate ; while the bruising, though inconsider- able, of the more prominent points upon the die, and a corre- sponding flattening of the plate at such points, will prevent uniform contact of the latter with the unchanged surface of the plaster model. EXTIRE DENTURES. 249 After final swaging, the plate should be again annealed with a heat nearly or quite equal to that which will be ultimately required in soldering ; after this any additional swaging should be avoided, unless the plate warps in the heat, and which may be determined by applying it to the die; if any change has occurred, it should be re-swaged and again annealed at a high heat, and the operation should be repeated, if necessary, until the plate retains its integrity of form after the last annealing. This process of final heating does not apply to silver if in the form of a swaged plate, as this metal invariably suffers some change of form when subjected to an annealing heat. Modifications in the Form of Plates for Entire Upper Den- tures. — Whenever a central air-chamber is employed, it may be constructed in either of the ways described when treating of Fig. 105. Fig. 106. partial atmospheric pressure plates. The general form of a plate for an entire upper denture, with a central chamber, is exhibited in Fig. 105. Other modifications in the form of cavity plates for full upper sets are in limited use, as where chambers are arranged one on each side of the sloping walls of the palate, or directly over that portion of the ridge previously occupied by the anterior molar and the bicuspids on each side, as seen in Fig. 106, called " Lateral Cavity Plates." Dr. M. Levett, of New York, has recently introduced another modification of cavity plate, consisting of a number of small air-chambers arranged directly over the ridge and placed at short intervals througiiout the entire border. It is claimed that plates con- structed in either of the ways last mentioned cohere with equal 250 MECHANICAL DENTISTRY. firmness to the jaw, and are less liable to " rock " in the mouth, than when formed with a central chamber. Whatever their general utility may be, cases doubtless occur where they may be advantageously employed, as when any great inequality exists in the hardness of the ridge and palate, and a plate con- structed in the ordinary manner is dislodged by "riding" upon the hard palate when forces are applied to the ridge on either side. It has been recommended, after having constructed a base of the form represented in Fig. 105, to cut through the plate im- mediately in front of the central chamber, making an opening of a semilunar form. It is claimed that, by the more ready application of the tongue to this part, the air contained in the chamber, when the plate is applied to the mouth, may be more easily and thoroughly exhausted. There is great danger, however, of the soft tissues being drawn into the opening, in which case it can scarcely fail to produce injury to the parts implicated ; the expedient, therefore, is seldom resorted to. There is still another form of cavity plate known as Cleve- land's modification of air-cliamber, and which is constructed in the following manner : A plate like that exhibited in Fig. 105 is first struck up and the chamber cut out. A thin sheet of wax^ or a layer of plaster, is then placed upon the lingual side of the plate, extending from two to three or four lines from the edges of the orifice in the main plate ; a thin, retreating edge is given to the wax or plaster at the outer borders, making it con- tinuous with the surface of the plate. The plate with the wax attached may now either be tacked to the model with softened wax along its outer borders, and shaped in such a way as to permit the model and plate to be withdrawn from the sand, and a mould of the parts taken in the ordinary way, and from this a die and counter ; or an impression in wax or plaster may be taken of the lingual face of the plate and wax, and afterwards a model, die, and counter. With the latter, a second plate, covering nearly or quite all of the palatal concavity, is swaged, and when this is applied to the main plate over the cut cham- ber, and united by soldering, a space, equal to the thickness of the wax or plaster placed on the primary plate, will be found ENTIRE DENTURES. 251 to exist between the two laminse. Fig. 107 exhibits a trans- verse section of the two plates, disclosing the space between them, and also the opening through the gum plate into the cavity. Before soldering on the duplicate plate, a half-round wire should be soldered around the opening in the palatal plate on its lingual side, to protect the soft tissues of the mouth from injury when drawn in as the air is exhausted from the chamber ; or, what is preferable, this form of cavity may be converted, practically, into what is known as " Gilbert's cham- ber" (which is the central swaged chamber before described), by filling in the space between the two plates with some im- pervious substance, as Hill's filling, or an amalgam of gold, the excess of mercury being driven off by heat. In the con- struction of continuous gum work, the interspace may be filled in with gum body. The advantages of these double plates are, a greatly increased strength imparted to the base, a diminished liability of warping in the process of soldering, a smoother sur- face presented to the tongue, and a more decidedly angular form of tlie chamber. In whatever way the plate is formed, a notch or fissure of sufficient depth to receive and permit an unobstructed play of the frtenum of the lip should be formed in the front part of the plate, while the borders of the latter nearly opposite the anterior molars on each side should be narrowed to pre- vent un<]ue contact of its edges with the folds of the mucous membrane stretching obliquely across from the cheeks to the jaw. Care should also be taken to trim away from the heel of tlie i)late any portions that might otherwise encroach upon the soft palate. 252 MECHANICAL DENTISTRY. It is only in the fewest number of cases that a rim can be swaged to form a groove or socket properly situated for the reception of the plate extremities of either single gum or block teeth, as it will usually be found impracticable to adjust the gum extremities to the socket thus formed without neces- sitating, in some degree, a departure from a just arrange- ment and antagonism of the teeth. Whenever it is thought best, therefore, to rim the plate, it will generally be necessary to adjust and solder a separate strip to the plate along the plate ends of the teeth after the arrangement of the latter on the base is completed. After the plate has been worked as nearly as possible into the required form, it should be applied to the mouth of the patient to ascertain the correctness of its adaptation to the parts before proceeding further with the operation. If the adapta- tion is found imperfect, the fault lies either in the impression, or in undue contraction of the die. In the former case, another impression should be taken, and the plate re -swaged; in the latter, a less contractile metal or compound should be employed in the formation of the die. To determine the practical effi- ciency of the adaptation and adherence of an atmospheric pres- sure plate, various tests may be applied. The coaptation of its borders to the external walls of the ridge may be ascertained by inspection, and the patient's sense of contact or non-contact of its central portion with the floor of the palate may, in some degree, be relied on as evidence of the accuracy of its adjust- ment to parts not visible. The tenacity with which the plate adheres on the application of direct traction cannot always be relied upon, inasmuch as a well-fitting plate will sometimes be readily dislodged in this manner, while, on the contrary, one but illy adapted to the parts may require considerable force to separate it from the jaw when acted on in the same way. The most trustworthy test of actual or practical stability is firm pressure applied alternately over the ridge on each side and in front. If the plate maintains its position and remains fixed under repeated trials of pressure applied in the manner indi- cated, the adaptation may be safely relied on ; if it slides upon ENTIRE DEXTURES. 253 the palate or is easily disengaged from the mouth, the insta- bility of the plate may be referred in many cases, not to a want of coaptation, but to a want of uniformity in the condition of the parts on which the plate rests. Thus, for example, if the ridge along the mesial line of the palatal vault is more than usually prominent and incompressible, and the alveolar ridge relatively soft and yielding, the plate, meeting with a fixed point of resistance at the floor of the palate, will prevent the ridge from being sufficiently compressed when the atmosphere is exhausted from underneath the plate ; and hence, when forcible pressure is made on one side over the ridge, the plate, riding upon the resistant surfoce of the arch, will be thrown off from the opposite side. Whenever, therefore, the condi- tions alluded to prevail to any considerable extent, a perfect coaptation of the plate to the parts, instead of favoring the retention of the former, will impair its stability for all practi- cal purposes. The remedy is found in so constructing the plate that, when adjusted to the mouth, and before the air is exhausted, a greater or less s])ace will exist between the central portion of the plate and palate, but which, when a vacuum is formed, will be carried up into contact with the roof of the mouth, and at the same time compress the ridge sufficiently to afford a firm and resisting basis for the plate in mastication. This peculiar adaptation of the plate may be obtained by ad- justing a piece of sheet-lead or wax plate over the central ridge on the plaster model, by means of which the corresponding portion of the plate, when swaged with a die obtained from the model so prepared, will be thrown far enough from the roof of the mouth to answer the purpose before indicated. This will be more particularly necessary in shallow arches ; while, if the arch is very deep, or even moderately so, the unavoidable contraction of the die may render the expedient unnecessary. Method of Construdinrj a Plate Bern; for an Entire Devture for the Under Jav\ — Aside from the differences in the form of the plate, and the manipulations incident thereto, the process of constructing a plate for the under jaw does not differ essen- 254 MECHANICAL DENTISTRY. tially from that already described in connection with full upper dentures. If the lower plate is constructed from a single lamina of gold or other metal, it should be somewhat thicker than that used in upper cases, and should also be of finer quality, as the addi- tional thickness of the plate and the peculiar form of the in- ferior maxilla renders a greater degree of pliancy necessary in swaging it to the form of the ridge. The general form of a base for an entire lower denture is exhibited in Fig. 108. The internal border of the plate should usually be doubled, — either by turning the edge over in swaging, or by soldering on a narrow strip of plate or half-round wire. A more perfect adaptation of the plate to the ridge may be obtained by the use of a double instead of a single plate, in Fig. 108. Fig. 109. which case a thin basement plate, not exceeding No. 30 of the gauge, should be swaged to the form of the ridge in the first instance, and then a duplicate plate, swaging the two together and uniting them to each other with solder. A plate of the specified thickness may be very readily and accurately con- formed to any irregularities in the ridge, and when the two are united the base will be heavier and stronger than a single lamina of the ordinary thickness. Instead, however, of dou- bling the entire plate, it will be sufficient, in most cases, to adapt the second plate only to the lingual surface of the first, extend- ing it up from the lower edge to a point corresponding as nearly as possible with the posterior portions of the base of the ENTIRE DENTURES. 255 teeth when the latter are adjusted to the plate (Fig. 109). A moderately thhi plate may, in this manner, be used for the primary base, while the duplicate band will impart the requi- site strength to the plate, and, at the same time, obviate the necessity of wiring its inner edges. In adopting either of the last-named methods, the plates after they are united to each other, should be again swaged to correct any change of form incident to the use of solder. Antagonizing Ilodel for an Entire Upper and Lower Den- ture. — Either of the following methods may be adopted in se- curing an antagonizing model for complete dentures : 1. Attach to the ridge of each plate a roll or strip of adhesive wax corresponding in widtli to the length of the teeth which will be required for each plate respectively ; place the plates with the wax attached in the mouth, and trim away from the proximate edges of the wax until the two sections close upon each other uniformly throughout the circle; then cut away from the labial surfaces of the rims of wax, above and below, until the proper fulness and required contour of the parts asso- ciated with the lips and mouth are secured. The approxima- tion of the two jaws, when the finished substitutes are ulti- mately adjusted to the mouth, will depend altogether upon the aggregate width given to the two sections of wax at this stage of the operation, and it is, therefore, important that the " bite " or closure of the jaws secured at this time should be such as will most perfectly fulfil the requirements of the case in respect to the utility and comfort of the appliance, and the proper restoration of the required facial proportions. If there is any considerable change produced in the relation of the jaws habit- ual to them })rior to the loss of the natural teeth, the charac- teristic expression of the individual will, in some degree, be changed or marred ; an unaccustomed and restrained action will be imposed ui)on the muscles concerned in the movements of the lower jaw, which will render the use of the appliances at least temporarily, if not permanently, uncomfortable and fatiguing, or even j)ainrid ; while the utility of the fixtures may be impaired or wholly destroyed, by compelling a partic- 256 MECHANICAL DENTISTRY. ular application of forces in mastication inconsistent with their stability in the mouth. No specific directions, of course, can be given that will apply to all cases, but it may be observed that, ordinarily, the two sections of wax should be cut away from their approxinating surfaces until the jaws close suffi- ciently to permit the edges of the lips to rest easily and natu- rally upon each other when in a relaxed condition, or the upper rim may extend somewhat below the margin of the up2)er lip, while the lower section of the wax is cut away on a level with the lower lip, or a little below it. Cases occur, however, where a less exposure of the upper portion of wax, even though quite narrow, will be required; as where the alveolar ridge is very deep, and the lip covering it either abso- lutely or relatively short, or where the latter is retracted, exposing, even when in a state of repose, a greater portion or all of the crowns of the teeth, and in extreme cases the mar- gins of the gum. Between the latter extreme and an inordi- nate extension of the upper lip below the ridge all intermediate conditions occur, and the practitioner, aiming to produce an agreeable, harmonious, and truthful expression of all the parts, must rely wholly upon his judgment in reference to the neces- sary approximation of the jaws, the restoration of the natural fulness and contour of the mouth, and the relative length to be given to the upper and lower teeth. Patients, when requested to close the mouth naturally, are very liable to j)roject the under jaw ; hence it is well to have them open and close the jaws frequently, observing, at the same time, if the separate portions of wax meet in precisely the same manner at each occlusion. If the bite varies at every approximation of the jaws, the patient should be directed to relax and abandon for the moment all control over the muscles of the lower jaw ; the operator should then grasp the chin and press the jaw first directly backward and then upward until the opposing surfaces of the wax meet, in which po&ition it should be steadily held by the patient until the two portions of wax are attached to each other in that particular relation. The latter may be done by drawing lines vertically across the ENTIRE DENTURES. 257 rims of wax at various points "wliicli will serve to indicate their relation to each other when out of the mouth ; or a heated knifeblade may be passed between the two sections, the melted wax temporarily uniting them. A very convenient and secure method is to attach them together by means of two strips of metal bent in the form of a stajile; these may be warmed in a spirit-flame, and pressed into the wax, one on each side — one end penetrating the upper rim of wax, the other the lower. Before removing the plates, the mesial line of the mouth should be indicated upon the wax by drawing a line vertically across the latter in front to serve as a ffuide in the arrano-ement of the central incisors. 2. Another method is to attach to either the upper or lower plate a single rim of wax somewdiat wider than will be required for both the upper and lower teeth. The plates are then placed in the mouth, and the jaws brought together, imbedding the opposite plate in the wax. When this method is adopted, the proper closure of the jaws is best determined by a gauge or guide consisting of .a strip of plate or other substance encased in the wax and interposed edgewise between the borders of the two plates in front in such manner that, when the latter are approximated, they will close upon the guide, the desired rela- tion of the jaws to each other having been previously ascer- tained by trial of the guide with the plates in the mouth before adjusting the wax. The exterior surface of the wax rim is then trinmied away, or additional portions added to it, until the proper fulness and contour are given to the lips; after which the medium line of the mouth should be traced upon the wax in front, as before described. The plates, attached to each other in either of the ways mentioned, having been removed from the mouth, a batter of plaster may be poured upon a piece of paper or other substance, forming a layer a fourth or a half an inch thick and two or three inches long, when the under surface of the lower plate may be imbedded in one end of the plaster, and the remaining portion of the latter projecting from the heel of the plate trinnned and formed for articulating with the second piece of ]7 258 MECHANICAL DENTISTRY. the antagonizing model in the same manner as described when considering partial dentures. The entrance to the cavity be- tween the two plates is now closed up with a sheet of softened wax or otherwise, and the whole surrounded by a piece of oil- cloth, wax, or other substance, and the second part of the model obtained by pouring plaster in upon the exposed surface of the upper plate and the plaster posteriorly to the depth of half an inch or more. When the plaster is sufficiently condensed, the line across the wax in front should be extended in a direct line across the borders of the plaster model above and below, as, in arranging the teeth, the wax will be cut away, and without this precaution the mesial point of the mouth may be lost. The form of an antagonizing model for an entire upper and Fig. 110. lower denture, with the plates and wax attached, the latter being cut away somewhat preparatory to adjusting the teeth, is shown in Fig;. 110. Antagonizing 3Iodel for an Mitire Upper Denture with the Natural Teeth of the Lower Jaw Remaining. — In forming an antagonizing model to be used as a guide in arranging and ar- ticulating a full upper denture where all or a part of the natural organs of the inferior jaw are remaining, a rim of wax should first be adjusted to the borders of the plate, one or two lines wider than the required length of the artificial teeth. When j)laced in the mouth, the exterior surface of the wax draft should be cut away or added to, until the proper fulness of the parts is restored. The patient should then close the lower teeth against the wax, imbedding them just sufficiently to indicate the cutting edges and grinding surfaces of the opposing teeth. If a fuller impression of the exterior faces of ENTIRE DENTURES. 259 the lower teeth are required, it may be obtained by pressing in a small strip of softened wax against them and the lower edge of the rim of wax upon the plate ; or the projecting borders of the latter may be forced down upon the crowns with the fingers. The median line of the mouth is then indicated upon the wax, the plate removed, and its palatal surface imbedded FiCx. 111. in one end of a layer of plaster spread upon a strip of paper; the portion of plaster extending from the heel of the plate trimmed, grooved, varnished and oiled; the entire piece in- closed, and plaster ])oured in upon the exposed surfaces of the wax and plaster to the depth of one-fourth or one-half of an inch. The two sections of the model, with the plate and wax Fig. 112. attached, the latter being cut away somewhat to receive the porcelain teeth, is exhibit(;d in Fig. 111. Various articulators, or antagonizing frames, have been de- vised, and may be substituted for the plaster articulator just described. A very excellent adjustable contrivance of the kind, invented by Dr. Hayes, is exhibited in Fig. 112. Witii this 260 MECHANICAL DENTISTRY. appliance, all the motions of the jaws can be represented, and the relative positions again brought back at pleasure at the starting-point. The screw hinge admits lateral motion. The set screv/ on the side plays into a slot, securing one central position, to which it can at all times, when desired, be brought back. The long screw in the foot produces back and forward motion, the main hinge up and down motion, and the large nut on the bottom renders all the parts taut and unyielding. Considerable space is here devoted to the consideration of an ingenious and novel device, introduced to the notice of the pro- fession by Dr. W. G. A. Bonwill, of Philadelphia, Pa., and characterized by him as the " Anatomical Articulator." As to the character of this instrument, the author cannot speak personally. Dr. B., whose name is inse])arably connected with the electric mallet, dental engine, original methods of attaching pivot crowns described elsewhere, and various other practical devices, says that it holds the same positive relation or position in his laboratory as do the electric mallet and engine in his operating room. In other words, it is indispensable to the perfect articulation of all artificial dentures from one to a full set, — that it is a sine qua non. He says : " It is modelled on the same geometrical system as the hu- man jaw. " I found by measurement that the average width of the lower jaw from centre to centre of each condyle was four (4) inches, and from the same centre of each condyloid process to the median line of the lower jaw, where the cutting edges of the lower in- cisors meet, was also four (4) inches, making of the human jaw an equilateral triangle. This holds good in all jaws, and the difference of a quarter of an inch in this radius of a circle of four inches would make but little practical difference as to the results. " This beautiful law enables us to have the fullest benefit of mastication at the least expense of power and motion in the arc of the circle of four inches as a radius. ENTIRE DENTURES. 261 " This being an absolute law, I have so made this articula- tor, and the cast of every case is set therein with tiie median line at the lower centrals just four (4) inches, by the dividers, from each condyloid process. If an unusually large jaw, then the cast is put a very little distance further out. " For all full sets, the articulation is so perfect, as made in this, in the laboratory, as to need but a trifling touch in fitting in the mouth. "I found that there is a further positive law in the mechan- ism of the human jaw that should be regarded in every sub- stitute made therefor, and, that is, just in proportion to the depth of overbite of the centrals, there is a curvature from the mesial surface of the first molars back, through the other molars, up the ramus. That this curvature upwards . and backwards at the ramus is due solely to the depth of closure of the ujiper over the lower jaw. That where there is occlu- sion or closing of the cutting surfaces of the incisors directly upon each other, then a straight line, directly backwards, is the consequence. If curved at the ramus, in such a case, no lateral or forward movement of the lower jaw could occur, — only the up and down. " Where there is an eighth of inch depth of bite, then, as you go back to the centre of motion — the condyloid processes — the cusps in the bicuspids and molars grow less deep, and the curvature at the ramus is an eighth of an inch out of line. " When there is an overbite of an eighth of an inch, then, in opening the lower jaw and carrying it forward to use the in- cisors for cutting, the back teeth of lower jaw are brought for- ward ; and, as the second molar is higher out of line than the first molar, it comes in contact with the distal surface of the first superior molar, which begins just here to curve u])ward, and is the highest out of line in the superior jaw, and they meet at same time that the incisors do. And the same law holds good when the lower j-aw is turned to the right or left, the molars are brought in contact to equalize the force which would be brought upon the incisors only. Besides, the recog- 262 MECHANICAL DENTISTRY. nizing of this law enables the cusps or palatal and lingual sides of the molars of both jaws to be utilized in every position the lower jaw may take in mastication. Upon this plan I make all my artificial dentures, most of their articulating sur- faces being utilized at every position of the lower jaw. Any human jaw will show this system, which by this system can be made just as complete, and more so, in many cases, than the normal, or such as is found in advanced civilization. " When a set is commenced in this articulator with the up- per overbiting the lower an eighth of an inch, as you set each tooth backward towards the condyloid processes, they will assume the exact angle and depth of cusps, as well as the cur- vature at the ramus, as found in nature. If both jaws are in Fig. 113. direct apposition at the incisors, then all of the teeth must of necessity be on a perfect plane, or but one would touch when in lateral position. " With this one base, which Fig. 114 shows, there is a sep- arate bow to each part of base, one for upper and one for lower jaw, which can be removed as soon as the plaster in one case is allowed to harden on the rim. This can be marked and laid away for a year if necessary, and then articulated. A pair of bows can be used for as many separate cases, while only one base is required, which should be made absolutely and geomet- rically exact — approximately so. " There is no need for set screws to hold the bows, as they ENTIRE DENTURES. 263 go up just so far and remain so. Nor is there any set screw and prop to hold the jaws or casts apart. This is regulated on the bite in wax, which, before it is taken off the base plate, has the exact height marked by a pair of dividers on the plaster at the median line, measuring- from the cutting^ edge of wax, and then when the first central or block is set, there is no longer any call for a prop to keep open the jaws of the articulator. When this height is taken with the dividers, it is marked on the top of each cast for future reference. It would interfere with the lateral movement if a rigid prop were there. The dividers make each case exact without a scale for measurement. " Articulate the upper set first, and retain on the lower base the wax for length and fulness. When the upper are all on, then the lower incisors are gauged as to the height or length by the dividers while the wax is still on the base plate and taken from the height marked on the lower cast for reference. " Make the lateral movement as soon as the first tooth or block is in position where the case is an upper one with a good lower jaw of natural teeth. "When a full set, the upper are first ground on and shaped so as to meet the intended overbite, and when the lower set are ground on, tlie uj)j)er can be changed to suit the lower, so as to allow the whole of every cusp to touch at nearly every lateral movement of jaw. " When the plaster case is to be set in the articulator, it must 264 MECHANICAL DENTISTRY. be done with the dividers set just four (4) inches, with one point at the median line as formed by the lower incisors, and the other carried over to each condyloid process as marked on the articulator. This makes the centre of jaw equidistant from the condyles. The study of this principle will make one fully realize the beautiful workings of Divinity, which is only gov- erned by positive law in every department of the universe. With this plan, understand one will never again attempt to articulate a set of teeth on the unwritten law, as now univer- sally made and recognized by every dentist in the land. " Until this system is taught in the schools, and by private practitioners, no truly artistic and fully natural set of teeth can ever be made, for we have been without law in this de- partment. To describe it is not enough. It must be seen and demonstrated, one tooth at a time, until the whole set is made. Only in this way can it be understood. "The Figs. 113 and 114 show clearly the simple construc- tion. It is made of brass wire (one-eighth inch in diameter), and brass tubing to allow the size of wire to fit closely, and move freely therein when drawn out or pushed up. The spiral spring on either condyle allows of easy lateral motion to the lower part, and from exactly the same standpoint as in nature ; that is, one of the lower condyles moves forward in the glenoid cavity while the other remains still. Every part of it is rigid except the movement at the condyles, and the joints or bows are only temporarily so. There is also an up and down motion made at the condyles by raising bow up or down. "No case, when once fixed in it, can become disarranged. If the bite in the wax is not correct, no articulator can make it so. You must go back again to the mouth, and retake it, 'svhich is easily done at first by asking the patient to swallow, when the jaws will automatically close and assume their normal position. If now correct, there is never any necessity for a screw to change it when once in this articulator. " There can be no excuse for failure or unartistic work when this instrument is once understood, and the law controlling the ENTIEE DENTURES. 265 human jaw. As we may forever have to resort to artificial dentures, we should demand of the colleges that such an instru- ment be used, and it alone, as furnishing the only hope now offered of an approach to high-toned, artistic, mechanical den- tistry. Until we can be taught to appreciate that law is the governor of the universe, and applicable in every branch of dentistry, we are false men, and will set ' false teeth,' and never realize our high destiny." Selecting, Arranging, and Antagonizing the Teeth; Rimming the Plate; Attaching Spiral Springs ; Investing, Lining, Sold- ering, and Finishing. — In selecting teeth for an entire upper and lower denture, the special requirements in respect to size, form, and color, will depend, in a great measure, upon the complexion, age, sex, general configuration of the face, etc., of the patient. Every separate denture, therefore, that is con- structed in strict conformity with a faithful interpretation of the special requirements of each individual case, will be char- acterized by shades of differences in the color, form, size, and arrangement of the teeth of replacement. It will be sufficient in this connection to observe that such selection of the teeth should be made as will most perfectly reproduce the lost pro- portions of the facial contour, and impart to the individual a natural, harmonious, and agreeable expression. In arranging or adjusting single gum teeth to the plate in those cases where the changes in the form of the alveolar rido-e consequent on absorption, are completed, the portions applied to the base should be ground away sufficiently to restore the required fulness of the parts and to give proper length and inclination to the teeth. The coaptation of the ground sur- faces to the base should be accurate enough to exclude perfectly particles of food, anracing the posterior half or two-thirds of the plate at these two points, — the change manifesting itself in an in- ward displacement of the lateral walls of the plate midway between the summit of the palatal arch and the most depending ])ortion of the ridge. We would suggest in explanation of this result that, as the ])liister contracts with sufficient force to carry the j)late with it, the sides (^f the latter are approximated, while the palatal portion is, at the same time lifted up. Now it seems plain that inasmuch as the portions of plate overlapping 18 274 MECHANICAL DENTISTRY. the ridge is incased in and" embraced by the plaster, and as the palatal portion is arched in form with its convexity pre- senting to the plaster and therefore self-sustaining in respect to its own peculiar . form, the special configuration of these parts cannot suffer any appreciable change ; but as they are forced toward the common centre of the mass, their relation to each other is also changed, and this changed relation must necessarily eventuate in a deformity of those parts of the plate which offer the least resistance to the contractile force of the plaster. In obedience to this necessity, the sides of the plate along the sloping walls of the palate, which from their form are neither resistant nor self-sustaining under pressure, and whose inward displacement is unopposed by any counter-force, is projected in toward the centre of the palatal excavation in proportion as the borders and central portions are approxi- mated ot" converged in the direction of the centre of the piece. The practical effect of this approximation of the lateral and posterior borders, and internal displacement of the plate, is to make the latter " bind " upon the outer and posterior borders of the alveolar ridge, and to tlirow the central portion of the plate from the roof of the mouth. To obviate, as far as prac- ticable, any change in the form of the plate which may result from the contraction of the plaster investient, various expedi- ents have been suggested, but the following will sufficiently counteract the influence of the plaster by permitting an unob- structed expansion and contraction of the metallic base. Take a band of tolerably thick copper plate as wide as the plate and teeth are deep ; bend it to the form of the plate, but large enough to leave a space of nearly half an inch between it and the teeth, the ends being united to each other back of the plate by riveting or otherwise. Holes are then made in the band at numerous points throughout its extent, through which wire is introduced and interlaced on the inside in such a way as to form loops, the latter extending in to within a short distance of the teeth. The plaster is then filled into the space between the band and teeth even with the cutting and grinding surfaces ENTIRE DENTURES. 275 of the latter ; the palatal surface of the plate is also covered with plaster and may be connected with the outer portion by a very tliin layer at the edge of the plate, or the two may be entirely disconnected. The expansion of copper being very nearly that of gold, the body of the plaster, when heat is ap- plied, will be carried in advance of the borders of the plate as the latter expands, while the thin portion of plaster at the edges of the plate will allow the central portion of the latter to expand with but little or no interruption. On cooling, the entire mass will contract together and assume its original form, unless warping is induced by other agencies acting indepen- dently of the enveloping plaster, as excess or unequal distribu- tion of solder, irregular heating, etc. It is not, ordinarily, necessary to provide by any special ex- l^edient against warping of the lower plate, as any slight change of form consequent on contraction will not materially affect its adaptation to the lower jaw, — its only effect being to impart to the substitute a slight lateral play upon the ridge. The plaster on the inside of the lower piece may be cut away to the edge of the plate, while that external to the teeth should not be added in greater quantities than is barely sufficient to hold the latter in place whilst lining and soldering them to the base. The plate being properly invested, all portions of the wax attached to the inner surface of the teeth and plate should be thoroughly removed with suitable instruments; after which stays are to be adjusted to the teeth. In reference to the method of forming and adjusting stays, little need be added to what has already been' said when treating of partial dentures. One method, not there specified, consists in first fitting to each tooth separately, in the usual manner, a thin stay formed of plati- num, which is temporarily fastened to the tooth by splitting and spreafling apart the ends of the rivets with a small chisel-sha])ed instrument. The teeth are then removed from the investicnt and partially imbedded side by side in plaster, tlie i)latinum strips remaining uncovered. The plaster and teeth may then 276 MECHANICAL DENTISTEY. be raised to a full red heat with a blowpipe or by placing them in the furnace. Small pieces of gold plate, of equal fineness with the base, are then placed upon the surfaces of the platinum stays and thoroughly fused with the blowpipe until they flow perfectly in around the rivets, and uniformly over the surface of the linings. If sufficient heat is applied, the solder will insinuate itself between the stay and tooth, and thus render the coaptation of the two perfect. Small pieces of gold plate should be added until sufficient thickness is imparted to the linings. The backings are then trimmed smoothly and burnished, when they may be placed back in the investient in their appropriate places. The linings which support the teeth may be united to each other laterally in sections or continuously. When the teeth are joined to each other throughout, a very small quan- tity of solder will be sufficient to support the teeth, provided it is well diffused along the joints uniting them perfectly at all points. The process of preparatory heating, soldering, pickling, and finishing the plate, is the same in all respects as that described when treating of partial pieces, and need not, therefore, be re- capitulated. In the final adjustment of the finished piece to the mouth, and after any additional grinding of the masticating surfaces of the teeth necessary to perfect the antagonism has been per- formed, such instructions should be given to the patient in regard to the care and management of the appliances as will best promote their immediate and successful use. The wearer should be impressed with the absolute necessity of early and prompt attention to any injuries inflicted upon the soft tissues of the mouth by the substitutes, as much future trouble and annoyance, if not permanent mutilation of the parts, may result from neglect, but which may be readily averted, in most in- stances, by a timely removal of the sources of injury. To obviate, in some measure, the tendency to displacement of the base, which usually accompanies the first use of artificial teeth, and especially the upper denture, the patient may be directed, ENTIRE DENTURES. 277 when dividing food with the front teeth, to press the substance back.ward and upward against the cutting edges of the superior incisors at the same time that the opposing teeth are closed upon each other, thus dividing completely the substance seized. In reference to the mastication of food, it has been sug-o-ested to instruct the patient to distribute, by the action of the tongue, the portions of food as equally as possible on each side of the mouth, in this manner distributing the forces applied, and thereby lessening the chances of lateral displacement of the substitute. 278 MECHANICAL DENTISTRY. CHAPTER XII. Porcelain Teeth — Carved Block-Teeth. PORCELAIN teeth. The perfection and completeness of results attained at this day in the production of porcelain teeth, approximating so nearly the natural organs in all their more obvious, physical, and distinctive characteristics as to be almost, if not quite, un- distinguishable from the latter when applied in obedience to the aesthetic requirements of individual cases, is one of the marvels of ceramic art. Nowhere, perhaps, have the conceptions of genius been embodied in porcelain with more truthfulness or greater fidelity to nature than in the exquisite and wonderful imitations of the dental manufacturing laboratory. So amply and satisfactorily has the intelligent, progressive, and well-directed enterprise of manufacturers provided for all the ordinary needs of prosthetic practice in the almost endless variety in size, color, configuration, relation, and adaptability of single and sectional teeth, that the work of hand-carving is now rarely demanded of the general practitioner except in ex- treme cases resulting either from accident or disease. Thus, as aptly remarked by the late Professor Austen, " The depot not only renders service by the superior excellence of the sur- gical instruments and prosthetic materials which it supplies, but it directly benefits the science and art of dentistry by re- leasing the practitioner from manufacturing toil, and giving time for the acquirement of increased knowledge and skill. Thus, if the time heretofore given to block-making were de- voted to the study of dental aesthetics, patients would have the PORCELAIN TEETH. 279 benefit of an artistic selection from a far larger variety of porcelain dentures than could otherwise be possibly made." As affording some curious as well as practical information in regard to the composition and manufacture of porcelain teeth, the following descriptions will be found of interest: Components of Dental Porcelain. — Manufactured single and sectional mineral teeth, carved block-teeth, continuous-gum material, etc., are composed of two distinct portions, — the body or base, and enamel. The chief mineral substances which compose the body, are, silcx, felsjjar, and kaolin. The enamel, both crown and gum, consists principally o^ felspar. The various tints or shades of color are imparted to the porcelain by certain metals in a state of minute division or their oxides. The Jiiore general properties of the mineral in- gredients will be first described. Sile.r. — Silex, silica, or silicic acid, is a white powder, in- odorous, and insipid. It forms the chief part of many familiar mineral formations, as quartz, rock crystal, flint, agate, calce- don, and most sands and sandstones, in some of which it occurs nearly pure. Silica, in its pure state, is insoluble in water or acids, and is infusible in the highest heat of the furnace; it melts, however, in the flame of the oxyhydrogen blowpipe, passing into a transparent colorless glass. Its specific gravity is 2.66 ; and it is composed of silicon, 48.04, and oxygen, 51.96. Only the purest varieties of silex are employed in the manu- facture of porcelain teeth. It is prepared for use by subject- ing it to a white heat and then plunging it into cold water, after which it is ground to a very fine powder in a mortar. Felspar. — This mineral substance occurs crystallized in ob- lique rhomboidal prisms, and is a constant ingredient of gran- ite, trachyte, porphyry, and many of the volcanic rocks. The felspathic mineral formations present either a pearly or vitreous lustre, and vary in color, being red, green, gray, yellow, brown, flesh-colored, pure white, milky, transparent, or translucent. Felspar yields no water when calcined ; melts at the blowpipe into a white enamel, and is unaflected by acids. It is composed, 280 MECHANICAL, DENTISTRY. according to Rose, of silica, 66.75; alumina, 17.50; potash, 12; lime, 1.25; oxide of iron, 0.75. It is found in various localities throughout the United States, the purest and whitest kinds being employed in the manufacture of mineral teeth. It is prepared for use in the same manner as silex. Felspar, from its ready fusibility, serves to agglutinate the particles of the more refractory ingredients, silex and kaolin ; and when diffused throughout the mass imparts to the porce- lain a semi-translucent appearance. Kaolin. — Kaolin, or decomposed felspar, is a fine white variety of clay, and is composed chiefly of silica and alumina, the latter being the characteristic ingredient of common clay. It is found in various localities throughout the Eastern States, and in parts of Asia and Europe. Kaolin is refractory or fireproof, but is rendered more or less fusible by the contami- nations of iron and lime with which it is usually combined. The opaque and lifeless appearance characteristic of the earlier manufacture of mineral teeth was due to the introduction of a relatively large proportion of this clay into the body of the porcelain. The peculiar translucent and lifelike expression which distinguishes the beautiful imitations of the present day, is due, in great part, to the comparatively small proportion of kaolin clay, and an increased amount of the more fusible and vitreous component, felspar. Kaolin is prepared for use by washing it in clean water; the coarser particles having settled to the bottom, the water holding the finer ones in solution is poured off, and when the suspended clay is deposited at the bottom of the vessel, the water is again poured oflP, and the remaining kaolin dried in the sun. Coloring Materials. — The following metals and oxides are employed in coloring mineral teeth ; titanium, platina sponge and oxide of gold being those chiefly used in producing the more positive tints, and by combining which in varying pro- portions, any desired shade of color may be obtained. PORCELAIN TEETH. 281 Metals and Oxides. Colors produced. Grold in a state of minute division, . . Rose red. Oxide of gold, .... Platina sponge and filings, Oxide of titanium. Purple of Cassius, Oxide of uranium. Oxide of manganese, . Oxide of cobalt, Oxide of silver, .... Oxide of zinc, .... Bright rose red. Grayish-blue. Bright yellow. Rose purple. Greenish-yellow. Purple. Bright blue. Lemon yellow. Lemon yellow. As the preparation of most of the above colors requires great care, and a soraewliat intimate knowledge of chemistry, and as the most delicate manipulations are necessary to secure accurate and satisfactory results, it is better for the "mechanical operator to procure the coloring ingredients already prepared from some competent chemist, rather than attempt their pro- duction himself. For a particular description of the various modes of preparing them, the reader is referred to Piggot's Dental Chemistry and Metallurgy, and other works treating fully of the subject. 3Iamifaeiure of Porcelain Teeth. — The subjoined account of the processes concerned in the manufacture of porcelain teeth is descriptive of those at present employed in the manufactory of the late S. S. White, and which, in the main, are doubtless the same as those of other leading establishments. The felspar is first calained by throwing it in large masses into a furnace, and subjecting it to a red heat and then plung- ing it into water, which renders it brittle and easily broken by the hammer into small pieces, so that all foreign matters, such as mica or iron, with which it may be mixed, can be separated. It is then crushed between Hint .stones, and when fine enough is afterwards ground under water in a mill in which heavy blfx;ks of French burr stone revolve upon a nether millstone of the same material, until sufficiently pulverized, when it is floated off and aHowed to settle. After this the. water is drawn off or evaporated, and the deposit of spar dried and sifted. The silex is subjected to the same treatment. 282 MECHANICAT. DENTISTRY. The kaolin, already of the desired consistence as found in nature, is prepared for use by first washing out impurities, and then drying. The mineral ingredients are ground somewhat coarsely, but the coloring materials are reduced to an impalpable powder by means of a mortar and pestle machine of great power. When properly prepared, the several materials are combined in suitable proportions to form the body and enamels, and are then mixed with water, and worked into masses of the required consistence for moulding. The degree of plasticity of the body and enamel pastes differ with the methods of manufacture. Formerly, the teeth, when moulded, were first exposed to a heat just sufficient to produce partial baking of the body, and this was called cruising or biscuiting, after which a thin paste of enamel material was applied with a camePs-hair brush, and the whole subjected to a second heat for complete and final fusion. This preliminary process of biscuiting is essential in carved block and continuous gum work, but in the S. S. White factory, and probably others, this partial baking is dispensed with, and the body and enamel pastes of the uniform consis- tency of putty are introduced into the moulds in the first in- stance, properly distributed, and final fusion effected by a single exposure to heat. The moulds are made of brass and are in two sections, one-half of the tooth being represented on either side. The exact form of the tooth or teeth is carved out with great care and precision, and must be anatomically correct and mechani- cally perfect, while the matrix, is made about one-fifth larger than the required size to compensate for shrinkage of the ma- terials in baking. Holes are drilled in each half of the mould to receive the platinum pins, and the exact closure of the two pieces of the mould secured by guiding pins. The moulds having been previously greased, and the plati- num pins, which vary in length and thickness to meet special requirements, placed with small tweezers in the holes provided for them, the crown and gum enamels are first carefully laid in with small steel spatulas in the required quantity and posi- PORCELAIN TEETH. 283 tion. The body is then added, in quantity exceeding some- what the capacity of the mould, when the sections of the mould are closed upon each other and subjected to a pressure sufficient to insure compactness of the inclosed mass. When thoroughly dried by a shnv heat, to which the moulds are ex- posed, the teeth are readily disengaged when the matrix is separated, and will be found at this stage extremely friable and tender, requiring great care in handling them. They are then sent from the moulding to the trimmer's room, where, after critical inspection, all defe(!tive ones are either repaired or condemned, all excess of material filed smoothly away, and the arch of the gum over each tooth made true and smooth with fine pointed instruments. They are then placed on beds of coarse quartz sand, on fire-clay trays or slides ready for the furnace. Referring to this stage in the process of manufacture, an in- telligent observer writes : " Beyond this, no tool can follow them. Imperfections here- tofore could be repaired, but in the future, beyond the fire, the tooth is either perfect or a failure irremediable. The furnace is an institution entitled to respect for its intensity. In its centre is a muffle of fire-clay, entirely surrounded by the glow- ing fuel, a charge of half a ton's weight of coal, itself carefully bricked up before firing, that no impurities of dust or vapor shall reach the teeth. Take out the small half-oval door of the muffle and you will see an inner glow the eye shrinks from registering, an incandescence that startles you by its fervor. In from fifteen to thirty minutes, teeth and fire-clay slide, glowing like the oven, are taken out done and finished. The dull enamel has become as glass. The lustreless oxides have yielded their color, and the tooth that went in friable and brittle has come out adamant. But there is an intermediate skill, the ac- quisition of which is one of the marvels of the mechanic arts. A little too long in that heat and the teeth are ruined, and the evils of 'underdone' are equally to be guarded against as in the housekeeper's baking. It is a trained judgment, a skill of eye and handling that enables the burner to lend success to the 284 MECHANICAL DENTISTRY. work of those who have gone before him, and at the precise point where a shade of failure is utter ruin. " The teeth are now done and ready for the curious, charac- teristic red wax cards, on which they go to the trade." We cannot close this account of the composition and manu- facture of porcelain teeth more appropriately than by quoting from an excellent popular treatise, entitled The Teeth, by Dr. J. W. White, the present accomplished editor of the Dental Cosmos : " If it is true of any pursuit, it is emphatically true of the attempt to imitate natural dentures, that ' the beauty of the result well repays the highest exercise of art.' The manufac- turer should furnish teeth in accordance with nature's types, and each tooth in a set should harmonize with the rest ; for though each may be an exact representation of a natural tooth, the general effect is spoiled unless they are, in all their distinguish- ing features, of the same family or class of teeth. No two teeth in a natural set are alike ; every one has its distinctive contour, and besides possessing individuality, indicates the character of the adjoining teeth. In an artificial set, unless these distinctive differences and resemblances have been faith- fully studied and copied, their artificial character is apparent. " The observant dentist will take into the account complexion* age, sex, height, the color of hair and eyes, and other charac- teristics of the individual when selecting teeth to replace lost ones ; and the manufacturer should be skilled in the observance of the varied classes of dentures required. To inattention in this direction on the part of the dentist, or to dictation on the part of the patient, is to be charged the unseemly incongruities constantly staring the observer in the face from mouths whose lost organs have been replaced in disregard of this universal law. "No matter how anatomically correct, or how skilfully adapted for speech and mastication, an artificial denture may be, yet if it bear not the relation demanded by age, tempera- ment, facial contour, etc., it cannot be otherwise than that its artificiality will be apparent to every beholder. PORCELAIN TEETH. 285 "This law of correlation, harmony, running through nature, attracts and enchants us by an infinite diversity of manifestations; the failure to recognize its demands by art is correspondingly abhorrent to our sensibilities. "In the social gathering, a lady who appreciates the law of harmony delights the eye by the taste displayed in her attire ; another, though more elaborately and expensively adorned, yet failing to harmonize the details of her costume, attracts atten- tion only by the impression of incongruity. We hear fre- quently from a lady who is selecting a bonnet, or from a gen- tleman pnrehasing a hat or other article of wearing apparel, the question to a friend, does this become me ? the query indicating the recognition that, however exquisite the material, or excellent the manufacture of the article, a certain law of fitness prevails, the failure to comply with which makes the wearer appear ridiculous. We meet in the street one the color of whose hair we expect, by the law of association, to be fair, or sandy, and if otherwise, a wig or a dye is instantly sug- gested. " There is a relation between the physical form and the voice, from which we are led to infer in advance the character of the tones which from any given individual may be expected, ^his law of association in any case, having led us to anticipate a bass voice, the anomaly, should a falsetto greet us, is almost ludicrous. " There is a similar relation between other physical character- istics and the teeth. A broad, square face, or an oval ; a large, coarse-featured man, or a delicately-organized woman ; a miss of eighteen, or a ra^atron of fifty ; a l)runettc or a blonde, — these and other varieties present as many diifering types, with teeth, in size, shape, color, density, etc., corresponding. If, then, teeth correlated in their characteristics to those which nature assigns to one class, be inserted in the mouth of one whose physical organization demands a different order, the effect cannot be otherwise than displeasing to the eye, whether the observer be skilled in perf;ej)tion, or intuitively recognizes inharmony without understanding the cause. 286 MECHANICAL DENTISTRY. "Artificial teeth should be natural as to shape, color, and vital appearance ; there should be a nice blending of the colors of the body and enamel, not an abrupt union of the two ; there should be the precise amount of translucency, and the peculiar texture of the surface, and these characteristics should be main- tained by artificial light as well as by daylight ; for many teeth which in daylight look reasonably well have a very artificial appearance when exposed in the mouth to an artificial light. They should also possess strength sufficient for the uses for which they are designed. This strength should come from the quality of their composition, the skilful distribution of bulk to parts most requiring it, and the due form, position, and pro- portion of the pins, rather than from any increase in bulk and weight beyond that of the natural organs. Besides all this, there must be taken into the account the varying forms of the jaw or maxillary ridge, so that the dentist may be enabled to select teeth which are adapted to each particular case, and which can be made to articulate nicely with each other or with the natural teeth, if there are any remaining in the mouth ; otherwise his best efforts will not secure a good appearance, comfort to the wearer, or usefulness in mastication. "To meet all these requirements, the reader can easily per- ceive, is no easy task, and cannot be accomplished without an amount of care and attention to every detail which effectually excludes artificial teeth from the list of cheap manufactures. The difference in all the essential characteristics which they should possess, appears when what are called cheap teeth are compared with the best. First upon the skill of the manu- facturer, and then upon the judgment of the dentist, depends whether an artificial set of teeth shall be pleasing or disagree- able to the observer; whether they shall disarm the suspicion of artificiality, or proclaim it to every beholder. " Those who desire the result of experience, skill, and culture in manufacture and application, who seek the advantages of artistic taste and faithful service, should ponder the signifi- cance of the following remarks by one who, in his time, con- tributed largely to the development of the art to which he was devoted : CARVED BI.OCK-TEETH. 287 "'All works of taste must bear a price in proportion to the skill, taste, time, expense, and risk attending their invention and manufacture. Those things called dear are, when justly esti- mated, the cheapest ; they are attended with much less profit to the artist than those which everybody calls cheap. Beau- tiful forms and compositions are not made by chance, nor can they ever, in any material, be made at small expense. A com- petition for cheapness, and not for excellence of workmanship, is the most frequent and certain cause of the rapid decay and entire destruction in arts and manufactures.' " CARVED BLOCK-TEETH. The fabrication of porcelain block-teeth constitutes a some- what distinctive branch of practical dentistry, and from the delicate nature of the manipulations and long experience neces- sary to attain to any considerable degree of excellence in the various processes connected with their manufacture, their con- struction is seldom attempted by those engaged in general practice. Cases occasionally present themselves, however, which, bv reason of unusual or unequal absorption, or exten- sive and irregular loss of tissue as the result of accident or disease, demand, for their successful treatment, specific forms of dental substitutes not obtainable from any collection of ready-made teeth, single or in sections, however large or varied. To meet properly such possible exigencies of practice, either the services of an experienced block-workman must be ob- tained, or the demands of the case must be supplied by such skill as the general practitioner can bring to the work. To the latter, the following descriptions of the process may prove helpful. A descri[)tion of the general properties of the several in- gredients, earthy and metallic, used in the formation of block- teeth, has already been given in the preceding part of the present chapter. The method of compounding and preparing the materials will next be given, with various approved recipes for body and enamel. CornponUion and Preparation of the Body. — The porcelain 288 MECHANICAL DENTISTEY. paste for the body of block-teeth may be compounded from either of the following formulas. There are a great variety of recipes, differing more or less in the proportion of the com- ponent ingredients, but the following will be found to answer every practical purpose, and are such as are generally employai' at this time by experienced block-workmen. NO. I. NO. III. Delaware spar, 12 oz. Spar, . 12 oz. Silex, 2 oz. 8 dwts. Silex, . 2 oz. 8 dwts. Kaolin, 11 dwts. Kaolin, . 12 dwts. Titanium, . 18 to 36 grs. Titanium, . . 24 grs. NO. II. NO, . IV. Delaware spar, 16 oz. Spar, . 8oz. Silex, 3Joz. Silex, . I5 oz. Kaolin, J oz. Kaolin, . 4 dwts. Titanium, . 20 to 60 grs. Titanium, . . 22 grs. NO. V. Spar, . 2oz, Silex, . 8 dwts. Kaolin, . . 2 dwts. Titanium, . 4 grs. The titanium is first ground in a mortar until reduced to an impalpable powder ; the silex is then added and ground from one to three hours, or until there is no perceptible grit ; after which the kaolin is added and thoroughly ground ; and lastly the spar, adding small portions at a time, and grinding the whole until perfect comminution and intermixture of the several ingredients are effected, say from half an hour to an hour. The ingredients may be ground dry or in water, — in the latter case a sufficient quantity of clean rain-water should be added, from time to time, to form a mixture of about the consistence of thick cream. After sufficient comminution is effected, the surplus water may be abstracted by pouring the mixture upon a clean, dry slab of plaster of Paris. When it acquires about the consistence of thick dough, it should be beaten with a wooden mallet, or thrown repeatedly and forcibly upon a marble slab, and, if prepared in quantities for future use, it should be preserved in its plastic state by confining it CARVED BLOCK-TEETH. 289 in a closely-stopped earthen jar. When ground dry, the materials are prepared for immediate use by adding to the powder clean rain-water in sufficient quantity to form a thick paste ; it is then well beaten on a porcelain or marble slab, and pressed, just before using, between folds of cloth, to expel perfectly all particles of air that may be confined in the body of the paste. Composition and Preparation of Crown Enamels. — The enamel, which forms the external covering to the crowns of porcelain teeth, is composed wholly of felspar, with such color- ing matters as serve to communicate to it the various tints or shades of complexion characteristic of the natural organs. The more positive tints, grayish-blue and yellow, are produced by titanium, platinum sponge, and oxide of gold; intermediate colors being produced by varying the special combinations of these ingredients. The following recipes will furnish various tinted enamels, the varieties of grayish-blue being applied to the points or coronal extremities of the teeth — the yellow to the necks: the two colors being so blended when applied as to run imper- ceptibly into each other. Grayish-blue Enamel. NO. I. NO. III. Spar* . 2 oz. Spar, . . 2oz. Platina sponge, . • ig'-- Platina sponge, . • f gr. Oxide of gold, . • \ gr- Oxide of gold, . . ^gr. NO. II. NO. IV. Spar, . . 2oz. Spar, . . 2 oz. Platina sponge, . . ^gr. Fli]x,t . 24 gr. Oxide of gold, • I gr- Platina sponge, . • i gr- * The Boston spar is preferred on account of its greater fusibility. t Flux is composed of silex, 4 oz. ; borax, 1 oz. ; sal tartar, 1 oz. ; these are ground to an impalpable powder and packed in the bottom of a clean, light-colored crucible. A piece of fire-clay slab is then fitted into the top of the crucible and luted with kaolin clay. It is then exposed to the heat of a furnace until con)pletely fused, when it is removed, and when cold the crucible is broken, all foreign particles or discolored portions thoroughly removed, and the remainder well pulverized. 19 290 MECHANICAL DENTISTRY. Yellow L Enamel. NO. I. NO. III. Spar, . 2 oz. Spar, . . 2 oz. Titanium, . 10 grs. Titanium, , 16 grs Platina sponge, *gr. Platina sponge, • igr- Oxide of gold. . ^gr. Oxide of gold, • i gr- NO. II. NO. IV. Spar, . . 2oz. Spar, . 2 oz. Titanium, . 14 grs. Flux, . . 20 grs Platina sponge, . . 2gr. Titanium, . 10 grs Oxide of gold, . Jgr. In compounding enamels from the foregoing recipes, the coloring ingredients should first be ground to a very fine powder, with five or six dwts. of the spar; the remaining portions of the latter should then be added, a little at a time, and ground for half an hour or more. The shades of color may be varied almost indefinitely by changing the propor- tions of the coloring matter. Grayish-Blue Enamel. NO. I. NO. II. Spar, . 1 oz. Spar, . 1 oz. Blue frit,* . . 5 grs. Yellow frit, f . 4 grs Gold mixture,! . 20 grs Composition and Preparation of Gum Enam,els. — Either of the following recipes will furnish a good gum enamel, and may be used in connection with any of the compositions for body heretofore enumerated. NO. I. Gum frit, No. 1, . Spar, . NO. II. 3 dwts. Gum frit, No. 2, . 3 dwts. 9 to 12 dwts. Spar,. . . 3 to 18 dwts. * Blue frit is composed of spar, 5^ oz. ; platina sponge, 4 dwts. ; powder finely, make up into a ball with water, and fuse very slightly upon a slide in a furnace. It is then plunged into water while hot, and when dry, finely pulverized. f Yellow frit is made by mixing intimately J oz. of spar with two dwts. of titanium, and heating as above. X Gold mixture is prepared by dissolving 8 grs. of pure gold in aqua regia, and then stirring in 12^ dwts. of very finely pulverized spar. When nearly dry, it is formed into a ball fused upon a slide, and then coarsely pulverized. CARVED BLOCK-TEETH. 291 It IS recommended, in order to impart a granular appear- ance to the gum, to grind the spar somewhat coarsely; any required shade or depth of gum color being obtained by vary- ing the proportions of the frit, — the latter containing the color- ing; ino;redients. Gum frit, No. 1, is composed of felspar, 700 grs. ; flux, 175 grs. ; oxide of gold, or metallic gold in a state of minute divi- sion, 16 grs. The above are ground in a mortar for five or eight hours, or until they are reduced to an impalpable powder; they are then packed in the bottom of a clean Hessian crucible, coated on the inside with a thin mixture of pulverized silex, and on the outside with kaolin. A piece of tile or slab is then luted with kaolin to the top of the crucible, when it is placed in the furnace for from one to two hours, or until complete vitrifi- cation is effected. It is then removed, and when cold, the crn- cible is broken and all traces of adhering silex ground off; it is then broken in pieces and ground until it will pass through a sieve, No. 9, bolting cloth. Gum frit, No. 2, is composed of spar, 700 grs. ; flux, 175 grs. ; purple cassius, 8 grs. The purple cassius is first thoroughly ground in a mortar, after which the flux is added in small quantities at a time, then the spar in the same manner, grinding until perfect com- minution and intermixture of the several ingredients are effected. It is then packed tightly in the bottom of a clean white crucible, the inside lined with silex, and a slab luted to the top, as before, and the whole exposed to a heat suflicient to fuse perfectly. It is then removed from the fire, and when cold, all foreign substances are ground off" and the remaining portions pulverized until it will pass through a sieve of No. 9 bolting cloth. Having given the composition and mode of preparation of tlie various compounds which enter into the formation of the body and crown and gum enamels, it only remains to describe the different processes, concerned in the construction of porce- 292 MECHANICAL DENTISTRY. lain blocks from the several compositions given, and first of the method of procuring an antagonizing model. Antagonizing Model for an Entire Upper and Lower Den- ture Constructed of Block-teeth. — The first step in the process of constructing block-teeth, for either a full upper set with the natural teeth of the opposite jaw remaining, or for entire den- tures for both jaws, is to secure an antagonizing model." For the latter, or complete dentures, above and below, the method does not differ from that employed when single gum teeth are used. A rim of wax is adjusted to each plate in the manner heretofore described, and the plates placed in their proper posi- tions in the mouth ; the wax drafts are then trimmed until the exact fulness and contour of the lips and cheeks are secured and proper relative width is given to the wax rims. Great exactness should be observed in these latter manipulations, inasmuch as the wax drafts are the only guides in the formation of the blocks, both as respects the form and fulness of the arch and the length of the teeth. The proper relation of the two pieces in the mouth is now secured, the wax rims attached to each other, and the median line of the mouth indicated on the wax, and being removed from the mouth, an antagonizing model pro- cured in the same manner as described in a former chapter. Antagonizing Model for an Entire Upper Denture with the Natural Teeth of the Opposing Jaw Remaining. — A rim of wax, half an inch or more in width, is attached to the ridge of the plate and the latter placed in the mouth. The patient is then directed to close the jaws until the cutting edges and grinding surfaces of the teeth of the opposing jaw are fairly imbedded in the wax. The piece is then removed from the mouth and the wax rim detached from the plate by holding the latter for a moment over a spirit-flame. The wax is then placed upon a strip of paper with the side indented by the teeth looking upward, the surface of the wax oiled and a batter of plaster poured upon it, filling the imprints of the teeth and running back an inch and a half or more behind the wax, raising the plaster to a level of half an inch above the wax. When the plaster is sufficiently condensed, it is turned over, the wax CARVED BLOCK-TEETH. 293 removed without fracturing the plaster teeth, and a crucial groove made in the surface of the model posterior to the teeth. This constitutes the lower section of the antagonizing model, and is a representation of the teeth of the lower jaw. The upper section is next obtained in the following manner : A second rim of wax, in width equal to the required length of the teeth, is adjusted to the plate as before and placed in the mouth. The exact contour and fulness of the arch required is then given to the external or labial surface of the wax draft, and the lower edge cut away until the required approximation of the jaws is secured, and the points of all the teeth remaining below touch the wax at the same instant. The patient is now required to close the jaws gently upon each other until a slight indentation is made in the Avax by the opposing teeth ; the median line of the mouth is then marked upon the wax and the plate removed. The plate and wax are now adjusted to the lower section of the model, the points of the plaster teeth being received into the indentations in the wax made by the natural teeth. The upper and posterior surface of the lower section of the model having been varnished and oiled, and the 294 MECHANICAL, DENTISTRY. exposed surface of the plate also oiled, a mixture of plaster is poured in upon the latter and back upon the model, raising the whole to a level of half an inch above the plate. The two sections, when the latter portion of plaster has consolidated, are then separated, reserving the lower part of the antagonizing model for future use. Forming a Matrix for Moulding the Body Preparatory to Carving the Teeth. — As the process of forming a matrix in which to mould the porcelain paste, giving the general form and Fig. 122. outlines to the blocks before carving the teeth, is the same for an upper and lower denture, it will be sufficient to describe the method as it relates to the superior arch. A matrix for an entire denture above or below, whether consisting of three, four, or six blocks, is ordinarily made to consist of three dis- tinct pieces independently of the plate and model, and is con- structed in the following manner : Three conical shaped holes are made in the sides of the model, one in front and one on each side, to furnish a fixed articulation for the three sections CARVED BLOCK-TEETH. 295 forming the external walls of the matrix. The appearance of the model when thus prepared with the plate and wax run m place is exhibited in Fig. 121. The sides of the model and external face of the wax are now oiled, and both surfaces covered with a batter of plaster to the depth of a fourth or a half of an inch, extending from the base of the model to the lower edge of the wax, and posteriorly about half way on each side of the model to form a matrix for the front block, "or the two anterior bl(»cks, if the arch is made to consist of more than three sections. Supposing the wax removed from the plate and this front piece in place, the several parts will j)resent the apiiearance shown in Fig. 122. The plaster rim forming the external wall of the front block being removed, plaster is again adde^l, as before, to the outer surfaces of the model and wax, extending it from the heel of the idate on each side forward an eighth or a fourth of an inch in advance of the posterior ex- tremities of the plaster rim first formed. Wiicn hard the plaster is trimmed even with the edge of the wax draft, and the two pieces removed from the model. The matrices ibrmed 296 MECHANICAL DENTISTEY. by these lateral sections when readjusted to the model with the wax removed are shown in Fig. 123. Having thus provided a matrix determining the general outline and length of the teeth for the entire arch, the wax draft is removed and the plate thoroughly cleansed preparatory to moulding the paste, — before doing which, however, the line upon the wax indicating the median point of the mouth should be extended across the model' Moulding the Porcelain Paste Preparatory to Carving the Teeth. — In the process of constructing an entire denture, it is impracticable, owing to the shrinkage of the body, to form a single continuous block or full arch without materially chang- ing its relation and adaptation to the metallic base, and also to the natural organs in cases where the latter are remaining in the opposite jaw ; hence it is customary, as before intimated, to divide the arch into sections, — usually three; a central front block embracing the incisors and cuspidati, and two lateral blocks including the bicuspids and molars on each side ; or the denture may consist of four blocks, dividing the arch between the central incisors, and also between the first and second bicuspids on each side ; making the two anterior blocks to consist each of a central and lateral incisor, a cuspidatus, and anterior bicuspid, and the posterior blocks of the second bicuspid and the two molars. Again, the arch is sometimes divided into six blocks, — an anterior embracing the central and lateral incisor and cuspidatus, a central comprising the bicuspids, and a p6sterior including the molars. If constructed in three sections, as is ordinarily the case, the front block should be moulded and carved first. The material for the body, if in a dry state, is mixed with a sufficient quantity of clean rain-water to form a thick batter, and mixed thoroughly in a mortar. It should then be poured upon a dry slab of plaster of Paris, and when the excess of water is absorbed, removed, and well beaten with a spatula on a marble or porcelain slab until it assumes a some- w^hat pasty form ; it may then be well pressed between folds of cloth to force out any remaining portions of confined air. The plaster rim forming the matrix for the front block is now ad- CARVED BLOCK-TEETH, 297 justed in its proper position to the model, and its inner surface, as well as that of the plate, oiled; the porcelain paste is then packed into the matrix as compactly as possible, filling it even with the upper edge of the plaster rim. When the paste has been worked in as solidly as possible, patting it with the fin- gers or suitably formed instruments as successive portions are added, it should be trimmed even with the edge of the plaster rim and the palatal surface cut away to near the thickness re- quired for the teeth included in the block, leaving it somewhat thicker, however, to compensate for the shrinkage of the body, and to allow for small portions which will be cut away in carving the teeth. The plaster rim forming the external bor- der of the matrix is now loosened by tapping gently upon the model and then carefully removed. The mark upon the model, showing the mesial line of the mouth and indicating the proper position of the central incisors, is then extended across the block, after which the width of each adjoining tooth is lined off, making each one as much broader than will be re- quired in the finished piece as the porcelain composition will shrink in baking, — this, in a block embracing the six anterior teeth, will be equivalent to about one-third or one-half the width of a bicuspid on each side. If the case is one requiring a full denture above and below, the operator should next pro- ceed to mould the front block for the lower arch in the same manner as described for the upper. The two sections of the antagonizing model are then placed together, and the proper relative width for the lower teeth indicated upon the inferior block, — the drawn lines upon the upper block serving as a guide. Tlie points to which the posterior extremities of the front block extend on each side of the ))late should be marked upon corresponding points of the model above and below, to enable the manipulator to determine how far the side blocks should be extended anteriorly when moulding the paste for the latter, — the marks upon the model being subsequently trans- ferred to the lower edges of the lateral sections of plaster con- cerned in the formation of the side matrices. Before njmoving the front blocks from the plates preparatory to carving the 298 MECHANICAL DENTISTRY, teeth, the surface of the paste may be dried somewhat by throwing upon it, with a blowpipe, a broad spreading flame from a spirit-lamp. The blocks are then carefully detached by rapping lightly upon the model, assisted by gentle traction with the fingers. The front blocks being removed from the upper and lower plates, the side sections of plaster concerned in the formation of the posterior matrices are adjusted to the model, and, being oiled, the paste filled in as before described, extending each block forward beyond the point occupied by the cuspidatus of the front block a distance equal to about one- third or one-half of the width of the latter. These are then cut away even with the edges of the plaster rims and trimmed on the palatal sides, leaving them somewhat thicker than will be required for the bicuspids and molars. The plaster walls of the matrices are then removed ; the two parts of the articu- lating model placed together, and the relative width and posi- tion assigned to the upper and lower teeth by drawing lines across the external surface of the blocks. They are then sepa- rately removed from the plates in the manner before described, and the necessary additional portions of paste added to the grinding surfaces to compensate for the contraction of the body in baking. In constructing a full upper denture with all or a portion of the natural organs remaining below, the proper width to be given to the upper teeth, as well, also, as the re- quired relation or antagonism of the artificial with the oppos- ing natural teeth, may be readily determined by applying the lower portions of the antagonizing model representing the teeth of the under jaw, and marking upon each block, as it is being moulded, the necessary width and position of each tooth above, — being careful to make allowance for shrinkage by adding to the length, width and thickness of each block as much as will compensate for the contraction of the body. In every other particular, the process is conducted in the same manner as heretofore described. Carving the Teeth. — The teeth are first separated by drawing between them a thread attached to a small bow, and it may be observed in this connection that the most careful and delicate CARVED BLOCK-TEETH. 299 manipulation is required in handling the blocks while carving to prevent portions of the paste from crumbling away, a ten- dency that may be counteracted, in some measure, by moisten- ing the paste occasionally with a little water taken up on the point of the carving knife. The general outline of each tooth having been traced upon the exterior surface of the block with the point of the instrument, the operator proceeds next to give the distinct and characteristic form to the crowns, and the har- monious and agreeable effects produced will depend upon the fidelity with which the manipulator copies nature in the form and arrangement of the teeth. The requirements of individual cases are too varied in their nature to admit of specific direc- tions in respect to their formation, — a careful study of the modified forms of the natural organs, combined with some de- gree of manipulative tact, will enable any one, after sufficient experience, to attain to satisfactory results in this particular. After the teeth are I'ormcd, and the body of the block is re- duced to the required thickness, superfluous portions extending from the ends of the block should be cut away, leaving enough, however, projecting to allow for grinding when jointing and adjusting the several blocks to the metallic base. Fig. 124 exhibits the general form of the blocks when carved, showing also the platinum pins, but which are not usually attached to the blocks until after the latter are first biscuited. Q-uoinfj, or Bbieaitiny — The blocks being carved, are next placed on a fire-clay slab with their palatal surfaces resting on a bed of silex. As soon as the paste has become thoroughly dry, the slab may be gradually introduced into the muffle of a baking furnace (Fig. 15), and exposed to a full red heat until semi-fusion of the body takes place. This partial vitrification of the body serves to agglutinate the particles of the compound, 300 MECHANICAL DENTISTRY. and is termed Gruoing or biscuiting. When removed from the furnace, and cool, the platina pins should be introduced into the blocks before applying the gum and crown enamels, and is accomplished in the following manner. One or two small holes, as the case may require, are drilled into the body of the blorik immediately behind and below the crown of each tooth, extending about half way through the block ; into these, plati- num pins or wires are introduced, a head being formed to the end of the pin entering the block. A small portion of the body composition, mixed with water to the consistence of thin cream, is then worked into the hole around the pin with a sharp-pointed carving knife or camel's-hair brush, its intro- duction being facilitated by first immersing the block in water immediately before inserting the ]>ins. AppliGation of the Crown and Gum Enamels. — The gum enamel is applied first, the material being first prepared by mixing the gum composition with sufficient clean rain-water to form a batter of about the consistence of thin cream. This is then taken up with a camel's-hair brush and applied uni- formly to all parts of the external surface of the block repre- senting the natural gum. It should be applied very carefully to the necks of the teeth, forming a neat and well-defined fes- toon at these points. In applying the crown enamel to the labial surfaces of the teeth, it is customary, in imitation of the natural organs, to so distribute the more positive tints as to give to that portion of the crown representing the neck of the tooth a somewhat yellowish hue, and to the points, a grayish-blue tint. To effect this, the material for the yellow enamel, re- duced to the consistence before mentioned, is first applied to the necks, uniting it carefully with the gum enamel ; and after- wards the grayish-blue to the points, extending it a little be- low the cutting edges of the incisors, and the cusps of the cuspidati, bicuspids, and molars, giving to the teeth, at these points, a translucent appearance. It is only the external and lateral surfaces of the teeth that are enamelled, the palatal surfaces remaining unglazed. The yellow and blue enamels CARVED BLOCK-TEETH. 301 should be so blended when applying them to the crowns that the one shall fade away imperceptibly into the other. Final Baking. — The enamelling completed, the blocks are placed upon a bed of silex on a slide, and the latter carefully and slowly introduced into the mouth of the furnace. The fire should then be urged to a clear white heat, and when per- fectly dry, the blocks should be carried with the slide into the body of the muffle, and the mouth of the latter closed tightly with a fire-clay plug. Some knowledge of the requi- site degree of heat and time necessary to effect perfect fusion of the ingredients composing the blocks is required, and these are ordinarily well known to experienced block-workmen, but those unaccustomed to the process will better determine the completion of the baking by introducing into the muffle along with the blocks a small portion of the body covered with enamel attached to one end of a platinum wire, the other pass- ing through a small stopper fitted to the centre of the plug closing the end of the muffle, and which may be removed and the wire withdrawn from time to time to observe the effect of the heat upon the test-piece. When this is seen to be per- fectly fused, as evidenced by a uniform glossiness of the sur- face, the slab should be drawn to the mouth of the muffle, the draft cut off, and the blocks allowed to cool gradually with the furnace. In place of using a test-piece, however, it will an- swer the purpose to withdraw the slide to the mouth of the muffle occasionally, where it may be readily inspected and the progress of baking noted. When sufficiently cool to be taken in the hand, the blocks are removed from the furnace. Fitting and Attaching the Blocks to the Metallic Base. — On applying the blocks to the plate, it will be found that a greater or less change of relation between the two has occurred in the process of baking, so that the base of the former will not fit the portion of the plate on which they rest as accurately as when first moulded. It will, therefore, be necessary, when adjusting each block, to grind away somewhat from the base of the latter until the coaptation of the two surfaces is as perfect as practi- cable. The «('V(;rul blocks should also at the same time be 302 MECHANICAL DENTISTRY. accurately united to each other laterally, grinding away from the ends, and approximating the sections as the articulation of the opposing dentures may require to eifect a proper and efficient antagonism, and which may be determined by the use of the antagonizing model employed in moulding the blocks. After the blocks are fitted, and the teeth antagonized, and before unit- ing the former permanently to the plate, a rim should be formed and attached to the borders of the metallic base to form a socket for the plate extremities of the blocks, and which, extending around the margins of the plate, should be continued across the heel of the latter on each side and made continuous with the band of lining on the palatal sides of the teeth. The manner of forming and attaching the rim does not differ from the method heretofore described in connection with full dentures constructed of single gum teeth, and to which the reader is referred. The rim fitted, and the blocks replaced, the whole is invested in the usual way, the wax removed from the plate, and a continuous band or lining adjusted to each block. The latter is accom- plished by first cutting a pattern of the band from sheet lead of the length of the block, and of the required width, trimming the edge applied to the plate in such a manner that when ad- justed to the backs of the teeth it will lie in uniform contact with the base; this is then pressed against the pins with suffi- cient force to perforate it. The lead pattern is then placed upon a strip of gold of the required thickness, and the counterpart of the pattern cut from the gold plate, marking at the same time the points to be perforated for the platinum rivets. This is then pierced with a plate-punch, and the strip bent to the proper curve and applied to the block, when it is bound to the latter by splitting and spreading apart the ends of the rivets. A band is thus applied to each block. Solder is then applied along the joints, and over the pins, and all parts united with the blowpipe in the usual manner. The piece is then finished up the same as ordinary gold Avork. Fig. 125, exhibits a palatal view of an upper set of block- teeth mounted on a metallic base. When skilfully executed, the finished work presents a beautiful and highly artistic appearance. The application of CARVED BLOCK-TEETH. 303 sectional porcelain blocks to the necessities of mechanical prac- tice has been greatly extended in connection with the vulcan- ite and celluloid bases, and, to a limited extent, with other processes. Their construction, however, is modified some- what by the requirements of these special processes, and as made for the latter are of such approved manufacture, and are supplied in such abundance and at so reasonable a cost by all the principal dental furnishing establishments, that the general practitioner, we apprehend, will ordinarily find it more convenient and economical to purchase rather than manu- facture them himself. Fig. 125. The subjoined account, descriptive of a new method of making block-teeth, by Dr. William Calvert, Avas inadvertently omitted in the former edition of this work. The process has received marked commendation by competent persons who have investi- gated its merits, and will be highly esteemed by those who desire to excel in this beautiful but difficult art. " The first pre})aratory step to be taken, after having correct articulating models, is to select single teeth so defined as may eithersuit the taste of the operator or the peculiarity of the case, and supposing the case to be an upper denture, it will be neces- sary to have hvo front and two lateral incisors, two canine or cuspids, two bicuspids (or if more convenient the cuspids), and four molars, all of which should be sufficiently large to com- pensate for shrinkage, in the material of which the teeth are to be corn[)Osed. " The plate upon which the blocks arc to be made, and to 304 MECHANICAL DENTISTRY. which they are to be subsequently fitted, being upon its cor- responding model, a rim of wax may be placed upon it, and the teeth arranged upon the wax, articulating with the antago- nizing model, allowing sufficient in the length of the teeth for shrinkage. Beginning with the front incisors, the teeth should be set to the wax (as above) as far back on each side as the first bicuspids, inclusive; then leaving a space equal to the width of half a tooth, the arch may be completed by the addi- tion of the molars, two on each side. The teeth having been thus arranged upon the wax, with reference to regularity or irregularity, height, etc., the desired outline of gum may be filled up with wax. " Special care is requisite in so trimming the wax where joints are contemplated, that no subsequent alteration will be needed during the further manipulations. " It will be necessary, previous to making the moulds, to make some provision for replacing them, after they have been once removed, so that they shall occupy the same position as they did previous to their first removal. For this, it will be only necessary to make some conical holes in the face of the cast, say two on each side, between the centre and the first bi- cuspid teeth, and two opposite the molar teeth of each side. These holes need not be more than about a quarter of an inch deep, and should be but a short distance below the edge or line of the plate. The face of the cast, including said holes, should now be varnished, when the case is ready for making the moulds. " The first mould to be made should be that including the four incisors, two canine, and two first bicuspids, eight teeth in all. This may be done by simply oiling the face of the teeth, outline of gum, and plaster cast, and pouring plaster of Paris of a proper consistency over the surface of the same, allowing it to fall slightly over the cutting edges, so as to form a more perfect mould. This mould should be divided in the centre, making two sections, which can be done by cutting through the plaster while in the state of hardening ; or, what is perhaps better, before applying the plaster, make an incision CAEVED BLOCK-TEETH. 305 in the wax outline of gum, in which place a thin slip of sheet lead, letting it extend a little above the cutting edges of the teeth, and as far down the face of the cast as is desired to ex- tend the mould. When hard, remove from the cast and teeth, and we have the untrimmed mould for said eight teeth. Pre- vious to making the moulds for the back teeth, it is necessary to remove the first bicuspids, or the cuspids representing them, from the position they occupied in making the mould just de- scribed, and placing them beside the first molars so as to represent the second bicuspids. Care is to be taken in re- moving and replacing them, so that the original form of the wax may be preserved, otherwise the end thereby intended to be secured will be defeated, and the joints at these points will be irregular and unsightly. " For the purpose of rendering clear a point necessarily left somewhat obscure in the foregoing description, it may be well here to state that the space of half a tooth, left between the first bicuspids and the first molars, is to compensate for shrink- age in the length of the arch, for after the first bicuspids are removed and set adjacent to the first molars, thereby repre- senting the second bicuspids, they occupy the entire vacancy first left and one-half the space formerly occupied by said first bicuspids ; hence the extension of the back moulds toward the centre is equivalent to the shrinkage of the entire arch. " As the foregoing is applicable where the case of fourteen teeth is to be divided into four blocks, as is usual in soldering, I would say that when the intention is to make pin-holes for riveting, the space of Jut/fa tooth must be left between tlie canine and bicuspids, instead of between the bicuspids and molars. "The moulds for the back teeth may now be made in the same manner as those of the front ones. After the moulds have been made as already described, they should be so trimmed that in the process of moulding the blocks there would be no liability of removing portions of the enamel oif the teeth in withdrawing the moulds. The moulds should now be varnished with some spirit varnish, and after it becomes dry are ready for use. 20 306 MECHANICAL, DENTISTEY. " The moulds being prepared, the next step is the enamelling of the teeth in the moulds. The enamels should be moistened with a little clean water, and having previously oiled the sec- tion or sections of the mould, the blue or point enamel may be first applied (as stiff as it will work) with a very small spatula made for the purpose. This enamel should be thin at the base, and gradually thickening with the concavity of the mould to the cutting edges of the teeth. The yellow or base enamel is next applied heavy at the base, and gradually terminating near the point. " After the enamelling has been completed so far as is de- signed to be moulded at one time, a small quantity of the body about the consistency of a thick paste may be spread over the surface of the moulds and of the enamels, the moulds replaced upon the model, and the body carefully filled in, at first rather soft, but subsequently harder and harder, until the mould is sufficiently full. Then applying the flame of a spirit-lamp for a few minutes with the blowpipe, the body will be tough- ened enough to work well, when the moulds may be removed. The teeth may then be separated and trimmed, the blocks di- vided as desired, the gum enamel applied, etc., and so com- pleted. \ " The process of enamelling and moulding being precisely the same with all the blocks, it needs not that I should go into further detail. " I have already said, that when the blocks are intended to be riveted upon the plate, the moulds are required to be some- what different. There is also another difference ; that is, the moulding of the pin or rivet holes, which may be done by re- moving the plate from the model, placing the moulds upon the model, and drilling a small hole upon the prominence of the ridge opposite the centre of each tooth, in which insert a piece of wire of a desired size. The enamelling, etc., may then be done as before described, and after the body has been hardened sufficiently, the pins may be removed, leaving the holes neatly moulded, perfectly smooth, and straight. The blocks may then be finished at once, before removing from the cast." DENTURES WITH CONTINUOUS GUMS. 307 CHAPTER XIII. Uniting Single Porcelain Teeth to Each Other and TO A INIetallic Base with a Fusible Silicious Com- pound, FORMING A Continuous Artificial Gum.* The process of uniting single mineral teeth to each other and to a metallic base by means of a porcelain cement, was attempted as early as 1820, by Delabarre, of Paris, France, but with such imperfect and unsatisfactory results as induced its early abandonment. At a later period. Dr. John Allen, a distinguished practitioner of dentistry in America, devised a method embracing original and important modifications of ])ractice both in the preparation and combination of materials, and the modes of manipulating them; and after an extended series of experiments, commencing in 1844, succeeded in ob- taining certain mineral compounds which vitrified at a heat much below that employed by Delabarre, and the contraction of which corresponded so nearly with that of the platina base * The attentive reader of the first edition of this work will not fail to note that the statements involving the question of priority, contained in the introductory portion of the above chapter, are at variance with those originally published. A more extended examination and careful analysis of tlie evi- dences as they appear upon record — evidences not fully accessible to the author at the time of the publication of the first edition — establish beyond reasonable doubt the just claims of Dr. Allen as the originator of that special and distinctive method here considered, by which the attachment of the teeth t(> the plate is effected liy direct fusion of the gum material. Dr. Hun- ter's earliest and contemporaneous experiments contemjilated simply a union of all the teeth, by means of a fusible cement, forming a single, continuous block, which was afterwards united to the l)ase by riveting or soldering. This brief explanation is here introduced as an act of simple justice to Dr. Allen, who has devoted the best energies of his life to the successful de- velopment of a process which stand* unrivalled in all tlie chief rcciuisites of an artificial denture. 308 MECHANICAL DENTISTRY. to which it was applied, that the shrinkage incident to baking conflicted in no material degree with the practical utility of the work in the mouth. In the construction of dentures upon this principle, plain single teeth, made for the purpose, are arranged, and soldered to a plate properly fitted to the mouth, after which different mineral compounds, made to represent the natural gums, roof, etc., are applied to the plate and teeth in a plastic state, then carved and trimmed in proper form, and by means of a strong furnace heat these compounds, which are called the body and the gum enamel, are fused, thus producing a continuous gum, roof, and ruga of the mouth, without seam or crevice. The compounds at present employed in this process, as well as the more fusible preparations used for repairing purposes, are manufactured in quantities sufficient to meet the wants of the profession, and may be procured at all the dental furnish- ing; houses throughout the United States. The intimate but later identification of Dr. W. M. Hunter with the above process has rendered his name familiar as one whose skill and devotion to this specialty of mechanical prac- tice has contributed to its development in a modified form. Dr. Hunter's formulas, and modes of manipulating his com- pounds, will be introduced hereafter. Following Dr. Hunter's descriptions, the reader will find practical and valuable instructions in this method of substitu- tion, contributed for this edition, at the solicitation of the author, by Dr. S. P. Haskell, of Chicago, Ills., and Professor George S. Field, of Detroit, Mich., both of whom are recog- nized experts, and whose long experience and intimate famil- iarity with the most approved methods of constructing continu- ous gum dentures impart special value to the subject-matter of their communications. Before introducing an account of Dr. Allen's modes of pro- cedure, the author would premise that it is unnecessary to repeat in this connection what has already been fully described in regard to impressions of the mouth, or the manipulations connected witli the formation of plaster models and metallic DE]>,TURES WITH CO^'TINUOUS GUMS. 309 swages, these processes being essentially the same as in the construction of ordinary gold work. Whenever a rira is to be formed to the border of the plate extending from heel to heel of the latter, and this is to be accomplished by swaging, the model should be shaped as described in connection with Fig. 37. If it is designed to enamel the entire lingual surface of the plate (a method now commonly practiced), the shoulder upon the model should be extended across tlie heel of the latter from each extremity of the ridge on a line with the posterior border of the hard palate, to form a groove in swaging similar to, and continuous with, that on the outside of the ridge. The edges thus turned in swaging will flare more than is required, — the operation must, therefore, be completed by carefully turning them over sufficiently with the pliers. In place of swaging the rim, however, it may be formed by fitting and soldering along the border a narrow plain strip of platinum, extending it as before, if desired, across the posterior edge of the plate. Or a triangular piece of wire may be soldered on, bevelled somewhat so as to overhang the base slightly, thus forming a shallow groov^e. The border to the palatal portion of the gum at the heel of the plate is sometimes formed in swaging by ad- justing a wire across the heel of the model, which will be transferred to the plate in the form of a ridge. The latter should be raised a line or more from the posterior border of the plate, and should incline gradually to the edge, while the anterior surface should present an abrupt shoulder to the mar- gins of the gum enamel. The process of forming the rim is sometimes deferred until after the first portion of the body is baked, and before the gum enamel is applied. In this case, the borders of the plate, to the depth of from a line to a line and a half, are left uncovered by the base ; after the latter has been baked, the uncovered margins are turned over uj)on the ])ody with pliers and })ur- nisher, and the gum enamel afterwards applied flush witli the edge or surface of the rim. In wJiat(!ver way the rim or socket is formed, it is j)racti- cally of the first importance that the exact dimensions of the 310 MECHANICAL DENTISTRY. plate required should be ascertained before the groove is formed, as it will be impossible to subsequently diminish the extent of the borders without, to some extent, impairing the integrit}' of the finished work. The mouth, therefore, should be carefnlly examined, and the precise location, extent, and fulness of the muscles and integuments along the external borders of the ridge above and below, the glands underneath the tongue, and the extreme boundaries of the hard palate carefully noted and accurately traced upon the plaster model, to serve as a guide in determining the dimensions of the plate. Additional strength will be imparted to the metallic base by doubling the central portion of the plate as described in Chap- ter XI. The following additional remarks on the method by Dr. Hunter are introduced : " Platina as usually applied I think objectionable, wanting stiffness; my method of using it is similar to that proposed by Delabarre, but possessing greater strength than even his method, and by it can be made as light as a good gold plate got up in the ordinary way. I first strike a very thin plate to the cast, and cut out a piece the size of the desired chamber, taking care not to extend it forward to embrace the palatal artery. Add wax to the plate for the depth of the cavity, diminishing it neatly as it approaches the alveolar ridge. Cement this plate to the cast and take another metallic cast, strike another thin plate over the whole, and solder throughout with an alloy — of gold twenty-two parts, platina two parts — or with pure gold. The chamber thus formed is precisely the same as 'Cleveland's Patent Plate,' but the space between the plates, for which he obtained his patent, is subsequently filled up, leaving a cavity resembling Gilbert's, but with a sharper edge when so desired. This space is filled up with base and enamel, and gives great stiffness without the ugly protrusion of the struck chamber. The plate thus formed assimilates much more closely to the palatal dome, not interfering with pronunciation ; another great advantage gained by it is the impossibility of warping. I say impossibility, because I have submitted plates so con- structed to the severest tests, and never had them to warp. DENTURES AVITH CONTINUOUS GUMS. 311 It is well to rivet the two plates together before proceeding to solder, especially gold plates, and to bring the heat carefully upon them ; once prepared there is no danger of change in the succeeding manipulations." Dr. Allen's Methods. The following descriptions, contributed by Dr. Allen, embrace a clear and concise account of the manipulations at present practiced by him in the construction of artificial dentures with continuous gums. "The plate or base is formed of platinum, or platinum and iridium. The plate being properly fitted to the mouth, and wax placed upon it for the bite, as in ordinary plate work, the teeth are arranged thereon, with special reference to the require- ments of the case. Tliey are then covered with a thin coating of plaster mixed with water to the consistence of cream. After this has become firmly set, another mixture of plaster and asbestos with water, somewhat thicker or more plastic than the first, is placed round on the outside of the previous covering and the plate. A convenient way of aj)iilying the second cover- ing is to turn the mixture out of the vessel upon a piece of tin, say four or five inches square, thus forming a cone, upon which tlie plate, with the teeth upward, is pressed gently down until within an inch or less from the tin. Then with a spatula the mixture is brought up over the teeth, forming an investient that will not crack in the process of soldering. Sand may be used with the plaster for this purpose, but I think asbestos preferable. " When the covering has become sufficiently hard, the wax is removed, and a rim of platinum is then fitted to the lingual side of the teeth, below the pins, and to the base plate. The pins in the teeth are then bent down upon the rim, and sold- ered with pure gold, or a mixture of gold and platinum, at the same time the rim is soldered to the plate. This rim, which forms tfie lining for the teeth, is usually about the thickness of tlie plate upon which they are set, say twenty-eight to thirty ; but should the case require more than ordinary strength, a double or triple thickness of rim should be used. This may 312 MECHANICAL DENTISTEY. become necessary in cases where the natural rnolar teeth are standing firmly in the opposite jaw, and antagonize with the artificial piece, or where from any cause an undue strain is brought to bear upon the artificial teeth. To attain successful results, the dentist must take into consideration all the circum- stances or conditions of each particular case, and then exercise his best judgment in executing the work. " In soldering platinum with pure gold, flat surfaces of this metal should be brought in positive contact, in order to become firmly united. Therefore in mounting teeth upon a plate of this kind the backing or inside rim should be a little wider than the distance between the pins in the teeth and the plate, say from an eighth to a fourth of an inch. This extra width of rim should be bent at right angles along the base of the teeth, so as to admit of being pressed down upon the plate after the rim is adjusted to the teeth, and the pins bent down firmly upon it. In this way flat surfaces of the rim and plate are brought to- gether and soldered. The pins in the teeth are also soldered to the rim at the same time. When the parts are thus united, they will remain so during the subsequent bakings; but if the edge of the rim only is fitted to the plate and soldered like gold or silver work, the subsequent heatings for baking the body and gum will cause the gold to become absorbed in the platinum, and leave the joints not united. It may be asked. Why not use common gold solder for this style of work? Answer, Because the alloy in the solder will greatly injure the color of the gum enamel in baking. Copper alloy will turn it to a greenish shade, and silver Avill give it a yellow tinge. Although pure gold requires more intense heat to melt it (being about two thousand degrees) than ordinary gold solder, yet when melted it flows much more freely than the latter. The best way to solder the teeth upon platinum plate is, to place small pieces of gold upon the joints or parts to be soldered, with wet ground borax, and then slowly introduce the piece with the investient into a heated muffle, and bring the whole mass up to a red heat ; then with- draw it from the furnace, and bring it quickly under the blow- pipe to flow the gold. In this way the teeth do not become DENTURES WITH COXTINUOUS GUMS. 313 etched, as they are liable to be if the soldering is done in the furnace. " The piece being soldered and cooled, the covering is re- moved from the teeth, taking care to preserve the base un- broken for the plate to sit upon during the subsequent bakings of the body and gum enamel. "All particles of plaster or other foreign matter should be removed from the teeth and plate by thoroughly washing and brushing them. It is well to immerse the piece for a short time in sulphuric acid, after which rinse and brush it well with water. This done, a colorless mineral compound, called the body, is applied in a plastic state (with spatulas or small instruments for the purpose) to the teeth and plate. It is then carved to represent the gum, roof, and rugae of the mouth, taking care to keep the crowns of the teeth well defined. The piece is then placed on the base upon which it was soldered, and set upon a slide on the apron in front of one of the upper muffles of the heated furnace, — and every eight or ten minutes it should be moved forward into the muffle, say two or four inches each time, until the piece shall have passed the centre of the same, which should be at a red heat. It is then with- drawn and passed into a lower muffle, where the heat is greater, in which the body soon becomes semivitrified, which is suffi- cient for the first bake. It is then taken out and (together with the slide on which it was baked) placed in a cooling muf- fle, the mouth of which should be closed to prevent the change of t(!mperature from being too rapid, and causing the teeth to become brittle. When the piece is sufficiently cool to handle, a second a))plication of body is made for the purpose of re- pairing any defects that may have occurred in the baking; this done, the piece is again introduced as before into the upper muffle, then in the lower, allowing the second bake to be(!omc a little harder than the first, but not so much as to appear glossy. It is then withdrawn, and cooled as described above. "A flesh-colored compound is then applied, which is called the gum enamel. This is also made j)lastic with water, and a thin coating is put over the body, and closely packed and 314 MECHANICAL DENTISTRY. carved around the teeth with small instruments made for the purpose, — still taking care to keep the crowns of the teeth clean and well defined. Small camel's-hair brushes are used wet with water, to cause the gum enamel, and also the body, to settle more closely around the necks of the teeth ; other brushes are also used dry to remove all particles of body, gum, or other substances from the crowns of the teeth. " After the application of the gum enamel, the piece is again subjected to the heat of the furnace as described for baking the body, with this difference : The heat should be a little greater than for either of the preceding bakes. It should be a strong, sharp heat, in order to produce a smooth glossy appearance, which is required for the enamel. These different degrees of heat for the first, second, and third bakings should be carefully observed for the purpose of getting an even temper in the piece, and thereby preventing it from crazing or cracking in cooling. " The enamel being thoroughly fused, the piece is withdrawn from the heated muffle, and passed into another, outside of the furnace. This muffle should be made quite hot before the denture is placed in it, in order to prolong the cooling process ; for if the piece is cooled too rapidly it is rendered more fragile. It is well to let the case remain in the cooling muffle, with the mouth of it closed, several hours before exposing it to the air. By baking just at night the piece will be in proper condition to finish up the next morning. " The finishing process consists simply in smoothing and polishing the plate, and burnishing the rim. It is then ready to be adjusted to the mouth. In baking, great care is necessary to prev-ent the piece from becoming gassed. This can be avoided by allowing the gas to escape entirely from the burning coal or coke i;i the furnace before the piece is introduced into the muffle. The presence of gas is indicated by the blue flame escaping from the coal. When the fire becomes clear, it is then safe to introduce the case to be baked (as before described) into the muffle. Pure anthracite coal is the best for this pur- pose, as it maintains a longer and stronger heat than coke. DENTUEES WITH CONTINUOUS GUMS. 315 Bituminous coal is not good for this kind of work unless first converted into coke. " It often occurs that the natural gums will change more or less after the teeth are inserted. In such cases a new impres- sion should be taken from the mouth, and a fusible die formed. The denture is then placed upon the die, and it will be seen at once where the change has taken place; then with the piece resting upon the die the artificial gum maybe chipped off with a small hammer and chisel. The platinum plate being soft can be refitted to the die very accurately with a burnisher, hammer, and small driver made for the])urpose. A new coat of body is then applied where the plate has been refitted, and then baked, cooled, enamelled, and baked again, — still observ- mgr the same directions as detailed in the management of new pieces. " If the tooth gets broken (a mishap which seldom occurs by use in the mouth), it can be replaced with another, by grind- ing out the remaining portion of the broken tooth, and the gum which covers the fang, and then fitting a new one in the place. This tooth need not be soldered to the inside rim; it is sufficient to o;rind a small notch or g-roove in the enamel which covers the lingual side of the rim for the pin of the tooth to fit into. The pin resting in the groove is covered with the body at the same time it is applied around the base of the tooth, and when this body is baked the tooth will become firmly fastened in place of the broken one. Any number of teeth that may be required can be replaced in this way. If it is desired to change the position of one or more teeth, or to make them longer, this can also be done as described above, with this additional precaution, which is simply to press softened wax upon the inside of the teeth and palatal arch of the denture before the others are removed, — this wax will serve as a guide or index as to the relative change to be made, and also to sustain the teeth in place while they are being fitted as desired to the den- ture. The wax soon becomes hard, and is readily removed as each sucrcssive tooth is ground and adjusted in its proper place. " When the teeth are thus fitted with each pin accurately 316 MECHANICAL DENTISTRY. pressed into the groove prepared for it, and the wax being placed upon the inside to support the teeth in proper posi- tion, — body is filled in around the base of the new ones, which are carved, trimmed, and brushed, so as to save the crowns of the teeth clean and properly defined. The wax is then care- fully removed from the piece, and more body is filled in around the teeth upon the inside,^ — ^filling up the grooves over the pins, and then carving, trimming, etc., as before, to give it the de- sired form. This done, if the teeth are set a little apart, and it is desired to keep them in that position, take a small piece of asbestos and gently press it in between the teeth at the cut- ting edges ; this will prevent them from being drawn together when the body is being baked. The piece is now ready for the furnace, but it should not be baked hard enough to gloss the newly applied body ; it should have more the appearance of Parian marble. " This beino; done, it is then withdrawn from the furnace and transferred to a cooling muffle as before described. When sufficiently cool, the gum enamel is applied and baked with a sharp heat until it becomes smooth and glossy. To prevent the old gum from bleaching or becoming lighter colored in consequence of repeated bakings, a very thin coating of fresh gum enamel should be lightly brushed over the entire en- amelled surface of the piece. The enamel thus applied should be mixed with water, quite thin, so as to flow evenly over the surface when applied with a camel's-hair brush. This should be done before the last baking, that the whole may be fused at the same time. Experience and judgment are essential requi- sites in order to produce good practical results. For example, if the carving of the body is not properly done, the form and shading of the gum and roof will not appear natural when the work is finished ; if the gum enamel is put on too thick it will produce a dark-red color ; if not thick enough it will be too light ; if fused too hard it will be liable to craze or crack ; if not hard enough it will be rough or granular; if the piece be- comes gassed in baking it will be porous and of a bluish color. Again, the teeth of different persons vary as much as any fea- DENTURES WITH CONTINUOUS GUMS. 817 ture of the face, and present as great a variety of expressions. Therefore, in the construction of artificial dentures, the dentist should select and arrange the teeth with special reference to each individual case. The length, size, form, shade, and posi- tion of the teeth should be varied to meet all the different physiognomical requirements tliat occur in dental practice. " This system also combines with great advantage the restora- tion of the face in cases where the muscles have become sunken or fallen in from the loss of the teeth and consequent absorp- tion of the alveolar processes. Here, again, the artistic skill of the dentist is brought into requisition. He should study the face of his patient as the artist studies his picture, for he dis- jjlays his genius not upon canvas but ui)on the living features of the face ; and of how much more importance is the living picture, that reflects even the emotions of the heart, than the lifeless form upon canvas. He should know the origin and insertion of every muscle of which the face is formed, and what ones he is to raise, otherwise he will be liable to produce dis- tortion instead of restoration. This improvement consists of prominences made upon the denture of such form and size as to bring out each muscle or sunken portion of the face to its original fulness ; and when these are rightly formed they are not detected by the closest observer. There are four points of the face (of many persons) which the mei-e insertion of the teeth does not restore, viz., one upon each side beneath the malar or cheek-bone, and also a jwiut upon each side of the base of .the nose, in a line toward the front portion of the malar bone. "The extent of this falling-in varies in different persons, according to their temperaments. If the ]ym[)hatic tempera- ment predominates, the diange will be slight. If nervous or sanguine, it may be very great. .The muscles situated upon the sides of the face, and which rest upon the molar or back teeth, are tlie zygomaticus major, masseter, and buccinator. The loss of the above teeth cause these muscles to fall in. The princi- pal muscles which form the front portion of the face and lips are the zygomaticus minor, hivator labii superioris alaeque nasi, and orbicularis oris. 318 MECHANICAL DENTISTEY. " These rest upon the front, eye, and bicuspid teeth, which, when lost, allow the muscles to sink in, thereby changing the form and expression of the mouth. "The insertion of the front teeth will in a great measure bring out the lips, but there are two muscles in the front por- tion of the face which cannot, in many cases, be thus restored to their original position ; one is the zygomaticus minor, which arises from the front part of the malar bone, and is inserted into the uj^jper lip above the angle of the mouth ; the other is the levator muscle, which arises from the nasal process and from the edge of the orbit above the infraorbitar foramen. It is inserted into the ala nasi or wing of the nose and upper lip. " The prominences before mentioned, applied to these four points of the face, beneath the muscles just described, bring out that narrowness and sunken expression about the upper lip and cheeks to the same breadth and fulness which they formerly displayed. If skill and judgment have presided over all parts of the operation, the result will be highly pleasing, and of practical utility."* Dr, Hunter^ Formulas and 3Iodes of Practice. — The fol- lowing methods of compounding and applying the continuous gum materials, as practiced by Dr. W. M. Hunter, are repro- duced from his latest published descriptions in 1852. The following is a description of the materials and com- pounds employed : " Silex should be of the finest and clearest description, and kept on hand ready ground, the finer the better. ^' Fused spar should be the clearest felspar, such as is used * Inasmuch as the improvement for restoring the face has been claimed by others, the reader is referred for the evidences establishing the claim of Dr. Allen to priority of invention to the historical record which appears in the old American Journal of Dental Science of 1845. In the published pro- ceedings of the American Society of Dental Surgeons of that year, it will be seen that a medal was awarded to one of its members, inscribed, " Awarded to Dr. John Allen, for his invention for restoring the contour of the face, August, 1845." This, in connection with the fact that no other record upon this subject is found in our dental literature, fixes the date of this improve- ment. DENTURES WITH CONTINUOUS GUMS. 319 by tooth manufacturers for enamels, completely fused in a porcelain furnace, and ground fine. " Calcined borax'is prepared by driving off the water of crys- tallization from the borax of commerce, by heating in a covered iron vessel over a slow tire, and it is better to use immediately after its preparation, as it attracts moisture. It should be perfectly clean and white, and free from lumps. " Caustic Potas.'ta Optimus. — Known also as potassa fusa. " Asbestos. — Take the ordinary clean asbestos, free it from all fragments of talc or other foreign substances, and grind fine, taking care to remove any hard fragments that may occur. " Granulated Body. — Take any hard tooth material (I use the following formula: spar 3 ozs., silex 1| ozs., kaolin ^ oz.) and fuse completely. Any very hard porcelain, wedge wood ware, or fine ciiina will answer the same purpose. Break and grind so that it will pass through a wire sieve, No. 50, and again sift off the fine particles which will pass through No. 10 bolting cloth. It is then in grains about as fine as the finest gunpowder. ^' Flux. — Upon this depends the whole of the future opera- tions, and too much care cannot be taken in its preparation. It is composed of silex 8 oz., calcined borax 4 oz,, caustic po- tassa 1 oz. Grind the potassa fine in a wedgewood mortar ; gradually add the other materials until they are thoroughly incorporated. Line a Hessian crucible (as white as can be got) with pure kaolin, fill with the mass, and lute on as a cover a piece of fire-clay slab with the same. Expose to a clear strong fire in a furnace with coke fuel for about half an hour, or until it is fused into a transparent glass, which should be clear and free from stain of any kind, more especially when it is used for gum enamels. Break this down, and grind until fine enough to pass through a bolting cloth, when it will be ready for use. " JJase. — Take flux 1 oz., asbestos 2 oz., grind together very fine, completely intermixing. Add granulated body 1^ oz., and mix with a spatula to prevent grinding the granules of IxxJy any finer. 320 MECHANICAL DENTISTEY. " Gum Enamels. — No. 1. Flux 1 oz., fused spar 1 oz., English rose 40 grains. Grind the English rose extremely fine in a wedgewood mortar, and gradually add the flux and then the fused spar, grinding until the ingredients are thoroughly in- corporated. Cut down a large Hessian crucible so that it will slide into the muffle of a furnace, line with silex and kaolin each one part, put in the material, and draw up the heat on it in a muffle to the point of vitr if action, not fusion, and with- draw from the muffle. The result will be a red cake of enamel, which will easily leave the crucible, which, after removing any adhering kaolin, is to be broken down and ground tolerably fine. It may now be tested, and then (if of too strong a color) tempered by the addition of covering. This is the gum which flows at the lowest heat, and is never used when it is expected to solder. " No. 2. Flux 1 oz., fused spar 2 oz., English rose 60 grains. Treat the same as No. 1. This is a gum intermediate, and is used upon platina plates. " No. 3. Flux 1 oz., fused spar 3 oz., English rose 80 grains. Treat as the above. This gum is used in making pieces in- tended to be soldered on, either in full arches or in the sections known as hloch-ioork. It is not necessary to grind very fine in preparing the above formulas for application. "■ Covering. — What is termed covering is the same as the formulas for gum, minus the English rose, and is made without any coloring whatever when it is used for tempering the above gums which are too highly colored, and which may be done by adding, according to circumstances, from 1 part of covering to 2 of gum, to 3 of covering to 1 of gum, thus procuring the desired shade. When it is to be used for covering the base prior to applying the gum it may be colored with titanium, using from two to five grains to the ounce. " Investient — Take two measures of white quartz sand, mix with one measure of plaster of Paris, mixing with just enough water to make the mass plastic, and apply quickly. The slab on which the piece is set should be saturated with water, to DENTURES WITH CONTINUOUS GUMS. 321 keep the material from setting too soon, and that it may unite with it. " Cement. — Wax 1 oz., rosin 2 oz. The proportions of this will vary according to the weather ; it should be strong enough to hold the teeth firmly, and yet brittle enough to chip away freely when cold. A little exjjerience will enable any one to prepare it properly." (Inasmuch as the method of constructing the platinum base, with Cleveland's modification of chamber as described by Dr. H., has already been introduced, this portion of the descrip- tion is omitted in this connection.) " After the plates are perfectly adapted to the mouth, place wax upon each, which trim to the proper outline as regards length and contour of countenance, marking the proper occlusion of the jaws and the median line. These waxen outlines are CJalled the drafts, and are carefully removed from the mouth, and an articulator taken bv which to arrange the teeth. " When the absorption is considerable and the plate in con- sequence is rather flat, it is necessary to solder a band or rim along the line where the upper draft meets the plate, about one-sixteenth or one-eighth of an inch wide, and fitting up against the outline of the draft. When the ridge is still prom- inent, the block will not of course be brought out against the lip so much, and a wire may be soldered on instead of the wider band. I think one or the other necessary, as it gives a thick edge to the block, rendering it far less liable to crack off than if it were reduced to a sharp angle; it also allows the edge of the plate to be bent in against the gum, or away from it, as circumstances may require, and affords in many cases a far iK'ttr-r support for the plates than can be given to one in which the band is druck up, or the edge turned over witli pliers, where the block must extend to the edge of the plate. Some few cases do occur when the band may be struck as far back as tlic bicuspids with advantage, and some in the lower jaw where it is nece-ssary to solder on the band, but the general practi(;c is not so. "The upper teeth are first arranged on the plate uiitago- 21 322 MECHANICAL DENTISTRY. nizing with the lower draft, supported by wax or cement, or both. Then remove the lower draft and arrange the lower teeth so that the coaptation of the cutting edges of the teeth shall be perfect as desired. The patient may now be called in again, and any change in the arrangement made to gratify his or her taste or whim. Now place the plates with the teeth thereon, on their respective casts, oil the cast below the plate and apply plaster of Paris over the edge and face of the teeth and down on the cast, say an inch below the edge of the plate. This will hold them- firmly in their place while you remove the wax and cement from the inside, and fit and rivet backs to the teeth. When backed, cut the plaster through in two or more places, and remove. Clean the plate by heating. Cut the plaster so that while it will enable you to give each tooth its proper position, you can readily remove it from the teeth when they are cemented to the plate. Adjust the sections of plaster and the teeth in their proper positions. The plaster may be held by a piece of soft wire. Cement the teeth to the plate and strengthen the cement by laying slips of wood half an inch long along the joint and against the teeth. (I gene- rally use the matches which are so plenty about the laboratory.) Remove the sections of plaster, being careful not to displace any of the teeth. If it be intended to cover the strap with enamel, you should solder a wire after backing, and previous to replacing the teeth, along the plate parallel with the bottom of the straps, and about ^ or J of an inch from them. " The teeth are now backed and cemented to the plate, and present an open space between the plate and the teeth, which is to be filled up with the base, using it quite wet to fill up the small interstices, filling in the rest as hard and dry as possible. Fill the cavity between the plates in the same manner, and oil the edge. Oil the surface of the base, envelop in the investient (precisely as you Avould put an ordinary job into plaster and sand for soldering), and set on a fire-clay slab pr-eviously satu- rated with water. When hard chip away the cement, cooling it if necessary with ice, until it is perfectly clean. Along the joints place scraps and filings of platina very freely, and cover DENTURES WITH CONTINUOUS GUMS. 323 all the surface you wish to enamel with coarse filings, holding them to their place by borax ground fine with water. Apply pure gold as a solder quite freely, say two dwt. or more to a single set. Put in a muffle and bring up a gradual heat until the gold Rows freely, which heat is all that will be needed for the base ; withdraw and cool in a muffle. Remove the invest- ient and fill up all crevices and interstices not already filled, with covering No. 2 ; cover the straps and base with the same, about as thick as a dime, and cover this with gum No. 2 about half that thickness. At the same time enamel the base in the chamber, and cover with thick soft paper. Set the plate down on the investient on a slab, with the edges of the teeth up. Fuse in a muffle, and the work is completed. Blemishes may occur in the gum from a want of skill in the manipulation; should such occur, remedy by applying gum No. 1. " Should the patient object to the use of platina as a base, the work can be made as above on an alloy of gold and platina 20 carats fine, and soldered with pure gold, etc., as above. In all cases, however, where it is used, the upper plate should be made as I have described above, but with platina any kind of plate can be used. "Ordinary Alloy. — Blocks may be made and soldered to the ordinary plate if the absorption is sufficient to require much gum, without any platina. Arrange the teeth on wax on the plate, fill out the desired outline of gum, and apply plaster one- fourth of an inch thick over the face of the teeth, wax and cast. When hard, cut it into sections (cutting between the canines and bicuspids), remove the wax from the plate and teeth, bind the .sections of the plaster mould thus made to their places with a wire, oil its surface and that of the plate, fill in the space beneath the teeth with the base, wet at first, but towards the last as hard and dry as possible, and thoroughly compacted. Trim to the desired outline on the inside, oil the base, and fill the whole palatal spa(;e with investient, supporting the block on its lingual side. Remove the plaster mould, and cut through the block with a very thin blade between the canines and bicuspids. Take the whole job off of the plate, and set on a fire-clay slab 324 MECHANICAL DENTISTRY. with investient, the edges of the teeth clown ; bring up the heat in a muffle to the melting-point of pure gold. When cold, cover and gum with No. 3 gum and covering. " Another mode is to back the sections with a continuous strap (using only the lower pin), fill in the base from the front, use covering and gum No. 3, finish at one heat. When the blocks are placed upon the plate, the other pin is used to fasten the gold back, which is soldered to it and the platina half-back ; neither of these backs need be very heavy, as soldering the two together gives great strength and stiffness. Very delicate block- work can be made in this way, and it is applicable also, where a few teeth only are needed. " A very pretty method, where a section of two or four teeth (incisors) is needed, and only a thin flange of gum, is to fit gum teeth into the space, unite by the lower platina with the con- tinuous back, and unite the joint with gum No. 3. A tooth left ungummed by the manufacturer would be best for the pur- pose. The same may be applied to blocks for a full arch, remembering not to depend entirely upon platina backs. " The method I prefer for full arches on ordinary plate, is to take a ribbon of platina, a little Avider than the intended base, and of the length of the arch, cut it nearly through in five places, viz., between the front incisors, between the lateral incisors and canines, and between the bicuspids. Adapt it to the form of the alveolar ridge with a hammer and pliers, and swage on the plate along where the teeth are to be set. Solder up the joints with pure gold, and proceed to back the teeth, etc., as before ; making preparations for fastening, and remov- ing the slip of platina from the gold plate before enveloping in the investient, when proceed as before. " When the teeth are arranged, insert four platina tubes, about one line in diameter, two between the molars, and two between the cuspidati and bicuspids, and solder to the platina base. These are designed, after the teeth are finished, to be the means of fastening to the gold plate, either by riveting in the usual way, or by soldering pins to the gold plate passing up through the tubes, fastening with sulphur or wooden dowels. DENTURES AYITH CONTINUOUS GUMS. 325 Bv these methods we are enabled to readily remove the block and repair it, should it meet with any accident, and also, in case absorption should go on, to restrike the plate, or to lengthen the teeth. The rim should be put on the gold plate after the block is finished ; it gives great additional strength and a beautiful finish. " Memoranda. — In preparing material always grind dry, and the most scrupulous cleanliness should attend all of the manipulations. In all cases where heat is applied to an article in this system, it should be raised gradually from the bottom of the muffle and never run into a heat. Where it is desired to lengthen any of the teeth, either incisors or masticators, or to mend a broken tooth, it may be done with covering, properly colored with platina, cobalt, or titanium. " In preparing a piece of work, wash it with great care, using a stiff brush and pulverized pumice-stone. Bake over a slow fire to expel all moisture, and wash again, when it will be ready for any new application of the enamel. Absorption, occurring after a case has been some time worn, by allowing the jaws to close nearer, causes the lower jaw to come forward and drive the upper set out of the mouth. By putting the covering on the grinding surface of the back teeth in sufficient quantities to make up the desix'ed length, the coaptation of the denture will be restored, and with it the original usefulness. " Any alloy containing copper or silver should not be used for solder or j)late, if it is intended to fuse a gum over the lingual side of the teeth, as it will surely stain the gum. Simple platina backs alone do not possess the requisite stiff- ness, and should always be covered on platina with the enamel, and on gold with another gold back. In backing the teeth, lap the backs or neatly join them up as far as the lower pin in the tooth, and higher if admissible, and in soldering, be sure to have the joint so made perfectly .soldered." Dr. IlaakelVs Methods. "It should be borne in mind that the strength of this work depends mainly upon the vietaf, and not upon the porcelain, 326 MECHANICAL DENTISTEY. though the latter adds to its strength. While platinum is a very soft metal, yet, by means of various devices, the plate, with the teeth properly soldered on, and ready for the porce- lain, can be made very stiff and strong, therefore everything that can be done to secure a strong foundation should be care- fully 'observed. " The plate should be of the best French material (not re- melted scraps and old plates), 29 to 30 gauge for the upper, and 26 to 28 for the lower, and should be swaged on Babbitt metal dies. The plate is then tried in the mouth, and if the fit is found to be correct, arrange the articulating wax, secure the ' bite,' and make the articulating model. " The back of the plate should be doubled, for the following reasons : It imparts increased strength ; leaves some margin for change, in case of necessity, after the work is in the mouth ; protects the edge of the porcelain ; and admits of a neater finish. This ' doubler ' should be about three-sixteenths of an inch wide, with the edge turned up slightly to receive the porcelain. Around the outer edge, solder a flattened wire, one-sixteenth, or less, of an inch wide, and 22 gauge, bringing the ends to meet the turned edge of the doubler. This strengthens the plate, and affords a good round finish to the edge, as well as protection to the porcelain. This is easily put on after a little practice, and is far preferable to turning the edge of the plate with pliers, or otherwise. Pure gold should always be used for soldering, and with just enough borax (using wevy little) to give direction to the flow of solder. " Then comes the arrangement of the teeth, and this should always be done in the mouth, the articulating model being only a preliminary guide ; for by the mouth alone can one de- termine the correct expression and arrangement desired ; and it is just here that three-fourths or more of the artificial den- tures fail in an utter lack of artistic skill. In this work there is ample opportunity for the display of taste and skill, so that perfection itself is attained at the hands of the true artist. " The investing process comes next. First, a coat of shellac over the teeth to prevent etching (although if this occurs, it is DENTURES AVITH CONTINUOUS GUMS. 327 not a matter of much account, as the baking remedies it). Then a thin coat of clear plaster; next plaster and asbestos, one part of the latter to two of the former. Let the portion under the plate extend at least one inch back of the latter, as this bottom portion is to be retained to bake the case on ; in- vest the whole one-half inch thick. Warm the case until the plate is sufficiently heated to remove the wax easily; dash boiling water over it (this is the best method to remove wax adhering to teeth and plate in all kinds of work). The back- ings should be continuous, and be lapped on to the plate, for in this is the main stay of the work for strength. Cut patterns in tin or lead, three pieces, one for the six front teeth, and one for each side, lapping over the eye-teeth ; the foot-piece should lap on to the plate about three-sixteenths of an inch. No borax is needed. The gold should be melted and rolled into a ribbon as thin as possible, and cut in small pieces and laid under the lap, or foot-piece, and a piece under each pin. The backings can be fitted more easily by slitting the foot-piece. The most convenient method of soldering is in the furnace, being careful not to let it remain too long, so as to fuse the enamel on the teeth. If a pin should fail to solder, it is not material, as the ' body ' will hold it. " After cooling, remove the plaster, and save the base. If any teeth are etched, sandpaper them and remove every par- ticle of plaster ; with a sharp instrument scarify the surface of the plate. Place the plate on the articulating model, and if it is sprung, press it into place, which is very readily done. "The ' body,' and enamel or gum color, as prepared by S. L. Close, is the only reliable material to be had, as Dr. Allen no longer furnishes it for the trade. Apply the ' body ' mixed with water, quite thin, by means of an oval-pointed knife, oc- casionally jarring with handle of spatula, and as the moisture comes to the surface, absorb with a cloth ; after it is well filled into all interstices, apj)ly it thicker, jarring, absorbing, and j)acking hard, until enough is on the outside to produce the proper shape and contour of the lips. Then ap})ly, with the curved point of knife, the body to the lingual side of the plate, 328 MECHANICAL DENTISTRY. same as on the outside, but only a thin coat on the plate. Trim around the necks of the teeth, remove all particles from between with a quill toothpick, and brush all particles off the surface of the teeth and exposed portions of plate, and the case is ready for baking. " The Philadelphia furnace, sold by all dealers in dental goods, we prefer. It is always best to use the largest size, No. 1, yet No. 2 will do if the larger size cannot be had. Be sure of a good draught. The furnace can be used as it comes ; a better plan is to knock the bottom out of the lower section, get longer bars, that will extend some distance through the front, the two centre ones at least 18 inches. Build a hearth, two bricks thick and three feet square ; build an inclosure of brick, about 12 inches high, large enough to set the furnace on, and line with fire-brick. Provide a sheet-iron cover for the front to close the draught. " In setting the ' muffle,' see that the vent-hole in the top is clear ; this is for escape of gas that may be in the muffle, and would injure the work. Fasten the front end with fire- clay, but leave the back end free. " The fuel to be used must be anthracite coal, or else coke ; Lehigh, range size, is the best. " A sheet-iron shelf, the edge bent into the space between the furnace and cover, and with a leg riveted to it and resting on the long bars, is needed to set the case on, to heat up and run into the muffle gradually. Set the case ten or twelve inches from the opening, move forward, every ten or fifteen minutes, a couple of inches, until it is in the muffle ; ])lace it within two inches of the back, and close the door. If the heat is right, five or ten minutes will suffice ; still it must be looked at so as not to get too much heat. This first bake should be only a glaze. Remove to a muffle on the hearth, and close up tight. When cool, place on the model, and, if sprung, press it into place. Next fill up all the cracks with very thin body, jarring with handle of the spatula often, so that the material will fill up thoroughly ; then spread on thicker until the proper shape and fulness are secured, trimming around the teeth, and DENTURES WITH CONTINUOUS GUMS. 329 doing as previously described, and bake as before, only more so ; it should be ghssy. After cooling, the enamel is to be put on the same as the body, applying only a thin and uniform coat. The rugae can be produced in the body or in the gum. The enamel should have a thoroughly glossy appearance when ready to remove from the furnace. Heated cooling muffles are unnecessary, as the case itself will heat the muffle all that is necessary. " Lower sets are better without a binding, as it is sometimes necessary to file or grind away the edge. Use plate No. 8, or even thicker, and solder on the edge a narrow strip, ^«^ " The case is finished by filing and polishing the exposed metal surface, not doing anything to the upper surface. "A 'defined' air-chamber is rarely necessary, — a Cleveland chamber, never. Raise the plate over the hard palate with a thin film of wax on the plaster cast, chamfering off the edges completely ; scrape the plaster model across the back, except right in the centre, according to the softness of the palate. "This work is not advisable for partial sets, except in some partial lower cases where there are no detached teeth. In these cases, the plate should be at least two thicknesses across the back of the front teeth, and resting well up on the necks of the same. " Very few seem to know how to prepare a case for repair- ing. Invest it in plaster and asbestos at least one-half of an inch deep entirely ; place in the muffle before lighting the fire, and allow it to remain witii the door open, as the fire comes up, until it is red hot ; then remove, cool, and clean off the plaster thoroughly, preserving the base, and it can be run into the furnace with as little danger of cracking as' if it had never been worn. "Grind out the remains of the teeth below the margins of the gum ; select a rubber tooth, as it is easier to get and just as good as one made for tliis work, filing off the pins; hold with wax until a little })la.ster and asbestos can be placed over it and the adjoining teeth ; remove the wax thoroughly and put 330 MECHANICAL DENTISTRY. on repairing body, and bake ; cool, put on the gum, having previously ground off a portion of the old gum if it is a very old ease, and put on just a little new, and bake as at first. " If blisters occur, grind into them and fi:ll with body and gum, three to one, press hard, and enamel." Dr. Field's Methods. " When the platinum has once touched the metal dies, never place it under the blowpipe without its having been thoroughly pickled. This is often neglected, and the consequence is that the plate will become more or less discolored from the absorp- tion, under heat, of the baser metal into the platinum. When the teeth are properly arranged with wax on the plate, as di- rected by Dr. Allen, invest, but use no sand, simply plaster and asbestos. My reason for this I will give further on. "After the investment has become sufficiently hard to han- dle, the backings may be adjusted, and here I shall differ some- what with Dr. Allen, for, instead of the continuous backing, I back each tooth separately, and for two reasons, one of which is, that I think my job will be stronger when completed, by allowing the body to be well worked in between, below, and completely around the teeth without a platinum wall, as it were, separating the body on a line running completely around the alveolar ridge, and only just touching over the top of this platinum. "My second reason is that, should the teeth be drawn out of place any, as they are sometimes by the investings cracking and pulling away from the plate, the single backing of each tooth admits of a much easier and more perfect re- adjustment than when the backing is continuous. Make the backings of a somewhat V shape, that is, let them be a little narrower at the top than where they come in contact with the plate ; bend up the lower part of the backing to the extent of about one-sixteenth of an inch, and at such an angle that when placed in position behind the platinum pin, to which it is to be soldered, it shall fit fairly and squarely on the plate ; put in position and press down your pin on it, first having placed DENTURES WITH CONTINUOUS GUMS. 331 a piece of, say number 20, gold foil, folded two or three times on itself, one-sixteenth of an inch square, against the backing, so that when the pin is bent down upon it, it shall hold it from slipping away; then with a pair of ordinary plugging pliers squeeze the foil up to and around the pin; then place one or two pieces of solder (pure gold) just behind, and close against, the heel of the foot-shaped backing. By placing it here, the danger of it slipping away when the borax calcines under heat is a%'oided. The less solder you use, and still have your teeth fastened, the better, for the reason that the gold flowing at a less heat than that required for the fusing of the body, the gold is in a state of fusion ichen the body has set, and there will be no adhesion between the gold and the body. Now solder as most convenient. I find the Fletcher furnace an ad- mirable contrivance for this purpose, ten minutes being all the time necessary to complete the work. Remove the investing carefully, and presei've it all for future use. The plate is then tried in the mouth, and the teeth nicely adjusted to those with which they are to antagonize. '' Everything is now ready for the first baking. Pour out upon a clean butter plate the amount of body required, into which pour sufficient pure water to make a thin paste, and then begin the work of moulding and carving your job by filling in between and under all the teeth, tapping your plate gently from time to time ; this will bring the water to the surface and settle the body into every nook and crevice. After each tap- ping, absorb the surface water with a clean napkin ; by so doing, you will the better hold the body to its place, and pre- vent its running where not wanted. Build over the roots of the incisors and cuspids boldly, leaving a corresponding de- pression between the teeth; thus, when the piece is completed, you will have that natural and lifelike appearance as of the roots of the teeth showing slightly through the gum. " Xow take that part of your investing material that cov- ered the teeth when the piece was soldered, and grind up fine, and with it make a cushion on the slab that is to hold the case in the furnace. This cushion should be about one-fourth of 332 MECHANICAL DENTISTRY. an inch thick ; then place your piece on this base, teeth down- wards, and take a small spatula and work the powdered ma- terial well up against the teeth, so that the bearing shall be equal under every tooth ; this, if properly done, will prevent any dravnng aioay of the teeth from their proper position, as is frequently the case when the plate is placed in the muiSe with the teeth upwards, the cause being the shrinkage of the body ; and now comes my reason for not using sand in this in- vesting material, viz., the sand acting as a flux would attach itself more or less to the teeth themselves, and I have seen this thing carried so far, when the heat was a little too high, as to solidly fuse teeth and slab together. " The piece is now ready for the first baking, and this should be carried no farther than to shrink the body as much as pos- sible, not going beyond a semi-fuse. After this is completed, and the case cooled, proceed to fill up all cracks and shrinkage by the application of more body, when the case is ready for the second baking. This should be done with the plate re- versed, teeth upwards, using for a support that part of the investing which came in contact with the platinum, and which should be preserved unbroken. In this second baking of the body, care should be taken that it be not overdone. A piece properly baked will present a beautifully granulated appear- ance, the tips of the granules sparkling like little dewdrops. Carrying the heat beyond the stage necessary to produce this effect, vitrifies the body, thereby very much lessening the strength of the work when completed. " If now it is found that a third body is not required (and it rarely is if proper care has 1 een taken with the work so far, although occasionally it may be necessary) proceed with the enamelling as directed by Dr. Allen. Should there be any little rough spots on the teeth, caused by overheating when soldering, paint them over with a little clean pulverized borax mixed with water ; this will flow the tooth enamel, and cause them to come out from the mufile as bright and smooth as when they first left the factory. "The work is now ready for its third and final baking, DENTURES WITH CONTINUOUS GUMS. 333 which should be with a quick, sharp fire. When fused, draw to the front part of the muffle; put in the muffle pUig, and then dump the fire, and leave until tlie furnace is cold ; by so doing, the case is well annealed, and all danger of checking the enamel avoided. Twenty or thirty minutes now are all that are necessary for what little finishing the plate will require, when it will be ready for the mouth. " Let it be remembered by the beginner tliat on the carving of the first body largely depends the artistic beauty of the work. Keep your patient's face well before you in your mind's-eye, and reproduce in the porcelain all those little minor details which, when properly arranged and blended together, shall so counterfeit nature's handiwork that that of man's can hardly be detected." Application of Continuous Gum to Partial Sets. — The fol- lowing method of constructing partial sets of artificial teeth with continuous gum is taken from a practical and well-written paper on this process by Dr. W. B. Roberts : " Partial cases may be made of continuous gum ; but the work is so various in its nature, that the dentist must neces- sarily depend much upon his own judgment. Difficult cases will constantly present themselves, that will require the exer- cise of much study and ingenuity ; in which the general instruc- tion that can be given in words, may be of but little service. The first attempt of this kind in my own experience, was in replacing two central incisors. Taking two continuous gum teeth, I placed upon them a platinum lining, slitting this down along the edge of one tooth nearly through the piece and up the edge of the other tooth by a parallel cut, leaving the two parts joined together by a narrow slip. This allowed sufficient motion between the teeth, so that they could be adjusted as desired. I then placed a bit of tissue-paper on the plaster mcxlel, covering the spot to be occupied by the teeth and gum, to i)revent the adhesion of the body to the plaster, and holding the two incisors in their j)laces, I worked the body into all the depressions of the gtim and around the roots of the teeth. I then removed the whole from the model, and pUu-ctl the 334 MECHANICAL DENTISTEY. piece in a paste of pulverized silex, or plaster and asbestos, upon a slide, and baked as described for full sets. The little slip of platinum kept the two teeth in place. The work shrunk somewhat ; but this was remedied by again placing the piece upon the model with the intervention of tissue-paper covered with a thin coating of body. Into this I pressed the piece, till it occupied its true place, and then filled in again with more body all the crevices around the roots of the teeth, and rebaked. " After enamelling, if the work has been carefully and skil- fully done upon this plan, it will be as fine a piece in appear- ance and fit, as can be made. It may then be soldered to a gold plate, and the little strip of platinum between the teeth be cut out. With the body and gum formerly in use many difficulties were often encountered from discoloration of the gum, or from other injuries incurred in soldering. But with Roberts's material, these are easily avoided, and the piece can be treated the same as a block or single gum teeth. In par- tial sets on entire plates of platinum, I have sometimes found trouble, from the enamel giving way upon the small narrow points that connect the teeth with the plate, by the shock occa- sioned in biting. I have consequently left these points un- covered, and used two or three thicknesses of platinum to give greater strength. But where this is likely to occur, gold plates would be preferable, if nicely adapted with single gum teeth, or blocks of continuous gum, as the case might require. I have also applied continuous gum in cases where the natural teeth, from one to five in number, were left in the mouth, by making the plates as in full sets, cutting out around the natural ones, and raising a small bead, or placing a light wire around, about one-eighth of an inch or more from the teeth, against which the gum or body is to be finished. The points around the teeth are to be left free, in order to be burnished down in case of imperfections caused by the difficulty of obtaining exact impressions in these places. In such cases I have sometimes formed a strong standard of several thicknesses of platinum fitting closely against one or more natural teeth, leaving a DENTURES WITH CONTINUOUS GUMS. 335 loophole through which to run a gold clasp for afterward securing the artificial set. "I have also secured the gold to the standard by rivets of platinum, and sometimes by two or three gold screws, not pro- viding, in these cases, the loophole. These methods are to be preferred to using solder for fastening ; for, in case of repair, the clasps are easily removed without leaving any foreign subr stance ; but in case of soldering, however carefully they may be removed, there will remain some alloy, which in the baking heat to which the piece is to be exposed, will be incorporated with the platinum. Even so small an amount of silver as may be in gold coin used for solder will communicate a yellowish tinge to the gum, spoiling the whole work. Many operators in their early practice, I doubt not, experienced this result ; and learned that no alloys, especially of silver or copper, can be admissible for soldering this work. I have tried platinum clasps without success, as no elasticity could be obtained, and therefore would not hold upon the teeth. Another source of mischief may properly be noticed in this place. In baking, especially with a new furnace, or with muffles lately renewed, either at the first or second heat, or it may be in enamelling, the piece is sometimes changed in its texture and color, as is supposed by tlie gases present, and the phenomenon is called gassing the piece. The body becomes porous like honeycomb, and of a bluish color. When this occurs there is no remedy but to place it on the metallic die, remove the whole of the injured part, and replace it with a new coating of body and gum. The teeth are seldom, if ever, thus affected. As a precaution, the muffles should be well ventilated with holes for the passage of tlie heated air and gases," 336 MECHANICAL DENTISTRY. CHAPTER XIV. Vulcanite Base. While there are undoubtedly many important uses to which vulcanized india-rubber may be applied in the practical depart- ments of dentistry, and for which it would be difficult to find an adequate substitute, yet there are accumulating evidences leading to the conclusion that its total abandonment, as a base for artificial dentures, by intelligent and conscientious prac- titioners everywhere is an event of the near future. This anticipated result, in respect to a material which has been almost universally employed as a base for the past twenty years, is assured by the confirmed and steadily increasing dis- trust of its suitableness for the purpose indicated, and the grow- ing tendency in the profession to return to higher and less objectionable forms of substitution as respects both material and construction. While what has heretofore been stated in regard to rubber as a base in former editions of this work reflected, as the author then believed, the estimate of its fitness by the profession gen- erally, so, it is believed, does what is now written embody the present judgment of the mass of enlightened practitioners in reference to its unsuitableness and the necessity of its abandon- ment as a base. That the latter is a consummation " devoutly to be wished," and that it would be in the interests not only of the profession but of all concerned, is scarcel}^any longer a disputed question, and should the present work ever reach another edition, the author hopes to find in a still more advanced professional and public sentiment authority for classifying it, as a base, among the obsolete methods of substitution. General Properties of India-rubber. — Caoutchouc, gum-elastic or india-rubber, exists as a milky juice in several plants, but VULCANITE BASE, 337 is extracted chiefly from the Siphonia cahuca, which grows in South America and Java. It is discharged through numerous incisions made in the tree through the bark, and is spread upon clay moulds, and dried in the sun, or with the smoke of a fire, which blackens it. The juice when first obtained is of a pale yellow color, of about the consistence of cream, and has a specific gravity of about 1.012. In the process of drying, 55 per cent, is lost, the residuary 45 being elastic gum. It immediately coagulates, by reason of its albumen, on the application of heat, the elastic gum rising to the surface. The specific gravity of the juice is diminished by inspissation, becoming 0.925 when hard, and cannot be permanently increased by any degree of pressure. When once stiffened by cold, or continued quies- cence, it cannot be restored to its original condition of juiciness. The inspissated juice, or crude rubber of commerce, is alto- gether insoluble in water or alcohol, but is readily soluble in ether deprived of its alcohol by washing, affording a colorless solution. On evaporation of the ether, the gum resumes its original condition. It swells to thirty times its bulk when treated with hot naphtha, and if triturated in this condition in a mortar, and pressed through a sieve, furnishes a homogeneous varnish employed in the preparation of a waterproof cloth. Caoutchouc is solul)le in the fixed oils, but is not readily decomposed by cold sulphuric acid or diluted nitric acid, and is unaffected by either muriatic acid gas, sulphurous acid gas, fluo- silicic acid, ammonia or chlorine, nor is it dissolved by the strongest caustic potash lye, even at a boiling heat, and is there- fore highly esteemed as an appliance of the chemical laboratory. According to the experiments of Ure, Faraday, and others, caout- chouc contains no oxygen, as almost all other solid vegetable products do, but is a mere compound of carbon and hydrogen, in the proportion of three atoms of the former to two of the latter. From its proi)crty of resisting the corrosive action of ar-id vapjrs, and its tenacity of adhesion to glass, caoutchouc, whea melteetter to dispense with the plaster model in forming the mould or matrix, and proceed as follows : When the teeth are 406 MECHANICAL, DENTISTRY. arranged, and the required contour and fulness given to the wax drafts, fill the lower section of the flask with plaster, and (having also filled the plate with the same), imbed the plate in it, making the dividing line on the external rim of wax. When the plaster has hardened, and the other section formed, and the two afterwards separated, the metallic plate will remain in the lower section, and the teeth in the upper. When using celluloid, plain teeth may be advantageously- employed, the former representing the gum ; this gives perfect freedom in the arrangement of each separate tooth in the den- ture, an optional disposition the importance of which cannot be over-estimated. GOLD ALLOY CAST BASE. 407 CHAPTER XYII. Gold Alloy Cast Base. The compound of gold, silver, and tin, in varied propor- tions, in connection with specific and original methods of cast- ing dental plates, recently devised and patented by Dr. George F. Reese, of Brooklyn, N. Y., is attracting attention as a pos- sible substitute for the plastic materials so commonly employed as a base for artificial dentures. The properties and capabilities attributed to this alloy, and which are deemed essential in a base, having been practically tested by many representative and responsible practititioners who have unreservedly indorsed its claims upon the confi- dence of the profession, the author feels warranted in substi- tuting Dr. Reese's materials and processes for the older alloys, appliances, and modes of manipulation described in former editions under the head of " Cheoplastic Method of Mounting Artificial Teeth," and which, for many years past, have been wholly abandoned except in the case of lower dentures where extreme and exceptional absorption of the alveolar processes make greatly increased weight necessary to provide against mobility and displacement of the substitute. After premising that the methods in common use for cast- ing alloys were not applicable to one having the molecular properties of Reese's compound, the inventor says he was led, after multiplied experiments, to adopt the plan of which the following is a description : Th(; impression is taken with plaster, to which salt or sul- phate of potassa has been added, and the model obtained from this with pure j)laster. Upon this the teeth are arranged. For the trial plate, gutta-percha, paraffin, and wax, or modelling compound, may be used. When satisfaction in the occlusion 408 MECHA]SriCAL DENTISTEY. is attained, then the case is returned to the model, and the waxing around the labial and buccal borders of the teeth com- pleted. That portion of the trial plate which covers the pal- atine surface is now removed, so that the pins of the teeth will be nearly exposed ; allowing the wax which is under the gums to remain. That the plate, after casting, shall not be too cumbrous, the trial plate, which has been removed, must be sub- stituted with two thicknesses of French flower wax, cut care- fully to the model, and pressed down closely with the finger in a manner that no wrinkles will appear to mar the beauty of the work. Fig, 161 represents a case thus prepared. The dotted lines show the borders of the thin wax. B, A, and C, represent nip- ples of solid wax, fixed to the posterior border and to the tuberosities ; A and C being the places of exit for the molten metal into the waste pockets, and B the place of entrance of the metal from the pouring-gaine. The case is now transferred to the small brass flask, r. Fig. 162, the sections of which having been well oiled, upon the inner surface, to facilitate their removal from the invest- ment. Either section is then placed upon a plate of glass and GOLD ALLOY CAST BASE. 409 plaster poured into it until half filled. The model, as pre- pared, after being well saturated with water, is imbedded in this single section, allowing the teeth and gums to remain un- covered. Set on the counter-part of the flask and add more plaster along the posterior border until the nipples are reached or slightly covered. After this has set, the upper section may be removed and the surface of the plaster covered with a thin solution of shellac^ Elliott's parting fluid or vaselin. Return Fig. 162. Case ready for the completion of Investment. the section and complete the investment. Fig. 162 shows the case thus made ready. After a proper time place the flask in hot water that it may be separated without injury. When separated, wash away all the wax, and, by means of gentle tapping, remove the flask rings from the investment and set them aside. The depressions formed i>y the nipples may now be extended tiirough the plas- ter to the external edge ; or, if the circumstances of the case 410 MECHANICAL DENTISTRY. make this impossible, the channels may be made at the line of division between the two sections, as shown by the dotted lines m figures 163 and 164. Externally, the channels, D, E, F, Fig. 164, should be neatly countersunk and varnished with Fig. 163. shellac to receive the pockets. The latter are made of the French wax by warming and wrapping the same around a cone-shaped stick, and the base and apex of the cone neatly trimmed of all inequalities. These pockets should be about one and a half inches long, and about half an inch diameter at GOLD ALLOY CAST BASE. 411 the base, and an eighth of an inch at the apex. The pouring- gaine is made in the same manner, but should be smaller in diameter at the base, and about two inches long. After re- moving these wax covers from the moulding-sticks, the larger ends of each should receive a thin wax cover secured to its place, and made water-tight, by flowing hot wax along the line of junction, after the manner of soldering. Trim the covers, then place the smallest ends of the large cones in the counter-sunk channels at the tuberosities and the small cone in the middle hole, and secure them with melted wax. Fig. 163, d', e',/', shows the pockets thus attached. Upper or counter section corresponding to Fig. 163. D, E, F, channels for entrance and exit of metal. Should the channels have been made through the solid plaster of the lower section, as in Fig. 163, then the upper section, P'ig. 164, need not be joined to it until after the pockets are secured to their places. Should, however, tiie channels have been made uj)on the line of division, then the sections must l>e joined before the pockets can be attached. The case is now ready for a second investment, which is 412 MECHANICAL DENTISTRY. done in a flask sufficiently large to embrace the case as it now presents. Fig. 165 represents the construction of the large flask. One section of the same is placed upon glass and about half filled with plaster. The case, having been well soaked with cold water, is laid carefully upon the plaster, allowing the long cone to rest in the notch at the heel of the flask, and the waste pockets to become imbedded in the plaster. Immediately put the other section of the flask in place and complete the invest- FiG. 165. ment by filling with plaster the uppermost section to fulness. Of course there will be no division of the sections as was the case in the former flashing. After solidification, the pouring- gaine must be neatly trimmed and countersunk, and great care must be exercised that no dirt be allowed to enter the channel. The wax, which is imbedded in the plaster, and which forms the waste pockets, will be entirely absorbed, and no trace of it will be seen upon opening the flask. GOLD ALLOY CAST BASE. 413 All is now ready for drying. This is done in an oven specially prepared for the purpose, but it may be accomplished in any way to be chosen by the manipulator. 'An ice-cold mouth-mirror placed over the opening of the pouring-gaine will detect the slightest moisture which may remain, and until this is entirely dispelled, the casting should not be attempted. There are several grades of the gold alloy, as compounded by Dr. Reese, which require a heat registering from 600° to Fig. 166. - S 700° Fah. to melt, but a higher temperature than this must be attaine<^l before pouring, in order to secure a satisfactory flow. At 900° rapid oxidation takes place. This, of course, should be avoided. The alhjy may be melted in an ordinary iron ladle or crucible over a gas or other flame, and should be poured while the mould is hot. After the lapse of an hour or two, or until tiic cast is suffi- ciently cooled to insure the integrity of the teeth, it may be 414 MECHANICAl. DENTISTRY. placed in warm water, when the investment can be easily removed. Fig. 166 represents the cast after removal. The surplus metal may be separated, along the dotted line S, with a ribbon saw, after which the denture is ready for the pumice-wheel and brush. Fig. 167 represents the finished case. Fig. 167, Repairing. — The process of repairing broken plates is, in principle, the same as above. A flask, specially constructed by the inventor, is used for this purpose, whereby a single in- vestment suffices. Suppose, for example, a plate is broken, from the labial to the posterior border, along the median line; the broken edges are scraped clean, and a separation made of about an eighth of an inch. The parts are then ad- justed upon the model, and the space between the approximate edges filled with wax. At each extremity of the fissure a pen- cil of wax, an eighth of an inch in diameter, and one and a half inches long, is securely attached, perpendicularly, to the palatine surface, and the whole surrounded with plaster to the depth of one inch. Thus will be constituted two sections, which are separated, and the wax washed out. The external ends of the channels, formed by the pencils, are then countersunk, and into each is inserted a wax cone, the one forming a pour- ing-gaine, and the other a waste-pocket. The latter should be entirely covered by the plaster. The whole is now invested in GOLD ALLOY CAST BASE. 415 the repair flask, and subsequently submitted to the process of drying. Dr. W. S, Elliott, of New York, has taken advantage of the method above described, to overcome the difficulties attend- ing the construction of continuous-gum work. To maintain a perfect adaptation of a swaged plate seems often impossible, in consequenc^e of the springing of the plate in the furnace. To avoid this difficulty, the following plan is suggested : The plaster model is first covered with two thick- nesses of French flower wax, carefully adjusted. From this a metallic die and counter-die are made, and a very thin (No. 32) platina plate is swaged to fit the waxed model. The labial border need not be returned as in ordinary cases. Upon this the teeth are arranged, and the case is transferred to the fur- nace for biscuiting and enamelling. After proper annealing, it is ref)laced upon the model and waxed up, on the labial and buccal borders, over the edge of the j)late ; then flashed, the wax removed, and the metal cast upon it in the manner hereto- fore described. Danger of checking the enamel is associated with the pro- cess ; but success has attended the effort, and it is hoped that present experiments will insure perfect and uniform results. 416 MECHANICAL DENTISTEY. CHAPTER Xyill. Defects of the Palatal Oegans, and their Treat- ment BY Artificial Means. • DR. KINGSLEY's artificial VELUM AND PALATE.* Palatine Defects. — Defects of the palatine organs may be divided into two classes, viz., accidental and congenital. The first includes all loss of substance in either hard or soft palate by disease or otherwise. Such defects are not uniform in locality or extent, being sometimes but a simple perforation of the palate, and at others involving the destruction of the entire soft palate, a considerable portion of the hard palate, the vomer and turbinated bones, and the loss of the teeth. The second class includes all malformations, from the simple division of the uvula, to an opening through the velum, pala- tine, and maxillary bones, and a division of the upper lip, thus uniting throughout their entire extent the nasal passages with the oral cavity. These malformations are quite similar in character, but not uniform in extent. They may be said to begin with the uvula, and in the uvula and velum always occupy the median line ; but as the defect progresses anteriorly, it may deflect to one side or the other of the vomer, and follow the nasal passage through the lips, leaving the vomer articulated with the pala- tine bone on one side ; while in other cases the deformity seems to follow the median line, and thus involves both nasal pas- sages, and terminates in a double fissure of the lip. * The descriptions, with accompanying illustrations, embraced in the above chapter were contributed, at the solicitation of the author, by Profes- sor Norman W. Kingsley, and may therefore be relied upon as an authori- tative exposition of the most approved manipulation and appliances involved in the practice of that difficult and important specialty of the Dental Art in which the writer excels. PE. kingsley's aetifictal velum and palate. 417 In both classes (accidental and congenital) the faculty of dis- tinct articulate speech is seriously impaired by defects of any extent. In ordinary cases of congenital deformity, deglutition is not materially interfered with. The patient having never known any other method of swallowing, is not conscious of any difficulty. Accidental lesions, however, coming generally in adult life, produce, in this respect, very great inconvenience. The remedy for these evils must be the closing of the abnor- mal passage by some means which will restore the functions to the deformed organs. In perforations of the hard palate, unless of extraordinary extent, the method is very simple. In the loss of the soft palate by disease the remedy is more diffi- cult, and in extensive congenital deformity still more compli- cated appliances will be required. As we have classified the defects, we shall also classify the appliances used for their remedy. The term obturator will be used for all appliances intended to stop a passage, as all openings in the hard or soft palate which have a complete boundary. Appliances made to supply the loss of the posterior soft palate, whether accidental or con- genital, will be called artificial vela or palates. Obturators. — Any unnatural opening from the oral cavity into the nasal cavity, which will permit the free passage of the breath, will impair articulation. Any appliance which will close such passage, and can be worn without inconvenience, will restore articulation.* Obturators were formerly made of me- tallic plate, gold or silver being most commonly employed, and many very ingenious pieces of mechanism were the result of such efforts, but latterly vulcanized rubber has almost entirely superseded the use of metals. Vulcanite has been found pref- erable to metals, being much lighter and much more easily formed and adapted, particularly when of peculiar shape. * The Htudent will hear in mind that no cognizance is here taken of open- ings similar to tliose descrlhed in cases of congenital fissure, where the sur- geon has united the soft palate, and left an opening through the hard palate, to be covered hy an obturator. In such cases, neither tlie surgeon's opera- tion nor the obturator will prove of any material advantage. 27 418 MECHAlSriCAL DENTISTRY. The steps to be taken in the formation of an obturator are not unlike those used in making a base for artificial teeth. It is essential that an accurate model be obtained of the opening, the adjacent palatal surface, and the teeth, if any remain in the jaw. For this purpose an impression in plaster is the only reliable means for such an end. Care must be used that a surplus of plaster is not forced through the opening, thus pre- venting the withdrawal of the impression by an accumulated and hardened mass larger than the opening through which it passed. To avoid this, beginners or timid operators had better take an impression in the usual manner with wax; if this is forced through, it can be easily removed, without injury to the patient. From this wax impression make a plaster model, and upon this plaster model form an impression-cup of sheet gutta-percha, with a stick, piece of wire, strip of metal, or any other convenient thing for a handle. This extemporized im- pression-cup must not impinge upon the borders of the open- ing, neither should it enter to any extent. With a uniform film of soft plaster of from one-sixteenth to one-eighth of an inch in thickness laid over this cup, a correct impression can be made without any surplus to give anxiety. Upon a correct plaster cast, taken from such an impression, make a model of the obturator out of gutta-percha, or any other plastic sub- stance, the subsequent steps being in principle the same as in making any other piece of vulcanite. It is desirable that it should enter the perforation and restore as far as possible the lost portion of the palate, but it must not protrude into or in any way obstruct the nasal passage. The entire freedom of the nasal passage is essential to the purity of articulation. That portion of the obturator which occupies the oral cavity should be made as delicate as possible, consistent with its strength and durability. A clumsy contrivance will interfere with articulation almost as much as it is improved by stopping the opening ; therefore if the obturator could be confined entirely to the opening, like a cork in a bottle, it would be all the more desirable, but as it DR. KIXGSLEY's artificial VELUM AND PALATE. 419 cannot, resort must be had to clasping to the contiguous teeth, if there are any, and if not, the obturator must spread out over the whole jaw, and receive its support in the same manner as would a set of artificial teeth. In fact this is just what it would become in such a case, viz., an upper set of teeth bridg- ing over and filling up an opening in the palate, thus combin- ing an obturator with a set of teeth. Fig. 168 represents an obturator without teeth and without clasps, for a perforation of the hard palate, being sustained in situ by impinging upon the natural teeth with which it comes in contact. Accuracy of adaptation and delicacy in form are Fig. 168. Fig. 169. all that is essential in such cases, and the restoration of the speech will follow immediately. Fig. 1G9 rei)resents a more complicated obturator, adapted to an opening in the soft palate. The necessity for a variation in the plan will be found in the anatomical fact of the constaut muscular action of the soft palate, which would not permit, without irritation, the presence of an immovable fixture. This is contrived, therefore, with a joint, that will permit the part attached to the teeth to remain stationary, while the obturat(jr proper is carried up or down as moved by the mus- cles. The joint A should occupy tiie position of the junction of the hard and soft palates. The joint and principal part of the applian(;e is made of gold, the obturator of vulcanite. The projection /> lies like a flange upon tlie superior surface of the palate, and sustains it; otherwise the mobility of the joint 420 MECHANICAL DENTISTRY. would allow it to drop out of the opening. This flange is better seen in the side view marked C It is readily placed in position by entering the obturator first, and carrying the clasps to the teeth subsequently. Figures 168 and 169 will illustrate the essential principles involved in all obturators. The ingenuity of the dentist will often be taxed in their application, as the cases requiring such appliances all vary in form and magnitude. Artificial Palates. — Before proceeding to a description of appliances, a brief reference to the anatomical relations and functions of the palate will be necessary. The palate exercises quite as important an office in the articulation of the voice as does the tongue or lips. Being a muscular and movable par- tition to separate the nasal and oral cavities, one edge is attached to the border of the hard jjalate, while the other vibrates be- tween the pharynx and the tongue. The voice, therefore, as it issues from the larynx is directed by the palate entirely into the mouth, or through the nose, or permitted to pass both ways. A very slight deviation in this organ from its natural form will make the voice give a different sound. So will also the presence of anything that clogs the natural passages, either oral or nasal. Place any obstruction in the nasal passages, paralyze the soft palate, or let it be deficient in size, and the power of dis- tinct articulation is wanting. The evidence of this statement is frequently found after the surgeon has successfully performed the operation of staphylor- raphy in cases of congenital fissure. In such instances (with rare exceptions) the newly formed palate is so deficient in length, and so tense, as to be deprived of its function. It cannot be raised so as to meet the pharynx and shut off the nasal passage, but hangs like an immovable septum to divide the column of sound. Fig. 170 represents a defective palate belonging to the first class ; the uvula and a portion of the soft palate contiguous being destroyed by disease. In such a case an obturator would DE. KINGSLEY's artificial VELUM AXD PALATE. 421 be useless ; the constant activity of the surrounding parts would not tolerate it. The material used' for a substitute must be soft, flexible, and elastic, and the elastic vulcanite is admirably adapted to this purpose. ^ By observing the cut (Fig. 170) it will be seen that a por- tion of the soft palate along the median line remains, and con- sequently there will be considerable muscular movement which must be provided for, and which may be taken advantage of. It is desirable to make this movement available in usine: an Fig. 170. artificial palate, as thereby more delicate sounds are produced than otherwise. This case presents some extraordinary difficulties, in the fact that all the teeth of the upper jaw have been extracted, and it was neces.sary, therefore, to adapt a plate which should not only sustain teeth for mastication but bear the additional re- 6ponsil)ility of supporting the artificial palate. In the choice of material best adapted for the base for the teeth in such in- stances, it is preferable to adopt that which will prove the most durable. Tliere are too many interests involved to risk the adoption of anything but the best. In the case under descrip- tion, the patient desired duplicates, and two sets of teeth were 422 MECHANICAL DENTISTEY. made, one on gold and the other on platina with continuous gum. The plates were made like other sets of teeth, with the ex- ception of a groove located on the median line at the posterior edge to receive the attachment for the palate (marked C, in Fig. 171). Fig. 171 will indicate the set of teeth with palate attached. The wings marked letters A and B are made of soft rubber; Fig. 171. the frame to support them is made of gold, with a joint to pro- vide for the perpendicular motion of the natural palate, as in the case of the obturator represented in Fig. 169. When the artificial palate is in use, the joint and frame immediately contiguous lie close to the roof of the mouth ; the rubber wing, letter A, bridges across the opening on the infe- rior surface or side next the tongue ; the wing, letter B, bridges across the opening on the superior or nasal surface, and is also prolonged backward until it nearly touches the muscles of the pharynx when they are in repose. Both these wings reach beyond the boundary of the opening and rest on the surface of the soft palate for a distance of from one-eighth to one-quarter of an inch, thus embracing the entire free edge of the soft palate. This last provision enables the natural palate to carry the artificial palate up or down, as articu- lation may require. When the organs of speech are in repose, there is an opening DR. KIXGSLEY's artificial VELUM AND PALATE. 423 behind the palate sufficient for respiration through the nares. When these organs are in action, a slight elevation of the palate, or a contraction of the pharynx, will entirely close the nasal passage and direct all the voice through the mouth. The palate thus becomes a valve to open or close the nares, and to be tol- erated must be made with thin and delicate edges which will yield upon pressure. An instrument thus made will restore, as for as is possible by mechanism, the functions of the natural organ. In the case under description the patient was a lady ; the defect had existed for seven years before remedy. Articulation Fig. 172. was very defective ; distinct and perfect articulation followed within one month. Fig. 172 represents the artificial i^alate separated into its constituent parts. The frame is bent at the joint, in the en- graving, to show a stop, marked D, which prevents the appli- ance from dropping out of position. Letter C shows the tongue, which enters the groove in tlie plate of teeth and connects them. Letters A and B are the rubber flaps, which are secured to the frame by the hooks as seen in the engraving. The process for making the rubber wings will be found de- scribed on page 429. Fig. 173 shows a more extensive i)alatine defect of the first cla.s.s. in this ca.se the entire soft palate is gone, together with a small portion of the hard palate at the median line. 424 MECHANICAL DENTISTEY. Although this defect is greater in extent, the means for its remedy are more simple. The muscles of the palate are en- tirely gone, and consequently no perpendicular movement need be provided for. The appliance in this case will resemble an elastic obturator more than the valve-like palate of the preceding one. The principle here adopted will be substantially that recomended by Mr. Sercombe, of London, some ten years since, and con- FiG. 173. sists of a plate with a set of teeth in the usual form, and attached to its posterior edge an apron of soft rubber, which shall bridge the opening on its inferior surface, extending nearly to the pharynx. Fig. 174 represents the set of teeth with the palate attached. In Mr. Sercdmbe's appliance this apron was made of the common sheet rubber in the market, prepared for other uses, and is objectionable for two reasons: 1st, a want of purity in the materials of which it is compounded, in many instances substances being used in its manufacture which would prove deleterious to the health of the patient ; and, 2d, its uniformity of thickness. It is far preferable, there- DR. KIXGSLEY's artificial VELUM AND PALATE. 425 fore to make a mould which will produce a palate of pure and harmless materials, and which shall be of sufficient thickness in the central part, and at its anterior edge, to give it stability, and shall have a thin and delicate boundary wherever it comes in contact with movable tissue. Such a palate may be made in a mould by substantially the same process as hereinafter Fig. 174. described. (See page 429.) It may be secured to the plate by a variety of simple means. One which will give as little trouble to the patient as any other, is to make a series of small holes along the edge of the plate and stitch it on with silk, or fine platina, gold, or silver wire may be used. It is desirable to have the plate and palate present a uniform surface on the lingual side. In fitting the plate, therefore, it may be raised along the posterior edge from the sixteenth to the tenth of an inch, according to the thickness of palate de- sired. The rul>ber will thus be placed on the palatine surface of the plate and present uniformity on the lingual surface. A little thought will show that in this case the patient must educate the ramdcH of the pJiarynx alone to do the work of shutting off the nares, which in the former case was per- formed by them in conjunction with the muscles of the palate. 426 MECHANICAL DENTISTRY. Perfection of articulation will therefore depend upon the suc- cess of the patient in this new use of these muscles. In cases of accidental lesions of the palate, such as are under consideration, this education of the muscles to a new work will not be difficult. The patient at some former time has had the power of distinct articulation ; his ear has recognized in his own voice the contrast between his present and former condi- tion, the ear will therefore direct and criticise the practice until the result is attained. In the case illustrated by Figs. 173 and 174, the defect had existed for twenty-eight years, the patient at the time of the introduction of the artificial palate being nearly fifty years of age. The effect upon the speech was instantaneous. Articu- lation was immediately nearly as distinct as in youth, and this remarkable distinctness can only be accounted for upon the assumption that the pharyngeal muscles had undergone a thor- ough training in the vain eifort to articulate without any palate.* The two cases chosen to illustrate the application of artificial palates in accidental lesion have required, as will have been perceived, entire upper sets of artificial teeth in connection with the palates. This selection was purposely made because the difficulties to be overcome are much greater. In cases where there are natural teeth remaining in the upper jaw, the palate and its connection with a plate would be substantially the same, and the plate might easily be secured to the teeth by clasps in the same manner as a partial denture. Artificial Palates for Congenital Fissure. — Congenital fissure of the palate presents far greater difficulties to be overcome than cases of accidental lesion. The opening is commonly more extensive, the appliance more complicated, and the result more problematical. Nevertheless, appliances have been made in a large number of cases, which have enabled the wearer to articulate with entire distinctness, so much so as not in the * An account of this case appears in the Argus, of Bainbridge, Georgia, August 1st, 1868, written by the patient himself, who is the editor of that paper. DR. KINGSLEY's artificial VELUM AND PALATE. 427 least to betray the defect. The first efforts in this direction were of the character of obturators, simply plugs to close the posterior nares, and the results were far from satisfactory. It was not until it was recognized that the two classes of cases (accidental and congenital) were entirely distinct that much progress was made. Nearly every case of accidental lesion can be treated with an obturator with considerable success; very rarely will an obturator be of any benefit in congenital fissure, even if the congenital and accidental case present substantially the same form of opening. For this reason so much mystification has been thrown around these appliances within a few years past. The character of the different classes has been confounded, and an instrument admirably adapted to one class has had claimed for it an equal application to the other class. Let it be understood, therefore, as a rule to which there will be but few exceptions, that congenital fissure of the soft palate re- quires for its successful remedy a soft, elastic, and movable appliance, and that when the most skilfully made and adapted instrument is worn, articulation must be learned, like any other accomplishment. Various inventions have been made for this purpose within the last twenty-five years, from the most complicated one of Mr. Stearns, described in the first edition of this work, to the extreme of simplicity of bridging the gap with a simple flap of rubber. The Stearns instru- ment, with all its complexity, embodied the only true principle, viz., the rendering available the muscles of the natural palate to control the movements of the artificial palate. The essential requisites of an artificial palate will be, to restore as far as possible the natural form to the defective organs with such material as shall restore their functions. Muscular power, certainly, cannot be given to a piece of mecha- nism, but the material and form may be such that it will yield to and be under the control of the muscles surrounding it, and thus measurably bestow upon it the function of the organ which it represents. Fig. 175 represents a model of a fissured i)alate, complicated 428 MECHANICAL DENTISTEY. with harelip on the left of the mesial line. There is a division also of the maxilla and the alveolar process, the sides being covered with mucons membrane which come in contact with Fig. 175. each other, but are not united. The left lateral incisor and left canine tooth are not developed. Fig. 176 represents the artificial velum, as viewed from its superior surface, together with the attachment and two artifi- cial teeth to fill the vacancy. Fig. 176. The lettered portion of this appliance is made of elastic vul- canized rubber ; its attachment to the teeth of hard vulcanized rubber, to which the velum is connected by a stout gold pin, firmly imbedded at one end in the hard rubber plate. The DR. KI^'GSLEY'S ARTIFICIAL VELUM AND PALATE. 429 other end has a head, marked C, which being considerably larger than the pin, and also the corresponding hole in the velum, it is forced through, — the elasticity of the velum per- mitting, — and the two are securely connected. The process, B, laps over the superior surface of the maxilla (the floor of the naris), and effectually prevents all inclination to droop. The wings A A, reach across the pharynx, at the base of the chamber of the pharynx, behind thQ remnant of the natural velum. The wings D D, rest upon the opposite or anterior surface of the soft palate. Fig. 177 represents a model, the same as Fig. 175, with the appliance, Fig. 176, in situ. Fig. 177. ,,-j,^;^^ The wing D D, in Fig. 176, and the posterior end of the artificial velum only in this cut being visible. Method of Making an Artificial Palate. — The success of these ap})liances dej)ends very much upon the accuracy of the model obtained to work by. It is essential that the entire border of the fissure from the apex to the uvula should be perfectly represented in the model, 430 MECHANICAL DENTISTEY. as the parts are when in repose. It is also necessary that the model show definitely the form of the cavity above, and on either side of the opening through the hard palate, being that part of the cavity which is hidden from the eye. It is desir- able, also, that the posterior surface of the remains of the soft palate be shown, but this is not essential ; but it is especially important that the anterior or under surface be represented with relaxed muscles and in perfect repose. The impression for such a model must be taken in plaster ; it is the only ma- terial now in use adapted to the purpose. An ordinary bri- tannia impression-cup may be used, selecting one in size and form corresponding to the general contour of the jaw. This cup will be found too short at the posterior edge to receive the soft palate, but it may be extended by the addition of a piece of sheet gutta-percha, which must be moulded into such form as not to impinge upon the soft palate, but which will reach under and beyond the uvula, and thus protect the throat from the droppings of plaster. Before using the plaster the posterior edge of the gutta-percha extension may be softened by heat and introduced into the mouth ; contact with the soft palate will cause it to yield, so that there is no danger of its forcing away the soft tissues when the plaster is used. With the pre- caution not to use too much plaster, the first effort will be to get only the lingual surface. After trial, if the impression show definitely the entire border of the fissure, and the soft palate has not been pushed up by contact with the cup, nor pulled up by the spasmodic action of the levator muscles, it is all that is thus far desired. If, however, the soft parts have been disturbed (which on close comparison a little experience will decide), it is better to cast a model into the impression, and upon this model extemporize an impression-cup as de- scribed on page 418. This temporary cup will have the advantage of the former, insomuch that it will require but a film of plaster to accomplish the result, thus lessening the danger of disturbing the soft tissues. After the removal, if it is seen that any surplus has projected through the fissure and lapped out to the floor of the nares, it may be pared off. DE. KINGSLEy's artificial VELUM AND PALATE. 431 The next step will be to obtain, in conjunction with tliis impression of the under surface, which we will call the palatal impression, an impression of the upper or nasal surface of the hard palate. This can be done by filling the cavity above the roof of the mouth wnth soft plaster down to the border of the fissure, and while yet very soft carrying immediately the palatal impres- sion against it, and retaining it in that position until the plaster is hard, which can easily be ascertained by the remains in the vessel from which it was taken. With the precaution to paint the surface of the palatal impression with a solution of soap, to prevent the two masses from adhering when brought in con- tact, there will be no difficulty in removing it from the mouth. Fig. 178. leaving the mass which forms the nasal portion in situ. AYith a suitable pair of tweezers this mass is easily carried backward and withdrawn from the mouth, and the irregular surface of con- tact indicates its relation to its fellow when brouglit together. Fig. 178 will show such an impression. The portion marked A, B, C, will readily be distinguished as that which entered the nasal cavity. The line of separation from the palatal im- pression is plainly indicated in the engraving. The groove, marked D, shows clearly the impression made by the delicate uvula in the soft plaster. The nasal portion is relatively large, showing an unusually large nasal cavity. The vomer lies between the projections marked A A ; these projections entering the nasal passages. The surfaces marked B B, came in contact witli the middle turbinated bones; the 432 MECHANICAL DENTISTRY. surface marked C in contact with the inferior turbinated bone. In many instances these turbinated bones are so large as to nearly fill the nasal passages. The method of obtaining the model of the jaw from the im- pression does not require any particular description. The process is similar to the making of a cast into any other mouth impression. The model represented in Fig. 175 shows a convenient form for such a cast. When the nasal portion of the impression does not indicate the superior surface of the soft palate, the part may be repre- FlG. 179. sented in the cast by carving. It is not essential to the success of the instrument to be made that the posterior surface of the soft palate should be represented with the same accuracy that is required of the inferior surface, or of both surfaces of the hard palate. By the aid of a small mirror and a blunt probe, the thickness of the velum and the depth behind the fissure can be ascertained and the model carved accordingly. The portion of the artificial palate coming in contact with it is so elastic that it easily adapts itself to a slight inequality, rendering absolute accuracy less important. DE. KINGSLEY's artificial VELUM AND PALATE. 433 The next step will be the formation of a model or pattern of the palate. Sheet gutta-percha is preferable for this pur- pose, although wax, or many other plastic substances, might answer. The form which should be given it is better indicated by the drawings. Figs. 176 and 183, than a written description would give. The Stearns instrument, of which a cut is here Fig. 180. given (Figs. 179, 180), was made to embrace the edges of the fissure, and was slit up through the middle, so that when the edges of the fissure approach each other, as they always do in swallowing, the two halves of the instrument would slide by each other, and a third flap or tongue was made and supported by a gold spring to cover and keep closed this central slit. This complicated provision for the contraction of the fissure is entirely superseded in Figs. 176 and 183, by making the instrument somewhat in the form of two leaves, one to lie on the inferior and the other upon the superior surface of the pal- ate, and joined together along tiie median line. When the fissure contracts the halves of the divided uvula slide toward 28 434 MECHANICAL DENTISTRY. each other between these two leaves. The posterior portion, marked A in Fig. 176, is made very thin and delicate on all its edges, as it occupies the chamber of the pharynx, and is subject to constant muscular movement. The sides are rolled slightly upward while the posterior end is curved downward. The inferior portion marked D D, in Fig. 176, should reach only to the base of the uvula, and bridge directly across the chasm at this point, and no effort to imitate the uvula should be made. The extreme posterior end should not reach the posterior wall of the pharynx when all the muscles are relaxed by a quarter of an inch, although sub- sequent use must determine whether this space be increased or diminished, thus leaving abundant room for respiration and the passage of nasal sounds. In cases where it is desirable to make the instrument independent of the teeth, as far as possi- ble, in its support, the anterior part which occupies the apex of the fissure in the hard palate may lap over on to the floor of one or both nares. Such a projection is seen in Fig. 176, marked B, and a like process is seen in Fig. 183, but not let- tered. Were it not for this process in this case, the palate would drop out of the fissure into the mouth, the single clasp at the extreme anterior end not being sufficient to keep the whole appliance in place throughout its entire length. Caution must be exercised that this projection entering the nares be not too large, or it will obstruct the passage and give a disagreeable nasal tone to the voice. All these described peculiarities must be provided for in the gutta-percha model, which, after having been carefully formed to the cast, may be tried in the mouth to ascertain its length or necessary variations. When its ultimate form has been de- cided upon, provision must be made to duplicate it in soft rubber. A parallel process, and one which will be a familiar illus- tration, is used when a set of teeth is made on vulcanite base. A model or patern form is made of gutta-percha, bearing the teeth, and in all its prominent characteristics is shaped as the completed denture is desired ; the rubber duplicate being vul- DR. KINGSLEY'S AETIFICIAL VELUM AND PALATE. 435 canized in a plaster mould. In like manner the rubber dupli- cate of the palate as before described may be made in a plaster mould. If plaster is used it must be worked with much care so that the surface shall be free from air-bubbles, or the rubber palate will be covered with excrescences that cannot be readily re- moved. By covering the surfiice of the mould with collodion or liquid silex, it will be much improved. But ordinarily plaster moulds will be found too troublesome for general use. They may be put to a most excellent use, however, by using one to make a duplicate of the gutta-percha in hard rubber. This is not necessary with those who have had much expe- rience, but w^ith beginners it will be difficult to work up the gutta-percha as nicely as may be desired ; a duplicate of vul- canite will enable the operator to make a more artistic model of the palate, and one wliich can be handled wdth greater free- dom. Fig. 181. As in the course of a lifetime a considerable number of elastic palates will be required, the mould which produces them should be made of some durable material. The type metal of commerce is admirably adapted to this use. The most com- plete mould is one made of four pieces, which will produce a palate of one continuous piece. Such a mould requires very nice mechanical skill in fitting all the parts accurately, and unless the operator lias had experience in such a direction it is better to simplify the matter. By making the palate in two pieces, to be joined after vulcanizing, the mould may be made in two pieces and with very little trouble. Fig. 181 shows a palate divided. 436 MECHAlSriCAL DENTISTRY. Fig. 182 shows the mould or flask in which it is vulcanized. These flasks were made expressly for this purpose, but they are not so unlike the flasks in common use in dentists' labora- FlG. 182. tories, that the latter will not answer. The common flask is simply unnecessarily thick or deep. The mould is readily produced in the following manner : Imbed the two pieces of the palate in plaster, in one-half of the flask; when the plaster is set and trimmed into form, Fig. 183. duplicate it in type-metal by removing the palate, varnishing the surface, moulding in sand, and casting. In making the sand mould take a ring of sheet-iron of the same diameter of the flask and three or four inches high ; slip it over the flask and pack full of sand. Separate them, remove the plaster, return the flask to the sand mould, and fill with the melted metal through a hole made in the side or bottom of the flask. With one- DE. KIXGSLEY's artificial VELUM AND PALATE. 437 half thus made, substantially the same process will produce the counterpart. Fig. 183 shows the palate complete with its attachment to the teeth. The palate is secured to the plate by a pin of gold passing through a hole in the palate of the same size; the head on the pin being larger than the hole is forced through, and thus the two halves of the palate are bound together and joined to the plate. Fig. 184 shows a mould in four pieces. The blocks C C, are accurately adapted to the body of the mould, marked A, Fig. 184. and are prevented from coming improperly in contact with each other by the flanges D D, which overlap the rest upon the sides of the main piece. B shows the top of the mould, and the groove E provides for the surplus rubber in packing. Such a mould makes the most perfect appliance that can be produced. The palate is one homogeneous and inseparable piece. The cut will sufficiently indicate the forms of tlie several parts. Each of these pieces is first made in plaster of exactly the form of which the type-metal is desired. They are then moulded in sand and the type-metal castas in making an ordi- nary die for swaging. When in use, a clamp similar to Fig. 185 is placed around the mould to keep the several parts firm in their position. 438 MECHAlSriCAL DENTISTRY. The packing of the mould with rubber will be done in the same manner as when hard rubber is used for teeth bases; with which process it is assumed that the operator is familiar. By- washing the surface of the mould with a thick solution of soap previous to packing, the palate will be more easily removed after vulcanizing. Fig. 185. The rubber used for this purpose must be a more elastic com- pound than that used as a base for teeth. The composition used for the elastic fabrics of commerce will answer if made of selected materials. The American Hard Rubber Company have recently placed on sale at the dental depots a compound admirably adapted to this purpose. The best results are obtained when the process of vulcanizing is carried from a heat of 230° gradually during four or five hours up to and terminating at 270°. INDEX. PAGE Air-chamber, manner of forming, 229 Alloys of gold for dental purposes, . . . '. . , .54 Alloys of copper, 88 silver, 76 platinum, 81 Aluminum, 83 alloys of, 85 Antagonizing model for partial dentures, 231 entire dentures, ...... 255 upper dentures, ...... 258 block-teeth, 292 Anatomical articulator, Bonwill's, 260 Antimony, 91 Application of heat, 17 Articulators, 259 Artificial dentures, 97 Artificial palates, 420 Artificial palates for congenital fissures, 426 Atmospheric pressure plates, ........ 227 Attaching teeth to metallic base with rubber or celluloid, . . . 400 Baking furnace, 29 Bismuth, 91 Block-teeth, 285 composition and preparation of body for, .... 285 crown enamel for, . . 287 gum enamel for, . . 290 Babbitt metal, 142 Blowpipe, 17 oxygen, .......... 17 oxy-iiydrogen, ......... 17 mouth, 18 Ijcllows, 22 Blank, celluloid, 384 Bla.st furnace, 32 Bonwill's method of attaching artificial crowns, 172 Brass, 88 Brass solder, 88 Carved l>lock-tecth, 298 440 INDEX. PAGE Celluloid base, 377 processes pi-eliminary to moulding, . . . • • . 380 blank, selection and preparation of, 384 moulding in hot moist air (dry heat), 387 glycerin, ........ 390 steam, 392 Chappell's method of attaching artificial crowns, .... 187 Charcoal, 36 Clasps, 200 Cleveland's air-chamber, 250 Coke, , 36 Components of dental porcelain, 277 Continuous gum work, 307 Dr. Allen's methods, 311 Dr. Hunter's formulas and methods, . . 318 Dr. Haskell's methods, 325 Dr. Field's methods, 330 application to partial sets, . . . . 333 Congenital defects of the palate, 416 Converting gold alloys into required forms for dental purposes, . . 68 Counter-die, • 135 Copper, 87 alloys of, 87 Crucibles, . _ ,40 Crucirjg or biscuiting, . . 299 Darby's method of attaching artificial crowns, .... 159-197 Dental porcelain, components of, 277 Dentures, partial, . . 224 entire, . 246 Defects of the palatal organs, 134 Dipping, 134 Diseased conditions of the mucous membrane and gums, . . . 102 Diseased remains of teeth, . . . . . . . . .103 Dies, , ... 128 essential properties of, . . . 136 Draw-plate, 74 DraBght or wind furnace, .28 Duplicating a set of teeth on rubber, 374 Entire dentures, . . . 246 Essential properties of a die, 136 Elements employed in refining gold, 48 Felspar, 277 Fitting pivot crown, 151 Flasks, vulcanite, 350, 352, 353 Formulas for silver solder, 78 gold plate, 55 clasps, stays, etc., 57 Forging, . . ." . 70 Fuel, . . . . . 35 Foster's method of attaching artificial crowns, 166 Furnaces, 28 Fusible alloys, 142 table of, 143 INDEX. 441 PAGE Gas furnace without blast, ......... 31 General properties of alloys, and their treatment and behavior in the process of compounding, 93 German silver, gg Gold, 41 geological situations of, ........ 41 geographical distribution of, 42 properties of, 42 influence of alloying on the properties of, 43 properties of particular alloys of, .45 refining, ........... 48 separation of foreign metals from, 49 alloy cast base, . 407 crown faced with porcelain, 164 solders, 57 wire, 73 Gutta-percha, 112 Hand furnace, 38 Hawes's moulding flask, 129 Impression in wax for partial upper dentures, 106 partial lower dentures, 109 entire upper dentures, 110 entire lower dentures, 112 Impression in plaster for entire upper dentures, 118 entire lower dentures, 120 partial upper dentures, . . . ,11.5 India-rubber, 33(3 general properties of, 336 compounding, 338 method of constructing an entire denture in a base of, . 338 formation of the mould or matrix, 342 packing the mould, 347 Influence of alloying on the properties of gold, 43 Ingot moulds, 68 Kaolin, 278 Kingsley's artificial velum and palate, 416 Laminating or rolling, 70 Lampg, .26 oil, ! '. 26 spirit, 27 Lead, 89 Malleability of gold, 44 Manner of a.scertaining carat of gold alloys, 59 reducing gold to a re>isea.He. Willi Formula and Illustrations. Large 12mo. Price, $2.00. ROBERTS' TEXTBOOK of tie THEORY M PRACTICE of fflEDIGINE. THIRD AMERICAN, FROM THE FOURTH LONDON EDITION. ONE VOLUME, OCTAVO. Price, bound in Cloth, $5.00. In Leather, $6.00. The unexceptional large and rapid sale of this book, and the universal com- mendation it has received from the profession, seems to be a sufficient guaran- tee of its merit as a Textbook. The publishers are in receipt of numerous letters from Professors in the medical schools, speaking favorably of it, and below they give extracts from the medical press, American and English, attesting its superiority and value to both student and practitioner. The present edition has been thoroughly revised and much of it re-written. " The best Textbook for Students in the English language. 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Founded on a Course of Lectures delivered at St. Mary's Hospital Medical School. The Third Edition, Revised and Enlarged, with new Illustrations. Octavo. Price in Cloth . . . j;4.oo " Leather . . . 5.00 Tliis new edition of Dr. Ilcwitt'.sbook has been bo much modificil, that it may bo considered subHtiintiuliy anf;w bv^k ; very much of the matter has been entirely rewritten, and tliewliole ■work ha.H been rearrancfcd in hucIi a manner jw to present a most decided improvement over previoiLS editions. \)t. Hewitt is tlie leadiiuj clinical teacher on Diseases of Women in London, and the characteristic attention paid to Diagnrwia by him has given his work great j>opnlarity 18 HILLIER (THOMAS), M.D., Physician to the Hospitai for Sicl< Children, &.c A CLINICAL TREATISE ON THE DISEASES OF CHILDREN. Octavo. Price ......... ^2.00 HANDY'S TEXT-BOOK OF ANATOMY and Guide to Dissec- tions for the Use of Students. 312 Illustrations. Octavo . $3.00 HOLDEN (luther), F.R.C.S. 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Royal octavo. Price, in cloth, ^6.50; in leather . . ^7-5° The many advances in Dental Science rendered it necessary that this edition should be thoroughly revised, which has been done in the most satisfactory manner by Professor Gorgas, Dr. Harris's successor in the Baltimore Dental College, he having added nearly three thou- sand new words, besides making many additions and corrections. The doses of the more prominent medicinal agents have also been added, and in every way the book has been greatly improved, and its value euhancetl as a work of reference. HABERSHON (s. a), M. D., F. R. C. R, Senior Physician, Guy's Hospital. ON DISEASES OF THE ABDOMEN, STOMACH, and Other Parts of the Alimentary Canal. Third London Edition. Price, $5.00 ON DISEASES OF THE STOMACH : The Varieties of Dyspepsia. their Diagnosis and Treatment. Third Edition. Octavo . ^1.75 19 HARDWICH AND DAWSON. HARDWICH'S MANUAL OF PHOTOGRAPHIC CHEMISTRY. With Engravings. Eighth Edition. Edited and Rearranged by G. 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SMITH (WILLIAM ROBERT), Resident Surgeon, Hants County Hospital. LECTURES ON THE EFFICIENT TRAINING OF NURSES FOR HOSPITAL AND PRIVATE WORK. With Illustrations. 121110. Cloth. Price . . . . . . . . ^2.00 SMITH (heywood), M. D., Physician to the Hospital for Women, kz, PRACTICAL GYNAECOLOGY. A Hand-Book for Students and Practitioners. With Illustrations. Price .... ^i-5o " It is obviously the work of a thoroughly intelligent practitioner, well versed in his art," — British Medical Journal. SANSOM (ARTHUR ERNEST), M.B., Physician to King's College Hospital, &c. CHLOROFORM. Its Action and Administration. Price $1.50 BY SAME AUTHOR. LECTURES ON THE PHYSICAL DIAGNOSIS OF DISEASES OF THE HEART, intended for Students and Practitioners. $1.50 SCANZONI (f. w. von), Professor In the University of Wurzbursr, A PRACTICAL TREATISE ON THE DISEASES OF THE SEXUAL ORGANS OF WOMEN. Translated from the French. By A. K. G--VRDNER, M.D. With Illustrations. Octavo. . $5.00 STOKES (WILLIAM), Regius Professor of Physic in the University of Dublin. THE DISfc:ASES OF THE HEART AND THE AORTA. Octavo. . . . . . . . . . . g^.oo SYDENHAM S0CIF:TY'S PUBLICATIONS. New Scries, 1859 to 1878 inclusive, 20 years, 81 vols. Subscriptions received, and back years furnished at $9.00 per year. Full jjrospectus, with the Reports of the Society and a list of the Books published, furnished free upon application. SANKEY (w. II. o.), M. D., F. R. C. P. LECTURF:S ON mental DISEASr:S. Octavo . . ^3.00 32 SWERINGEN (hiram v.). Member American Pharmaceutical Association, &,c. PHARMACEUTICAL LEXICON. A Dictionary of Pharmaceu- tical Science. Containing a concise explanation of the various subjects" and terms of Pharmacy, with appropriate selections from the collateral sciences. Formulae for officinal, empirical, and dietetic preparations; selections from the prescriptions of the most eminent physicians of Europe and America; an alphabetical list of diseases and their defini- tions; an account of the various modes in use for the preservation of dead bodies for interment or dissection ; tables of signs and abbrevia- tions, weights and measures, doses, antidotes to poisons, &c., &c. Designed as a guide for the Pharmaceutist, Druggist, Physician, &c. Royal Octavo. Price in cloth . . . . . . ^3.00 " leather ...... 4.00 SEWILL (h. e.), mTrTc. S., Eng-., L. D. S., Dental Surgeon to the West London Hospital. THE STUDENT'S GUIDE TO DENTAL ANATOMY AND SURGERY. With 77 Illustrations. Price . . . • ^i-S© SHEPPARD (edgar), M. D. Professor of Psychological Medicine in King's College, London. MADNESS, IN ITS MEDICAL, SOCIAL, AND LEGAL AS- PECTS. A series of Lectures delivered at King's College, London. Octavo. Price . . . . . . . . . ^2.25 SAVAGE (henry), M. D., F. R. C. S. Consulting Physician to the Samaritan Free Hospital, London. THE SURGERY, SURGICAL PATHOLOGY, and Surgical Anat- omy of the Female Pelvic Organs, in a Series of Colored Plates taken from Nature : with Commentaries, Notes, and Cases. Third Edition, greatly enlarged. A quarto vohime. Price . ^12.00 SAVORY AND MOORE. A CONDENSED COMPENDIUM OF DOMESTIC MEDICINE AND COMPANION TO THE MEDICINE CHEST. With En- gravings. i2mo. Cloth. Price . . . . . . ^0.50 SUTTON (FRANCIS), F. C. S. A SYSTEMATIC HAND-BOOK OF VOLUMETRIC ANALYSIS, ' or the Quantitative Estimation of Chemical Substances by Measure, Applied to Liquids, Solids, and Gases. Third Edition, enlarged. With numerous Illustrations. Now Ready. Price . . ^5- 00 SMITH (EUSTACE), M.D. Physician to the East London Hospital for Diseases of Children, &c, CLINICAL STUDIES OF DISEASES OF THE LUNGS IN CHILDREN. Price ^2.50 33 TANNER (THOMAS hawkes), M.D., F.R.C.P., &c. THE PRACTICE OF MEDICINE. Sixth American from the last London Edition. Revised, much Enlarged, and thoroughly brought up to the present time. With a complete Section on the Diseases Peculiar to Women, an extensive Appendix of Formulas for Medicines, Baths, &c.,&c. Royal Octavo, over iioo pages. Price, in cloth, ^6.00; leather $7-oo There is a common character about the writings of Dt. Tanner — a characteristic wliich constitutes one of their chief values : they are all essentially and thoroughly practical. Dr. Tanner never, for one moment, allows this utilitarian end to escajje his mental view. He aims at teaching how to recognize and how to cure disease, and in this he is thorouglily suc- cessful. ... It is, indeed, a wonderful mine of knowledge. — 31edical I'imes, SAME AUTHOR. A PRACTICAL TREATISE ON THE DISEASES OF IN- FANCY AND CHILDHOOD. Third American from the last Lon-- don Edition. Revised and Enlarged. By Alfred Meadows, M.D., London, M.R.C.P. , Physician to the Hospital for Women and to the General Lying-in Hospital, &c., &c. Price .... $S-oo TANNER'S INDEX OF DISEASES AND THEIR TREAT- MENT. Second Edition. Carefully Revised. With many Additions and Improvements. By W. H. Broadbent, M. D., F. R. C. P., Phy- sician to the London Fever Hospital, &c., &c. Octavo. Cloth. 153.00 A MEMORANDA OF POISONS. A New and much Enlarged Edition. Price . . . . . . . . . $0.75 TYSON (jAMEs), M.D., Lecturer on Microscopy in the University of Pennsylvania, &c, THE CELL DOCTRINE. Its History and Present State, with a Copious Bibliography of the Subject, for the use of Students of Medi- cine and Dentistry. With Colored Plate, and numerous Illustrations on Wood. Second Edition. Price ..... ^2.00 BY SAME AUTHOR. A PRACTICAL GUIDE TO THE EXAMINATION OF URINE. For the use of Physicians and Students. With a Colored Plate and numerous Illustrations Engraved on Wood. Third Edition. Price TAFT (JONATHAN), D. D. S., Professor of Operative Dentistry in the Ohio College, &c. A PRACTICAL TRICATISE ON OPERATIVE DENTISTRY. 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Price $8.00; in Leather ....... ^10.00 Trousseau's Lectures have attained a reputation both in England and this country far greater than any work of a similar character heretofore written ; and, notwithstanding but few medical men could aflford to purchase the expensive edition issued by the Sydenham Society, it has had an extensive sale. In order, however, to bring the work within the reach of all the profession, the publishers now issue this edition, containing all the lectures as contained in the five-voluuie edition, at one-half the price. The London Lancet, in sjjeaking of the work, says: '" It treats of diseases of daily occurrence and of the most vital interest to the practitioner. And we should think any medical library absurdly incomplete now which did not have alongside of Watson, Graves, and Tanner, tlie ' Clinical Medicine' of Trousseau." 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Cloth^ red edges. Price . . $5.00 TOMES (JOHN), F. R. S. Late Dental Surgeon to the Middlesex and Dental Hospitals, &c. A SYSTEM OF DENTAL SURGERY. The Second Revised and Enlarged Edition, by Charles S. Tomes, M.A., Lecturer on Dental Anatomy and Physiology, and Assistant Dental Surgeon to the Dental Hospital of London. With 263 Illustrations. Price . . $5.00 TOMES (c.s.),M.A. Lecturer on Anatomy and Physiology, and Assistant Surgeon to the Dental Hospital of London, A MANUAL OF DENTAL ANATOMY, HUMAN AND COM- PARATIVE. With 179 Illustrations. Now Ready. Price . $3.50 TRANSACTIONS OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA. New Series. VOLUMES I., II., III., & IV. Price, per volume . . . ;?!2.50 THUDICHUM (JOHN l. w.), M. D.,. Lettsomian Professor of Medicine, Medical Society, London, &c. ON PATHOLOGY OF THE URINE. Including a Complete Guide to Analysis. A new Revised and Enlarged Edition. With Illustrations. Octavo. Price . . . . . . $5.00 TOLAND (h. h.), M. 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A Description and Expla- nation of the Method of Performing Them in the Dead House of the Berlin Charite Hospital. Price . , . . . ^T.25 ARTHUR VACHER, Translator and Edilor of Fresenios's Cheroical lloalfsis. A PRIMER OF CHEMISTRY. Including Analysis. i8mo. Cloth. Price ......... $0.50 WARING (EDWARD JOHN), F.R.C.S., F.L.S., &c., &c. PRACTICAL THERAPEUTICS. Considered chiefly with refer- ence to Articles of the Materia Medica. Third American from the last London Edition. Price, in cloth, ^4.00; leather . . ^5.00 There are many features in Dr. Waring's Tlierapeutics which render it especially valuable to the Practitioner and Student of Medicine, much important and reliable information being found in it not contained in similar works; also in its completeness, the convenience of its ar- rangement, and the greater prominence given to the medicinal ai3plication of the various articles of the Materia Medica in the treatment of morbid conditions of the Human Body, &c. It is divided into two parts, the alphabetical arrangement being adopted throughout. It contains also an excellent Index of Diseases, with a list of the medicines applicable as remedies, and a full Index of the medicines and preparations noticed in the work. WYTHE (JOSEPH h), A.M., M.D., &c. THE PHYSICIAN'S POCKET, DOSE, AND SYMPTOM BOOK. Containing the Doses and Uses of all the PrincipalArticles of the Materia Medica, and Original Preparations; A Table of Weights and Measures, Rules to Proportion the Doses of Medicines, Common Abbreviations used in Writing Prescriptions, Table of Poisons and Antidotes, Classifi- cation of the Materia Medica, Dietetic Preparations, Table of Symptom- atology, Outlines of General Pathology and Therapeutics, &c. The Eleventh Revised Edition. Price, in cloth, $1.00; in leather, tucks, with pockets, ......... ^1.25 BY SAME AUTHOR. THE MTCROSCOPIST, a Compendium of Microscopic Science, Micro-Mineralogy, Micro-Chemistry, Biology, Histology, and Prac- tical Medicine. Fourth Edition. 252 Illustrations, . . $5- 00 WILKS AND MOXON. LECTURES ON PATHOLOGICAL ANATOMY. By Samuel WiLKS, M.D., F.R.S., Physician to, and Lecturer on Medicine at, Guy's Hospital. Second Edition, Enlarged and Revised. By Walter Moxon, M.D., F. R.S., Physician to, and late Lecturer on Pathology at, Guy's Hospital. . . . . ... ... ^6.00 WILSON (ERASMUS), F.R.S. HEALTHY SKIN. A Popular Treatise on the Skin and Hair, their Preservation and Manageuitnt. Eighth Edition. Cloth. . Si. 00 WILSON (GEORGE), M. A., M. D. Medical Officer to the Convict Prison at Portsmouth, A HANDBOOK OF HYGIENE AND SANITARY SCIENCE. "With Engravings. Fourth Edition, carefully Revised. Containing Chapters on Public Health, Food, Air, Ventilation and Warming, Water, Water Analysis, Dwellings, Hospitals, Removal, Purification, Utilization of Sewage and Effects on Public Health, Drainage, E})i- demics. Duties of Medical Officers of Health, &c., &c'. Price $2.75 WAGSTAFFE (william Warwick), F. R. C. S. Assistant-Surgeon and Lecturer on Anatomy at St. Thomas's Hospital, THE STUDENT'S GUIDE TO HUMAN OSTEOLOGY. With Twenty-three Lithographic Plates and Sixty Wood»Engravings. i2mo. Cloth. Price ......... $3- 00 WARD ON AFFECTIONS OF THE LIVER AND INTESTI- NAL CANAL; with Remarks on Ague, Scurvy, Purpura, &c. ^2.00 WHEELER (c. gilbert), M. D., Professor of Chem'stry in the Univ^ersity of Ch'cago, MEDICAL CHEMISTRY: Including the Outlines of Organic and Physiological Chemistry. Based in Part upon Riche's Manual De Chimie. Octavo. Cloth. Price ..... ^3.00 WILSON (JOSEPH c), M. D., Physician to the Phil delphia Hospital, &c, THE SUMMER AND ITS DISEASES. (Vol. III., American Health Primers.) Cloth. Price ..... ^^0.50 W0AKEs7f^ARD), M. D. ON DEAFNESS, GIDDINESS, AND NOISES IN THE HEAD. With Illustrations. Price . . . . . . . ^1.25 WEDL (^^), M. D., Professor of Histology, &lc., in the University of Vienna. DENTAL PATHOLOGY. The Pathology of the Teeth. With Special Reference to their Anatomy and Physiology. With Notes by Thos. B. Hitchcock, M.D., Prof, of Dental Pathology, Harvard Uni- versity, Cambridge. 105 Illustrations. Cloth, $3.50; Leather, $4.50 WE.ST (charl^^J^)7m. D., F. R. C. P. LECTURES ON THE DISEASES OF WOMEN. Revised and in part Rewritten by the Author, With numerous Additions l)y J. Matthews Duncan, M. D., Obstetric Physician to St. Bartholomew's Hospital. Fourth London Edition. Octavo. Price . . $5.00 WILKES 6^r^EL), M.I)., Physician to, and Lecturer at, Guy's Hospital. LECTURES ON DISEASES OF THE NERVOUS SYSTTCM. Delivered at Guy's Hospital. With Additions. Numerous Illustrative Ca.ses, etc $5-oo 38 WOODMAN AND TIDY. A TEXT-BOOK OF FORENSIC MEDICINE AND TOXI- COLOGY. By W. Bathurst Woodman, M. D., St. And., Assistant Physician and Lecturer on Physiology at the London Hospital ; and C. Meymott Tidy, M. A., M. B., Lecturer on Chemistry, and Professor of Medical Jurisprudence and Public Health, at the London Hospital. With Numerous Illustrations. Now ready, cloth, ^7.50; leather, $8.50 WELLS (j. sgelberg), Author'' s Edition, Ophthalmic Surgeon to King's College Hospital, &,c. TREATISE ON THE DISEASES OF THE P:YE. Illustrated by Ophthalmoscopic Plates and numerous Engravings on Wood. The Fourth London Edition. Cloth, Leather . This is the author's own edition, printed in London under his supervision, and issued in this country by special arrangement with him. SAME AUTHOR. ON LONG, SHORT, AND WEAK SIGHT, and their Treatment by the Scientific Use of Spectacles. Fourth Edition Revised, with Additions and numerous Illustrations. Price . . . ^2.25 WRIGHT (henry g.), M. D., Member of the Royal College of Physicians, &c, ON HEADACHES. Their Causes and their Cure. From the Lon- don Edition. Seventh Thousand ^o 50 WILSON (JOSEPH), M. D.,' Medical Director, U. S. N. NAVAL HYGIENE— Human Health and the Means of Prevent- ing Disease. With Illustrative Incidents derived from Naval Experi- ence. Second Edition. With Colored Lithographs and other Illus- trations. Octavo. Price ....... ^3.00 WALTON (haynes). Surgeon in Charge of the Ophthalmic Department of, and Lecturer on Ophthalmic Medicine and Surgery in, St. Mary's Hospital. A PRACTICAL TREATISE ON DISEASES OF THE EYE, Third Edition. Rewritten and enlarged. With five plain, arid three colored full-page plates, numerous Illustrations on Wood, Test Types, &c., &c. Octavo volume of nearly 1200 pages. Price . ;^9-oo WATERS (a. t. h.), M.D., F.R.C.P., &c. 'DISEASES OF THE CHEST. Contributions to their Clinical His- tory, Pathology, and Treatment. Second Edition, Revised and Enlarged. With numerous Illustrative Cases and Chapters on Haemoptysis, Hay Fever, Thoracic Aneurism, and the Use of Chloral in certain Disease's of the Chest, and Plates. Octavo. Price . . . . ^4.00 WALKER (ALEXANDER), Author of " Woman," ".Beauty," &c. INTERMARRIAGE; or, the Mode in which, and the Causes why, Beauty, Health, Intellect result from certain Unions, and Deformity, Disease, and Insanity from others. With Illustrations. i2mo. *i.oo AMERICAN HEALTH PRIMERS. Edited by W. W. KEEN, LI. D., Fellow of the College of FhT/.tidans of rhiladclplda; Surgeon to St. Mary^s Hospital, etc. This serips of American Health rriniprs ia prepared to (iiffuse ns widely and cheaply as possible. unong all cIh.-scs, a knuwlfdge of the eli-iuentary {acts of Treventive Medicine, and the bearings and Bpplicatiuiis of tlie l.itest and best researches in every brandi of Medical and Hygienic Science. TUey are ni-t intemled (save jiiciiientiiUy) to assist in curing disease, but to teach people how to talie care of themselves, tlieir children, pujils, employees, etc. They are written fiom an American standpoint, with especial reference to our OlimHte, Sanitiry Legislation, and Slodes of Life; and in these respects we differ niaterially frum other natimis. The subjects selected are of vital and practical inijiortance in every-d;iy life, and are treateil in as popular a stylo as is consistent with their nature. Each volume, when the Bubject calls f.r it, is I'ully Illustrated, so that the text may be clearly and readily understood by any one heretofure eiitirelj ignorant of the structure and functions of the body. The object being to lurnish the general or un- Bcientific reader, in a compact form and at a low price, reliable guides tor the prevention of disease and the pieservation of b.ith body and mind in a healthy state. The authors have been selected with great care, and on account of special fitness, each for his subject, by reason of iis previous careful study, either privately or as public teachers. Dr. Keen has supervised the Series, us Kditor; but is not responsible for the statements or opinions of the individual authors. I. Hearinfff and How to Keep It. With Illustrations. By Cha.s. H. Burnett, M. D., of Philadelphia, Consulting Aurist to the Pennsylvania Institution for the Deaf and Dumb, Aurist to the Presby- terian Hospital, etc. II, Long life, and Hoiv to Heach It. By J. G. Richardson, M. D., of Philadelphia, Professor of Hygiene in the University of Pennsylvania, etc. III, The Smnnier and its Diseasen. By James C. Wilson, M.I)., of Philadelphia, Lecturer on Physical Diagnosis in Jeflerson Medical College, etc. IV. Eyesight f and How to Care for It, With Illustrations. By George C. Harlan, M. D., of Philadelphia, Surgeon to the Wills (Eye) Hospital. F. The Throat and the Voice. With Illustrations. By J. Solis Cohen, M. D., of Philadelphia, Lecturer on Diseases of the Throat in Jefferson Medical College. VI, The Winter and its Dangers, By Hamilton Osgood, M. D., of Boston, Editorial Staff Boston Medical and Surgical Journal. VII, The Mouth and the Teeth, With Illustrations. By J. W. White, M. D., I). D. S., of Philadelphia, Editor of the Dental Cosmos. VIII, lirain Work and Overwork, By H. C. Wood, Jr., ]\I. D., of Philadelphia, Clinical Professor of Nervous Diseases in the University of Pennsylvania, etc. JX. Our Homes, With Illustrations. By Henry Hartshorne, M. D., of Philadelphia, formerly Professor of Hygiene in the University of Penn.sylvania. X, The Skin in Health and Hisea.se, By L. D. Bulkley, M.D., of New York, Physifiiin to the Skin I)ej)artmeut of the Demilt Dispensary and of the New York Hospital. XI, Sea Air and Sea liathing. By John H. Packard, M. D., of Philadelphia, Surgeon to the Episcopal Ilo.spital. XII, School andlndustrial Hygiene, ]iy I). F. LrN( oln, M. D., of Boston, Mass., Chairman Department of Health, American Social Science Association. Tho volumra are Fold BRpamtcly. Prifft 50 cnnts nnch, neatly bound In cloth, or tho set compb-'te, pot up In boxof, jirieij i)(»i (mi ; with ii B|ieci!illy liberal discount to the Trade when ordered by the dozen vuIuuieH amorted, or lu larger quantities. rUESLEY JiLAKISTON, ruhfishrr, 1012 l^alDut Street, I*ltllu(lelpbla. LINDSAY $t BLAKISTON'S PHYSICIANS' VISITING LIST, PUBLISHED ANNUALLY. For twenty-nine years this Yisiting List has steadily increased in popularity, and the publishers have constantly modified or re-arranged it as the wants 0/ the profession have become known. NEW FEATURES IIT THE LIST. A New Table of Poisons and their Antidotes. The Metric or French Decimal System of Weights and Measures. Posological Tables, showing the relation of our present system of Apothecaries' Weights and Measures to that of the Metric ■ System, giving the Doses in both. This is a most valuable addition and will materially aid the Physician. So many writers now use the metric system, especially in foreign books and journals, that one not familiar with it is constantly confused, and in many cases unable to understand the measurements or doses. SIZES AND PRICES. For 25 Patients weekly. Tucks, pockets, and pencil, inn a a u a li n 00 1 25 1 50 2 00 2 50 50 " " 2 vols, {jsry^/c} " 100 " " 2 vol. {'j^^Zml] " • • • • ^«» INTEKLEAVED EDITION. For 25 Patients weekly, interleaved, tucks, pockets, <&c., . . . 1 25 50 " " " " " "... 1 50 50 " " 2vols. {J^f/,»/C^} " " . . .3 00 NOTICES OF THE PRESS. " It is certainly the most popular Visiting List extant." — N. Y. Medical Journal. "Its compact size, convenience of arrangement, durability, and neatness of manufacture have everywhere obtained for it a preference." — Canada Lancet. " The book is convenient in form, not too bulky, and in every respect the very best Visiting List published." — Canada Medical and Surgical Journal. '' This standard Visiting List makes its usual annual visit. For completeness, compactness, and simplicity of arrangement it is excelled by none in the market." — Neiu York Medical Record. «@°- Sent by mail post paid to any address upon receipt of the price, or can be had through any Bookseller in the United States or Canada. LINDSAY & BLAKISTON, Publishers, 2B S. SIXTH ST., PHILADELPHIA. "^^S \^^o n \ ± COLUMBIA UNIVERSITY LIBRARIES (hsi.stx) RK 651 R39 1880 C.1 A pracfeal treatise on mechanical denti .-, J