THE LIBRARY 
 
 OF 
 THE UNIVERSITY 
 
 OF CALIFORNIA 
 LOS ANGELES
 
 CAST GOLD AND PORCELAIN INLAYS
 
 TECHNIC AND SCOPE 
 
 OF 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 WITH A CHAPTER ON 
 
 ENDOCKINODONTIA, OR THE DUCTLESS GLANDS 
 THEIR EXPRESSION IN THE IIUMAX MOUTH 
 
 I ', Y 
 HERMAN' E. S. CHAYES, D.D.S. 
 
 NEW YORK CITY 
 
 With 372 Illustrations 
 
 ST. LOUIS 
 C. V. MOSBY COMPANY 
 
 1920
 
 COPYRIGHT, 1918, BY C. V. MOSBY COMPANY 
 
 
 Press of 
 
 C. V. Mosby Company 
 St. Louis
 
 U 
 
 o 
 
 aw* 
 
 IN MY FIRM CONVICTION THAT THE 
 TRIALS AND TRIBULATIONS WHICH HARASS 
 Us ARE BUT AN EVIDENCE OF OUR ULTI- 
 MATE VICTORY OVER THE EVILS WHICH AT 
 PRESENT ENSLAVE Us, THIS BOOK Is AF- 
 FECTIONATELY DEDICATED TO MY FEL- 
 LOWMEN.
 
 PREFACE 
 
 The introduction to this book was written in the early part 
 of 1913, before tlie people of the world even dreamed of the ter- 
 rible catastrophe which has since overtaken three continents and 
 threatens to force the remaining ones into the horrible and 
 voracious whirlpool of an uncivilized warfare. 
 
 I am including this introduction in spite of pressure 
 brought to bear upon me, because I feel that a new order of 
 things in general is about to appear in the world and I feel im- 
 pelled to do what I can to speed the day of clearer thinking, 
 greater tolerance, and more virile idealism. 
 
 It holds something for the man or woman who will read it 
 with the same sincere desire and regard for truth and equity 
 and justice which the author felt himself possessed of when he 
 wrote it. 
 
 I want to at this time pay my respects and acknowledge my 
 obligation to the many writers of the many helpful hooks I may 
 have quoted in this volume, and express my thanks to the many 
 men in my profession who have labored and are laboring in the 
 same or similar pursuits, and whose work has been helpful to 
 me to no small degree. 
 
 I want to acknowledge my deep obligations and register a 
 pupil's sincere affection for my dear friend and teacher, Dr. 
 Joseph Fraenkel, of Xew York, for the many interesting, help- 
 ful, and clarifying hours of instruction he unselfishly devoted 
 to me and to many others, and which have made me familiar 
 with a new, a higher, a clear, sane conception of the physiologic 
 and the morbid processes which affect living beings and things. 
 
 My thanks to my friend Dr. Chas. G. Taylor, an associate 
 of Dr. Fraenkel, for his measure of helpfulness in the correct 
 interpretation of the functions of the endocrines in their asso- 
 ciation with the dental apparatus. My thanks to Dr. J. O. Lief 
 who kindly waded through the entire manuscript to formulate 
 the questions at the end of each chapter. 
 
 Manv thanks to all mv friends who have stood hv me and 
 
 V t */ 
 
 9
 
 10 PREFACE 
 
 encouraged me. To the officers and members of the Chayes 
 Dental Club whose loyalty I cherish and rejoice in, whose ideal- 
 ism I admire and approve of, and whose success is my ardent 
 desire. 
 
 Last, but not least, I wish to express my sincere appre- 
 ciation and thanks to my wife who has been a source of genuine 
 inspiration. 
 
 H. E. S. CHAYES. 
 
 New York City.
 
 CONTENTS 
 
 CHAPTER I 
 
 INTRODUCTION 
 
 Sequence of Thought and Its Value in Teaching, 21 ; The Chief Factors Induc- 
 ing Coordinate Mental Efforts, 24; Some Rational and Acceptable Conclusions, 48. 
 
 CHAPTER II 
 
 THE FUNCTIONS OF THE TEETH 
 
 The Functions of the Teeth, 52; Passive Reciprocal Functions, 58; Active 
 
 Reciprocal Functions, 58. 
 
 CHAPTER III 
 
 THE CAST GOLD INLAY 
 
 The Cast Gold Inlay, 62. 
 
 CHAPTER IV 
 
 SELECTION OR ELECTION OF THE CASE PRESENTING 
 
 A CAVITY 
 
 The Selection or Election of the Case Presenting a Cavity, 04. 
 
 CHAPTER V 
 
 CAVITY PREPARATION 
 
 Geometric Landmarks of Teeth, 65; Hygienic Landmarks of the Teeth, 69; 
 Cavity Preparation, 76. 
 
 CHAPTER VI 
 
 THE MESIO-DISTO-OCCLUSAL CAST GOLD INLAY 
 
 The Cast Gold Complement for a Tooth Presenting a Alesio-Disto-Occlusal 
 Cavity, 120; Cavity Preparation, 121. 
 
 CHAPTER VII 
 
 THE SELECTION OF THE PROPER WAX 
 
 The Selection of the Proper Wax, 127. 
 
 11
 
 12 COXTKXTS 
 
 CHAPTER VIII 
 
 MAKING AND CARVING OF THE WAX INLAY BY THE USE OF 
 THE DIRECT METHOD 
 
 Making and Carving of the Wax Inlay by the Use of the Direct Method, 131. 
 CHAPTER IX 
 
 TAKING AN IMPRESSION OF THE CAVITY AND MAKING A 
 DIE FOR PROCEDURE BY THE INDIRECT METHOD 
 
 Taking an Impression of the Cavity and Making a Die for Procedure by the 
 Indirect Method, 139; The Making of the Amalgam Die, 148. 
 
 CHAPTER X 
 
 THE INVESTMENT, OR REFRACTORY, COMPOUND 
 
 The Investment, or Refractory, Compound, 158; Silicon, 160; Calcium, 162; 
 Magnesium, 162; Alumina, 163. 
 
 CHAPTER XI 
 
 THE DRYING OUT OF THE MOLD AND THE BURNING OUT OF 
 
 THE WAX MODEL 
 
 The Drying Out of the Mold and the Burning Out of the Wax Model, 173. 
 
 CHAPTER XII 
 
 THE CASTING OF THE MOLTEN METAL INTO THE MOLD 
 
 The Casting of the Molten Metal into the Mold, 178. 
 
 CHAPTER XIII 
 
 THE METALS FOR THE INLAY WORKER 
 
 The Metals for the Inlay Worker, 182. 
 
 CHAPTER XIV 
 
 THE CASTING OF THE MOLTEN METAL INTO THE MOLD AND 
 
 A CONSIDERATION OF THE VARIOUS MACHINKs 
 
 EMPLOYED 
 
 The Casting of the Molten Metal into the Mold and a Consideration of the 
 Various Machines Employed, 187.
 
 COXTKXTS 13 
 
 CHAPTER X V 
 
 THE CLEANSING OF Till-: CASTING IN II VDROPLUORIC ACID 
 AND IN A SODIT.M UlCAUBnNATE BATH 
 
 The Cleansing of tlio Casting in Hydrofluoric Acid and in a Sodium Bicar- 
 
 Imiiate I'.atli. lid'.). 
 
 CHAPTKK XVI 
 
 RE.MnVAL OK Till-] EXCESS OF METAL. THE POLISHING. AND 
 Till-: CEMENTATION OF THE INLAY 
 
 Removal of the Excess of Metal, the Polishing, and the Cementation of the 
 Inlay. I'l.",. 
 
 CHAPTER XVII 
 
 THE SPLINTING OF LOOSE TEETH BY MEANS OF INLAYS 
 
 The Splinting of Loose Teeth by Means of Inlays, 218. 
 
 CHAPTER XVIII 
 
 E XTEXS I VI-: RESTORATIONS OF OccLfSAL BALANCE BY 
 MEAXS OF GOLD INLAYS 
 
 Extensive Restorations of Occlusal Balance by Means of Gold Inlays, 236; 
 Construction of the Splint, 245. 
 
 CHAPTER XIX 
 
 GOLD INLAYS AND THE SILICATES OR PORCELAIN 
 
 Gold Inlays and the Silicates or Porcelain, 269. 
 
 CHAPTER XX 
 
 THE PHENOMENA OF LIGHT AND COLOR 
 
 The Phenomena of Light and Color, 302; Reflection and Refraction and Ab- 
 sorption, 304. 
 
 CHAPTER XXI 
 
 THE PORCELAIN INLAY 
 
 The Porcelain Inlay, 322; Cavity Preparation, 328. 
 
 CHAPTER XXII 
 
 ENDOCRINODONTIA, OR THE DUCTLESS GLANDS THEIR 
 EXPRESSION IN THE HUMAN MOUTH 
 
 Endocrinodontia, or the Ductless Glands Their Expression in the Human 
 Mouth, 359.
 
 ILLUSTRATIONS 
 
 TIG. PAGE 
 
 1. Diagram showing reciprocal functions of the teeth 59 
 
 l'. Showing diaiirammatically the various surfaces, line angles, and cutting, or 
 
 point, angles of incisor teeth 66 
 
 3. Showing diagranmiatically the surfaces, line angles, and cutting, or point, 
 
 angles of a cuspid 66 
 
 4. Showing diagranmiatically surfaces, line angles, and point angles of bicus- 
 
 pids and molars 66 
 
 5. Immune areas of anterior teeth and susceptible areas 70 
 
 (5. Immune areas of posterior teeth ... 70 
 
 7. Immune areas and susceptible areas of posterior teeth 70 
 
 x . A set of chisels used by the author in tooth structure cutting 72 
 
 9. Cross section of molar tooth illustrating prepared cavity and bevel ... 74 
 
 10. Cross section of molar showing a disto-occlusal cavity 74 
 
 11. Longitudinal section of molar, showing mesial and distal planes .... 78 
 
 12. Cross section of bicuspid 78 
 
 13-17. Five views of an upper first bicuspid presenting a simple occlusal cavity, 
 
 and the cast gold inlay made for it .80 
 
 18-24. Seven views of a first right lower bicuspid presenting a compound disto- 
 
 occlusal cavity involving also the cervical portion of the buccal wall, 
 
 restored with a cast gold inlay disto'-occlusally, and a porcelain inlay 
 
 buccally 82 
 
 -o -:\'2. Eight views of an upper first bicuspid presenting a mesio-occlusal cavity, 
 
 and the restoration made for it 84 
 
 33-37. Five views of a lower second bicuspid presenting a mesio-disto-occlusal 
 
 cavity, and the inlay made for it 86 
 
 38-46. Nine views of a mesio-occlusal cavity in a first lower bicuspid, and 
 
 restoration made for it 88 
 
 47-54. Eight views of a lower second bicuspid presenting a mesio-disto-occlusal 
 
 cavity, and the restoration made for it 90 
 
 55-60. A first lower molar presenting a labio- or bucco-occlusal cavity, and the 
 
 cast gold inlay made for it 92 
 
 61-68. A lower molar presenting a disto-occlusal cavity, the lower half of the 
 
 buccal wall being involved to the full mesial-distal extent .... 94 
 69-78. A disto-occlusal cavity in an upper molar and a disto-buccal cavity in the 
 
 same tooth. Two cast gold inlays for the respective cavities and three 
 
 views of the finished operations 96 
 
 79-86. A mesio-disto-occlusal cavity in an upper molar, also a buccal cavity in 
 
 the same tooth 98 
 
 87-88. Two illustrations of teeth worn down by attrition, restored by means of 
 
 the cast gold inlay, imitating the conditions of adjacent teeth . . 100 
 89-94. Loft first lower molar presenting deficiency of occlusal third. Views 
 
 illustrating preparation of cavity and restoration made for it in the 
 
 shape of a cast gold inlay 102 
 
 15
 
 JU.rSTItATIOXS 
 
 PAGE 
 
 no. 
 95-102. A complex cavity in an upper molar involving every surface of 
 
 the tooth, and cast gold inlay made for it ....... 104 
 
 103-111. Nine views of a second lower molar present ing a mesio-disto-oc- 
 
 clusal-bnccal cavity and two interlocking cast gold inlays made 
 
 for it 
 
 100 
 
 112-119. A mesio-occlnsal-palatal cavity in an upper molar restored by 
 
 means of a cast gold inlay 10S 
 
 120-127. Eight views of a mesio-disto-occlusal cavity in an upper second bi- 
 cuspid, and the cast gold inlay made for it HO 
 
 128-135. Eight views of a complex cavity in an upper second bicuspid, and 
 the restoration made for it in the shape of a cast gold inlay. The 
 labial portion of this inlay has been, in turn, inlayed with synthetic 
 porcelain . 
 
 136. Stress index for upper teeth 
 
 137. Stress index for lo.wer teeth 
 
 138-139. Buccal and lingual views of a case of nearly normal occlusion . 117 
 
 140. The first cut after the decay has been removed in the preparation of a 
 
 mesio-occlusal-distal cavity in a molar 122 
 
 141. The second cut, removal of the" mesial wall, to provide for the onlay 
 
 part of the inlay .... 1-- 
 
 142. The third cut. The removal of the distal wall to provide for the onlay 
 
 part of the inlay 123 
 
 143. The final cut. The bevel upon the occlusal surface continuous with the 
 
 mesio biiccal, disto-buccal, mesio-lingual, and disto-lingual guides 
 
 of the cavity, which guides are beveled outward 123 
 
 144. The wax inlay made for the mesio-occluso-distal cavity 124 
 
 145. The finished inlay in position upon the tooth 124 
 
 146. The Taggart automatic wax warmer 132 
 
 147. A glass of water with cork and pins for submerging wax .... 134 
 
 148. A spatula, a set of right and left and straight flat burnishers, lancets. 
 
 right and left carvers, and hand drills 137 
 
 149. Method of making a handy matrix 141 
 
 150. Illustrating a handy matrix in position upon a molar 141 
 
 151-152. Hinged trays for taking correct impressions of mesio-disto-occlusal 
 
 cavities and teeth upon which they present 144 
 
 153. Disto-occlusal cavity tray 144 
 
 154. Mcsio-occlusal cavity tray 144 
 
 155. Hinged tray for anterior teeth 144 
 
 156. Hinged tray in position 145 
 
 157. Hinged tray in closed position 145 
 
 158. Complete impression of tooth and cavity embedded in plaster impres- 
 
 sion of adjacent teeth, ready for the packing of amalgam die . . 147 
 
 159. Complete impression of tooth and cavity, removed from the mouth . 147 
 
 160. Model presenting a view of amalgam replica of tooth requiring restora- 
 
 tion in correct relation to adjacent teeth 150 
 
 161. Model lubricated with mixture of castor oil and glycerine .... 150 
 
 162. Occluded models of case requiring restoration 151 
 
 163. The Taggart automatic investment mixer attached to a lathe . 168
 
 ILLUSTRATIONS 17 
 FIG. PAGE 
 
 KV4. The Taggart automatic invcstniont mixer attached to its own motor, a 
 clock with an alarm which rings when the compound is ready for 
 
 use 168 
 
 KM. The Taggart mixer as used in the author's laboratory 170 
 
 166. Taggart automatic (gas) burner for removing wax pattern from mold 174 
 
 l'i~. 1'lat check furnace closed, showing flue, or chimney 175 
 
 1<>8. The platcheck furnace for burning out the wax 176 
 
 1>9. The charcoal block with a depression in it to act as a crucible . . 183 
 
 MO A. The Elgin vacuum casting machine and Masks 192 
 
 MOB. Same machine as in Fig. 170.4, ready for casting 192 
 
 171. Taggart machine with flask in position on its base 201 
 
 I?!'. The Taggart machine raised to permit the use of a number of sizes of 
 
 larger flasks 202 
 
 I".'!. To the right is a view of a small Taggart flask and its crucible former 
 
 which holds the sprue wire 204 
 
 174. A special flask, barrel-shaped 204 
 
 17-"). Acid cup, support, and stopper for hydrofluoric acid 210 
 
 17i. showing the parallelometer wrench in position on locking stud . . . 219 
 177. Measuring posts on parallelometer in position for all measurements 
 
 from (5 mm. iip to and including 10 mm 219 
 
 17v Measuring posts in same clamps as in preceding cut, but with the dis- 
 tance between them increased to 10 mm 220 
 
 17!'. Showing position of measuring posts for all measurements from 10 mm. 
 
 up to and including 25 mm 220 
 
 IMI. Measuring posts in same clamps as in Fig. 179, but with the distance 
 
 increased to 40 mm 221 
 
 181. When the distance to be measured exceeds 40 mm., the parallelometer is 
 
 reversed and the measuring posts are placed in the clamps as shown 221 
 
 182. Measuring posts in same damps as in Fig. 181, but the distance has 
 
 been increased to 55 mm 222 
 
 183. The above cut shows where the parallelodrill should be oiled . . . 223 
 JS4. Distance established between cuspids 224 
 
 185. Showing the operation of the parallelodrill reaming out two root canals 
 
 in the two upper cuspids to receive the split pin and tube 
 
 attachments 224 
 
 186. Showing the method of transferring the distance from the parallelom- 
 
 eter to the parallelodrill 226 
 
 187. Distance established between cuspid and lateral on opposite side of 
 
 the arch 228 
 
 188. Distance established between right cuspid and left lateral .... 228 
 
 189. Distance established between left cuspid and right central . . . 230 
 
 190. Distance established between right cuspid and left central .... 230 
 
 191. Finished splint ready to be inserted 232 
 
 192. A case of extensive restoration 237 
 
 193. A view of a splint made for a case of extensive restoration .... 247 
 
 194. Another view of the splint shown in Fig. 193, which, when it was first 
 
 made and worn, covered all the anterior portion of the jaw, as well 
 
 as the part now occupied by it " 247
 
 18 ILLUSTRATIONS 
 
 FIG. PAGE 
 
 195. The splint in position on the model 247 
 
 196. An occlusal view of the models of a case, showing the terrible havoc 
 
 wrought by neglect 252 
 
 197. The model of the upper teeth of case after six months' treatment . 2.12 
 
 198. The lower model model showing clearly the rebuilding of the anterior, and 
 
 sonic of the posterior, teeth by moans of the cast gold inlay and 
 cast base crowns 252 
 
 199. The upper and lower models in occlusion 252 
 
 200. An occlusal view of a finished case of extensive restoration by means of 
 
 cast gold inlays and two upper bridges 254 
 
 201. A side view of the same case upper and lower models in occlusion . 254 
 
 202. Diagram of face showing normal proportions 255 
 
 203. Chart showing geometrical construction of crown 256 
 
 204. Illustrating determination of proximal contact between molars . . 258 
 
 205. (1) A horizontal section representing the occlusal plane of the middle 
 
 third of an upper second bicuspid. (2) A horizontal section repre- 
 senting the occlusal plane of the middle third of a lower second 
 bicuspid . . . 259 
 
 206. Showing how perfectly occlusal surfaces may be carved in the wax and 
 
 reproduced by means of the casting process 260 
 
 207-209. Three illustrations of beautiful occlusal surfaces 263 
 
 210. Note the two illustrations on the lower portion to the left, with their 
 
 inefficient occlusal surfaces, and compare the four other illustra- 
 tions with their definite sulci cusps, and fissures 264 
 
 211. Showing the ways in which attrition manifests itself in different 
 
 types 265 
 
 212. Another type of the result of attrition 265 
 
 213-218. A case of extensive restoration 267 
 
 219-225. Gold inlays and porcelain or the silicates. A number of views of a 
 
 lower central fractured in a fall 270 
 
 226-232. A number of views of a lower lateral restored by means of a cast 
 
 gold inlay and synthetic porcelain 272 
 
 233-239. A number of views of a lower lateral involved by fracture and 
 decay restored by the use of a gold inlay in conjunction with 
 silicate cement root filled 274 
 
 240-246. A number of views of a lower lateral fractured in a fall. Extir- 
 pated pulp 278 
 
 247-253. Seven views of a lower cuspid, presenting another type or restora- 
 tion, also a combination cast gold inlay and porcelain insert . . . 280 
 
 254r260. Seven views of a broken-down cuspid restored with a cast gold in- 
 lay and a porcelain insert 282 
 
 261-267. A left upper lateral presenting a mesio-labio-linguo-incisal defi- 
 ciency restored to use and cosmetic acceptablencss by a cast gold 
 inlay and synthetic porcelain 284 
 
 268-275. Views of a right upper central presenting a large mesio-labio-linguo- 
 incisal deficiency, restored to use annd cosmetic acceptableness by 
 a cast gold inlay and porcelain insert 288
 
 II.I.rSTItATFONS 19 
 
 FIG. PAGE 
 
 276-282. Views of a left upper central presenting a mesio-disto-labio-incisal 
 deficiency, restored to use and cosmetic acceptableness by a cast 
 
 gold inlay and synthetic porcelain insert 290 
 
 2H:!-2S9. A number of views of a right upper central presenting an eroded 
 and pitted labial surface, a mesio- and disto-proximal cavity, and a 
 
 lingual enamel surface which was perfect, as was the incisal edge 292 
 
 290-296. Seven views of another type of restoration in an upper cuspid . . 296 
 
 297-303. Seven views of a right upper cuspid presenting a prehenso-labio- 
 
 linguo-mesial deficiency 298 
 
 304. Diagram showing refraction of light 307 
 
 305. Color chart 316 
 
 306. Method of obtaining a separation between two teeth which are to be 
 
 inlayed 330 
 
 307. Method of separating two teeth that lean towards one another . . 331 
 
 308. Manner of preparation of a simple cavity for a porcelain inlay . . 332 
 309-311. Foil between two layers of goldbeater's skin 333 
 
 312. A set of eight glass burnishers used in adapting a foil matrix to the 
 
 cavity in a tooth or in a die 334 
 
 313. A set of tantalum instruments 334 
 
 314. A small platinum tray 334 
 
 315-318. The mixing of the silver amalgam 335 
 
 319. Foil reposing between the layers of goldbeater's skin and the applica- 
 tion of the hand swager 336 
 
 .'L'". A disto-labial cavity in a central 338 
 
 '.'-}. A strip of platinoid bent at an obtuse angle and perforated so as to 
 hold the compound which is softened in the flame and deposited 
 
 upon the improvised tray 338 
 
 '.',-2. Carrying tray and compound between the teeth and forcing the ma- 
 terial into the cavity 338 
 
 323. Lingual view showing surplus of compound 338 
 
 324. Flat straight spatula to aid in placing and holding impression material 338 
 
 l'<-~t. A labio-disto-lingual cavity in a lateral 339 
 
 :'.Jii. First step in formation of tray 339 
 
 ..i'7. Second piece of metal 339 
 
 328. Improvised slide made from metal shown in Fig. 327 to fit into that 
 
 shown in Fig. 326 339 
 
 329. Showing completed slide 339 
 
 330. Slide carrying compound and taking impression of lingual part of 
 
 cavity and all of distal part 339 
 
 331. Slide is raised and the impression is removed from the tooth in a lin- 
 
 gual direction 339 
 
 332. A linguo-mesial cavity in a lateral 340 
 
 333. The tray 340 
 
 334. The impression 340 
 
 335. The plastic instruments used as an aid to project the compound into 
 
 the cavity 340 
 
 336-338. Showing cervical cavity in a cuspid, the partly and completely 
 
 formed tray 340
 
 20 ILLUSTRATIONS 
 
 FIG. PAGE 
 
 339-341. A cervical proximal in a lateral and the partly and the com- 
 pletely formed tray for taking impression 341 
 
 342-346. A cervical cavity in the disto-labial surface of a molar, the partly 
 and the completely formed tray with compound in position on the 
 tooth, and the impression of the cavity 341 
 
 347-351. Same as shown in Figs. 340 to 349 on opposite side of the arch . 342 
 
 352-354. A disto-occlusal cavity in an upper molar, the partly and the com- 
 pletely formed tray 342 
 
 345-357. A labio-occlusal cavity in a molar, the partly and the completely 
 
 formed tray 342 
 
 358-360. Another type of disto-occlusal cavity in a molar, the partly and the 
 
 completely formed tray for taking impression 342 
 
 361-362. A mesio-occlusal cavity in a lowar molar and tray for taking 
 
 impression 343 
 
 363-366. A mesio-disto-occlusal cavity in a molar, partly and completely 
 formed tray for carrying the compound to take impression of this 
 cavity 343 
 
 367-370. M. O. D. cavity in bicuspid, partly and completely formed tray for 
 
 taking impression 344 
 
 371. A handle and set of trays, or cups, which may be trimmed to suit the 
 
 case to facilitate the taking of impressions of various cavities . . 344 
 
 372. The Protector of David 378
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 CHAPTER I 
 INTRODUCTION 
 
 SEQUENCE OF THOUGHT AND ITS VALUE IN 
 TEACHING 
 
 Usefulness, in the broad sense of the word, determines the 
 value of man to mankind. Usefulness is the purpose of this 
 volume. To help, to improve, to simplify, to make clear obscure 
 problems in this particular field, will mean a better equipped 
 profession, and hence must mean betterment to the great human 
 family depending upon our profession for their comfort and 
 health. 
 
 The ambition to determine definitely for the profession the 
 best mode of procedure in this work, to coherently elucidate 
 innumerable points much discussed and poorly understood, to 
 delve into all crevices of the task, to throw the ray of sane, 
 investigating reason into the shadows of the recesses, to at- 
 tempt and succeed in proving all statements, to evade noth- 
 ing, a task to be reckoned with but worthy of the best efforts. 
 
 To best serve its purpose, this volume must be both ele- 
 mentary and postgraduate, and no apology is offered if, at the 
 beginning, it may appear to the student that he is reading some- 
 thing he already knows. In fact it is best to make it plain now, 
 that in order to be truly useful, and readily comprehended, 
 leaching must always begin with something already well estab- 
 lished in the student's mind, 
 
 In attempting to teach a body of students or a single stu- 
 dent anything their or his knowledge of which is deficient, it 
 is conducive to best understanding to start at first principles. 
 
 To be efficient, a textbook must be so written, and par- 
 ticularly so begun, that the first thing to greet the student 
 
 21
 
 22 CAST GOLD AND PORCELAIN INLAYS 
 
 mind is a statement of a fact, or a fact, already fixedly estab- 
 lished in his mind; and from that lone but well-established fact, 
 all avenues of research and investigation and proof must issue, 
 to converge again at and upon a perfectly logical and hence 
 well dovetailed conclusion. Thus it is seen that sequence in a 
 textbook plays a great part in determining how valuable the 
 book is to prove to the student. 
 
 We must have then, a well-known fact, a universally known 
 fact, so far as our profession is concerned, and proper sequence 
 as we go along; and we must, after diverging with proper 
 sequence and reaching into every cranny of the process, so con- 
 verge our thoughts that only one, and that the proper conclu- 
 sion, is possible. 
 
 The foregoing qualities will make up a useful and neces- 
 sary textbook. It is easy for the student to prove the real 
 value of this book to himself by carefully reading it from the 
 beginning, and if he reaches his conclusions before he finishes 
 the last chapter, and if his conclusions coincide with the con- 
 clusions of the book, then the correctness of its logic is proved, 
 and its value as a textbook becomes apparent. 
 
 If I were to attempt to teach the science of cooking, I 
 should begin my textbook's first chapter with the statement 
 that food is absolutely essential for the maintenance of the 
 various functions that make up the activities of mankind, and 
 the animal as well as the vegetable kingdoms. That would be 
 stating a fact already well established in the student's mind, 
 so fixedly established that no amount of argument could dis- 
 lodge it. From that lone fact, I could send out mental expedi- 
 tions of investigation into e<very phase of the question, covering 
 food as to kinds, quantity and quality, necessity and luxury; 
 food for man, for animal, and for vegetable: and we could, 
 after discussing all of them, their origin and preparation, and 
 reasons thereof, their comparative values and reasons there- 
 for, so converge my findings as to very properly feel that the 
 very best thought with which to end the book would be the food 
 thought. 
 
 Were I to attempt a work on architecture, does it not seem 
 to you, the neophyte, the uninitiated, that it would be best to
 
 SEQUENCE OF THOUGHT Z6 
 
 start at the very beginning of tilings and state a fact already 
 fixedly established in your neophytic mind? Suppose then, 
 I were to say that man is poorer than animal in brute force, 
 and richer than the animal in intellect; and that even prehistoric 
 man had a cave to live in, to house him and his descendants: 
 that would be stating a simple and true fact, already well estab- 
 lished in the student's mind (in any mind for that matter), and 
 how easy it would be to logically follow up that simple state- 
 ment of fact and show comprehensively that that cave or dwell- 
 ing varied in size with the requirements of the human numer- 
 ically, and that it varied in kind with the requirements of the 
 human geographically. 
 
 Could I not very naturally go on to show how, with the 
 evolution of man from prehistoric type to complexly civilized 
 variety, desires, requirements and habits changed and brought 
 on housings as different from the prehistoric cave in appear- 
 ance and in service as, let us say, Gladstone differed in type and 
 mentality from prehistoric man? 
 
 So may I not very simply, and very truthfully, and with 
 clarifying and illuminating sequence, go to the next statement 
 which tells us that with the great increase in the human species, 
 came the emigration of tribes into various corners of the globe, 
 and that their various requirements in the direction of being 
 properly housed, were influenced as before by geographic and 
 geologic conditions ! Perhaps too, in their travels to their new 
 locality, they had imbibed some of the beauty of Nature's vast 
 architecture, and had become desirous of injecting part of it 
 into their own handiwork. This seems very reasonable, and so 
 one can go on and readily proceed to show how the architecture 
 of today originated, how it grew and developed into its apparent 
 complexity, but in reality into its scientific simplicity. I can 
 trace them all, the Greek, the Koman, the Ionic, the Benaissance, 
 etc., and can, after tracing them all with proper sequence and 
 perfect logic, so converge my findings as to very properly feel 
 that the very best thought with which to close the book on archi- 
 tecture would be the thought that the human is poorer than the 
 animal in brute force, but richer than the animal in intellect. 
 So, in the beginning, for his own preservation and protection,
 
 24 CAST GOLD AND PORCELAIN INLAYS 
 
 and for the protection and preservation of his species, he built 
 himself a cave, and it grew and he grew; and, because of 
 superior intellect, he outgrew the cave and built for himself a 
 hut; and because his intelligence further grew, he discarded 
 his hut and built for himself a house mark you, a house. Still 
 his intellect grew and lie traveled; and he saw the wonderful 
 beauty of the heavens and the earth, and the sun, and the stars, 
 and the streams, and the oceans, and lo and behold! his desires 
 to see all these beauties before him at all times were father to 
 his attempt to reproduce them in his dwellings! So his intellect 
 grew, and so art was born, and so man builds for himself palace 
 and paints for himself pictures of the things he has seen in his 
 migrations and travels. 
 
 THE CHIEF FACTORS INDUCING COORDINATE 
 MENTAL EFFORTS 
 
 The Optic Sense 
 
 A fact has been poorly stated, or a statement has been 
 improperly presented, unless it produces within the mind of 
 the person to whom it is presented a coordinate effort reaching 
 out for further information on the same subject. Thus a subject 
 is never closed, never completed until its power to awaken 
 mind-developing desires and efforts for further research in it, 
 has been exhausted. 
 
 Mental efforts are of two kinds mind-developing and mind- 
 disturbing. Both may be coordinate, and both may mean mental 
 activity. One is productive and good; one is destructive an-d 
 hurtful. One, being good, is, of course, absolutely harmless; 
 one, though hurtful, may, for a long period, seem productive 
 and good; thus its malignancy is greater than it first appears 
 to be. 
 
 The things we see, the things we hear, the things we touch, 
 the things we read, all induce mental efforts of one kind or 
 another. These mental efforts are crystallized into thought, 
 and, as the case may be, these thoughts manifest themselves 
 in our acts, daily or unusual. If the things we see are beautiful 
 to us, the pleasing effect upon our retinae is cumulative and re-
 
 XCE OF TIKHHJliT 25 
 
 current; and directly as tlie effect upon our visual sense is the 
 power of the things we see to induce coordinate mental effort. 
 To see a thing beautiful is to long to see more of it, to be near 
 it that is the first mental effort induced upon us. Although 
 some may not consider it so, in the ultimate analysis we learn, 
 nevertheless, that it is so. 
 
 \Ve go forth on a hot summer day to find the cooling com- 
 fort of some wooded country section. AVe enter the confines 
 of this section and our visual sense is pleased. That pleasure 
 is immediately reflected in our mental self, in that it causes 
 us to pause for a fraction, or an hour, or a day, and demands 
 that we look again, be it at the soft green of the grass, or the 
 tall trunks of the trees, or the overhanging bowers of whis- 
 pering leaves; and we do look again, and, looking again, we love 
 the scene more and long more for it. 
 
 This coordinate mental effort is now crystallized into 
 thought, the greatest abstract force in the universe, and thought 
 now manifests itself in our very next act. AVe cast about for 
 a means that will enable us to see and absorb more of the beauty 
 at hand with the least expenditure of physical effort. It is not 
 essential that we see this green grass, these tall trees, or leafy 
 bowers. \Ve may will for them only, and, if our mental effort 
 in that direct ion be acute enough, we may run through the 
 same cycle. Thus we have the will producing a mental effort, 
 crystallizing into thought, manifesting itself in a distinct 
 physical act. There is the subconscious mental, the conscious 
 thought, and the physical manifestation. 
 
 The will to call forth the mental impression, crystallizing 
 into thought on, and of, beautiful things, such thoughts later 
 manifesting themselves in our respective acts while calling 
 for both mental and physical activity, is in no way hurtful or 
 exhaustive. 
 
 AVe leave our enchanted little Eden, or oasis, and come out 
 into the broad grass prairie shriveling beneath brilliant rays 
 of the noon sun. AVe are as yet in the grasp of the beautiful- 
 aware of the effect produced upon us by our communion with 
 the beautiful -and the sum total of this effect is in the period 
 of transition; that is, in the process of being stored up within
 
 26 CAST GOLD AND PORCELAIN INLAYS 
 
 the memory cells of that part of our brain which concerns 
 itself with the doings of our subconscious ego. We see nothing 
 of the dying grass or grain, our feet move lightly over the 
 parched earth, while our eyes are turned upward in awe and 
 wonder and admiration of that wonderful ball of shooting fire 
 sending out rays that light and heat and stimulate to growth 
 a billion and half of people, and a quint illion and a half of 
 animals. As we look upon it we wonder, and will to look upon 
 it more, and that mental effort crystallizes into thought coordi- 
 nate, all coordinate and yet, what is this physical act now 
 manifesting itself! To be sure, we might have known, the rays 
 of the sun blind, hurt, and cut the eye; and so the hand goes 
 up to shield the careless member. Now, as in sheer pain we 
 look down at our feet and visually sweep our immediate sur- 
 roundings, we see that the rays that light may also ignite, the 
 rays that heat may also scorch, and the rays that stimulate may 
 kill. We slowly begin to realize that we have mistaken a mind- 
 disturbing mental effort for a mind-developing one. Both are 
 coordinate, or may be; both mean mental activity. One is pro- 
 ductive and good; one is destructive and hurtful. One in being 
 good, is, of course, absolutely harmless; one, though hurtful, 
 may, for a long period, seem productive and good. Thus the 
 malignancy of some mental efforts is greater than it first ap- 
 pears to be, as shown here above. 
 
 The Auditory Sense 
 
 The things we hear, how powe<rful a factor are they in 
 arousing us to mental efforts, mind-developing or mind-disturb- 
 ing, as the case may be ! Because of things heard, empires were 
 born and destroyed, maps of continents were changed, armies 
 faced one another in gory contests, and innumerable lives were 
 sacrificed upon the altar of gossip ! 
 
 Krishna, Confucius, Buddha, and Moses heard the voice of 
 the great Universal Mind, or Spirit, or Soul, and the fate of 
 millions was changed. Pharaoh heard the voice of Moses, and 
 the children of Israel were free to follow the great leader. Yes, 
 and the children of Israel heard the voice of discontent and 
 greed, and they were ready to follow the golden calf. Cleopatra
 
 SEQUENCE OF T If OUGHT 27 
 
 heard of the great Antony, and the conquest of Egypt way 
 the time being forgotten. Octavius then heard the voice of 
 opportunity, conquered Egypt, and Cleopatra died. 
 
 Like other great leaders mentioned, Jesus* heard the voice 
 and transmitted and translated it to, and for, the people, in the 
 si i ape of a doctrine of righteousness and goodness and peace and 
 tranquillity and happiness. The people were free to follow if 
 they willed, and some did; but the great number heard the 
 voice of doubt, and they are still traveling in the desert. 
 
 The voice Jesus heard and gave to the people what has 
 become of it, and what have they done with his teachings? 
 There are a dozen different sorts of Christians, each proclaim- 
 ing themselves the right sort and real original followers of 
 Him who heard the voice and told freely of what He heard, 
 and none of the different ones professing belief, have faith 
 enough to realize that they themselves may hear the great Voice 
 if they but will to hear it. But they have heard, instead, the 
 voice of doubt, and the mirage upon the sands of their own 
 mental desert lures them astray. 
 
 And we, who some time or other go forth upon some pleas- 
 urable little excursion and perhaps lose our way for a spell in 
 the tranquillity and peace of the forest, may just be fortunate 
 enough to come upon some bird singing his love song to the 
 creative spirit. As we hear the wonderful notes tumbling over 
 one another in their eagerness to arrange themselves into a per- 
 fect ly wonderful symphonic harmony of appreciation and joy, 
 we are enthralled and roused at once. That is the impression, 
 is it not? Now comes our mental effort to follow each trill 
 and each bend of each note; and that mental effort is it not 
 crystallized into thought that great abstract force in the uni- 
 verse as w T e begin to think of the wonder of it all and marvel 
 at the beauty and its influence upon us? And does not this 
 thought now manifest itself in our very next physical act, in 
 that our very physical being smiles for sheer joy, our head is 
 erect, our ears are alert, our chest is expanded, and we are, 
 in fact, physically better for having heard the voice that induced 
 the will to cause the mental effort which crystallized into 
 
 *The nanio Jesus is IK-IT usi-d to epitomize the ideal monotheistic man, the 
 iilrul Israelite, who so thoroughly recognized his relationship to the Cosmos and 
 whose work has been " most ignored by those who most pretend to follow him.
 
 28 CAST GOLD AND PORCELAIN INLAYS 
 
 thought, and which thought, almost instantaneously, manifested 
 itself in a distant physical act? And again let it be said that 
 the will to call forth the mental effort, crystallizing into thought 
 on, and of, beautiful things, and which thought later manifests 
 itself in a distinct physical act, while calling for both mental 
 and physical activity, is in no way hurtful or exhausting. 
 
 As we leave the foliage home of the Great Spirit, the home 
 where every tree, every branch, every leaf, is an altar of wor- 
 ship and a worshiper at once, and where every bird worships 
 his Creator in musical praise and adoration, we are as yet in 
 the grasp of symphonic harmony, aware of the effect produced 
 upon us by our communion with the beautiful, and the sum 
 total of this effect is in its period of transition, so far as we 
 are concerned; that is, it is in the process of being stored up 
 within the memory cells of that part of our brain which concerns 
 itself with the doings of our subconscious ego. 
 
 We are out of the foliage, into the field, with a clear view 
 for rods ahead of us, and we see in the distance swarming 
 masses of people; we realize suddenly that some sound is crav- 
 ing our aural attention. It is music too. The will to determine 
 the change as to kind causes a mental effort to compare. X<>, 
 it is not the immaculate trill of the song bird, not the per- 
 fect, the beautiful, the soulful harmony of the feathered little 
 interpreter of the divine language of perfect trust and under- 
 standing. It is the intensely electrifying call of a bugle that we 
 hear, that is the thought crystallized from the mental effort 
 to compare., which in turn was caused by our will to determine 
 the change as to kind; and that crystallized thought now mani- 
 fests itself in a distinct physical act, in that we hasten our walk 
 to more quickly reach the field of action. Rapidly we walk 
 onward, our eyes fixed upon the swarming, teeming mass, our 
 sense of hearing alert to every incisive call of the bugle, inter- 
 rupted and augmented now and then by the thunderous beating 
 of the drum. 
 
 Instinctively we realize that, as a part of the teeming, 
 swarming mass of men, we are facing some sort of a crisis. 
 \Ve are near enough now to recognize that two opposing armies 
 are engaged in a hand to hand battle; we hear the clang of the
 
 SEQUENCE OF THOUGHT 29 
 
 bayonet and the rays of the sun scorn to dissolve the blades 
 into an ever halving- ocean of scintillating steel. Upon a hill 
 not far distant, the artillery is feverishly working to get the 
 rapid-firing gun into action; and now the prophet of death and 
 destruction and desolation speaks in a staccato of killing syl- 
 lables. And man, the image of Ciod, kills; and man, the image 
 of God, dies, a roar of victory, mingled with a cry of pain! 
 
 The bugle calls, the drum encourages, the army rushes 
 forward, the conquered slowly retreat. Another roar of the 
 cannon, another Catling gun address from the hilltop, and more 
 things made in the image of God see no more, hear no more, and 
 work no more. The conquered host becomes disorganized and 
 breaks into a demoralized run, leaving the field of conquest 
 strewn with the bleeding dead. 
 
 Tremblingly we hear the bugle call again, a long call, a sort 
 of minor note, plaintive and gladsome at once, followed by an 
 insistent and imperative order to desist from pursuit and cease 
 firing. 
 
 The battle is over. We realize somewhat hazily as yet, that 
 somehow humanity has been weighed and found wanting, that 
 it has been tricked by its own lack of understanding. We can 
 see the suffering thousands writhing in the death agony of 
 man-inflicted wounds. We can picture to ourselves the thou- 
 sands of homes of mourning, of despair, of desolation. We see 
 widowed women, orphaned children, starving families, uttering 
 prayer upon prayer, and curse upon curse. We can see also the 
 land of the victorious in the throes of delirium. The news- 
 papers are singing the praise of the great victorious soldiers. 
 The town is decorated in their honor. We see the fireside of 
 the returned victor ablaze with light; joy seems to have run 
 riot in this circle; a helpmate and clinging children, eagerly 
 listening to his minute account of the great battle ; he glories in 
 the mess of blood and carnage left behind him; his face seems 
 transfixed; his eyes are staring straight ahead. His finger 
 pointing at the imaginary foe, he tells what a wonderful, mad- 
 dening effect the persistent call of the bugle had upon his men- 
 how it spurred them on to victory, and the enemy on to death. 
 
 The reaction is upon us in its full and remorseless effect.
 
 30 CAST GOLD AND PORCELAIN INLAYS 
 
 Dry sobs of contrition may shake our physical frame, but they 
 are as nothing to the mental agony we have gone through. 
 Weary in body and mind, we ponder over the whole problem, 
 and slowly the mist begins to clear. AYith the clearing of the 
 mist, comes power of greater mental vision, and we begin to 
 analyze the situation; to reach into the vitals of the wherefore; 
 to find that humanity has been, and is still, being tricked into 
 murderous impulses and killing contests not by the call of 
 the bugle, not by the beating of drums, but by a lack of clear 
 understanding, a lack of a clear vision, an incapability of seeing 
 the great love light of the infinite tolerance, and absence of 
 unity of purpose, and a greedy desire for advantage. 
 
 False leaders, pointing the road into eternal darkness, con- 
 taminate unto vileness the minds of their weakened followers 
 with doctrines that are as ephemeral as their motives are greedy. 
 They are responsible for the mental misconception of real issues 
 by a heretofore real people. 
 
 A year passes by, and the doctrines fall to pieces collapse 
 because they were built upon the quicksands of untruth. Other 
 false leaders with other false doctrines play their enticing tunes 
 to win the crowds; and so things have been going on until 
 man's mind (mass man, I mean) has become a chaos, a wilder- 
 ness, an instrument readily responding to martial influence and 
 impulses ready ever to be in on a killing. 
 
 The teachers, the leaders, their teachings, and their doc- 
 trines, are to blame. The warping of the public mind is their 
 doing, since they have had the public ear; the public eye has 
 been upon them. The misapplication of the public's mental 
 power to malformed problems presented and ever represented 
 with the sole purpose of so bewildering the public mind that 
 the real issue will forever be clouded and not be seen by it, may 
 be laid directly at the door of those whose teachings have been 
 accepted, and are being followed by the public. 
 
 They have men in such a condition mentally that they will 
 stand up, face, and kill one another for so-called good reasons, 
 ever kept before them by industrious exponents of the teach- 
 ings; and should they threaten to lag or demur or should per- 
 chance a ray of reason or light enter the mind of the killer or
 
 SEQUENCE OF THOUGHT 31 
 
 victim, and lie begin to doubt the wisdom of killing or being 
 killed, the heroic bugler is pressed into service with his elec- 
 trifying clarion call, and the thunderous drum; and dare-devil- 
 ishly, he puts his entire lung power into his efforts to rally and 
 encourage his comrades to face a few bullets and perpetuate the 
 system, always the same the doctrines apparently ever chang- 
 ing with the leaders, but the system always the same. Onward 
 Christian Soldiers! 
 
 And so they rally. They hear the call of the bugle, and the 
 healing of the drum, and that, to them, means kill, and they 
 kill. That the bugle call is music does not matter; that music 
 is the immaculate language in which all bird life speaks to its 
 creative spirit does not matter to the system; that music is the 
 infinite language that makes possible the intercommunication 
 of spirits, even as ordinary words make possible the intercom- 
 munication of man, does not matter. 
 
 The soldier, the citizen, the people, they 'have been told 
 and they know; they know, that bugle calling means rally 
 that bugle calling means kill; and so to them the waves of 
 electrifying sound have a destructive undertow, the bewitching 
 tune of the bugle is the reaper's own, and the symphony that 
 urges them on to battle, leads them unto death. 
 
 \Yc slowly begin to realize that they have mistaken a mind- 
 disturbing mental effort for a mind-developing one. Both are 
 coordinate, or may be; both mean mental activity. One is 
 productive and good, one is destructive and hurtful. One, be- 
 ing good, is, of course, absolutely harmless; one, though hurtful, 
 may, for a long period, seem productive and good. Thus the 
 malignancy of some mental efforts is greater than it first appears 
 to be, as shown here above. 
 
 The Tactile Sense 
 
 We have reached so nearly the vulnerable vitals of our 
 present civilization, that it will prove a relief to retreat into the 
 past. 
 
 If we attempt to learn how much of an influence the things 
 we touch may have in arousing us to mental efforts, mind-devel- 
 oping or mind-disturbing, as the case may be, it obviously 'can
 
 32 CAST GOLD AND POIU'KI.AIX INLAYS 
 
 make little difference whether we arc passive or active in our 
 process. In other words, for the purpose of consideration, it 
 will serve equally well to consider the sense of touch as a factor 
 in repose, actod upon; or in active, investigating- exercise of its 
 function. 
 
 Touch is first, accidental, impulsive, or premeditated; then 
 it is either seriously or idly investigative, defensive or offensive, 
 prehensile or repelling, cruel or caressing, constructive or de- 
 structive. It is therefore, respectively pleasing or abhorrent, 
 and in its final effect either salubrious or hurtful. 
 
 Touch, in itself is a distinct physical act, either accidental, 
 impulsive, or premeditated; and, being a distinct physical act, 
 it has behind it the abstract force called thought, crystallized 
 from some previous mental effort. Our investigation of its in- 
 fluence in rousing us to mental efforts must, therefore, be less 
 circumscribed, but more fully rounded. To put it into very 
 simple language, it is a case of starting at a beginning, com- 
 pleting a cycle, and coming back to a start. 
 
 When touch is accidental, the mental effort it rouses crys- 
 tallizes into a thought which manifests itself into a distinct 
 physical act, which is usually involuntary, automatic, and bene- 
 ficial. 
 
 When touch is premeditated, it is, as said before, the mani- 
 festation of a thought, or thoughts, crystallized from a previous 
 mental effort, and any mental efforts aroused by the physical 
 act of touching will be secondary, coordinate, and deductive, 
 which secondary, coordinate and deductive efforts will again 
 crystallize into coherent thought, which thought will manifest 
 itself in a physical act. This will go on in rotation, until the 
 power of the thing we touch to awaken within us mind-develop- 
 ing desires and efforts to further research in it shall have been 
 exhausted, for the time being at least. 
 
 It will not do to continue this any further at preseait, for 
 the simple reason that while every statement made is absolutely 
 true, it does not necessarily follow that the mere statement of a 
 truth makes it acceptable dogma to. the reader or student. 
 
 Since truth is conclusive, it follows that the student has a 
 right to read and review that which led me to truth and con-
 
 SKO.UKXCK OK TIIOCGHT 33 
 
 elusion, so that lie, the student, be enabled to reason as lie reads, 
 and perhaps reach the same conclusion as I, and that before 
 having read mine-. 
 
 And so let us all go back to the past not too far back at 
 once, lest we lose our way in the labyrinth of eternal time; 
 but let us go back to the day when Hying 1 machines were not 
 a reality. That is not so Jong ago. Here let us stop for a 
 moment, to find that we were quite the same people, with quite 
 the same habits, opinions, and peculiarities even, as we are 
 now. 
 
 For the purpose of our present needs, we, therefore, find 
 flying-machinelees time barren of attraction, and touch upon 
 it only to mark a milepost on the road upon which we journey. 
 Back farther we must go to the next previous era in the com- 
 plex commercial growth of our means of get-aboutness; and 
 so we linger at the point when railroads were not in existence, 
 and scan this period for any ray of light it may throw upon our 
 subject. 
 
 But, first, we shall mark the place with another milepost. 
 \Ye have wriggled through the underbrush of centuries of time, 
 with their obliterating effect of forgetfulness, and we must be 
 careful to blaze the trail so that we may safely return to the 
 present. \Ve shall find ourselves in strange surroundings upon 
 our return, else our journey into the past shall have been in 
 vain. 
 
 A railroad is a carrier born of the human desire to con- 
 serve time. 
 
 Time, next to thought, is the most precious heritage of 
 man. Time is life, real eternal life. A waste of time is a waste 
 of life. Anything which conserves time conserves life. 
 
 A railroad, as a carrier, shortens the time it takes to reach 
 one's destination from a given starting point. One can reach 
 two, three, or four places in the time it took to reach one. The 
 railroad made four hours grow where but one grew before. 
 To put it differently, four lives are mine who lived but one 
 before. 
 
 A railroad is great because it serves; and its greatness 
 is in proportion to the multitude it serves. More service more 
 greatness.
 
 34 CAST GOLD AXO POltCKLAIX INLAYS 
 
 On the principle that no part can he greater than the whole, 
 the railroad can not be greater than he who conceived it; and 
 yet lie who conceived it may find that it outgrew his conception. 
 
 A railroad is definite, dependable, and helpful because it 
 has a plan, a starting point, and a destination. Nothing else 
 but good management matters. Given the four mentioned units 
 working in unison, a railroad serves, and, serving, becomes 
 great. 
 
 We lived before the raliroads Avere built; we lived quite 
 as long, but more meagerly, more slowly, and intellectually, 
 more poorly. AVe could, in our lifetime, see but one small part 
 of the things we may see today, and so we could, in our life- 
 time, learn to know but part of what we may learn to know 
 today. Possession of knowledge means possession of power- 
 as the former grows, the latter multiplies. 
 
 AVe were then a people, slower of motion, more meager of 
 life, and poorer in knowledge; but we were great; for we con- 
 ceived the thing we needed to ma"ke us quicker of motion, less 
 meager of life, and more wealthy of knowledge. 
 
 Ours is the railroad by right of conception, inception, and 
 safe birth. AVith all its wonderful attributes and cumulative 
 powers for good, the railroad outgrew our conception of it. AVe 
 conceived it for service and serving; it became great, and having 
 become great, we serve it. 
 
 Like great arteries supposed to carry life-giving substance 
 to the remotest parts of the great body of the people, railroads 
 now wind their course through the various sections of the con- 
 tinent, but we, who conceived them, own them no more; they 
 have slipped the halter of the multitude and become the weapons 
 of the few who are ever present in all communities. 
 
 The better the railroads, the more dangerous a weapon in 
 the hands of the few, and the greater menace to the many. 
 
 So it would seem that good roads are bad when they are 
 very good, and bad roads are not good even because they are 
 bad. 
 
 But it seems that the multitude might learn from the rail- 
 roads, and have a plan, a starting point and a destination- 
 manage its affairs well. Given these units working in unison,
 
 SKQTKNCK OF TIlorcilT 35 
 
 a multitude- shall serve itself best, and, serving, it shall become 
 great. 
 
 It must be remarked in passing that we are an impatient 
 race, all apparent evidence to the contrary. \Ve may be la/y 
 or indolent and our point of view perv< rted, but we really are 
 impatient, which, if we acknowledge it, proves that we are ever- 
 changing. 
 
 The thing to do seems too obvious to require notice. If 
 our point of vie^w is perverted, and we are impatient and are 
 ever-changing, then in order to turn all our seeming detriments 
 into benefits, we need but change our point of view; for that 
 becoming correct, and we being impatient, and we ever-chang- 
 ing we should then change in the direction of greater growth 
 and consequently progress. 
 
 Our view was not always perverted, for taking our im- 
 patience for granted, we have progressed in a way, or we never 
 could have conceived the railroads. The heavens are not al- 
 ways immaculate, and the earth is not always wicked, but one 
 would not dream of asserting that heaven was heaven because 
 it is not always immaculate, and that the earth persists because 
 of its wicked intervals. 
 
 (iood never comes from evil, but makes itself felt in spite 
 of it; and so our progress has come, not because our point of 
 view was perverted, not because we were lazy or indolent, etc., 
 but in spite of these things. 
 
 Our restlessness, our impatience, in their spasmodic efforts 
 to rouse- us, overcame our indolence. Our needs, manifesting 
 themselves, ihe spark of intelligence was fanned into the flame 
 of invention. The results were progressively and cumulatively 
 good, until our definite intention to grow was blurred by our 
 worship of the evidence of our growth, and we ceased growing 
 to serve growth. 
 
 AVhat has been said of the railroads applies to the steam- 
 ships, and in sequence to the horse, and the sailing vessel, and 
 again in sequence to the ox-team and the rowboat, and in se- 
 quence again to man's travel on foot and to the log which served 
 him in crossing the first body of water, which interposed itself 
 between him and further lands.
 
 36 <AST GOLD AND PORCELAIN 1XLAYS 
 
 A huge reel of film, rich in telling and epoch-making events, 
 unrolls itself before our mental eye, and we see the civilization 
 of today, and of yesterday, of this year and yesteryear, and of 
 this century and the last; and through it all, perhaps, the same 
 figure of man, the same grace of woman. We see the almost 
 ideal Switzerland, the would-be-right New Zealand, England 
 and its Monarchy, France and its Republic. Russia rises and 
 growls at us and reveals one of the bloodstains of the last 
 centuries. Turkey staggers under her misdeeds, and we call 
 Germany efficient. More films are seen as we go deeper into the 
 past. We see Austria born and Spain at its height, while the 
 boot of Europe attempts to crush the Hebrew race and loses 
 prestige for its pains. Darkness alternates with light, the stars 
 are cloud-obscured, and still perhaps the same figure of man, 
 the same grace of woman. More films. The Roman empire in 
 its powerful strides towards the rule of the earth; Greece, the 
 beautiful mother of the beautiful. The Huns terrorize a con- 
 tinent, and the scene shifts to Asia, to Africa, to America 
 no matter. Now see the Ancients come to life; the building of 
 the house of worship of one and only one God by the Jews; the 
 rise of the same race from slavery to the position of powerful 
 people. See the mummies of ancient Egypt, and follow the lore 
 of the Chaldeans. See Assyria, Babylonia, Arabia, and now see 
 Egypt at its height of glory about to be humbled. 
 
 Watch the films and see the dismemberment of nations, the 
 dwindling of powers, and the loss of definition as to the out- 
 line, boundary, and position of authority. Eons are passing and 
 you must note the gradual and persistent change in the human 
 being, as we recede into the hazy past. 
 
 When we reach the beginning of the cave era in the de- 
 velopment of man, we shall have gone back far enough for our 
 present needs; for the difference in the man of today and the 
 man of erstwhile cave time, is so unquestionably apparent that 
 no one will fail to see it. 
 
 It will be noted that we have retraced our march to the 
 beginning of the cave era, and our reason for this was to get 
 in touch with the human while he was in a transition period, 
 about to climb from a lower to a higher level ; our purpose be-
 
 SEQUENCE OF THOUGHT 37 
 
 ing to ascertain .just what part the sense of touch, active or 
 passive, played in the transition of the animal biped, from a 
 beast, lacking in intelligence, to a comparatively intelligence- 
 possessed, nearly human being. 
 
 It must be remembered that these beings were the fore- 
 runners of man of today, they lived in the day and through 
 it without a thought of the morrow. Might alone was the tri- 
 bunal that decided for them. Their members were few, and 
 they had reached their present stage in their evolutions from 
 the primordial slime, through no conscious cooperation on their 
 part. Like animals, they possessed the instincts of the sexual 
 urge, and the females had perhaps in addition to that the in- 
 stinct of mother love. 
 
 Suppose we select for the purpose of close observation, 
 three characters from this unhurried mass, and that these are 
 Brute Force, "Weak Hands, and Lily-white. 
 
 Brute Force, huge, massive, coarse-featured, sleepy, glut- 
 ton-faced, hairy, small-eyed, low-browed, a voice like a lion's 
 roar, a rage like the rending asunder of mountains, slow of 
 motion, and indifferent to surroundings, a consciousness of 
 power, only because bigger in bulk than the rest. 
 
 Weak Hands, tall, comparatively lean, agile, restless of "eye 
 and limb, rebellious in movement, alert ever to the impending 
 danger of crossing the path of the Brute, and resentful in every 
 motion of his quick body. 
 
 Lily-white, the female of the species, lithe in form, well- 
 shaped in limb, clear-eyed, well-featured and long-haired, sin- 
 uous of motion, sensuous in the pursing of her lips. She looked 
 well to the right of her and well to the left of her, behind and 
 in front of her. She saw Brute Force and the likes of him, 
 and liked them not. He, she figured in her simple intuition, 
 would crush her with his ponderous bulk. She could feel his 
 hot stinking breath upon her, and she reeled with apprehension 
 and illness. 
 
 To him she would mean nothing could mean nothing but 
 a mass to be ripped, torn, rent asunder into shapeless chaos to 
 satisfy his brutish sexual vehemence. 
 
 She stroked her arms, her face, her breasts covered with
 
 38 CAST GOLD AND rOltl'KLAlN INLAYS 
 
 her long lustrous hair, she allowed her hands to gently caress 
 her belly, and she trembled violently as she contemplated her 
 helplessness. 
 
 And yet, there was \Veak Hands, she rather favored him; 
 they seemed companions in their fear of Brute Force. She could 
 contemplate cave relations with Weak Hands without consider- 
 ing herself a shapeless mass in the aftermath. She could even 
 crave cave relations with Weak Hands, for her instinct told her 
 it was good. 
 
 Weak Hands was to be considered. A leer came into Lily- 
 white's eye. Weak Hands was to be desired. She wanted him. 
 She would have Weak Hands and mate with him, in spite of 
 Brute Force and his like, and just then wary Weak Hands 
 crawled out into the open from behind a rock and touched Lily- 
 white gently. She wheeled as if struck and they faced one 
 another for a spell. On his pale face she read longing and crav- 
 ing and passion. She saw his muscles twitch like the twigs of 
 a young tree in a fast wind; his mouth was open and his lips 
 seemed dry; his tongue seemed to fairly force his breath out of 
 him. His eyes were fixed upon her and seemed to travel from 
 her face down to her well-muscled abdomen and thighs. Her 
 hands instinctively shot out toward him, as her legs began to 
 tremble. Thus Lily-white conveyed to Weak Hands the mes- 
 sage that she was ready to mate and she wanted to mate with 
 him. 
 
 They were forced to seek cover by the approach of Brute 
 Force, who was on a hunt for Lily-white. She ran swiftly in 
 one direction, while Weak Hands crawled behind the rock and 
 thence downward until he reached his cave, into which he 
 wriggled. Here he felt safe from Brute Force and his roar. 
 The entrance was just barely large enough to admit the occu- 
 pant, but far too small for the great hulk of the giant chief. 
 
 Weak Hands sat upon a stone and stared into the semi- 
 ilarkncss of his cave. He reached out with his right hand and 
 picked up a stout stick that lay there, to carelessly toy with it. 
 His hand holding the stick moved aimlessly across the floor of 
 his cave immediately in front of him, and in its wanderings, 
 the stick embedded itself in a jagged hole of a round piece of
 
 OF Tiiorcirr 39 
 
 stone. Weak ] lands tilled at tlie stick to free it from its 
 prison, but in vain. His inability to separate the two tilings 
 irritated him. The small piece of stone was held in place by 
 a larger piece of the same material, and the stick was held in 
 the jailed hole of the smaller stone. The constant tugging of 
 Weak Hands finally moved tlie larger stone and suddenly the 
 queer combination of stick and stone held in the right hand of 
 Weak Hands, as liberated, and, describing an arc, the stone 
 struck the cave dweller full on the temple, while he, losing his 
 balance, found himself on the ground, speculating as to the 
 peculiar, strange, and unfriendly behavior of his slick and stone. 
 
 A change came over the cave man. He raised himself care- 
 fully and very slowly into a sitting position, and he looked first 
 at the stick, then at the stone on the end of it; then he deliber- 
 ately felt his head where it had come in contact with the stone, 
 and then he again looked at the stone and the stick, brought 
 them nearer the entrance and the light, in order to discover 
 the source of its power. With that end in view he swung it 
 slowly and gingerly toward his head. In spite of his care the 
 force of the contact startled him and he tried again, this time 
 on his thigh. The result was a grunt of pain and satisfaction 
 if we can conceive any such combination. 
 
 We may recognize now that there was no aimless move to 
 be detected in the activity of Weak Hands. He was alive, and 
 intelligence was dawning; that means that his movements had 
 behind them the quality of volition. The accidental and then 
 the premeditated touch or blow he had given himself started 
 things going in his mind. The touch roused a mental effort 
 which crystallized into thought, and these thoughts were mani- 
 festing themselves in his immediately following physical acts, 
 as we shall see directly. 
 
 Weak Hands crawled out of his cave into the great open 
 and stood erect. In his right hand he carried the wonderful 
 stick and stone; he brought it up directly in front of him and 
 studied it in awe for a spell. Suddenly he grasped the stick 
 firmly at the extreme end and swung it with all the force that 
 was in him to send the stony end of it swishing into the earthy 
 side of his cave, burying the stone from sight. Weak Hands
 
 40 CAST GOLD AXD PORCELA1X 1XLAYS 
 
 was tensely alert now. He withdrew his find and looked at it 
 again. It was none the worse for its work. He handled it 
 carefully now we might say he fondled it; he stroked the stick 
 and stone with his left hand, he brushed the side of his face 
 against it, and caressed it with his eyes. This satisfied him for 
 a few brief moments, then the cave man became strangely 
 active. He found an enormous stone near his cave; this he 
 moved up and barred the entrance. Then he turned his back 
 upon it, his extended right hand held the stick and stone up 
 before and above him; for a moment his eye was fixed upon 
 the stone, and we can see the light of definite inalterable pur- 
 pose suffuse his entire being; his right hand drops to his side, 
 and Weak Hands is off in his search for both Lily-white and 
 Brute Force and pray note he has burned his bridges behind 
 him. 
 
 With rapid strides he walked in the direction leading to 
 the giant's cave, a considerable distance off. From afar he de- 
 termined that Brute Force was asleep; his snoring caused the 
 very ground to reverberate . Lily-white sat beside the sleeping 
 mass of brutality. When the familiar guttural sound of Weak 
 Hands roused her from her stupid fear, she looked, and in com- 
 pliance with an imperative gesture from the man with the stick 
 and stone, she carefully crawled a few steps away from Brute 
 Force, then arose and walked to meet her caller. 
 
 Another guttural sound from Weak Hands and Brute Force 
 opened his small eyes to behold his pestering rival trespassing 
 upon his preserves. With a roar that struck terror to Lily- 
 white and brought her to a standstill, Brute Force was up and 
 at her in a moment. He grasped her by the hair and spun her 
 around toward the cave, then he made for Weak Hands. 
 
 A hideous grin from his glutton face, his ponderous, hairy 
 hands extended before him, he advanced toward the much 
 smaller Weak Hands who calmly waited. 
 
 This irritated Brute Force, he missed the sport of chasing 
 the ferret as heretofore, and it nonplussed him somewhat to see 
 another one of the tribe who dared stand still while he, the 
 chief, was advancing bellowing with rage. 
 
 The Giant reached out with his right hand to make short 
 work of Weak Hands when the right hand of the latter shot
 
 SEQUENCE OF THOUGHT 41 
 
 through the air and a crashing blow from the stick and stone 
 rendered the wrist of Brute Force's right arm a mass of man- 
 gled bone. 
 
 The brute stopped in his tracks, confused for a moment 
 only, then, frothing at the mouth with rage, and with his right 
 hand dangling uselessly by his side, he reached out with his 
 left hand to wreak vengeance upon the interloper. Again a 
 swift rise of \Yeak Hands' right, a furiously fast traveling, and 
 another crashing blow, and Brute Force was minus a useful 
 left arm and plus two useless dangling members. 
 
 Lily-white crouched near the cave, transfixed with terror 
 and desire, and the other members of the tribe had been at- 
 tracted to the scene by the roars of rage with which Brute 
 Force filled the air. They were standing rods away and looking 
 on in awe and fear and incomprehension at what they thought 
 was the foolhardiness of Weak Hands, who alone seemed un- 
 moved. 
 
 Brute Force, his face distorted with rage and pain, his eyes 
 bloodshot and his hands dangling by his side, put his mon- 
 st ions head forward and swayed toward this merciless physical 
 inferior and tried to butt Weak Hands, as if he would throw 
 him to crush him with his feet. Weak Hands stepped to one 
 side and quickly turned ; with all his might he swung his friendly 
 stick and stone and brought it crashing down upon the skull 
 of the staggering hulk. The giant's knees gave way under the 
 ponderous weight of the trunk. Another blow and Brute Force 
 had made the earth tremble with his roar for the last time. 
 
 Some of the members of the tribe rushed up to wreak 
 vengeance upon the presumptuous Weak Hands, who smote the 
 foremost one a crashing blow upon the chest with his weapon. 
 The crowd fell back in fear, and retreated. 
 
 AVeak Hands walked toward the giant and slowly touched 
 him with his foot. He motioned Lily-white over toward him and 
 placed Ids left arm around her shoulder; he slowly turned to- 
 ward the onlooking tribe and motioned them to remove the body 
 of the late chief. His gestures were obeyed with alacrity and 
 he and Lily-white were left alone. 
 
 The stick and stone were at his right shoulder, and she was 
 in his left arm. She looked at him and marveled and trembled
 
 42 CAST GOLD AND rOUCKLAlX JXJ,AYS 
 
 and moved her hand caressingly across his face, his chest, his 
 arms. He looked at her face, and her breast and her hair, and 
 his arm grew tighter around her. His breath came faster and 
 his nares expanded. Thus they stood for a spell Weak Hands 
 and Lily-white. Then they raised their eyes to the far-off coun- 
 try and saw the sun go down to its rest. 
 
 It calls for no very great analytic power to enable one to 
 discern how far-reaching an influence the sense of touch had 
 in awakening mental efforts within the three characters in the 
 preceding sketch, and it requires no very keen sense of judg- 
 ment to realize that they were variously influenced by the same 
 sense of touch. 
 
 To Weak Hands the accidental touch meant the awakening 
 of a mental effort which crystallized into coherent thoughts, 
 which manifested themselves in a series of distinct physical 
 acts, partly involuntary and automatic, partly premeditated, 
 and for him ultimately altogether beneficial. 
 
 To Brute Force, the premediated touch or blow from the 
 stick and stone controlled by Weak Hands aAvakened within 
 him mental effort of such low order that it crystallized into 
 thought of such poor rationality, that these thoughts manifested 
 themselves in such irrationally aggressive physical acts that 
 they brought to him destructive tactics from Weak Hands and 
 their destructiveness increased with the irrational perseverance 
 of offensive tactics on the part of Brute Force. 
 
 Thus the performance went on until the giant had fallen 
 an easy prey to the mind-developing mental effort of Weak 
 Hands, on one side, and his own mind-disturbing mental effort 
 on the other. Nor did the cessation of the battle prove the end 
 of .the series of mental efforts, crystallizing thoughts, and phys- 
 ical acts, and again mental efforts and crystallized thoughts, 
 etc., so far as Weak Hands was concerned, and through him so 
 far as Lily-white was concerned. 
 
 The moment his touch of the weapon became premeditated, 
 it was the manifestation of a thought crystallized from a pre- 
 vious mental effort, and, in turn, roused mental efforts which 
 were secondary, coordinate and deductive, which secondary co- 
 ordinate and deductive mental efforts again crystallized into 
 coherent thought, which coherent thought again manifested
 
 SK(,>rKX('E OF TIHU'CHT 4.') 
 
 itself in distinct physical acts. This went on in rotation until 
 the power of this newly found friend to awaken within him 
 mind-developing -desires for further research in it or with it 
 was exhausted. 
 
 It is quite safe to assume that this stick and stone as the 
 crude ancestor of the modern scepter has held, and is still 
 occupying a more or less prominent place within the cryptic 
 mind of modern "Weak Hands, with benefits to some, and dire 
 results to others. 
 
 Reading- and Its Influence to Coordinate Action, Mental and 
 
 Physical 
 
 The things we see, the things we hear, the things we touch, 
 result as shown before, in what we think, and, as also shown 
 In-fore, in the things we do. 
 
 Xow, it is so with some that the things they see, hear 
 and touch, rouse them to mental efforts which crystallize into 
 thoughts, which thoughts manifest themselves in the physical 
 act of writing or recording what they saw, heard, and touched. 
 
 Thus are things recorded, that their contemporaries or 
 posterity may learn of what the recorders, or writers, saw, 
 heard, and touched, or by which they were seen, heard, or 
 touched. 
 
 Seven thousand years of this world's history have been 
 recorded correctly and incorrectly. 
 
 A great many of the records are mere guesswork, and were 
 made long after the events to be recorded were supposed to 
 have taken place. It is only the last few centuries that can boast 
 of absolute authenticity of chronicled past happenings, because 
 it is only a few centuries ago, that it became easy to record 
 things in so multiple a way and in so comprehensible a manner 
 that no doubt was left as to the things said to have happened, 
 having really happened. 
 
 Thus the invention of the printing press easily stands up- 
 permost and foremost in the rank of causes for properly under- 
 standing why humanity does not understand. 
 
 This is not written with any attempt to make it seem clever 
 that is a bitter pill, which leaves a hitter taste, and, sugar off, 
 the bitterness remains.
 
 44 CAST GOLD AND PORCELAIN INLAYS 
 
 Millions of books have been written by as many writers 
 upon as many subjects, and these books have been read by many 
 more millions of readers, sometimes for mere amusement, some- 
 times in an ardent search for truth. 
 
 It is only natural that these readers should have been in- 
 fluenced in their directions and modes of thinking by the crys- 
 tallized thoughts of the various authors and since a man's acts 
 are what he thinks, it follows that the work done by the readers 
 was enhanced or adversely modified by what they read. 
 
 Thus we see at a glance how great a responsibility they who 
 write assume. 
 
 The sum total of all science is already existing in this 
 universe, merely awaiting our discovery of it in its affirmative 
 actions. That is proved by the wonderful cosmic progression 
 which is taking place in a definite, unhurried, and absolutely 
 irresistible manner, and tends always towards a more complete 
 evolution to a higher type from a lower one. 
 
 The more complete a realization an author has of this won- 
 derful cosmic urge, the more valuable in the end will be his 
 writings to his readers. 
 
 It may be a novel, a treatise, a catecism, or a dogma ; all 
 these are valuable, if the author realize the fundamental cor- 
 nerstone of all knowledge to be the clear demonstration of the 
 working of all for each, and of each for all. In this manner 
 only can he bring home to his reader a full recognition of the 
 interdependence of all media in the universe, and upon a com- 
 plete recognition of this interdependence must rest the basic 
 mental effort of his work. 
 
 A great many books have been written with an absolute 
 disregard to this truth, and often in direct opposition to it, a 
 great many of these books have been read and accepted by the 
 readers as a guide for subsequent thinking and hence actions. 
 Thus the errors of one, have become the misdeed of the many, 
 and the misdeeds of the many have grown into a plague for the 
 whole. 
 
 How often do we hear the words, "I should have been 
 earlier, if I had not lost my way," and how infrequently do we 
 realize the significance of this utterance. 
 
 It is an absolute fact that untold men and women have lost
 
 SEQUENCE OF THOUGHT 4.") 
 
 tlieir way on their road to complete evolution from a lower to 
 a higher type, not permanently, for that, because of the irre- 
 sistible law of cosmic progression, is impossible; but for the 
 time being, and they will arrive, undoubtedly. They will 
 awaken to throw off the retarding blanket of mind-disturbing 
 mental efforts and strike out into the broad highway of clear 
 understanding. They w.ill come under the influence of mind- 
 developing mental efforts and they will arrive, for can we not 
 recall the sentence, "I shall light a candle of understanding 
 within their hearts," which means that they who have eyes shall 
 see, and they who have ears shall hear ! 
 
 It does not matter how many beings are at present in the 
 grasp of misunderstanding; that is it does not matter so far 
 as the ultimate result is concerned. 
 
 The one regrettable fact is that these beings are so to 
 speak in bondage so long as they persist in their course. Ulti- 
 mately they will turn about and reach the destination assigned 
 for humanity which is complete evolution. In the interim, they 
 will have suffered, and will have brought suffering to many. 
 All that, because one man was blind and recorded the black of 
 night and called it the ray of light. 
 
 It is incontrovertibly true, that ultimately we shall all have 
 a correct understanding of the interdependence of all media in 
 the universe, in spite of all the erroneous theories spread by the 
 reading of hybrid volumes. They shall be forgotten, lost and 
 destroyed by the virulence of the thoughts they called forth, 
 for we see that everything in Nature tends ever to a fuller 
 expression of life, and life means completeness, and the full 
 expression of life implies happiness, and happiness implies har- 
 mony, and harmony implies order, and order implies proportion, 
 and proportion implies beauty, and (lest we forget) the will to 
 call forth the mental impression, crystallizing into thoughts on, 
 and of, beautiful things; such thoughts later manifesting them- 
 selves in our respective acts, while calling for both mental and 
 physical activity, are in no way hurtful or exhausting. 
 
 Thus we recognize the existence within us of an inexhaust- 
 ible supply of energy to oppose and surmount the deleterious 
 and self-destructive influence of the secondary, though coordi- 
 nate, mind-disturbing and incorrect mental efforts awakened
 
 46 CAST GOLD AND POHCKLAIN' INLAYS 
 
 by the mind-disturbing propaganda of the unfortunate authors 
 of misfortune spreading 1 thoughts. 
 
 If a more concrete example of the influence of reading in 
 rousing us to mental efforts he required, I would submit for 
 your consideration, the reading of Kipling's "If." 3t is in- 
 spiring and powerful, and throbs with the essence of truth and 
 purpose and a lofty ideal. It will stir you with its mighty pur- 
 pose for humanity's growth, and it will awaken within you, 
 mental efforts which will crystallize into thoughts, which 
 thoughts will manifest themselves in your physical acts. You 
 will know more, think more clearly, and work better; and all 
 these enhanced activities, though calling for an apparently in- 
 creased expenditure of both mental and physical effort, w T ,ill 
 prove in no way hurtful or exhaustive. 
 
 Again I would submit for your consideration, Tom Moore's 
 "Veiled Prophet of Khorassan." It will rouse you and thrill 
 you, and shake you and wake you, and almost kill you with its 
 insane emotions of the insane prophet and his benighted fol- 
 lowers. 
 
 It will rouse 'you into mental efforts which will crystallize 
 into thoughts, which thoughts will probably manifest themselves 
 in the physical act of your nausea. It will leave you less virile, 
 more fretful, and almost consume you with the fury of your 
 anger at one of thousands who have duped the world's inno- 
 cents, and are still duping them to the holy tune of "Blessed are 
 they that know not and believe." 
 
 A Consideration of the Foregoing 1 Plus Our Ideal 
 of a Task 
 
 If \ve read the foregoing carefully and follow the trend 
 of the thought it expresses, we must realize that usually our 
 thoughts and deeds are tinged to a great extent with the hues 
 of the deeds of those that have gone before, and we realize also 
 that in this manner are traits, habits, and usages formed and 
 confirmed. 
 
 If that were a fixed rule in the evolutionary strife of the 
 cosmos, there would be cosmic repetition instead of cosmic pro- 
 gression, and there would be no need whatever to attempt to
 
 SKQCKXCI: or TiiorciiT 47 
 
 form a new spectral aspect of things in general, an<l this part 
 of what shall prove a recreative art in particular. 
 
 But this is not a fixed rule, fortunately, and the lixiiy and 
 influence of this rule, or rather tendency, varies inversely with 
 the number of humans that start their tasks, no matter what 
 they he, from the standpoint of simple feeling. 
 
 Xow what does this mean? It means just this: AVe seek 
 to express in our work that which we feel we would have the 
 work he, and that brings us to the problem of attempting to 
 feel ourselves to he so possessed by our ideal of what we wish 
 to do, that our accomplishment of the deed will be a physical 
 manifestation of what our ideal of it was. 
 
 If the sum total of our efforts in this cosmic certitude be 
 nothing but a reflection of the mental efforts, crystallized 
 thoughts, and physical acts of those who were here before us, 
 or even here now, plus the expenditure of a given amount of 
 energy, then the most we can hope for is to make fairly accurate 
 constrnctionists or analytic scientists of ourselves. 
 
 But, if we take what we see, hear, touch and read, and care- 
 fully absorb what is thus offered, and then, putting these into 
 the background for a moment, start our task with an ideal of 
 what we wish to accomplish; in other words, if we feel whai 
 is required, and we have a conception, an ideal of what the thing 
 that is required must look and act like; that is, if we start 
 our task from the standpoint of .simple feeding, we have, not 
 only the chance but the assurance, that our work will transcend 
 the scope of simple mechanics, and it will, in truth, become 
 creative. 
 
 The interdependence of all media in the universe makes it 
 < ''iitial that we be able to distinguish absolutely between cause 
 and effect; and though an effect may, and usually does, start 
 a train of secondary causation, our ideal of a task must be high 
 enough and its hold upon us must be firm enough to enable us 
 to see the mentally conceived, physically manifest itself, devoid 
 of any limiting conditions imposed by outside influences, of 
 what may be an effect of a secondary train of causation. 
 
 Virtually, that is creation on the level of the human growing 
 in evolutionary definition and degree. 
 
 For creation /s tltc inception of first life from something 
 intangible into something tangible.
 
 48 OAST GOLD AND PORCELAIN' INLAYS 
 
 SOME RATIONAL AND ACCEPTABLE CONCLUSIONS 
 
 We must understand and accept in order to understand: 
 
 That the creative effort of the universal creative force 
 is, as said before, always toward the evolution to a higher type 
 from a lower one. 
 
 That we as humans, represent within ourselves every step 
 in the evolutionary efforts of the creative force in its attempt 
 to advance from a lower to a higher type. 
 
 That since we are possessed of the qualities of life, intelli- 
 gence and individual volition, we may greatly aid in this ad- 
 vance, or we may, in a measure, temporarily retard cosmic 
 progression in the human, by either doing what we should not, 
 or not doing what we should do. 
 
 That since the creative force is the source of all creation, 
 it follows that no one manifestation of the evolutionary effort 
 of the creative force can permanently affect in an adverse man- 
 ner its laws of growth, tendency, and cosmic progression. 
 
 That the acknowledgment or the acceptance of the theory 
 of evolution does not argue against inception of life in a creative 
 sense. 
 
 That since the creative force is the source of all creation, 
 it must be the source of all first life upon this, or any other 
 planet. 
 
 That it is preposterous to assume that any man will spend 
 his entire time developing any sort of work with the sole pur- 
 pose to ultimately destroy every evidence of his efforts. 
 
 That it is far more preposterous to assume that the creative 
 force will tolerate conditions which tend to nullification of any 
 creative effort on its part. 
 
 That the ultimate purpose of the creative force is the per- 
 fection of species which are physical manifestations of its 
 varied activities. 
 
 That, of all these species, the human is the closest relation 
 of the creative force, because the human possesses, not only the 
 quality of appreciation of the creative grandeur, but also the 
 power of imitation and imagination, and, to a limited extent, 
 origination or creation. 
 
 That the creative force has displayed upon a stupendous 
 scale the faculties of selection and adaptation of means to ends.
 
 SEQUKXCi: OF TJIOTOHT 49 
 
 Tliat the human possesses these faculties to a remarkable 
 degree. 
 
 That the purpose of the creative force toward the human 
 species from the first inception of its existence has been, and 
 is, that of a gradual, but constant, evolution from helpless in- 
 efficiency to perfect type. 
 
 That perfection of type, to be displayed by the human 
 species, implies a perfect equilibrium of perfect organs which 
 shall make up the physical body of the human. 
 
 That when the tendency of the creative force is toward per- 
 fection of type, that stage will ultimately be reached through 
 the aid of the particular species itself. 
 
 That the creative force of the universe is at our disposal 
 in direct proportion as we understand the determined laws of 
 growth, tendency, and cosmic progression, and submit to them 
 in order to transcend them. 
 
 That perfection of the human species implies the elimina- 
 tion of all disease of mind or body. That it implies also the 
 elimination of all economic or social conditions which make the 
 presence of disease possible. 
 
 That any individual or communal tendency of the human 
 species to oppose the general evolutionary progression to per- 
 fect type is effectually counteracted by the creative force, in 
 that it calls forth conditions which overwhelm opposition or the 
 result of opposition. 
 
 That human misinterpretation of tendency and purpose of 
 the creative force is almost, if not quite, as old as the first spark 
 of intelligence which appeared in the genus homo. 
 
 That limited intelligence was the cause of this misinter- 
 pretation. 
 
 That a misinterpretation is an error. 
 
 That an error is a hindrance in the path of our evolutionary 
 cosmic progression. 
 
 That as such, it is in conflict with the tendency of the crea- 
 tive force which immediately sets about to call forth conditions 
 to overwhelm the result of the error and the cause of it. 
 
 That hence, the healing art is as old as the first error of 
 man. 
 
 That errors and accidents are the primary causes of all 
 human ills, and all accidents are errors of one kind or another.
 
 50 CAST GOLD AND PORCELAIN INLAYS 
 
 That all errors are traceable to tlie as yet incomplete evo- 
 lution of the human, physically and mentally. 
 
 And finally that the complete evolution of the human, phys- 
 ically and mentally, will he attained through the properly 
 directed efforts of the humans themselves, working along and 
 in accord with the universal laws of growth, tendency, and 
 cosmic progression. 
 
 The healing art is as old as the first error of man. 
 
 The milestones that mark the important events in its ex- 
 istence are the periodically determined incontrovertible facts, 
 which will finally make out of the art of healing the science of 
 health restoration and maintenance. 
 
 Dentistry is the art of restoring to use and service dete- 
 riorated oral organs and tissues. 
 
 Dentistry was, and to a large extent still is, a medley of 
 acts devised by humans to counteract the breaking down of the 
 oral organs and tissues through disease or accident. 
 
 Dentistry is a part of the healing art, and is as old as the 
 first error which resulted in the initial oral or dental deviation 
 from the physiologic, or normal. 
 
 The milestones that mark the important events in its de- 
 velopments are the periodically determined incontrovertible 
 facts, which will finally make out of the art of dentistry, the 
 science of tooth and oral health restoration and maintenance, 
 with emphasis on the maintenance. 
 
 Millions of the human species are as yet in the grasp of 
 ills resulting from errors of judgment, and opposed to these 
 millions are a handful, who, under A T eritable inspiration, are 
 doing the work of the creative force in bringing about con- 
 ditions which will ultimately make man understand that he is 
 headed in the direction of evoluting into a perfect manifestation 
 of the creative force; that is, of evoluting into that which it feels 
 itself to be, to wit: a creative force. That handful of men, 
 working against what would seem to be insurmountable obsta- 
 cles, will be triumphant in the work in which they are the 
 fortunate instruments. 
 
 If we reflect for a moment, we shall find this very simply 
 and very easily proved. 
 
 We understand that no one manifestation of the creative 
 force in the universe. Its very name implies, that .and the re- 
 growth, tendency, and cosmic progression.
 
 SEQUKXCK OK TllorcTFT ")L 
 
 We understand also that man is one of the manifestations 
 of the varied activities of that creative force. 
 
 If we understand that even in their most active periods, 
 human ills can he hut a part of man, that is but a part of one 
 of the manifestations of the creative force, and no primary part 
 at all, then we must realize how simple and predestined is the 
 final conquest of all influences which would tend to retard com- 
 plete evolution along, and in accord with, the laws of growth, 
 tendency, and cosmic progression. 
 
 Xo one will dispute that the creative force is the greatest 
 force in the universe . Its very name implies that, and the re- 
 sults of its efforts sustain that assertion, and it is concrete 
 enough in its manifestation to enable even the uninitiated to 
 become aware of its presence. We may even have a very con- 
 crete example to illustrate the final victory for evolution over 
 cosmic repetition. 
 
 If two forces, acting in opposite directions, exert their 
 efforts upon a movable body, the resultant will be the difference 
 between the two forces, and the body will travel in the direction 
 of the greater force. 
 
 If this holds true in simple mechanics, how powerfully over- 
 whelming must finally be the triumph of the creative force in 
 overcoming the effects of human error upon humans. 
 
 This also explains why it is possible for a few men to 
 counteract conditions brought about by the acts of untold num- 
 bers. The few are working along, and in accord with, the laws 
 of growth, tendency, and cosmic progression of the creative 
 force. 
 
 It may take a dozen years or a dozen centuries for the cre- 
 ative force to accomplish its work, or it may take a thousand 
 centuries. "Who knows ? That the work will be accomplished 
 is as certain as if it were a finished deed at present. 
 
 The problem that tlieu irho desire to ivork with tlie creative 
 force are face to face irith, Is, how can they best accelerate 
 tJ/e irork <>f tiiis creative force: and since that problem is uni- 
 versal, t]ie solution must be one capable of universal application; 
 and this means tJiat if ice are engaged in any human error- 
 correct in (/ u-ork. ire must at tempt to so do our work as to make a 
 recurrence of tie error impossible, or as nearlu that as possible.
 
 CHAPTER II 
 
 The teeth, as organs of incision, prehension, mastication, 
 and as accessories of vocalization, speaking or singing, have 
 these varied functions to perform. To be best suited for this 
 task, nature has caused them to acquire, in the process of their 
 development, certain qualities and certain definite structural 
 shapes. Any deviation from their macroscopic normality and 
 their microscopic organization, causes a lack of functional effi- 
 ciency and interferes with their normal contribution toward the 
 maintenance of vital balance. Hence all dental efforts should 
 be directed toward a re-creation of macroscopic and microscopic 
 acceptableness of these organs when they require our attention 
 at all. 
 
 In health, gums, teeth, in fact all organs in the animal body, 
 perform their function as a matter of grateful exercise without 
 undue consciousness on the part of the animal contributing to 
 the maintenance of an efficient organization, in which the income 
 is greater than the expenditure to obtain this income; but, in 
 order to obtain such a condition, there must be perfect inter- 
 play of all organs making up the animal body, and the first 
 requisite for perfect interplay is absolute lack of interference 
 by one organ with any other one or more organs. 
 
 We have had our lectures on anatomy of the teeth, and we 
 know what they look like, or should know. We have had our 
 lectures in physiology, and we know what the gums and the ad- 
 joining structures look like in a healthy mouth; we have like- 
 wise also been able to learn the beautiful lessons of occlusion. 
 All these should have given us a picture of healthy conditions 
 not easily erased. And it is this picture we must ever seek to 
 re-create, and we can not re-create it en masse unless we re- 
 create it in spots in individual teeth and their surrounding 
 gingivae. 
 
 Let me call your attention to a remarkable realization, 
 
 52
 
 OF THE TEKT11 53 
 
 which must come to all of us who would endeavor to obliterate 
 the effects of human error upon the human system. Every mol- 
 ecule that makes up the human, or animal, or plant body is in 
 a state of constant rhythmic movement, which motion is in def- 
 inite geometric relation to the motion of the molecules neigh- 
 boring it, which warrants the conclusion that the molecules 
 influence one another by their rhythmic movements to the point 
 of causing corresponding geometric gyrations in each other. 
 
 This is, of course, not a matter of first causation; that is, 
 not a. matter of life inception, but rather a matter of life main- 
 tenance by virtue of the maintenance of the equilibrium. 
 
 If we conceive the animal as a delicate clock or watch, for 
 example, we may obtain a concrete illustration of the interrela- 
 tion of all the organs. Let us assume that we are accelerating 
 the minute hand of a clock by slowly rotating it to the right 
 (take out your watch and make the example more concrete); 
 we can readily understand that we shall by this act influence the 
 entire mechanism to a more accelerated motion, and that this 
 motion will be in definite relation to the intensity of the acceler- 
 ator force, and that there will be a definite rhythmic and geo- 
 metric relation between the motion of each separate piece of 
 mechanism which makes up the whole of the clock. 
 
 If we remove the influence of the accelerator force, an 
 immediate rhythmic and geometric adjustment takes place, and 
 the hands of the clock proceed to travel at the original speed. 
 This may be called a stimulating interference with the mech- 
 anism, and results in a greater amount of work or activity being 
 done in a given time than the apparatus was intended for. If 
 \ve no\v place the hour hand at the numeTal 9 and the minute 
 hand at the numeral 3 and suspend a minute weight from the 
 extremity of the hour hand, we shall have an inhibitory inter- 
 ference with the mechanism, resulting in a given amount of 
 energy doing a smaller amount of the work than the apparatus 
 was intended for; the spring will uncoil or attempt to uncoil at 
 the same ratio, but its effect upon the wheels, and through 
 these upon the hands, will be less marked than before; again 
 there will be a rhythmic and geometric readjustment to normal 
 when the inhibitory interference is removed. 
 
 Up to a certain point, these experiments may be repeated
 
 54 CAST GOLD AND PORCELAIN INLAYS 
 
 without .impairing 1 tlie inherent virility of the spring, hut as 
 soon as the point of impairment is reached, a rhythmic re- 
 adjustment becomes impossible, a lack of perfect interplay man- 
 ifests itself, resulting in a heedlessness of expression; the parts 
 interfere with one another, and a great deal of energy is ex- 
 pended to bring about a result; work which is as unsatisfactory 
 as it is unreliable. 
 
 For the purpose of elimination of mechanical shock to the 
 nervous system during mastication, and for the purpose of en- 
 hancing the vibrating effect produced during vocalization, be 
 it singing or speaking, also for the purpose of minimizing me- 
 chanical injury to the teeth themselves, the latter are held in 
 their bony sockets through the intermediary agency of an elas- 
 tic membrane, which is so disposed beneath and around them, 
 as to fairly hold them suspended in a resilient cushion. 
 
 The elastic fibers composing the membrane dispose them- 
 selves longitudinally, diagonally, transversely, and circularly 
 around the teeth; they interlace with the periosteum and with 
 the gum tissue, and thus during the exercise of dental function 
 they effect an increase of circulation into the surrounding parts, 
 which constantly brings fresh nourishment to these tissues. 
 
 The very structure of this elastic membrane and its pecu- 
 liar function precludes the possibility of abundant blood supply 
 and makes it a ready prey to inhibitory interference. Such in- 
 hibitory interference may be brought about by impaction of 
 foods into what are known as interdental spaces or by the ac- 
 cumulation of calcific material known as tartar, either upon or 
 around the neck of the tooth, or upon portions of the root. The 
 impaction of food into the interdental spaces may be caused by 
 the malrelation of the adjoining teeth (malocclusion) or by the 
 improper restoration of approximal surfaces of teeth calling for 
 dental attention. An inhibitory interference may also be 
 brought about by a break in the continuity of surface upon a 
 tooth in the region mentioned. A tooth may be inlayed and a 
 portion of the inlay material may have been left extending 
 beyond the margin of the cavity. 
 
 If pressure be exerted upon any one or two teeth in the 
 mouth, the pressure will be transmitted to all the surrounding 
 structures, and through them to all other teeth in the same
 
 FUNCTIONS OF THE TEETJI .).) 
 
 mouth iii a series of rhythmic waves or undulations of varying 
 degrees, changing the physical outline of the surrounding' struc- 
 tures in every direction. Upon the cessation of the pressure a 
 rhythmic and geometric readjustment will take place in these 
 tissues and a return to a condition of comparative equilibrium 
 obtains. Where there are no inhibitory interferences, that is 
 where the relation of the teeth is correct, as to position, con- 
 dition and form, these pressure-induced waves or undulations 
 may take place ad infinitum with beneficial results, because un- 
 der a correct condition, intermittent pressure is the essential 
 stimulating interference inducin<i an increase of circulation, 
 bruif/inf/ irith it a fresJi supply of nutriment essential to life 
 maintenance. 
 
 AYlien inhibitory interferences are present, that is, when the 
 relation of the teeth is not correct as to position, condition, and 
 form, each pressure exerted upon the teeth during mastication 
 causes the same series of waves or undulations in the soft tissues 
 surrounding them, but each wave or undulation causes these tis- 
 sues to come in contact with injuring or bruising obstructions, 
 and the rhythm of recoil or readjustment is first interfered with 
 and ultimately destroyed. 
 
 Poorly executed inlay restorations may be classed as in- 
 hibitory interferences with the free and unhampered undulating 
 and very essential excursions of the soft tissues surrounding 
 the teeth. They produce states not conducive to the health of 
 the individual, and are, therefore, incorrect dental conditions; 
 and any dental operation that will entirely eliminate them will 
 be an operation conducive to the health of the individual, and, 
 therefore, a correct dental operation. 
 
 All tissues must be exercised, or, rather, they must have 
 the freedom to indulge in such exercise as they need, and all 
 tissues of all organs need exercise to keep them from under- 
 going atrophic changes. Hence anything which will interfere 
 with the free and unhampered undulations of the gum tissues, by 
 any means whatever, results in pathologic conditions by bring- 
 ing about, first, a lethargic state in the tissue; second, a dimi- 
 nution in vasomotor action, because of lack of restimulation; 
 third, an accumulation of waste material in the cellular and 
 intercellular substance, resulting in a rapid death of cells;
 
 .')() CAST GOLD AND PORCELA1X IXLAVS 
 
 fourth, an atrophy or loss of tissue, resulting in a physical 
 change which makes it difficult to maintain a hygienic balance. 
 
 We may stimulate life processes and thus for a time induce 
 a greater degree of livingness. 
 
 We may do this by relying on external extraneous, foreign, 
 therapeutic agents which will act directly upon certain organs 
 and drive them unmercifully to greater activity, leaving them 
 exhausted in the end ; or we may, by means of air, water, proper 
 food, and careful exercise, which brings about intermittent 
 pressure, induce a constant current of restimulation, which will 
 activate the life processes to greater expression, and so in time 
 make them the source of the restimulating factor. 
 
 Life, in the abstract, general, or universal, unlimited sense, 
 is a complete cycle of such activities with the restimulating fac- 
 tors inherent in the activities themselves, so in a sense these ac- 
 tivities and life are synonymous. 
 
 Life, in the concrete, the limited, the personal, or particular 
 sense, is a complete cycle of such activities with the restimulat- 
 ing factors inherent in the activities themselves, but to the 
 individual, in a constantly less appreciable degree, and hence 
 producing a constantly diminishing result or activity. 
 
 Like begetting like, this diminished activity will induce re- 
 stimulating factors of minor influence upon the life processes, 
 the latter will become sluggish and metamorphosis sets in. 
 
 Thus we, as individuals, are subject to the law of change; 
 we are not and can not expect to be, permanent fixtures of the 
 great cosmos forever expressing itself in the creation of new 
 centers or vehicles for the display of its endless energy. 
 
 For the reasons stated above, all human work is limited 
 and transitory, that is not permanent in its effects or results. 
 The things we do are as much subject to change or metamor- 
 phosis as we ourselves are. This applies particularly to our 
 endeavors, when they are concerned with attempts to prevent 
 or inhibit the reduction of that cycle of our activities which 
 are synonymous with life. 
 
 We are forever falling short of our ideal of a task when 
 our task consists in an effort to balance income and expenditure 
 of human energy, and it will ever be so, no matter how we may 
 improve our relations between our vegetative and objective
 
 IT. XC'TIOXS OF THE TEETH 57 
 
 Life, or how much we may learn of the mysteries of the bio- 
 chemical life processes themselves. 
 
 It is equally true that constant effort for correct under- 
 standing of these things must result in improved conditions, 
 which will enable us to husband the now vastly dissipated 
 energy, ami so prolong our activities and usefulness to a con- 
 stantly growing degree. Intuitively we are all aware that this 
 is true, the best proof of it being that we are in constant search 
 for means of so improving remedial efforts for our patients, that 
 they, the efforts, will result in a harmonious interplay of the 
 intact functionating organs and the artificial work. 
 
 \\V must, therefore, face the self-evident proposition, that 
 the cruder our remedial efforts are, whatever organ w r e may be 
 working upon, whatever our sphere of activity, whether it be 
 general medicine, surgery, or the specialized field of dentistry, 
 and all its kindred divisions, the less acceptable will the results 
 l>e to the other functioning organs; this means immediate rebel- 
 lion on their part; and, unless the cause be removed, must result 
 in a physical state which is physiologically minus and patholog- 
 ically plus: conversely, the more finished or refined our efforts 
 are, the more acceptable will the results be to the other function- 
 ing organs. 
 
 A finished or refined, remedial effort, in behalf of any organ, 
 implies a knowledge of its individual and relative anatomy or 
 physical relationship, and a comprehensive understanding of 
 the physiologic functions of that organ. 
 
 This brings us up to the affirmation that teeth have func- 
 tions (plural used advisedly) and a careful enumeration and a 
 critical classification of these functions are now in order. 
 
 We may now record the truth that the so-called masticatory 
 apparatus is not a separate, distinct, and independent part of 
 the human organism, but a functioning multiple member, or 
 cog, of a very complex ifriWocosm, in the maintenance and pres- 
 ervation of which it plays a very important part. The so-called 
 masticatory apparatus is not a simple functioning member 
 of this complex machine, but is, in itself, a very complex com- 
 ponent, in that it comprises many organs diversely endowed 
 with specialization. 
 
 The thing that suggests itself first in my mind in regard
 
 58 CAST GOLD AXD PORCELATX INLAYS 
 
 to tooth function is tlie reciprocal functions of tlie teeth ; recip- 
 rocal because they do some things for the organism which does 
 some things for them. 
 
 Since every organ of the body passively and actively ex- 
 ercises such functions, these may be called the reciprocal func- 
 tions, and must be classified as the passive and active reciprocal 
 functions of the special organs. 
 
 PASSIVE RECIPROCAL FUNCTIONS 
 
 The passive reciprocal functions of the teeth are defensive, 
 cosmetic, developmental, and phonetic. (See Fig. 1.) 
 
 The defensive functions depend upon the gross anatomy 
 of the teeth; that is, they are so shaped as to prevent injury 
 to the soft tissues surrounding and supporting them. 
 
 The cosmetic functions depend upon the gross anatomy, 
 geometric harmony, and the biochemisry, of the teeth. They 
 must be in harmony with other features of the face, and, by 
 correct growth, influence the other features of the face to har- 
 mony, thus also partly exercising the developmental function. 
 
 The phonetic functions depend upon the gross and micro- 
 scopic anatomy of the teeth and their position relative to each 
 other. That is, they must not only be of a shape and relation 
 conducive to clear enunciation, but also of a texture insuring 
 the proper degree of resonance and vibration. The latter part 
 of this function we can unfortunately not restore by artificial 
 means. 
 
 ACTIVE RECIPROCAL FUNCTIONS 
 
 The active reciprocal functions of the teeth must be further 
 classified into general and special. 
 
 The general functions are cardioauxiliary or yasoauxiliar\ . 
 and symptomatic. 
 
 The cardioauxiliary or vaso auxiliary function consists in 
 the restimulating effect, which the mobility of the teeth has 
 upon the circulation of the structures in which they are, and 
 with which they are resiliency joined. 
 
 By virtue of this mobility, they induce a rhythmic inter- 
 mittent pressure which, inimical to end tissue stasis, brings
 
 J-TNCTIOXS OF Till-: TKKTJI 
 
 59 
 
 ExOGENCOS ( I 
 
 DEFENSIVE PASSIVE 
 RECIPROCAL FUNCTIONS 
 
 o 
 
 I/ GENERAL ACTIVE RECIPROCAL FUNCTI 
 
 SYMPTOMATIC f f f 
 
 (OBJECTIVE) G/EMER*L RECIPROCAL FUNCTION 
 
 ;4 4 't-\ 4, > 
 
 / / Wfc 
 
 
 
 INCISION 
 
 Fig. 1. Diagram showing reciprocal functions of the teeth.
 
 60 CAST GOLD AND POKCELAHST INLAYS 
 
 about a constant change of the nutrient elements traversing the 
 nutrient channels of these tissues. 
 
 The symptomatic functions must be subdivided into struc- 
 tural and positional. 
 
 The structural symptomatic functions may be indicaitve of 
 some congenital or acquired constitutional anomaly; such as, 
 Hutchinson's teeth, thyroidal disbalance (as illustrated in teeth 
 easily attacked by caries), or in the presence of a marked pro- 
 creative urge, often bordering on lack of sexual equilibrium, as 
 illustrated in canines of decided prominence and marked pre- 
 hensile formation, reflecting, perhaps, the animalistic trend of 
 the individual in whom very frequently also are to be found 
 small suprarenal bodies with narrow cortex, demonstrating, 
 perhaps, a greater procreative and a less intellectual mission in 
 the cosmic scheme. 
 
 The positional symptomatic functions deal with the mal- 
 position of different teeth in the maxilge and mandible, and are 
 valuable diagnostic determinators in that they thus unerringly 
 point to pituitary, gonadial, thyroidal, and adrenal disturbances 
 which would otherwise be most obscure. 
 
 The special active reciprocal functions of the teeth are 
 communal and individual. 
 
 The communal special reciprocal functions of the teeth are 
 alimentary and inhibitory. 
 
 The alimentary functions consist in the part they all play 
 in the preparation of certain foods for the process of digestion. 
 
 The inhibitory functions consist in the physical relation- 
 ship of the teeth or their relative apposition mesio-distally in 
 particular, so as to retard, or limit, the laterorotary motion they 
 acquire when in use. 
 
 The individual functions are those of incision, prehension, 
 mastication, and trituration, and, in the sequence enumerated, 
 involve the incisors, canines, bicuspids, and molars. 
 
 Since all functions are recriprocal, there can be no fixed 
 rule or line of demarcation as to where one stops and the other 
 begins. 
 
 All these enumerated, classified and dissected, present them- 
 selves vividly at some point, the height of the particular func-
 
 FUNCTIONS OF THE TEETH 61 
 
 tional expression, to gracefully and gradually merge or lose 
 themselves in those which follow. 
 
 Thus we have an interplay of parts devoid of harsh or 
 interruptive demarcations. A pleasing harmony as expressed 
 in coordinate effort, salubrious in effect; a song of work as 
 marvelously planned as it is symphonically expressed in living- 
 ness,! and yet more livingness, to the glory of the mind that 
 bade it come into being. 
 
 SUMMARY FOR CHAPTER II 
 The Functions of the Teeth 
 
 1. What is meant by the reciprocal functions? 
 
 2. How are the reciprocal functions classified? 
 
 3. Name the passive reciprocal functions and define each. 
 
 4. How are the active reciprocal functions classified? 
 
 5. Define the cardioaxiliary or vasoauxiliary functions. 
 (5. Subdivide and define the symptomatic functions. 
 
 7. Define the following functions: communal, alimentary, inhibitory, in- 
 dividual.
 
 CHAPTER III 
 THE CAST GOLD INLAY 
 
 Human teeth decay and become a source of discomfort and 
 danger unless they can be restored by therapeutic, operative, 
 and mechanical means. 
 
 The foregoing is a statement of facts that no amount of 
 argument can dislodge. It is universally known, so far as our 
 profession is concerned, and it stands as a comprehensive reason 
 for our entire and particular field of endeavor. It, therefore, 
 presents a proper basis or fundamental statement for this 
 volume, although this volume concerns itself with only that 
 part of corrective endeavor known as inlay work or the cemented 
 filling. 
 
 This work, that is, the restoration of a broken-down tooth 
 by means of a cast gold inlay, may be broadly defined as a den^ 
 tal operation. 
 
 Any operation may be correct or incorrect; and a correct 
 dental operation may be defined as one, the result of which is 
 conducive to the health of the individual upon whom the opera- 
 tion is performed. We understand by the term health, the main- 
 tenance of that vital balance which is expressed by the normal 
 functioning of all organs which compose the human body. 
 
 Inlay work may be divided into two classes, metallic and 
 nonmetallic. 
 
 Metallic inlays, which, because of their importance as tooth- 
 restorers, shall have first place, are those that are made of 
 gold or any alloy in which gold or other suitable metal pre- 
 dominates. 
 
 The making of metallic inlays may be brought about by the 
 swaging or casting method. The former are so imperfect and 
 have proved so unsatisfactory that they are becoming obsolete 
 and will not be considered; and since gold, as a rule, predomi- 
 nates in the cast metallic inlay, it will hereafter be referred to 
 as *he cast gold inlay. 
 
 62
 
 CAST GOLD IXLAY 63 
 
 A cast gold inlay may be defined a*, a max* of molten 
 metal under definite </aseons pressure, forced into <uid shaped 
 in a special wold, so that it trill, upon cooling or crystaUissmg t 
 accurately fit into the cavity of the tootJi from irliich the ira.r 
 pattern embedded in the mold iras taken, and that cool mass 
 of metal shall in outline and eminences so conform to the out- 
 lines and eminences of that particular tooth, and opposing and 
 adjoining teeth, if Iliere be any, that it shall form an acceptable, 
 anatomic, co)nplement to the tootli ref/idr'nig restoration, and 
 if shall make that tooth macroscopicaUy perfect. 
 
 In short, then, a ca^st gold Inlay is an accurate metallic 
 complement to the macroscopic anatomy of a brokcn-doirn tooth. 
 
 The process of restoring broken-down teeth by means of 
 cast gold inlays consists of a series of steps or operations which 
 in their proper sequence may be enumerated in the following- 
 order : 
 
 1. Selection or election of the case. 
 
 2. Preparation of the cavity. 
 
 3. Selection of the proper wax and the making and carving 
 of the wax model by means of the direct or indirect method. 
 
 4. Taking an impression of the cavity and making a die for 
 procedure by the indirect method. 
 
 5. Selection of the refractory compound and the imbedding 
 of the wax model to construct the mold. 
 
 6. Drying out of the mold, and the burning out of the wax 
 model. 
 
 7. Casting of the molten metal into the mold. 
 
 8. Cleansing of the casting in hydrofluoric acid and in a so- 
 dium bicarbonate bath. 
 
 9. Removal of the sprue, forming excess gold, and the 
 polishing of the inlay. 
 
 10. Cementation of the inlay. 
 
 SUMMARY FOR CHAPTER III 
 The Cast Gold Inlay 
 
 1. Classify inlay work. 
 
 2. What metal is most suitable for inlay casting? 
 :'*. What is the function of a cast gold inlay? 
 
 4. What :m> the steps (in thoir proper sequence) that arc necessary to 
 produce a cast gold inlay.
 
 CHAPTER IV 
 
 SELECTION OR ELECTION OF THE CASE 
 PRESENTING A CAVITY 
 
 (A) Any tooth distally to the clisto-proximal surface of the 
 canines, requiring a gold filling, can be restored more perfectly 
 by means of a cast gold inlay. 
 
 (B) Any labio- or linguo-gingival cavity larger in diameter 
 than 3 mm. distally to the second bicuspid calls for a restora- 
 tion by means of an inlay rather than a malleted filling. 
 
 (C) Any tooth requiring restoration of proximal contact 
 calls for an inlay rather than a malleted filling. 
 
 (D) Any tooth requiring occlusal restoration in its relation 
 to opposing teeth calls most emphatically for a cast gold inlay 
 in preference to a malleted gold foil filling. 
 
 (E) Any compound cavity in any tooth, distally to the first 
 bicuspid, calling for a gold restoration, indicates the use of an 
 inlay rather than a malleted filling. 
 
 (F) Every mesio-disto-occlusal cavity in any multicuspid 
 tooth, should be filled by means of an inlay rather than a mal- 
 leted gold foil filling. 
 
 The gold inlay is contraindicated in : 
 
 (a) Small proximal cavities in the anterior teeth. 
 
 (b) Small fissure cavities in anterior teeth lingually and, 
 
 (c) Small cavities in posterior teeth occlusally, 
 
 (d) Small labial cavities in posterior teeth in mouths com- 
 paratively immune to progress of decay. 
 
 SUMMARY TOR CHAPTER IV 
 Selection or Election of the Case Presenting a Cavity. 
 
 1. Name the types of cavities when a east gold inlay is indicated. 
 
 2. In what cases is the inlay contraindicated? 
 
 61
 
 CIIAITKU V 
 
 CAVITY J'UKI'ARATIOX 
 
 GEOMETRIC LANDMARKS OF TEETH 
 
 Tooth Surfaces and Angles 
 
 Kvcry incisor tooth presents for examination four distinct 
 surfaces; a cutting, or incisal edge, and a nunil)er of line and 
 point angles as follows: (See (.Fig. 2.) 
 
 SURFACES OF INCISOR TKKTII 
 .Mesial (1) 
 Distal (2) 
 Labial (3) 
 Lingual (4) 
 A distinct incisal surface at times (5) 
 
 ANGLES or INCISOR TEETH 
 
 Line Angles 
 Mesio-labial (6) 
 Mesio-lingual (7) 
 Disto-labial (8) 
 Disto-lingual (9) 
 
 Cutthif/, or Point, Angles 
 Mesio-labio-incisal (10) 
 Disto-labio-incisal (11) 
 Mesio-linguo-incisal (12) 
 Disto-linguo-incisal (13) 
 
 In incisors having a distinct incisal surface, the following 
 line angles must be added. 
 
 Line Angles 
 Labio-incisal (14) 
 Linguo-incisal (15) 
 Mesio-incisal (16) 
 Disto-incisal (17) 
 
 05
 
 66 
 
 CAST GOLD AXD PORCELAIN IXLAYS 
 
 d 
 
 >> s 
 
 S 'So 5 
 
 Xv> 
 
 c3 u 
 vi cs 
 
 fcJO <H fee 
 
 =S fa B 
 
 i P .S 
 
 1-3 tc +j 
 "tJ 
 
 tc S3 
 
 fcJO P 
 
 * *S 
 
 1 5 
 
 1 II 
 
 S CH
 
 CAVITY ntKPAKATIOX 67 
 
 The cuspids, upper and lower, present for examination four, 
 and rarely five, distinct surfaces, a tearing point, or cusp, which 
 latter is sometimes replaced hy a cutting edge or a distinct 
 incisal, or, better, prehensile sin-face. (See Fig. l>.) 
 
 SURFACES OF CUSPIDS 
 Mesial (1) 
 Distal (2) 
 Lingual (3) 
 Labial (4), sometimes broken 
 
 by the labial ridge into 
 Labio-mesial and (5), 
 Labio-distal surfaces (6) 
 
 AXGLES OF CUSPIDS 
 
 Line Angles 
 Mesio-labial (7) 
 Mesio-lingual (8) 
 Disto-lingual (9) 
 
 Disto-labial (10), and very often the labial angle (11), 
 formed by the mesio-labial and disto-labial surfaces, and when 
 there is a distinct prehensile surface, there are the line angles 
 of the 
 
 Labio-prehensile (12) 
 Linguo-prehensile (13) 
 Mesio-prehensile (14) 
 Disto-prehensile (15) 
 
 Line Angles 
 
 Mesio-labio-prehensile (16) 
 Mesio-linguo-prehensile (17) 
 Disto-labio-prehensile (18) 
 Disto-linguo-prehensile (19), 
 
 and, at the cusp extremity, the 
 
 Labio-linguo-prehensile (20), point angle formed by the 
 labial, the lingual surfaces, and the prehensile surface of the 
 tooth. And when the labial ridge is present in a cuspid, the last 
 named point angle may be referred to as the antero-labio-incisal, 
 or prehensile (21), and postero-labio-incisal, or prehensile, angle 
 of the cuspid (22).
 
 68 CAST (;<>!. I> AND POUCKLAIX INLAYS 
 
 With the appearance of a distinct incisal or prehensile sur- 
 faces circumscribing the prehensile surface for its entire extent, 
 the prehensile surface assumes the shape of an ellipse, line 
 angles only, present themselves, and we have the mesial and 
 distal arcs formed by the mesial, labial, lingual, and distal sur- 
 faces circumscribing the prehensile surface for its entire extent. 
 
 The bicuspids and molars present for the inlay Avorker live 
 surfaces as follows: (See Fig. 4.) 
 
 SURFACES OF BICUSPIDS 
 
 Mesial (1) 
 Distal (2) 
 Buccal (3) 
 Lingual (4) 
 Occlusal (5) 
 
 The occlusal surfaces of the bicuspids and molars are sub- 
 divided into twice as many smaller surfaces as the cuspids have 
 ridges, each ridge diA-.iding the surface of the cusp upon which 
 it presents itself into tAVO surfaces; the number of line angles 
 and point angles present in these teeth is, therefore, correspond- 
 ingly increased. 
 
 If the occlusal surface is considered as an interrupted hor- 
 izontal surface, the line angles in the bicuspids and molars are, 
 according to Black (AV!IO, by the way, treats this surface only 
 as such), as follows: 
 
 ANGLES OF BICUSPIDS AND MOLARS 
 
 Line Angles 
 
 Mesio-buccal (6) 
 Disto-buccal (7) 
 Mesio-lingual (8) 
 Disto-lingual (9) 
 Mesio-occlusal (10) 
 Disto-occlusal (11) 
 Bucco-occlusal (12) 
 Linguo-occlusal (13)
 
 CAVITY PRKL'AKA'liOX 6'{) 
 
 Point A U 
 
 Mesio-bucco-occlusal (14) 
 Disto-bucco-occlusal (lf>) 
 Mesio-linguo-occlusal ( 1 <>) 
 Disto-lingno-occlusal (17) 
 
 Tt might he well to remember that in tliis geometric geogra- 
 phy, we a iv much closer to spherical than just plain geometry, 
 and so the reference to each surface as distinct by, and for, it- 
 self, and the corresponding angle (surface angles) need not be 
 dwelt upon. 
 
 It is best to consider the surfaces of these teeth as merging 
 into one another presenting no harsh or sharp deviations which 
 are always weak points both in beauty and construction. 
 
 The exception to this foregoing-, is the occlusal surface of 
 the posterior teeth. Here the division of this surface by the 
 various ridges presenting themselves upon their respective 
 cusps must be distinct and well defined, producing eminences, 
 sulci, and fossa' in contradistinction to the undulations present 
 upon the other surfaces of these teeth. 
 
 HYGIENIC LANDMARKS OF THE TEETH 
 
 The inlay worker must consider two distinct areas in each 
 tooth : 
 
 First: The immune, or comparatively immune, area. 
 
 Second: Susceptible area. 
 
 The immune area of a tooth is that part of it which is 
 constantly being cleaned and kept free from debris by incision, 
 prehension, mastication, and trituration, or by the action of 
 lips, cheeks, tongue and toothbrush. 
 
 The susceptible areas are the portions of the teeth not so 
 cleaned; in other words, the portions inaccessible to cleansing 
 friction by the agents named. 
 
 Among the former, or comparatively immune areas, may be 
 mentioned the labial, lingual, and incisal surfaces of the an- 
 terior teeth; the buccal, lingual, and the welling portions of the 
 occlusal surfaces of the posterior teeth; and, in mouths free from 
 pathologically invaded alveoli, the gingival and subgingival cir- 
 cumference.
 
 70 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 To tlie susceptible areas belong the proximal surfaces of the 
 teeth, the distal surfaces of the last molars, and the gingival 
 third of the buccal surfaces of the last molars; the deep sulci, 
 fossae, and fissures upon the occlusal surfaces of the posterior 
 teeth; the deep fissures on the lingual surfaces of anterior 
 teeth; and, in cases subject to pathologic invasion of the alveoli, 
 and the consequent breaking of the last named structure, all 
 gingival and subgingival surfaces open to contact with fer- 
 mentation and not easily dislodged food debris. (Figs. 5, 6, 
 and 7.) 
 
 Fig. 6. 
 
 Fig. 7. 
 
 Fig. 5. Showing immune areas of anterior teetli and susceptible areas. Im- 
 mune areas: 1, labial surface; 2, lingual surface; 3, incisal surface. Susceptible 
 areas: 4, disto-proximal surface; 5, mesio-proximal surface; 6, cervical portion of 
 labial surface. 
 
 Fig. 6. Immune areas of posterior teetli. 1, 2, 3, 4, welling portions of occlusal 
 surface; 5, buccal surface; 6, lingual surface. 
 
 Fig. 7. Immune areas and susceptible areas of posterior teeth. Immune 
 areas: 1, buccal surface; 2, lingual surface; 3, 4, 5, 6, welling portions of occlusal 
 surfaces. Susceptible areas: 1, mesio-proximal surface; 8, disto-proximal sur- 
 face; 9, 10, 11, sulci and fissures of occlusal surfaces. 12 and 13, bucco- and linguo- 
 gingival areas; sometimes susceptible, often immune.
 
 CAVITY PKKPAKATIOX 71 
 
 Three great factors enter into actual cavity preparation. 
 They are: 
 
 1. The surgical or operative, which means the actual cutting 
 of tooth structure (including the extirpation of the pulp, the 
 proper treatment and filling of the root canals). 
 
 2. The mechanical, or formative, which means that mode 
 of tooth structure cutting which brings it, when cut, into the 
 field of physics, geometry, and mathematics. 
 
 3. The alterative factor, which means the factor tending to 
 produce a change from a decrepit or abnormal to a healthy con- 
 dition because of its restoration to proper physical relation to 
 the surrounding tissues. 
 
 A cavity prepared for the reception of a cast gold inlay, 
 must comply with the following requirements: 
 
 1. It must offer a series of angles and surfaces best suited 
 to resist stress or tendency to fracture the tooth. 
 
 2. It must present margins so prepared as to conserve the 
 enamel structure of the tooth and not expose it to injury dur- 
 ing stress of occlusion and mastication. 
 
 3. It must offer a ready access for the making of the wax 
 model in the direct method or for the taking of an impression 
 of the cavity in the indirect method. 
 
 4. It must offer a retentive receptacle and support to the 
 inlay. 
 
 5. It must offer a series of angles and surfaces best suited 
 to resist the stress of tendency to dislodge the inlay. 
 
 6. It must present margins so prepared that the finished 
 operation will conform as nearly as possible to the highest con- 
 ception of beauty of form. 
 
 7. It must present a form for the reception of the inlay 
 which shall bring the various margins into areas of compara- 
 tive immunities. This last requirement is what is commonly 
 understood as extension for prevention, and the necessity for 
 it varies with the condition, habits, and understanding of the 
 patient, and to a limited extent must be left to the judgment 
 of tlie operator. 
 
 Root canal treatment does not come within the scope of 
 this volume, and, since the canals of the teeth we are called upon 
 to restore or rebuild by means of inlays, play a very important
 
 {'2 CAST GOLD AX1) TORCELAIX INLAYS 
 
 part ill the preparation of the cavity, the reader will please 
 bear in mind that I speak of canals properly treated and filled 
 as we understand this work today. For comprehensive, though 
 by no means final, information on the subject, the student is 
 referred to the writing's of such men as Rhein, Callahan, Otto- 
 lengui, etc., whose splendid and careful work in this field, has 
 been of inestimable aid to the profession. 
 
 It is further assumed that the student has enjoyed the ad- 
 vantage of a course in the microscopic study of the structure 
 of the tooth; that he understands the histology, and is familiar 
 
 Fig. 8. A set of chisels used by the author in tooth structure cutting. 
 
 with the manner in which the enamel rods are disposed over the 
 crown surfaces of the teeth, and the consideration he is to give' 
 this factor, when cavity preparation is attempted. 
 
 For the uninitiated, this will make a serious break in the 
 sequence of this volume, but they, in fact, should not read this 
 at all. The two mentioned departments of root work and his- 
 tology are part of the embryo of knowledge which he who would 
 practice inlay work, must possess himself of. 
 
 Piersol, Schafer, or Noyes, on the histology of the teeth,
 
 PltKPAIIATlOX (.'5 
 
 will give the student a mass of very necessary and very per- 
 tinent information. 
 
 Among the instruments of the inlay worker must be in- 
 cluded: Comprehensive set of chisels, straight, right and left, 
 at varying obtuse angles, to facilitate cutting of gingival areas; 
 pear-shape;! and inverted cone burrs; and various file-cut inlay 
 burrs for straight handpiece and centra-angle; mandrils for 
 carrying sandpaper discs and carborundum discs for both; and 
 most important, a set of small gem stones mounted upon man- 
 drils for both handpit ees, and a variety of shapes to fill every 
 possible requirement. 
 
 Fissure burrs, cross-cut or plain, plug-shaped and tapered, 
 may be added to complete the surgical and mechanical abrasive 
 instrument list for cavity preparation. 
 
 The nect ssity for the rubber <iam and clamp is manifest 
 when the saliva interferes with clean, rapid work. 
 
 The general rules for tooth cutting may be enumerated as 
 follows: 
 
 All overhanging enamel walls must be removed with the 
 properly inclined chisels, driven by direct hand pressure or a 
 leather covered metallic mallet. 
 
 The opening of cavities must be started with sharp burrs, 
 plug-shaped or cross-cut tapered fissure burrs of the smallest 
 size suitable. 
 
 As soon as the cavity is large enough to permit the using 
 of a gem stone, the use of steel burrs must be discontinued and 
 the stones substituted. 
 
 At no time of the operation shall the tooth be allowed to 
 heat up, and with this end in view, all stones used in cavity 
 cutting are run under water. 
 
 The margins are chiseled and then finished with sandpaper 
 and cuttlefish discs. 
 
 A cavity in a tooth can not be properly prepared unless 
 that tooth and the teeth adjoining it, if there be any, have been 
 thoroughly cleansed of any deposits which may be present; and 
 if the cavity extends beneath the border of the gingival line, un- 
 it ss the gum has been carefully but effectually displaced from 
 the field of operation. 
 
 Scah-r> for the removal of deposits and porte-polishers.
 
 74 
 
 CAST COLD AND POIU'KLAIX INLAYS 
 
 carrying finely powdered pumice stone or silex, will accomplish 
 the first part of the operation; while the displacement of gum 
 tissue is readily brought about by packing the cavity with soft- 
 ened gutta-percha base plate, and leaving that in the cavity for 
 a few days. The case presenting itself again, the base plate is 
 softened by means of warm instruments and removed. 
 
 A comprehensive view of the field of operation will aid us 
 in determining just what instruments we shall have to employ 
 in the actual preparation of the cavity we are about to begin. 
 
 The inlay worker recognizes three distinct types of cavities; 
 they are, the simple, the compound, and the 
 
 Fie. 9. 
 
 Fig. 10. 
 
 Fig. 9. Cross section of molar tooth illustrating prepared cavity and bevel. 
 1, 2, 3, cavity and bevel; 4, 5, 6, arms and body of pulp. Simple cavity. 
 
 Fig. 10. Cross section of molar showing a disto-occlusal cavity. 1, bevel 
 upon occlusal surface; 2, inclined plane offering powerful resistance to displace- 
 ment; 3, flat portion of gingival seat; 4, beveled portion of gingival seat. Com- 
 pound cavity. 
 
 A simple cavity is one which involves but one surface of a 
 tooth. 
 
 There are the simple-labial, the simple-lingual, and simple- 
 occlusal, or incisal, cavities. 
 
 A compound cavity is one which involves more than one, 
 and may involve all but one, surface of the tooth.
 
 CAVITY PHKPAKAT10X 75 
 
 There are as examples of compound cavities: 
 
 1. The mesio-occlusal 
 
 2. The disto-occlusal 
 
 o. The mesio-labio-occlusal 
 
 4. The disto-labio-occlusal 
 
 5. The mesio-labial 
 
 6. The mesio-lingual 
 
 7. Tlie disto-labial 
 
 8. The disto-lingual 
 
 9. The labio-occlusal 
 
 10. Tlie linguo-occlusal 
 
 11. The labio-occluso-lingual 
 
 12. The inesJo-occluso-distal, or what 
 
 is known as the M. 0. I), cavity. 
 
 A complex cavity is one that takes up at least a part of 
 every surface of a tooth, and as an example may be mentioned, 
 
 A mesio-labio-linguo-occluso-distal cavity. 
 
 The surgical work in the preparation of simple cavities con- 
 sists, outside of root treatment and elimination of impeding 
 gum tissue, merely in the laying open of the cavity area and the 
 chiseling of the surrounding walls. 
 
 The mechanical or formative part of the work consists in 
 stoning the walls and floor of the cavity in such a manner that 
 it will conform in curvature to the curve of the surface upon 
 which it is present. 
 
 The surrounding walls may be stoned so that for two-thirds 
 of their depth they shall be perpendicular to the cavo surface, 
 and the remaining third of the surrounding walls nearest the or- 
 ifice of the cavity may deviate from the perpendicular and di- 
 verge to form an angle of 30 to 45 degrees. 
 
 The alterative part of the work consists in so completing 
 the preparation that it will present a sightly and pleasing ami 
 lasting result, properly protecting the enamel, that it will bring 
 all the margins into areas of comparative immunity, and thus 
 present a restoration most acceptable to the surrounding tis- 
 sues, and hence conducive to the utmost conservation of the 
 tooth. 
 
 In compound and complex cavities, the alterative part of 
 the preparation concerns itself with the proper amount of sepa-
 
 76 CAST CIO LI.) AND rORCKLAlN INLAYS 
 
 ration required (when any is required), and with the restoration 
 of what may be called the occlusal balance. 
 
 We must bear in mind that the occlusal surface of the pos- 
 terior teeth serves, not only in the function of mastication and 
 trituration, but by virtue of its peculiar formation at the mesio- 
 and disto-occlusal lines, respectively, prevents the crowding of 
 the food into the interdental spaces with an efficiency in propor- 
 tion to the correct formation of the points indicated. In other 
 words, the occlusal surfaces of these teeth has more than one 
 function; that of mastication and trituration of food, and that 
 of the prevention of the crowding of food into the interdental 
 spaces. 
 
 A great many cases of so-called pyorrhea and other gin- 
 gival lesions, may be traced directly to poorly executed occlu- 
 sal restoration; and when we realize this, we shall conclude that 
 these surfaces must be treated with as great, if not greater, care 
 than any other tooth surface in the oral cavity. 
 
 A poorly restored occlusal surface may throw the entire 
 face out of balance, and so become the cause of a case of mal- 
 occlusion, which may entail months or years of unremitting 
 effort to correct. 
 
 This brings us face to face with the realization that only 
 by means of the cast inlay is a perfect occlusal restoration pos- 
 sible. 
 
 CAVITY PREPARATION 
 
 The surgical work in the preparation of the compound and 
 complex cavities, consists in the cleansing of the field of opera- 
 tion, and its surroundings, of the chiseling away of the over- 
 hanging walls in such a manner that no unsupported enamel 
 walls be left standing. 
 
 The margins are so prepared that no short enamel rods 
 present any feather edge for the inlay to frictionally play 
 against. If the margin of destruction terminates in a deep sul- 
 cus of the occlusal surface of a tooth, then the cavity must be 
 extended so that the margins of it, at that point, are carried 
 into, and beyond the sulcus onto the ascending portion of the
 
 CAVITY IMIKPAIIATIOX , r 
 
 cusp. The suk'iis is then reproduced in the wax inlay, to be 
 subsequently duplicated in the gold. 
 
 The enamel seat of the inlay should be as broad and ex- 
 tensive as possible, and with that end in view, the bevel butt 
 joint is used. 
 
 In teeth presenting a live pulp, the location of this organ 
 must more or less determine the extent of botli surgical and 
 mechanical or formative work to be done on and in the cavity. 
 
 When no pulps are present, the pulp canals and chamber 
 must come in for their share of the surgical attention, in that 
 the former are properly tilled, and the coronal part so cut as 
 to form flat and variously slanting substantial seats for the inlay. 
 
 It is the mechanical, or formative, part of the work that 
 comes in for very careful attention and for considerable study. 
 The direction of the stress, which the particular tooth is called 
 upon to withstand, should largely determine the form of cavity 
 which we shall prepare for an inlay. As a broad and general 
 rule, the following may be considered: 
 
 The frictional or contact relation which exists between a 
 tooth and the inlay made for it, should be, at least half again 
 as large as that part of the inlay which will be called upon to 
 enter into stress relation with the opposing teeth and surround- 
 ing tissues. 
 
 This applies to all cavities and most particularly to com- 
 pound and complex cavities, and in these latter cavities, the 
 rule may be elucidated as follows: the more of an inlay inside 
 the tooth, and the less of an inlay outside the tooth, the less 
 chance for surgical or mechanical injury to that tooth. 
 
 Please note the hixidc of the tooth and outbid? of the tooth, 
 and do not confuse with mi or above the tooth. An inlay may 
 be made for a tooth, 'and it may present or restore the entire 
 occlusal surface of that tooth, and so expose a very extensive 
 area to stress relation with the opposing teeth, and the area 
 of frictional relation between this cavity and this inlay may 
 >eem to be smaller in extent than the area exposed to stress. 
 These inlays must be considered as resting in a box seat; in 
 other words, the cavity is one presenting the appearance of a 
 simple one in every surface but the floor; here is found a devia- 
 tion in that floor, instead of conforming in shape to the sur-
 
 78 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 face upon which it presents, slopes to become an inclined plane 
 to offer the required resistance to displacement during- stress 
 of mastication. The incline should be sharp and well defined; 
 a step may be used, but an incline tends to better conservation 
 of the tooth. 
 
 In teeth subject to stress, from and in more than one di- 
 rection, these lines of stress must be carefully studied, and an 
 inclined plane must be formed upon the floor of the cavity to 
 oppose each line of direction of stress. 
 
 In cases where the cusps are very deep, and where the man- 
 dible enjoys a limited laterorotary motion, thus subjecting the 
 molar teeth to a considerably greater amount of laterorotary 
 stress than would be the case if the motion of the mandible were 
 
 Fig. 11. 
 
 Fig. 12. 
 
 Fig. 11. Longitudinal section of molar, at 1 and 2, mesial and distal planes, 
 respectively, with apex at 3. Note correspondence of incline in planes and 
 bevels at 4 and 5. Planes and bevels are practicall parallel. Complex cavity. 
 
 Fig. 12. Cross section of bicuspid showing (1) occluso-disto-lingual plane 
 and (2) occluso-mesio-buccal plane. Complex cavity. 
 
 very free in that direction, the floor of these cavities should pre- 
 sent four distinct planes, and, for convenience, may be desig- 
 nated as: the mesial plane; the distal plane; the lingual or 
 palatal plane; and the buccal plane. The highest point of the 
 floor of the cavity may be called the apex; and these planes will 
 correspond, or should, as nearly as possible, correspond, in pitch 
 or angles to the plane presenting as a bevel upon surface of 
 the cavity, to-wit: mesio-occlusal; disto-occlusal; bucco-occlusal ; 
 linguo-occlusal. Thus if the extent of the area of the inlay in
 
 CAVITY HIKPAItATIOX 79 
 
 f rirtional relation with the cavity of the tootli he carefully ex- 
 amined, it will |)o found to exceed the area of the inlay in stiv>- 
 relation with the opposing teeth and surrounding tissues. 
 
 In molar teeth and bicuspids, which are unusually small, 
 and in which restorations of this character are necessary, the 
 preparation of these planes may be so varied that only two 
 instead of four planes are made, and in these cases, the high- 
 est part of the iloor shall be a diagonal line from the disto-buccal 
 to mesio-lingual, or the disto-lingual to the mesio-buecal angle 
 of the tooth, respectively; there will be the 
 
 Occluso-disto-lingual plane, and the 
 Occluso-mesio-buccal plane. 
 
 With a view to greater resistance to fracture of the tooth, 
 and to displacement of the inlay, planes are by far to be pre- 
 ferred to supplemental pins, except when these pins can be 
 placed into the pulp chamber, or canals, and even then, a multi- 
 plicity of these supplemental pins would needlessly complicate 
 the preparation, in that the holes to receive them would neces- 
 sarily have to be parallel to all vertical walls of the cavity and 
 to each other. 
 
 In vital teeth these pins should be looked upon as a means 
 of last resource, and, when used at all, they should be as stout 
 as the bulk of the tootli structures in that locality will allow; 
 they should enter the tooth structure to a depth equal to at least 
 half of their circumference and no greater than their circum- 
 ference. 
 
 For molar teeth a 15- or 16-gauge iridio-platinum wire is 
 used and for bicuspids a 17- or 18- or even 20-gauge wire will 
 suffice. 
 
 There should be at least 15 per cent iridium in the platinum, 
 and it may be threaded in two or three inch lengths and cut into 
 small pieces equal in length to the circumference of the wire. 
 
 These pieces are coated to half their length with graphite 
 or whiting, and a small piece of pure gold is wrapped around 
 the other half and joined to it with the blowpipe. This pre- 
 caution will insure the picking of these wires when the inlay 
 is cast, and will also insure a perfect union between the gold 
 of the inlay and these wires.
 
 so 
 
 CAST <!<>Li> AND POIICKLAIX INLAYS 
 
 Fig. 14. 
 
 Fiff. 15. 
 
 l-'i-T. ]<) 
 
 iff. 1".
 
 CAVITY IMtKI'AKATloX 81 
 
 FIVK VIKWS OK AX UPPER FIRST BICUSPID PRESENTING A 
 Orrr.rsAL CAVITY, AND THE CAST GOLD INLAY MADE FOR IT. 
 
 Fig. 13. A view of the cavity. Note the depth and the bevel 
 on the occlusal third of the depth. 
 
 Fig. 14. Occlusal view of the carved inlay. Note the trans- 
 verse groove and the marginal ridges. 
 
 Fiy;. lo. A cavo-surt'ace view of the inlay. Note the well- 
 ilelined outlines and the bevel. 
 
 Figs. 16 and 17. Views of the finished operation. Note the 
 extension of the margins to the ascending portions of the cusps 
 siiid marginal ridges. 
 
 Stress Index: Upward, out and backward, in and forward or 
 
 intriHllrcohir, LABIO-DlSTALLY and LlNGUO-MESTALLY.
 
 82 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 18. 
 
 Fig. 19. 
 
 Fig. 20. 
 
 Fig. 21. 
 
 Fig. 22. 
 
 Fig. 23. 
 
 Fig. 24.
 
 CAVITY PREPARATION" 83 
 
 SEVEN VIEWS OF A FIRST EIGHT LOWER BICUSPID PRESENT- 
 ING A COMPOUND DISTO-OCCLUSAL CAVITY INVOLVING ALSO THE 
 CERVICAL PORTION OF THE BUCCAL WALL, RESTORED WITH A CAST 
 GOLD INLAY DISTO-OCCLUSALLY, AND A PORCELAIN INLAY Buc- 
 
 CAI.LY. 
 
 Fig. 18. A view of the cavity. Note the well-defined step 
 with its inclined plane running mesially, the well-defined gingival 
 scat with its bevel, the broad, well-beveled enamel margins ling- 
 ually, buccally, and occlusally. 
 
 Fig. 19. A view of the cervical cavity prepared for the por- 
 celain inlay. Note the bevel of the external third of the cavity 
 walls and note how the floor of the cavity conforms to the wall 
 of the tooth upon which it presents. 
 
 Fig. 20. An occlusal view of the disto-occlusal cavity. Note 
 the bevel of the margins here, how they have been carried to the 
 immune areas. 
 
 Figs. 21 and 22. Views of the inlay. Note in Fig. 19 the 
 carving upon the occlusal surface, and in Fig 20, the well-balanced 
 retentive form and seat of the inlay. 
 
 Fig. 23. A view of the finished inlays in position. Note the 
 operation carried into the area of immunity buccally. 
 
 Fig. 24. A disto-bucco-linguo-occlusal view of the finished 
 operation. Note here the lingual part of the operation carried 
 into the area of comparative immunity. 
 
 The gold inlay for the restoration of the disto-occlusal part 
 of the tooth is completed and forms the disto-buccal angle of 
 the cavity for the porcelain inlay. 
 
 Stress Index: Down and inward, down and backward and 
 down and forward or INTRALINGUALLY,* intradistally* and intra- 
 mesially.* 
 
 "Intraalvoolar.
 
 CAST COLD AND POIiCKLA I X IX LAVS 
 
 Fig. 25. 
 
 Fio-. 2(5. 
 
 Fig. 27, 
 
 Fig. 28. 
 
 Fig. 29. 
 
 Fig. 30. 
 
 Fig. 31. 
 
 Fig. 32
 
 CAVITY I'KKI'AKATION 
 
 EIGHT VIEWS OK AX UPPER FIRST BICUSPID PRESENTING A 
 AlKSIO-OCCLUSAL CAVITY, AXI) THE RESTORATION MADE FOR IT. 
 
 Fig>. -~>, -('), and 27. Different views of the cavity. They 
 explain themselves. 
 
 Fi-s. 28 and 2!>. Views of the gold inlay. 
 
 Figs. 30, 31, and 32. Showing the finished operation, and 
 how the mesial portion of the gold inlay may be replaced with 
 porcelain. 
 
 Stress Index : Upward, out and backward and in and for- 
 ward or IXTRAALVEOLAR, labio-ilistally and linguo-mcsially.
 
 86 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 33. 
 
 Fig. 34. 
 
 Fig. 35. 
 
 Fig. 36. 
 
 Fig. 37.
 
 CAVITY PREPARATION 87 
 
 FIVE VIEWS OF A LOWER SECOND BICUSPID PRESENTING A 
 MESIO-DlSTO-OCCLUSAL CAVITY, AND THE INLAY MADE FOR IT. 
 
 Fig. 33. A view of the cavity. Note its well-defined step, 
 the beveled gingival seat, the beveled enamel margins. Note the 
 whole operation carried into areas of comparative immunity. Note 
 the incline of the occlusal surface of the cavity so that it forms 
 an acute angle with the distal wall. 
 
 Figs'. 34 and 35. Occlusal and mesial views of the cavity. 
 
 Figs. 36 and 37. Views of the inlay. Note in Fig. 36 the 
 definition of every part of the inlay, and in Fig. 37, the occlusal 
 restoration anatomically correct. Note the lingual cusps and the 
 well-defined marginal ridges. 
 
 Stress Index: Down and inward, down and backward, down 
 and forward, or INTRAIJNGUALLY, intradistally and intramesially.
 
 88 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 38. 
 
 Fig. 39. 
 
 Fig. 40. 
 
 Fig. 41. 
 
 Fig. 42. 
 
 Fig. 43. 
 
 Fig. 44. 
 
 Fig. 45. 
 
 Fig. 4G.
 
 CAVITY PIIKI'AIIATIOX S!) 
 
 NINE VIKWS OK A MEsio-Occ'LrsAi. CAVITY i\ A FIRST Lo \VKII 
 , AND RESTORATION MADE FOR IT. 
 
 A CAST COLD INI.AV, THE MKSIO LIXCU-AL PART OF IT, ix 
 
 Tl'KX. INLAYED AVITJI SYNTHETIC PORCELAIN. 
 
 Figs. 38, 39, and 40. Views of the cavity. Note the bevel- 
 ing of the walls, margins, scat, etc. Note the acute angle formed 
 by the ocdusal and mesial surfaces of the cavity. 
 
 Fig. 41. A mesio-occlusal view of inlay. 
 
 Fig. 42. A cavo-surface view of inlay. 
 
 Figs. 4:i and 44. Occlusal views of finished operation. Note 
 how the margins of the inlay are carried to the ascending portions 
 of cusp and sulci of the tooth. 
 
 Figs. 45 and 46. Mesio-lingual and mesio-buccal views of 
 the finished operation carried into areas of comparative immunity. 
 Note in Fig. 46 the outline of the porcelain insert. 
 
 Stress Index: Down and inward, down and backward, down 
 and forward, or iNTKALiNGUALLY, intradistally and intramesialty.
 
 90 
 
 CAST GOLD A^TD PORCELAISf IXLAYS 
 
 Fig. 47. 
 
 Fig. 48. 
 
 Fig. 49. 
 
 Fig. 50. 
 
 Fig. 51. 
 
 Fig. 52. 
 
 Fig. 53. 
 
 Fig. 54.
 
 CAVITY PREPARATION 91 
 
 EIGHT VIEWS OF A LOWER SECOND BICUSPID PRESENTING A 
 MESIO-DISTO-OCCLVSAL CAVITY, AND THE RESTORATION MADE FOR 
 IT. 
 
 A CAST GOLD INLAY, THE MESIO-BUCCAL AND DISTO-BUCCAL 
 PARTS OF IT, IN TURN, INLAYED WITH SYNTHETIC PORCELAIN. 
 
 Figs- 47, 48, and 49. Views of Cavity showing bevels, seats, 
 and taper, also occluso-disto-lingual piano and occluso-mesio-buc- 
 cal plane. 
 
 Fig. 50. Occlusal view of inlay. 
 
 Fig. 51. Cavo-surface view of inlay. Note reproduction of 
 planes. 
 
 Fig. 52. Occlusal view of inlay in position. Note the carry- 
 ing of the margins of the inlay to the ascending portions of the 
 cusps and sulci. Note reproduction of marginal ridges. 
 
 Figs 53 and 54. Views of inlay with synthetic insert in 
 position on the tooth. Note the carrying of the restoration into 
 areas of comparative immunity. 
 
 Stress Index: Down and inward, down and backward, down 
 and forward or INTRALINGUALLY, intradistally and intramesially.
 
 92 
 
 CAST GOLD AND POUCKLAI X INLAYS 
 
 Fig. 55. 
 
 Fig. 56. 
 
 Fig. 57. 
 
 Fig. 59. 
 
 Fig. 60.
 
 A FIKST LowF.it MOLAR PRKSKXTIXI; A LABIO- OR Bucco-Oc- 
 CAVITY, AND THK CAST GOLD IXI.AY MADE FOR IT. 
 
 Fig 5o. View of the prepaid! cavity. Note bevel upon oc- 
 dusal surface carried to the ascending portions of all cusps. Note 
 acute anglo formed by the floor and buccal wall of the cavity. 
 
 Fig. 56. A clearer view of the buccal surface and the taper 
 and bevel. 
 
 Fig. 57. A view of the carved inlay. 
 
 Fig. 08. A cavo-surface view of the inlay. 
 
 Figs. o9 and 60. View of the finished operation. 
 
 Stress Index: Downward, ' down and outward, down in and 
 forward, down, back and inward, down, fore and outward or 
 IxTRAAi.VF.or.AK, i nt fdbiicco -(I ixtiil 1 >i, intrdluifiuo *nix\uU)i. intra- 
 ly and intramesio-buccally.
 
 94 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 61. 
 
 Fig. 62. 
 
 Fig. 63. 
 
 Fig. 64. 
 
 Fig. 65. 
 
 Fig. 66. 
 
 Fig. 67. 
 
 Fig. 68.
 
 CAVITY PRKPAUATIOX 95 
 
 A LOWER MOLAR PRESENTING A DISTO-OCCLUSAL CAVITY, THE 
 LOWER HALF OP THE BUCCAL WALL BEING INVOLVED TO THE FULL 
 MESIO-DISTAL EXTENT. 
 
 Figs. 61, 62, and 63. Views of the cavity. 
 
 Figs. 64 and (55. Views of the disto-ocelusal inlay made for 
 the cavity. 
 
 Figs. (!6, '57, and 68. Showing the finished operation, the 
 bm-cal surface having been restored with a porcelain insert. 
 
 The disto-ocelusal restoration was first made and cemented, 
 thus leaving a simple cavity on the buccal surface. 
 
 Stress Index: Downward, down and outward, down in and 
 forward, down, back and inward, down, fore and outward or IN- 
 TRAAI.VEOLAK, i iitrdbiicco-dist ally, intralinguo-mcsially, intradisto- 
 lingualiy and intramesio-buccally.
 
 CAST COM) AND POKCKLAI N INLAYS 
 
 Fig. 69. 
 
 Fig. 70. 
 
 Fig. 71. 
 
 Fig. 72. 
 
 Fig. 74. 
 
 Fig. 75. 
 
 Fiff. 78.
 
 CAVITY PREPARATION 1)7 
 
 A DlSTO-OCCLUSAL CAVITY IX AX UPPER MOLAR AND A DlSTO- 
 
 B rev A i, CAVITY ix TIIK SAME TOOTH. 
 
 Two CAST GOLD IM,\\S FOR THE RESPECTIVE CAVITIES AND 
 THREE VIEWS OF THE FINISHED OPERATIONS. 
 
 Fig. 69. A view of the disto-buceal cavity. Note the bevel 
 of the external third of the walls and the conformity of the floor 
 to the wall of the tooth upon which the cavity presents. 
 
 Figs. 70 and 71. Views of the disto-ocelusal cavity. Note 
 the acute angle formed by the distal and occlusal surfaces. Note 
 the bevels and gingival seat, also the taper of the cavity. 
 
 Figs. 7l* and 73. Occlusal and cavo-surface views of the 
 finished inlay for the disto-occlusal portion of the tooth. 
 
 1'i-s. 74 and 75. Buccal and cavo-surface views of the disto- 
 buccal inlay. 
 
 Figs. 76, 77, and 78. Views of the finished operations. Note 
 areas of immunity into which the operations have been carried. 
 
 Stress Index: Upward, out and backward, back and inward, 
 fore and outward or IXTRAALVEOLAR BUCCO-DISTALLY disto-pala- 
 t<i!lii and m< xin-buccally or in a latero-rotary direction.
 
 98 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 80. 
 
 Fig. 81. 
 
 Fig. 82. 
 
 Fig. 83. 
 
 Fig. 84. 
 
 Fig. 85. 
 
 Fig. 86.
 
 CAVITY I'KKI'AKATIOX !>!) 
 
 A MKsio-DiSTO-Orri.rsAL CAVITY ix AX I'IM-KI; MOI.AK. ALSO 
 A I'.rccAi, CAVITY ix THK SAMI: TOOTH. 
 
 F'IL;. "!. View of the lim-cal cavity. Xote bevel and con- 
 1'oniiity nl' surface. 
 
 Fig. Si I. View nf occlusal surface of cavity, also showing 
 mesial ami ilistal parts of it. 
 
 Fig. 81. Distal portion of cavity showing also the occlusal 
 planes. Xote lievels of all surfaces ami taper of cavity as whole. 
 
 Ki-s. Mil ami M.'!. Occlusal ami cavo-sm fa:-e views of finisheil 
 inlay. Note definition of occlusai carving in \-'\^. SL'. ami defini- 
 tion of cavn-siirface in Fi^. - 
 
 Fii;. SI. Finishi d ojieration upon Iniccal surface. 
 
 Fij;-. 80. Occlnsal view of finished ojieration of nicsio-disto- 
 ncclusal inlay. 
 
 Fig. 80. View of distal surface of completed operation. Note 
 areas of immunity into which the whole operation has been car- 
 ried. 
 
 Sti ss Index: Upward, out and backward, back and inward, 
 fore and outward or I XTKAAI.VKOI.AK Hrrro-PisT.\u.Y 
 t nil ii and iit> xio-bnrt-tillti or in a latero rotary direction.
 
 100 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 87. 
 
 Fig. 88.
 
 CAVITY PREPARATION* 101 
 
 Figs. 87 and 88. Two illustrations of teeth worn down by 
 attrition, restored by means of the cast gold inlay, imitating the 
 conditions of adjacent teeth. (Dr. R. Ottolengui.) 
 
 Note the well-defined carving upon the occlusal surfaces and 
 ac(|ii;iint yourself with the fact that definition does not necessa- 
 rily mean depth.
 
 CAST G()U> AND POIH'KLAIX INLAYS 
 
 Fig. 89. 
 
 Fig. 90. 
 
 Fig. 91. 
 
 Fig. 93. 
 
 Fig. 94.
 
 CAVITY IMIKI'AKATIOX 103 
 
 I.I KT FlUST Lii\VKK MOJ.AK J'KKSKNTIX*; DKKH'IENCV Of OC- 
 Cl.rSAI. TlIIKU. VlK\VS Il.I.rSTKATINi; I'KKPAUATIOX OK ( '.VV1TY AXD 
 
 HKSTOKATION MAIM: KOK IT i\ TIIK SIIATK OF A CAST (ioi.n INI.AV. 
 
 Fig. 89. Occlusal view of the cavity. Xote tlio bevels pre- 
 s ntiiiji 1 aruund tlie jici ipliciv of the tootli ainl at the circumfer- 
 ence of the cavity. The extent of the outer or peripheral bevel i> 
 ei|ii!il to one-half the depth of the cavity at its deepest part. 
 Xote the four distinct planes, to wit: The mesial plane, the 
 distal plane, the lingual plane, ar.d the buccal plane. X'ote also 
 the apex. 
 
 Fi^. !(). A buccal \ie\\ of the cavity showing the apex of 
 the four ])lanes to be somewhat below the surface of th: 1 cavo- 
 peripheral bevel. 
 
 Fij;. 91. Ofdusal view of the carved inlay. 
 
 Fij;. V'2. Cavo surface view of the inlay. Xote the amount 
 of frictional contact between inlay and tooth gained by this 
 four-planed preparation of the floor of the cavity. 
 
 Fi;s. !-'! and 94. Views of the finished operation, a power- 
 ful and lasting restoration. 
 
 Stivss Index: Downward, down and outward, down in and 
 forward, down back and inward, down fore and outward or 
 IXTKAAI.VKOI.AK, i c t I'dlnicco ilixtiill i/. in! niliiifini>-Hi< xiitlti/. intra- 
 
 nii mtramcsio-bvccally.
 
 104 
 
 CAST (JOLD AND PORCELAIN INLAYS 
 
 Fig. 95. 
 
 Fig. 96. 
 
 Fig. 97. 
 
 Fig. 98. 
 
 Fig. 99. 
 
 Fig. 100. 
 
 Fig. 101. 
 
 Fig. 102.
 
 c:.\VJTV PREPAKATinX 105 
 
 A COMIM.KX CAVITY ix AN UPPKR MOLAR INVOLVING EVERY 
 
 SrRKACK OF THE TOOTH. 
 
 A CAST GOLD INLAY MADE TO RESTORE THE TOOTH TO USE 
 A xi) ANATOMIC ACCEPTABLENESS. 
 
 Fig. 95. A view of the ocelusal preparation of the cavity. 
 Note the occluso-disto-lingual plane and the occluso-mesio-buccal 
 plane. 
 
 Fig. !t(i. A tii'iieral view of the cavity. Note the well-sup- 
 ported enamel, the beveled margins practically continuous, the 
 well defined steps, and the general taper of the whole cavity as 
 shown in Figs. 96 and 97. 
 
 Fig. 98. A view of the ocelusal surface of the carved inlay. 
 
 Fig. 99. A cavo-surface view of the carved inlay. 
 
 Fig. 100. An ocelusal view of the inlay in position. 
 
 Fig. 101. A buccal view of the restoration showing how a 
 synthetic insert may be made for this surface. 
 
 Fig. 102. A disto-palatal view of the finished operation. 
 
 Stress Index: Upward, out and backward, back and inward, 
 fore and outward or INTRAALVKOLAR, Bucco-DiSTALLY, disto-pal- 
 utaVy and mcsio-buccally or in a latero-rotary direction.
 
 CAST GOLD AND POKCELAIN INLAYS 
 
 Fig. 103. 
 
 Fig. 104. 
 
 Fig. 105. 
 
 Fig. 106. 
 
 Fig. 107. 
 
 Fig. 108. 
 
 Fig. 109. 
 
 Fig. 110. 
 
 Fig. 111.
 
 CAVITY PREPARATION 
 
 \I.\K \1K\\S OK A SKCOMi LOWKK MOI.AK l'KKSKXTIXJ A 
 
 MKSIO iMsTO-Ocru'so Hrrcu. CAVITY AND Two JXTKKI.OCKIXI; 
 CAST GOLD IM.AVS MAKK FOK IT. 
 
 Fig. 1<>;{. View of tli.- ccclnsal surface prepared to present 
 the plan.s for added f rictional relation lietween inlay ami t< oth. 
 Note lievels presenting in all margins. 
 
 Fi-. KU. --View of distal part of <-avity. Note steji. Ix-vels, 
 s at. ami taper. 
 
 Fi_U. Ido. Jinccal view. Note lievels of outer third of 
 cavity. 
 
 Fi^. L06. Ocelusa] view of mesio-disto-oeclusto ]>ortion of 
 inlay. Xote the lucking device in it Inicco-occlusally. 
 
 Fiy. In7. C;i \o-surfac.' view of the !)iiccal portion of the 1 
 inlay. Note lievel and lock to fit into tlu' part reiiresented by 
 Fi-.' 106. 
 
 Fig. 108. Cavo-surface view ,.f Fi^. ll>. 
 
 Fi^s. 109, 110, and 111. Views of the finished operation; 
 in sequence, a luiccal vi;'w, a niesio-lnu-cal view and an occluso- 
 Imccal view. 
 
 The niesio-disto-occhisal jiortion of this restoration is finished 
 fir>t and cemented into position, thus making a bncfo-occlnsal cav- 
 ity to lie con.-idered for the second operation. 
 
 Stress Index: Downward, down and outward, down in and 
 forward, down hack and inward, down fore and outward or IXTKA- 
 AI.VKOI.AK. mtrabucco-dirtatty, mtrelinffito-mesially, intradisto-lin- 
 gnally an<l iiitraine.-io-luiccally.
 
 108 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 112. 
 
 Fiff. 113. 
 
 Fig. 114. 
 
 Fig. 115. 
 
 Fig. 116. 
 
 Fig. 117. 
 
 Fig. 118. 
 
 Fig. 119.
 
 CAVITY PRF.PAKAT10X 109 
 
 A MESIO-DlSTO-OCCLUSO-PALATAL CAVITY IN AN UPPER MOLAR 
 KKSTOKKD HY MEANS OF A CAST GOLD INLAY. 
 
 Fig. 112. A view of the palatal surface of the tooth. Note 
 the bevel on this part of the cavity walls. 
 
 Fig. 113. A view of the distal part of the cavity. Note 
 the \v< 11 -defined step, the buccal and lingual guides where the inlay 
 part terminates and the unlay part begins. Note the taper of the 
 cavity, the bevel of the gingival seat and other margins. 
 
 Fiji. 1 H- A view of the occ-lusal surface and its planes. 
 Note the bevel presenting upon this surface. 
 
 Fig. 115. Occlusal view of the carved inlay. 
 
 Fig. 116. Cavo-surface views of the carved inlay. 
 
 Figs. 117, 118, and 119. Views of the finished operation. 
 Note the well-defined occlusal restoration, the restored bell shape 
 of the tooth. 
 
 Stress Index: Upward, out and backward, back and inward, 
 fore and outward or INTRAALVEOLAR, BUCCO-DISTALLY, disto-pal- 
 and mcsio-buccally, or in a latero-rotary direction.
 
 no 
 
 CAST GOLD AND PORCKLAIX INLAYS 
 
 Fig. 121. 
 
 Fig. 122. 
 
 Fig. 123. 
 
 Fig. 124. 
 
 Fig. 125. 
 
 Fig. 126. 
 
 Fig. 127.
 
 CAVITY PREPARATION 111 
 
 EIGHT VIEWS OF A MESIO-DISTO-OCCLUSAL CAVITY IN AN UP- 
 PER SECOND BICUSPID, AND THE CAST GOLD INLAY MADE FOR IT. 
 
 Figs. 120, 121, and 122. Views of cavity. Note in Fig. 120 
 the removal of the weakened lingual cusp, the beveling of the 
 margins occlusally, lingually, gingivally, and buccally. Note care- 
 fully in Fig. 121 the formation upon the occlusal surface of the 
 occluso-disto-liugual plane and the occluso-mesio-buccal plane, and 
 in Fig. 122, a view illustrating the taper of the entire cavity to 
 insure the perfect seating of the inlay. 
 
 Fig. 123. Occlusal view of the carved inlay. 
 
 Fig. 124. Cavo-surface view of the inlay. Note carefully 
 the definition of each line and angle, and the correct reproduction 
 of the occluso-disto-lingual plane and the occluso-mesio-buccal 
 plane. 
 
 Figs. 125, 126, and 127. Views of the finished operation. 
 Fig. 125 shows how the mesial portion of the gold inlay may, for 
 cosmetic reasons, be replaced in the porcelain. 
 
 Stress Index: Upward, out and backward and in and for- 
 ward or INTRAALVEOLAR, tabio-distally and linguo-mesially.
 
 112 
 
 CAST GOLD AND POKCELAIN INLAYS 
 
 Fig. 128. 
 
 Fig. 129. 
 
 Fig. 130. 
 
 Fig. 131. 
 
 Fig. 132. 
 
 Fig. 133. 
 
 Fig. 134.. 
 
 Fig. 135.
 
 CAVITY PliKPAHATIOX 113 
 
 EIOHT VIEWS OF A COMPLEX CAVITY IN AX UPPER SECOND 
 
 AND THK RKSTOKATIOX MADE FOK IT IN THE SHAPE OF 
 \ CAST dm.!) IM.AV. THE LABIAL PORTION OF THIS INLAY HAS 
 
 I5KKX, IX Tl-RX. I.XLAYKP WITH SYNTHETIC PORCKLAIX. 
 
 Figs. 128, 129, and 1:50. Views of the cavity and bevels of 
 tlic various walls, margins, etc. 
 
 Ki.u. I -"'I. Occlusal view of the inlay. 
 132. Cavo-surt'ai-e view of inlay. 
 
 Figs. 133, 134, 135- Views of finished restoration showing 
 liii;' of demarcation between gold and porcelain. 
 
 Stres> Index: reward, out and backward, in and forward or 
 
 IXTKAALVKOLAK, lilhiu-tlixtn II i/ and I ' nil Ho- l> .i<lHl/.
 
 114 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 The floor of all disto-occlnsal or mesio-occhisal cavities 
 should present the appearance of an inclined plane instead of 
 a level horizontal surface, as this simple precaution will relieve 
 the vertical walls of any possible stress, and will prove a great 
 factor in the retention of an inlay placed upon the disto-occlusal 
 surface of a tooth which has no neighboring teeth in opposition 
 to it. 
 
 The floor of all labio-occlusal and lineruo-occlusal cavities 
 
 Fig. 136. Stress index for upper teeth. Note in the center of the quad- 
 rangles representing the molars, the heavy black marks denoting intense intra- 
 alveolar stress, which is lessened as the anterior part of the mouth is approached. 
 Left upper second molar marked with letter P indicating this tooth as the most 
 nearly perfect one in this upper jaw. 
 
 should present the appearance of an inclined plane instead of 
 a level horizontal surface. This is particularly essential and 
 even imperative where the amount of dentine, supporting the 
 enamel is small, and where the cavity is of a depth greater than 
 the thickness of these vertical walls. 
 
 As a guide, which will, of course, have to he varied as the 
 cases present themselves, the following table of the different
 
 CAVITY PIIKPAItATION 1 1 .") 
 
 directions in \vliicli stress is brought to hear upon the different 
 teeth is here ^iven: 
 
 The anterior teeth in the upper jaw are called upon to re- 
 sist stress exercised against them in an intraalveolar, labial, 
 and distal direction; that is, they are constantly forced upward, 
 outward, and backward. 
 
 The upper cuspids, in a slightly intraalveolar, markedly 
 
 l-'ig. l.>7. Stress index fur l(i\ver tcoth. Note in the center of the quad- 
 rangles representing the molar, the heavy black marks, denoting intense intraalveolar 
 stress, which is lessened as the anterior teeth are approached. Right lower second 
 molar ma iked with the letter P, indicating this tooth as the most nearly perfect on 
 this lower ja\v. 
 
 labial, and equally mesial and distal direction, so that the lat- 
 ter stress is practically balanced. 
 
 Bicuspids, in a markedly intraalveolar labio-distal and lin- 
 Lnio-mesial or upward, outward, backward, inward and forward 
 direction, the latter two directions predominating. 
 
 Molars, in a markedly intraalveolar, markedly bucco-distal, 
 palato-distal, mesio-buccal or, better, in a rotary direction, buc- 
 co-distal direction predominating.
 
 116 CAST GOLD AND PORCELAIN INLAYS 
 
 The lower teeth are called upon to resist stress exercised 
 upon them in the following directions: 
 
 The four incisors, intralingual and mesial; that is, the four 
 lower incisors are constantly being forced downward, and in a 
 linguo-mesial direction. The downward pressure is counter- 
 acted by the suspension ligament, and the lingual impulse is 
 checked by the ligament and the tongue. 
 
 The cuspids are resisting a pressure tending to force them 
 in an intra, mesial, distal, and a minor lingual direction; or 
 downward, forward, backward, and inward. 
 
 The bicuspids are being driven markedly intra and lingual ly 
 and in a minor way, intradistally and intrainesially. 
 
 The molars bear a stress, decidedly intraalveolar markedly 
 intrabucco-distally, and intralinguo-mesially, minor intradisto- 
 lingually and- intramesio-buccally. 
 
 All of these indications of the direction of stress are for 
 teeth in normal, or very nearly normal, occlusion; with any 
 marked deviation from the normal occlusion, will, of course, 
 have to come a study of the individual case and a preparation of 
 the cavity to fill the need of the case at hand. 
 
 If the foregoing stress index is carefully noticed and mem- 
 orized, -deductions may be made that will show the direction of 
 stress which any case presenting itself may be subjected to. 
 The best manner in which this should be done is to take im- 
 pressions in plaster of the case, and obtain what are called 
 study models. All the teeth needing attention having been pre- 
 viously marked off on a chart, the models and the chart are 
 now carefully scrutinized and the teeth needing attention arc- 
 marked off on the models. 
 
 A close study of the upper and lower models individually, 
 and in their relation to one another, is now begun, and the cavi- 
 ties may be outlined to their surface extent, if the student so 
 desires; as a further aid, the cavities may even be chiseled into 
 the plaster teeth, as the operator would have them appear in the 
 mouth. This w r ould, of course, render the models useless as 
 record models, and would necessitate the taking of two other 
 impressions, or the models at hand may be reproduced before 
 any cavity cutting is done. 
 
 This may be accomplished by placing the model, which
 
 Fig. 
 
 Fig. 139. 
 
 Kiy>. !.".* ami ]:>!.- Huccal and lingual views of a case of nearly normal oc- 
 clusion. Note tin- perfect interdi^itation of the cusps of the upper and lower teeth, 
 the constriction of the teeth at the gingival circumference, the slight malposition 
 of the molars as manifest in the lack of relation of upper third molar to lower sec- 
 ond molar. (Dr. .1. I..->we Young.)
 
 118 CAST COLD AXD POIICKLAIX INLAYS 
 
 has been made perfectly smooth with talcum, upon a glass slab, 
 and surrounding- it with a tin or brass or glass ring, about four 
 inches square and about two and one-half or three inches high. 
 Melted gelatin is now poured upon the model, covering the 
 latter completely. It will be best to fill the ring. When the 
 gelatin has set, the ring is inverted, and so, of course, is the 
 model. With a sharp knife some of the gelatin is trimmed away, 
 and because of the elasticity of the gelatin, the model may be 
 removed. 
 
 Thus a gelatin impression of the model is secured, and into 
 this impression, plaster of Paris may be poured and a record 
 model obtained. 
 
 In the study of these models for determination of stress, 
 the operator should be in possession of a complete history of 
 the patient. A careful examination of the muscular structures 
 of the face should be made and the extent of the freedom in 
 a laterorotary direction enjoyed by the mandible, should be 
 noted. 
 
 It must be borne in mind that the shock to a tooth under 
 stress mastication is inversely proportional to the elasticity of 
 the suspension ligament, or the peridental membrane, and the 
 free mobility of the mandible. 
 
 The elasticity of the suspension ligament is inversely pro- 
 portional to the free mobility of the mandible. This is a sec- 
 ondary condition often resulting from a poor condition of the 
 teeth, finally affecting them to such an extent that the effort 
 to masticate is painful, and so the patient refrains from exer- 
 cising the necessary pressure and shifts the mandible before 
 the maximum of pressure or tension required for mastication 
 has been exerted. This will, in time, produce the condition of a 
 too freely movable mandible; and, because of lack of proper 
 exercise of the peridental tissues, pathologic change will take 
 place in them, the effect of which change, unless remedied, will 
 be cumulative, and lead to the ultimate loss of the teeth. 
 
 Upon restoration of occlusal balance, the condition of the 
 too freely moving mandible may be modified, if the attention 
 of the patient be properly directed to the importance of balance 
 between the various factors in occlusion.
 
 1'llKI'AliATlON 1 1!) 
 
 SUMMARY TOE CHAPTER V 
 Cavity Preparation 
 
 1. Name surfaces, line angles and point angles of 
 (a) Incisors 
 (1)) Cuspids 
 
 (c) Bicuspids 
 
 (d) Molars. 
 
 L'. What is meant by tlie iiiiniune area of a tooth? 
 
 .'!. Why are certain areas susceptible to decay.' 
 
 I. Name the immune ar; a<. 
 
 ~>. Xanie the susceptible areas. 
 
 (i. What factors inter into cavity preparation.' 
 
 7. What are the requirements for tlie formation of a cavity to receive a 
 
 cast gold inlay .' 
 
 ,s. What instruments arc necessary for pro|ier cavity preparation? 
 
 !>. Name tlie g neral rules for teeth cutting. 
 
 Id. What steps are taken before the cavity preparation is commenced? 
 
 11. Name the types of cavities and their subdivisions. 
 
 ll". Kxplain what is meant by tin* surgical mork in the preparation of 
 cavities.' The formative work? The alterative work? 
 
 }:\. Why is the anatomic restoration of the occlusal surface necessary? 
 
 14. How are the margins of the cavity to be prepared? 
 
 ].">. What general rule can be applied to the formative preparation of the 
 cavity? 
 
 16. Explain the technic of the preparation of th - cavity floor in teeth with 
 
 deep cusps. 
 
 37. Illustrate in cross section the preparation in molar or bicuspid of the 
 following cavities: (a) Disto occlusal, (b) Mesio-oeclusal, (c) Linguo-occlusal, 
 (d) ]iucco-occlusal. 
 
 18. Illustrate in cns section the preparation in a molar or bicuspid of a 
 m: sio-occluso-disto linguo-buccal cavity. 
 
 1!>. What is a mesial plane? What is a distal plane? 
 
 :2H. What is the o.-dusodisto lingual plane? What is the mesio-buccal plane? 
 
 L'l. (live the directions of stress which the teeth arc called upon to withstand. 
 
 (a) Upper inci>or 
 
 (b) Upper cuspids 
 
 (c) Upper bicuspids 
 
 (d) Upper molars 
 
 (e) Lower incisors 
 
 (f) Lower cuspids 
 
 (g) Lower bicuspids 
 (h) Lower molars. 
 
 "2'2. What is the purpose of 7iiaking study models? 
 
 -'.'>. (Jive the gauges and si/.es of supplemental pins when used. How would 
 you prepare these pins for use.' Why should (,he use of these pins be avoided.'
 
 CHAPTER VI 
 
 THE MESIO-DISTO-OCCLUSAL CAST GOLD IXLAY 
 
 THE CAST GOLD COMPLEMENT FOR A TOOTH PRE- 
 SENTING A MESIO-DISTO-OCCLUSAL CAVITY 
 
 We must recognize the inherent qualities of whatever suit- 
 able materials we wish to use in our work; never seek to de- 
 stroy these qualities, but rather urge their expression in a man- 
 ner best calculated to enhance our effort. 
 
 This is an abstract principle, the recognition of which will 
 save artists and artisans, as well as those engaged in many other 
 useful pursuits, many discouraging failures. It is one of the 
 keystones in the house of truth; one may go further and say 
 that it is the very cornerstone of success in one's manual or 
 mental work. 
 
 The properties of all things which enter into inlay work 
 must be considered in two ways or from two angles. First, 
 in their oneness, or aloneness, a state of imperious reserve and 
 haughty aloofness the absolute state; and second, in their 
 interdependent copartnership with their coagents a state of ad- 
 justment now tardy, now ready, now yielding, or impelling yield, 
 finally in harmonious understanding of the properties of each 
 other, yielding their own to acquire new ones the relative state. 
 
 In inlays made for simple cavities, or mesio- or disto-oc- 
 clusal cavities, it becomes necessary to pit the inherent pressure 
 of the gas or air used in casting against the inherent inverse 
 pressure of the molten gold. By the inherent inverse pressure 
 of the molten gold, is meant its loss of cube dimension when 
 changing from a molten to a solid state. 
 
 In considering gold and platinum, the former the quan- 
 titatively predominating metal used in inlay work, we find that 
 they are very ductile, royal metals subject to varying dimen- 
 sional changes, under varying intense temperatures, the maxi- 
 mum gain in cube dimension being reached at the boiling point. 
 
 120
 
 .M Ksio-msTo-orcM'SAi. C\ST coin I.M.AV 121 
 
 I'pon removal of the heating clement, the molten mass will 
 gradually cool hy giving up its inl.-iix- heat to the air and things 
 surrounding it, and (luring the cooling process or process of 
 crystallization, will lose in cube dimensions the amount gained 
 while its temperature was heing raised from room temperature 
 to boiling point: or simply this, gold and platinum will expand 
 on being heated with maximum expansion at their boiling points 
 and will contract on cooling with maximum contraction on reach- 
 ing room temperature again. This very phenomenon may ruin 
 work or may contribute markedly to the success of it when con- 
 structing an inlay for a mesio-disto-occlusal cavity. It depends 
 greatly, if not altogether, on how the cavity in the tooth to be 
 inh'.ved is prepared. 
 
 The form of cavity preparation advocated in tins volume 
 for mesio- or disto-occlusal or for labio- or linguo-occlusal cav- 
 ities will not do for mesio-disto-occlusal or for labio-linguo-oc- 
 clusal cavities. 
 
 In all cavities, but the last groups, an inlay is exactly what 
 it.- name implies; in the latter two groups it takes a new form 
 unto itself when two things, an inlay and an onlay are merged 
 into one. So that a cast gold inlay complement for a mesio- 
 di.-to-ocdusal or a labio-linguo-occlusal cavity may be truthfully 
 called an oii-inlay, the occlusal and the extreme inner or cavo- 
 part of the mesial and distal portion of it being the inlav, and 
 the extreino outer part of the mesial and distal portion of it, 
 that is, the extreme bnccal and lingual sections of the mesial 
 and distal portions of the gold complement being the onlay. 
 
 CAVITY PREPARATION 
 
 1. Open the occlusal surface by means of a carborundum 
 wheel %-i- Vir. of an inch wide held in the contraangle handpiece, 
 the stone is to be run under water. 
 
 2. Remove the mesial and distal portions of the tooth by 
 the use of a safe-sided carborundum disc held in the straight 
 or < ontraangle handpiece as the need presents, these discs to be 
 run under water. Tin >e portions are removed in such a man- 
 ner that the mesial and distal surfaces of the tooth will taper 
 slightly toward the occlusal.
 
 CAS'!' COLD AND I'OIH'KLAIX INLAYS 
 
 Fig. 140. The first cut after the detay has Ixv'ii ivmov; <l in the preparation 
 of a mesio-occluso-distal cavity in a molar. This is the occlusal cut and, barring 
 extensive fissure involvement, should givo at once the entire width of the main cav- 
 ity upon the occlusal surface. 
 
 Fig. 141. The second cut, removal of the mesial wall, to provide for the 
 onlay part of the inlay. Ajoining this flat wall are seen the lingual or palatal and 
 labial or buccal guides, as well as the gingival seat of the cavity. Note that the 
 mesial wall has been cut so that it tapers slightly toward the occlusal wall.
 
 MKSIO-DISTO-OCCU'SAI. CAST COLD INLAY 1 -'.} 
 
 Fig. 142. The third cut. The removal of the distal wall to provide for the 
 unlay part of the inlay. Adjoining this flat wall are so;>n the lingual or palatal 
 and labial or buccal guides, as well as the gingival seat of the cavity. Note that the 
 distal wall has been cut so that it tapers slightly toward the occlusal wall. 
 
 l-'iy. 14:;. 'I'll,- final cut. The bevel upon the occlusal surface continuous with 
 the nifsio-liuccal, disto-liuccal, niesio-lingual. and disto-lingual guides of the cavity, 
 which guides are licveled outward. An inlay made for a cavity such as this must 
 never he put into position het'ore thoroughly lubricating it with a small amount of 
 
 carholated vaseline.
 
 124 
 
 CAST GOLD AXI) PORCELAIN INLAYS 
 
 Fig. 144. The wax inlay made for the mesio-occluso-distal cavity. It is 
 mounted upon a sprue wire and held in the crucible former. Note reproduction of 
 all lines and bevels in the wax. 
 
 Fig. 145. The finished inlay in position upon the tooth. The small amount of 
 contraction of the gold served here to more closely force the mesial and distal 
 onlays against the tooth surfaces. This is a hybrid, not an inlay, but an on-inlay.
 
 MKSlO-DISTO-OCCLrSAL CAST COLD IXLAV 1 -~) 
 
 .">. Provide buceal or labial and lingual guides, and pro- 
 vide the gingival scat in the cavity by means of very thin cylin- 
 drical carborundum stones held in the contraangle handpiece 
 and run under water. 
 
 4. Polish all cavity walls by means of, first, coarse sand- 
 paper, followed by finer sandpaper, and ultimately by fine 
 cuttlefish discs. 
 
 The removal of all decay and all doubtful tooth tissue is 
 imperative and should be done before any attempt is made to 
 prepare the cavity at all. The practice of leaving this until 
 the last for fear of creating undercuts is reprehensibly bad 
 practice. 
 
 The grinding or cutting of tooth structure, e\c pt it be done 
 with chisels before all the decay lias been removed, is likely 
 to contaminate the as yet unaffected layer of dentine, a result 
 as undesirable as it is ultimately disastrous. 
 
 If the saliva interferes with clean rapid work, the rubber 
 dam must be applied. 
 
 All that has previously been said in the chapter on Cavity 
 Preparation for simple, compound, and complex cavities ap- 
 plie.x in M.O.I), cavities; that is, the adjoining teeth must be 
 scaled and polished, and by far the best way is to subject the 
 patient's mouth to a thorough prophylactic treatment. The 
 dam may then be applied and the cavity preparation undertaken 
 and completed as directed. 
 
 The tooth should then be washed with warm water, until 
 no sign of d< hris exists; tooth and cavity are now flooded with 
 alcohol (!).V, ) and dried with a gentle warm air blast. A gen- 
 erous quantitiy of chloroform is now applied and again the 
 warm air is used to dehydrate the tooth presenting the cavity. 
 The next application consists of a saturated solution of potas- 
 sium carbonate in glycerine Hooding every part of the cavity 
 'his solution is allowed to remain in the cavity for about five 
 minutes, when the warm air is again applied. 
 
 The glycerine will further dehydrate the dentinal tubules, 
 and the carbonate of potash, held in solution, will enter to 
 efficiently occlude these with a material acceptable to the tooth 
 economy. 
 
 In order to exclude the possibility of thermal shock, this
 
 lL!() CAST COLD AND rOIICKLAl.X INLAYS 
 
 procedure may be followed up with a solution of rosin in chlo- 
 roform, y* dram of rosin to 4 drams of chloroform. This makes 
 a very tough varnish, which will cling to the dentine walls in 
 the cavity, and which will enter the dentinal tubules to some 
 extent. It is a nonconductor of thermal changes and will pre- 
 vent shock to the tooth when the inlay is set and after it has 
 been set. This varnish may be applied with a pellet of cotton 
 and it must be dried with the warm air. 
 
 AYhen all these preparations have been completed, we may 
 proceed to band the tooth or put a matrix on it and to force 
 the wax into the cavity that is, we may proceed to make the 
 wax inlay. 
 
 This should be done by the direct method as already de- 
 scribed, or by the use of the indirect as an accessory to the di- 
 rect as also described. 
 
 The mode of cavity preparation advocated and illustrated 
 here for mesio-occluso-distal and B.O.L. inlays takes into con- 
 sideration and partnership the small amount of contraction that 
 will take place in the casting of the metal and make use of this 
 property of the metal, in that thus a better coaptation is ob- 
 tained between inlay and tooth. 
 
 This preparation will not do for mesio-occlusal, disto- 
 occlusal, bucco- or linguo-occlusal cavities, because, in getting 
 a closer adaptation mesially or distally, buccally or lingually, 
 the gold would be pulled away from the margins upon the 
 occlusal surface, and the margins upon this surface would be 
 exposed to the recurrence of decay. 
 
 SUMMARY FOR CHAPTER VI. 
 The Mesio-Disto-Occlusal Cast Gold Inlay 
 
 1. Describe the preparation of an M.O.D. cavity. 
 
 2. Describe the preparation of the cavity for the reception of the \\:ix. 
 .'5. Describe the taking of the impression. 
 
 4. What quality of the casting metal is recognized in the preparation of 
 mesio-disto-occlusal or a bnceo-occluso-lingual cavity?
 
 CIIAPTKU VII 
 THK SKLKCTIOX OK TIIK PliOl'KU WAX 
 
 \\'a\ is a name given to various animal excretions or vege- 
 table substances having some similar and some identical phys- 
 ical peculiarities, but differing in chemical coni])osition, and 
 possessing a delinite physical individuality. 
 
 All waxes are hydrocarbon compounds, related to the groups 
 of oils and fats, common wax differing from ordinary wax in 
 pos>essing no glycerine. 
 
 A great many waxes are known to commerce and employed 
 in the arts. 
 
 The most widely known, or common wax, which forms the 
 honeycomb of the wonderful bees, is in its untampered-with 
 condition, a comparatively hard substance, unctuous to the 
 touch, tasteless, and of a sweet odor. It is easily obtained from 
 the combs by immersing them in hot water, when the wax will 
 float to the surface as a thin oily fluid. This fluid is drawn off 
 and allowed to solidify into cakes. This wax may be bleached 
 or purified into cera alba or white wax, by the following 
 process : 
 
 In the shape of thin flakes, the wax is exposed to the air 
 and light until the surfaces of the flakes have been bleached, 
 much after the process used in bleaching linen. The wax is then 
 remelted. and thus new surfaces are brought under the bleaching 
 influence of light and air. This is continued until a uniform 
 white wax is obtained. 
 
 Bleaching powders as chemical agents, are sometimes used, 
 but they are objectionable because the whole of the chloride is 
 not removed in the process, and in the subsequent burning of 
 the wax, irritating and harmful fumes of hydrochloric acid an- 
 given off. 
 
 \Vhite wax made pure by the process of boiling and bleach- 
 ing consists of: 
 
 127
 
 128 CAST GOLD AXD PORCELA1X IXLAYS 
 
 Creatine, 80 per cent, soluble in boiling alcohol and an in- 
 soluble waxy substance called inyricin, nearly 20 per cent. A 
 small proportion of cerolin gives hardness to the mass. 
 
 The wax is tasteless, inodorous and semitransparent. At 
 85 F. it becomes somewhat plastic, and may be molded with 
 the fingers. It. melts at 145 F. It is chiefly used for making 
 candles, artificial flowers, and wax fruits. It has emollient 
 properties and is employed in the making of ointments. Because 
 of its high price, it is often adulterated with spermaceti (an 
 inferior wax chalk), starch and finely powdered si lex, etc. 
 
 Another wax is made from candleberry, known as wax 
 myrtle, wax or tallow tree, or bayberry (Myrica Cerifera), a 
 small tree, or more generally a low spreading shrub, a native 
 of the United States, most abundant and luxuriant in the South. 
 The evergreen leaves are dotted with resin glands, and are 
 fragrant when bruised. The drupes, popularly called berries. 
 are about the size of peppercorns, and, when ripe, are covered 
 with a greenish white wax. The wax is collected by boiling and 
 skimming them, and is afterwards melted and refined. A bushel 
 of berries will yield four or five pounds. An excellent scented 
 soap is made from it. 
 
 Paraffine was practically unknown to the candle maker un- 
 til 1847-50, when the late Dr. James Young discovered the 
 method of producing hydrocarbons by the distillation of coal 
 at a low red heat. It is now produced in Scotland from shale 
 in large quantities; in the United States, from petroleum; in 
 Germany (in smaller quantities), from brown coal; and in 
 Burma, in yet smaller quantities, from rangoon petroleum. 
 Crude paraffine (technically "scale") contains, in addition to 
 the harder paraffine suitable for candles, soft paraffine (used 
 by match makers), and a small proportion of oil. The scale is 
 melted and cast into thin cakes, which are then placed on slop- 
 ing shelves in an oven kept at a regular temperature sufficiently 
 high to melt the soft paraffine. The soft paraffine and oil flow 
 away, and leave behind a mass of hard paraffine ready for the 
 candle maker. 
 
 Mineral wax is a name employed for certain fossil hydro- 
 carbons, occurring chiefly in small quantities in carboniferous 
 formation. The commonest one of these is ozokerite, used in
 
 SKLKCTIOX OK TIN-: IMIOI'KI! \\'A.\ 1 1 } !) 
 
 the candle industry. A preparation of this substance known as 
 oiokcf'nic, is employed in Hi" making of ointments. It lias the 
 advantage over lard for this purpose as it do* s not spoil with 
 time and age, and does not turn rancid. 
 
 There is a great variety of these vegetable and mineral 
 waxes, hut these enumerated will suffice to enable the reader 
 to learn something of the origin and properties of the most 
 widely known to the arts and commerce. 
 
 It must he said that ,iu and by themselves none of these 
 waxes are suitable for inlay purposes, because for this purpose, 
 the wax must possess the following properties: 
 
 1. It must leave absolutely no residue within the mold after 
 it has been subjected to the proper amount of heat. 
 
 2. It must volatilize at a temperature much below that at 
 which the disintegration of the mold begins. 
 
 3. It must remain rigid at 25 F. above the temperature of 
 the mouth, which means that it will break before it will bend. 
 
 4. It must possess when heated, the property of perfect 
 
 plasticity. 
 
 ."). It mu>t not flake when brought to a plastic state. 
 
 6. It must be of a dark shade, preferably green, so as to 
 more easily detect marginal deficiencies. 
 
 7. It must be capable of being willed to with hot instru- 
 ments. 
 
 8. It must he subject to the least possible variation in bulk 
 at slightly above or slightly below normal temperature. 
 
 9. It must permit of being carved to sharp definition of 
 outline. 
 
 10. It must be reliable in these qualities so that the worker 
 may be enabled to definitely duplicate his operations. 
 
 These properties are possessed by no single wax, and so a 
 combination of waxes had to be carefully studied out and 
 experimented with in order to obtain the desired results. 
 
 A simple stellate cavity was prepared in a molar tooth and 
 wax inlays were made for it from the various waxes offered 
 to the profession. 
 
 These wax inlays were invested in the refractory com- 
 pounds, one inlay at a time. A separate mix of investment was 
 made for each inlay. As nearly as possible, physical conditions,
 
 130 CAST GOLD AND PORCELAIN INLAYS 
 
 such as quantity of powder and water, and relative proportions, 
 as well as temperature, were duplicated in each instance, and 
 the automatic mixer was used. 
 
 It must be apparent that if the precautions of making a 
 separate mix of investment for each inlay had been omitted, and 
 if an attempt had been made to invest several of the wax pat- 
 terns at one time, the physical conditions and environments of 
 the second mold would have been different from those of the 
 first, and the conditions governing the third, fourth, fifth and 
 sixth, etc., would all have varied from those of the first, and 
 from those of each other, and any deductions made from such 
 experiments would necessarily have carried with them an ele- 
 ment of guess and surmise, which from my point of view would 
 have rendered them altogether unreliable. 
 
 It is always Avell to remember that the fluidity or creamy 
 consistency of the mixed refractory compound changes as the 
 moments pass, and what may be practically a fluid at the time 
 of investment of the first wax inlay, would prove to be but a 
 plastic compound at the investment of the third or fourth pat- 
 tern, and its plasticity would be a rapidly disappearing a*nd 
 hence much interfering, quality of very doubtful merit. 
 
 Each mix was given an even half hour to harden and each 
 flask was subjected to the flame of the Bunsen burner under a 
 "Platcheck stove." 
 
 Upon casting, it was found that, at a temperature that 
 would not endanger the integrity of the mold, most of the waxes 
 left a residue that excluded the possibility of satisfactory re- 
 sults, and that, in order to clear the molds of this residue, the 
 temperature had to be raised to a degree that made the mold 
 too weak to resist internal pressure, thus obliterating margins 
 and producing a casting unfit for use. 
 
 These experiments, carried on for a lengthy period of time, 
 justify my conclusion that up to the present, the Taggart green 
 wax is the most ideal wax with which to work. 
 
 SUMMARY FOR CHAPTER VII 
 The Selection of Proper Wax 
 
 1. What is a wax? 
 
 2. What are the properties a wax must possess to make it suitable for inlay 
 purposes?
 
 CHAPTER VIII 
 
 MAKIXC AND CARVING OF THE WAX INLAY BY THE 
 USE OF THE DIRECT METHOD 
 
 The wax may be brought to the proper state of plasticity 
 by dry or moist heat, greater care being necessary if the direct 
 Maine is used. 
 
 1'ntil an automatic wax warmer made on correct principles 
 is readily obtainable, hot water heat is to be preferred and a 
 serviceable wax warmer and softener may be made by taking a 
 small glass with a diverging or flaring month, and fitting into 
 it a cork of a size that will, upon partly descending into the 
 glass, also act as a cover to retain the heat present there. 
 
 Bankers' pins are inserted into the cork and are allowed 
 to so penetrate it that the points w r ill reach into the hot water. 
 The cones of wax are then speared upon these pins, and the 
 cork carrying the pins, which in turn carry the wax, is now al- 
 lowed to drop into the glass containing the water at a tempera- 
 ture of 140 F. 
 
 The wax-laden cork will float and will allow the hot water 
 to play around the impaled wax and evenly soften it. , 
 
 A wire loop or glass pin push button placed upon the top 
 or outside of the cork will facilitate the handling of it. In 
 about two minutes the wax will be plastic enough to be used. 
 
 It is now removed from its pin, and with the pressure of 
 thumb or index finger it is forced into the cavity. The pres- 
 sure is to be exercised in one direction only and that is in the 
 direction of the floor and perpendicularly to the walls of the 
 cavity. 
 
 While the wax is being forced into the cavity, lubricated 
 icitJi (i solution of castor oil and glycerine, half and half, it will 
 gradually begin to stiffen; and when the finger or thumb has 
 flattened the surplus of it against, the tooth surface, a stream 
 
 131
 
 132 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 146. The Taggart automatic wax warmer.
 
 HIIIKCT .MKTIIOH OF CAKVIXi; \V.\\ INLAY 
 
 DKSCKJPTIOX OK T.\(;;AKT ATTOMATIC WAX WAK.MKK 
 Sfc e opposite page) 
 
 "This instrument, an automatic wax warmer, has as a heat- 
 ing clement a Hi-candle-power lamp, with a carbon filament. The 
 carbon filament is being abandoned for lighting purposes, because 
 it furnishes more heat than light. The Tungsten filament fur- 
 iii-h s more light than it dues heat. For that reason I have used 
 the carbon filament to furnish the heat. 
 
 "The principle on which it works is this: We have here a 
 glass disc, which we can turn to one side in order to place our 
 wax mi it- On account of the heat all coming from one direction, 
 a mi-tal disc or surface that was Mat would receive heat upon its 
 upper surface, and the under surface of the wax would be cool. 
 I found that one of thcs di>c gla-se.s is thin enough so that as 
 the heat strikes it. it is reflected back so that the under side of 
 the wax is warmed as well as the upper. I have had wax on here 
 for fifty six hours at a time, and when I examined it, it was 
 plsatic in its mass, and no more heated on the upper than on the 
 lower side. 
 
 "The electric heating apparatus was hard to control auto- 
 matically if the current was allowed to go in a continuous path, 
 but by adopting the principle I have used here, of having the 
 heat all on or all off, it permits the intermittent heating of a ther- 
 mostat. It heats the thermostat, and as soon as it gets a little too 
 warm it breaks the electric circuit. As soon as tli? electric circuit 
 is broken the thermostat logins to cool down, and the thermostat 
 throws the current into the lamp ai'.ain. It works by excessive 
 heat, and it shows there is not a one-hundredth degree of differ- 
 ence in temperature between the surface on one si'V or the other. 
 Sometinus it will flash 50 or 60 times in a minute; sometimes 
 slower. The ivason is. it is a very sensitive test of the voltage 
 that is passing through the wire. You liav.? often noticed that 
 when the lights would go up high it would make your room light 
 enough. When the current is at a high voltage the lamp is 
 heated more, and that works the thermostat quicker and as soon 
 as it is worked quicker it immediately drops' down. The dancing 
 you see is worked by that voltage. 
 
 "The wax is placed on this glass disc and the even tem- 
 perature throughout the whole mass lias a great deal more to 
 do with the correct molding of wax in a tooth cavity than you 
 think. It is peculiar, but a soft, wobbly condition of the surface 
 of wax will invariably make it shrink from the cavity walls; 
 whereas, if you have a wax of uniform texture, it will move to 
 its plac;> in an exact way, and there will be no change in form 
 when it cools off." (Taggart Items of Interest, June, 1911.)
 
 134 
 
 CAST GOLD AND POIU'KLAIX INLAYS 
 
 of cold water is directed upon it and the force which compelled 
 it to assume its new shape is removed. 
 
 An explorer may now be inserted into the body of the wax 
 inlay and it may be withdrawn to be carefully examined. 
 
 If the wax was in the proper plastic condition, and all 
 directions have been carefully followed, the wax inlay, if the 
 cavity be simple, will be a perfect impression of the cavity, and 
 it may be replaced in the tooth to assume its final shape, which 
 will be a perfect wax complement to the macroscopic anatomy of 
 
 Fig. 147. A glass of water at a temperature of 140 F. A large cork carry- 
 ing two banker's pins upon which two pieces of inlay wax are impaled. A pin to 
 serve as a handle inserted into the upper surface of the cork. The two pieces of wax 
 are constantly submerged in the water. The cork seals the glass and keeps the 
 temperature more or less constant for an appreciable length of time. 
 
 the tooth, and which shape is created with carvers and bur- 
 nishers of the different patterns illustrated. 
 
 With a pellet of cotton dipped into oil of cajeput or alco- 
 hol, and deprived of most of its oil or contents by rolling the 
 pellet in a towel or napkin, the wax inlay is finally polished,
 
 DIRECT .MKTHol) OF C.MIVIX.: \VA\ INLAY 1 .'!") 
 
 care being exercised to always polish towards the margins of 
 the cavity. 
 
 Again the explorer is inserted into the body of the wax. 
 midway between all margins, and the wax inlay is removed 
 from the mouth, to he transferred to a glass of cold water until 
 it can he surrounded with and imbedded in the refractory com- 
 pound. In a very delicate wax inlay, it is wiser to use coin- 
 pivs>ed air to remove it from its seat in the cavity; this can 
 readily be done by applying the blast of air at the cervical part 
 of the inlay. 
 
 In compound cavities the technic of preparing the wax for 
 the making of tlie wax inlay, is, of course, the same, except that 
 the tooth is banded in extremely large restorations, when it 
 becomes necessary to join two or more of the cones of wax in 
 order to obtain a piece large enough for the inlay, and some 
 surplus against which to apply the force. 
 
 AYhen this becomes necessary, two cones of the softened 
 wax are brought together at their base, and a hot spatula is 
 drawn longitudinally through both cones at four or five places 
 on the circumference, and twice through the joints of the cones 
 horizontally. This will result in an inseparable piece of inlay 
 wax twice the usual size. 
 
 If the piece has stiffened too much in the process of han- 
 dling, it is again impaled upon the pin and placed in the hot 
 water to become properly plastic. 
 
 The large piece of wax is now removed from the water 
 bath and forced into the cavity, care being taken to exercise the 
 pressure in one direction, that of the floor of the cavity, and 
 perpendicularly to the walls of it and the band which sur- 
 rounds it. 
 
 The wax will gradually cease to yield to the pressure, and 
 while the force is still in place, the wax must be chilled with a 
 stream of cold water. 
 
 In this manner the handling of wax is brought about under 
 pressure, and thus the shrinkage and expansion of waxes, so 
 much talked and written about, and worked up into red letter 
 scareheads by investigators who shoot off at a tangent, really 
 deserve no consideration at all if the technic laid down by the 
 originator of the process be followed to the letter.
 
 136 CAST GOLD AND PORCELAIN INLAYS 
 
 To repeat a point to be carefully observed: the easiest A\ay 
 to make a wax inlay for compound or complex cavities is to 
 convert them into simple cavities by placing a copper band over 
 and around them. 
 
 These bands may be made up in quantities out of sheet 
 copper 36-gauge B&S and kept on hand, or a matrix such as 
 illustrated in Figs. 349 and 150 .may be used. 
 
 The case presenting itself, a band of suitable size is selected, 
 trimmed to gingival contour, and placed over the tooth after 
 the cavity has been prepared. 
 
 The softened wax may then be forced into the cavity against 
 the walls of the band, the pressure may then be removed and 
 a stiff cone of wax may be forced into the mass within the band, 
 the center of the mass having first been softened with a suitable 
 hot instrument. 
 
 It may be well to reiterate here that the wax is thoroughly 
 plastic that is forced into the cavity, the pressure being ex- 
 ered in one direction, and that while the force is still upon and 
 behind it, it is greater than the force acting upon the molecular 
 structure of the wax in its attempt to shrink or alter its form; 
 thus the deleterious part of the shrinking force or tendency 
 will be overcome, and the result will be a wax filling, occupying 
 every part of that cavity and abutting all margins accurately. 
 It again becomes a question of two forces acting in opposite 
 directions upon a movable body (the wax), and it must be 
 clearly seen that the greater force, if properly applied, will 
 prevent any change of form in the wax, in the wrong direction 
 after it has induced it (the wax) to assume a certain definite 
 shape ; to-wit, that of the cavity. 
 
 At this time the various margins occupy, or should occupy, 
 the operator's entire attention. With the proper carvers, all 
 marginal surplus of wax is removed. With right and left bur- 
 nishers and always in direction of the various margins that part 
 of the work is completed before we proceed with the carving of 
 the occlusal surface in order to restore occlusal balance. 
 
 A large ball or egg-shaped burnisher is heated in the gas 
 or alcohol flame, or it may be attached to the switchboard, and 
 the occlusal surface of the wax inlay, resting in the cavity, is 
 softened sufficiently to enable the patient to occlude and tritu-
 
 DIHKCT .MKTIIOD OF t'AltVINU \V.\X INLAY 
 
 1:57 
 
 Fig. 148. A spatula, a set of right and left and straight flat burnishers, lancets, 
 right ami left <-;uvcrs. ami hand drills used by the author.
 
 138 CAST GOLD AND PORCELAIN INLAYS 
 
 rate; if the wax be lacking in bulk, a portion may be added. 
 
 In the case of an inlay for a lower tooth, we simply place 
 a piece of inlay wax upon the occlusal surface of the wax inlay, 
 and with the hot burnishers the two waxes are united. 
 
 In an upper case, it is advisable to first soften the occlusal 
 surface of the wax inlay in place, and then carry an additional 
 piece of the wax into the softened surface. The union is com- 
 pleted by again using the hot instrument and virtually melting 
 the added portions into the wax inlay. 
 
 When the required bulk is obtained, and sufficiently sof- 
 tened, the patient is allowed to occlude and to triturate, and 
 again to simply occlude and hold that position while a stream 
 of cold water fixes the wax. 
 
 None but the occlusal surface will undergo any change, all 
 margins will be found undisturbed, since the softening process 
 was not carried to any marginal portion. 
 
 When the maxillary tension is removed and the mouth 
 opened, the proper landmarks for occlusal carving will be 
 clearly indicated and must be rigidly adhered to, if an occlusal 
 surface that will be truly serviceable in the full sense of the 
 word is to be obtained. 
 
 SUMMARY FOR CHAPTER VIII 
 Making and Carving of the Wax Inlay "by the Use of the Direct Method 
 
 1. Describe a method of bringing the wax to the proper state of plasticity 
 by moist heat. 
 
 2. Describe the method of making the wax pattern if the cavity is a simple 
 one. 
 
 3. Explain the details of preparing the pattern for compound or complex 
 cavities. 
 
 4. Describe the finishing of the margins. 
 
 5. Describe the technic of carving the pattern to restore the occlusal surface.
 
 CHAPTER IX 
 
 TAKING AN IMPRESSION OP THE CAVITY AND 
 
 MAKIXC A DIE FOR PROCEDURE BY THE 
 
 INDIRECT METHOD 
 
 The problem of making a cast gold inlay by means of the 
 impression or indirect method, should really not be considered 
 as a problem by itself, because as such it at present admits of 
 no solution worthy of the name. 
 
 If used at all, it should prove but an accessory step in the 
 direct method, and so be employed in cavities so inaccessible, 
 and under circumstances so remote that the infrequency of these 
 stipulations shall in themselves exclude it from the routine of 
 daily work. 
 
 Some disto-occlusal cavities in the third molars may call 
 for the indirect method as an aid to the direct, but under no 
 circumstances should sufficient reliance be placed on an im- 
 pression of such a cavity to complete the inlay upon a die made 
 from this impression, without giving the wax its final shape in 
 the cavity itself. 
 
 The very name which the advocates of this method have 
 given it, namely, the indirect method, in itself stamps it as 
 soi net! ling remote, far off; labor and time and energy are 
 wasted in attempts to have an assistant assume that part of 
 the constructive work in the laboratory which should be done 
 right in the mouth. 
 
 These advocates who claim satisfactory results from their 
 procedure, are being misled by burnished margins of their in- 
 lays; they lose all frictional relation between their product and 
 the cavity it is to occupy, but they honestly overlook the fault, 
 grave though it be, because the method shifts responsibility to 
 give time to work. 
 
 The fact is, that if no better inlay could be made than the 
 best which have been made up to date by means of the indirect 
 
 139
 
 140 CAST GOLD AND PORCELAIN INLAYS 
 
 method, the entire process of cast gold inlays would be a medi- 
 ocre palliative measure, instead of the greatest boon to the 
 dentistry-requiring public, and if that had been the best it were 
 possible to obtain, I doubt much if it would ever have been given 
 to the profession at all. 
 
 The first step in the construction of an inlay is to take a 
 perfect impression of the properly prepared cavity. If the 
 direct method is to be employed, that impression must be taken 
 in the inlay wax. If the indirect method is to be employed, the 
 initial impression is taken in a modeling compound, preferably 
 "Detroit." 
 
 The most persistent argument of the advocates of the in- 
 direct method is that they can not get a proper pattern of the 
 cavity in using the direct method; in other words, they can 
 not get a perfect impression of that cavity in inlay wax. 
 
 If that be true, how does it happen that they can get what 
 they consider a perfect impression in a compound, not nearly 
 so reliable in its physical properties as is the wax they should 
 use. 
 
 When the direct method is employed, the margins of the 
 cavity in the tooth are an ever present help to thorough work, 
 and an ever present deterrent to the slip-shod, just-as-good 
 results. 
 
 Once the margins are obtained, the major part of the 
 carving may be done outside of the mouth, and the wax inlay 
 replaced from time to time to insure correctness of manipu- 
 lation. 
 
 Proper occlusion may be obtained beyond the question of 
 a doubt, and that, without the additional work of taking an 
 additional bite in a filmy piece of wax, and without taking an 
 impression of the affected tooth, carrying the compound impres- 
 sion of the cavity, and of the surrounding area for a guide to 
 the desired correctness, and often that is as far as one can get 
 to the correct result, ergo the desire for it. 
 
 The answer is made that while all of these steps are nec- 
 essary, they may be done in the laboratory, and here the great 
 mass of errors, which follow the use of such materials as com- 
 pounds, plaster, amalgams, variation in mass, temperature, and 
 physical structure in the hands of a laboratory assistant, who
 
 TAKIXC I.MI'KKSSIOX AND .MAKIXi; DIK 
 
 141 
 
 can only begin working upon and with these materials, after 
 the errors have crept in, all combine to give a result not looked 
 for, and this result is made to assume a semblance to the one 
 
 End to be inserted 
 in slide 
 
 Slide 
 
 Fig. 149. The upper figure shows a piece of sheet copper 33- or 36-gauge, 
 cut as illustrated. The lower figure shows the same piece of copper formed into a 
 baii-1 and locked by bending surplus back upon itself. Note at aa two vertical and 
 two horizontal cuts to allow the improvised band to be forced apart in order to ob- 
 tain contact with adjacent tenth. 
 
 1'i^. 150. Illustrating a handy matrix in position upon a molar. 
 
 looked for by using the burnishers freely, and the good or fairly 
 good margins deceive most of us.
 
 142 CAST GOLD AND PORCELAIN IXLAYS 
 
 They who admit their incapability to make an accurate 
 impression of a cavity in inlay wax, have never familiarized 
 themselves with its physical properties, and should start right 
 there. Let them study the wax, its physical properties under 
 various temperatures, its adaptability, its toughness, etc. "NYork 
 it carefully, use it as if it were something alive, vibrant, re- 
 sponsive; for it has in it all the things that give life and re- 
 sponsiveness, put there by a very inspiration. Then let these 
 indirect method men compare their results of the time at hand 
 and the time past. 
 
 The advocates of the indirect method obtain an impression 
 of the cavity for which they expect to make an inlay, and they 
 construct a die upon and into this impression. The result is a 
 partial model of the tooth to be inlayed, the partial model being- 
 made of amalgam or cement, preferably the former. 
 
 Some proceed to form the wax inlay in this very die, which 
 is equivalent to making a complement to the human anatomy 
 without having that part which is to receive the complement 
 before you in its entirety. They guess at bulk, width, length 
 and contour, and if they guess correctly, the indirect method 
 is a success and they proceed to give it to those whom they 
 designate as the rank and file of their profession. 
 
 Now, let me ask this of the rank and file and laymen: 
 What would we be likely to think of a man who tried to supply 
 a part of one finger of a hand without having the whole of 
 that hand before him all through the operation? AVould we 
 consider him correct? Of course not, because he will have 
 constructed the complemental portion without due reference to 
 the whole; without having at his disposal a comprehensive view 
 of that with which the complemental part must ever interplay 
 and harmonize, and so the least these indirect method advocates 
 can do is to have before them a complete model of the tooth. 
 Some of them, realizing this, obtain a wax bite (indefinite 
 and inaccurate), and so to speak, plant this die into the wax 
 bite, filling in the rest of it with plaster. Too often, almost 
 always, a microscopic shift takes place, and multimicroscopic 
 errors are the result. 
 
 They are also prone to harp upon the subject of gold and 
 porcelain inlays, as if the problems were one, ignoring pur-
 
 TAKING IMlMiKSSIOX AXI> .MAKIXC DIK 143 
 
 y or otherwise, the fact that there is no comparison be- 
 tween the two, except that both act as fillings or inlays for a 
 tooth. 
 
 The preparation of the cavity is wholly different; the phys- 
 ical properties of the material are wholly different; the method 
 of construction after obtaining impression and die is wholly 
 different; and the problems or obstacles in the way of making 
 porcelain inlays for posterior teeth by the use of the direct 
 method, are many times greater than when we are working 
 in gold. 
 
 So in justice to themselves and the art, and for the sake 
 of those who read and wish to learn, they should be more care- 
 fully accurate in their statements, and less confusing to the 
 learner. They speak of the advantage of the indirect method 
 in case of failure at the time of casting, ignoring the fact, that 
 they (with emphasis on the ///<//) have a failure as the result 
 of every so-called successful casting. 
 
 If they tested the machine before every casting; if they 
 were always careful to properly mix the investment, and to 
 always duplicate that proper mix; if they took the time to 
 learn how to properly manipulate the wax; if they were careful 
 to note the boiling point of the gold they were using for their 
 casting, which is considerably different from the fusing point; 
 assuming that all their materials were clean; and if with all 
 the foregoing, they used the direct method, they would not need 
 to consider the possibility of failure. 
 
 They say that the "Great Taggart" (and they are care- 
 ful to say "great"), and a few of his closest followers perhaps 
 (note the perhaps) can do the work by the direct method, and 
 show perfect results; thus convicting themselves by the ad- 
 mission that they have not followed the Great Taggart. Thus 
 they admit the perfect results of Taggart and his close fol- 
 lowers, but they Avant the rank and file of the profession to 
 follow them, even though they qualify their results as but fairly 
 accurate. 
 
 If Taggart obtains perfect results (which they admit), and 
 if the close followers of Taggart obtain perfect results, and if 
 it is perfect results they are trying to obtain, clearly the easiest 
 and surest way is for them to follow the directions they have
 
 144 
 
 CAST GOLD AXI) PORCELAIX IXLAVS 
 
 been persistently trying to confuse and obscure for the rank 
 and file of the profession. 
 
 They are of course wasting their time, and the time of those 
 who follow their indirect-niethod-ward pointing index finger, 
 and it may not please them much to contemplate the fact that 
 a waste of time is a waste of life. 
 
 We shall, because of the foregoing, take up the indirect 
 method of making a wax inlay only as an accessory to the di- 
 
 Fig. 151. 
 
 Fig. 152. 
 
 Figs, 151 and 152. Hinged trays designed and constructed by the author for 
 taking correct impressions of mesio-disto-occlusal cavities and teeth upon which 
 they present. 
 
 Fig. 153. Disto-occlusal 
 cavity tray. 
 
 Fig. 154. Mesio-occlusal 
 cavity tray. 
 
 Fig. 155. Hinged tray 
 for anterior teeth. 
 
 rect, remembering that the wax must be given its final shape 
 and fitting in the tooth cavity itself. 
 
 With this end in view, the hinged and perforated trays 
 here illustrated, were constructed in their various sizes and in 
 respect to the tooth forms for which they were made; they are 
 universal in application. 
 
 There are ten trays for the upper molars, divided as fol- 
 lows:
 
 TAKING I.MI'KKSSIOX AND MAKl.XG DIK 
 
 ur, 
 
 Two right upper for disto-occlusal cavities. 
 
 Two right upper for ine.-io-occliisal cavities. 
 
 One riglit upper for mesio-ilisto-occlusal cavities. 
 
 One for riglit upper bicuspids for disto-occlusal cavities. 
 
 One for riglit upper bicuspids for mesio-occlusal cavities. 
 
 One for riglit upper bicuspids for mesio-disto-occlusal cav- 
 
 ities. 
 
 Fig. 156. Hinged tray in position. Impression of m. sio-disto-occlusal cavity partly 
 
 completed. 
 
 Fig. 157. Hinged tray in closed position. Completing impression of mesio-disto- 
 occlusal cavity and tooth upon which it presents. 
 
 Several hinged trays in three sizes, as illustrated, are made 
 for use upon anterior teeth, when occasion presents itself. 
 
 These trays enumerated for the right upper are duplicated 
 for the left side of the superior maxilla, except that the trape- 
 zoidal angles are changed to conform with the requirements.
 
 146 CAST GOLD AND POHCELA1N INLAYS 
 
 Only half of the number of trays is required for the lower 
 molars; for what will serve as a disto-occlusal tray on the right 
 side, may be used as a mesio-occlusal on the left; and so but two 
 mesio-occlusal and two disto-occlusal, and one mesio-disto-occlu- 
 sal tray for the molars, will be necessary. 
 
 We shall need one mesio-occlusal and one disto-occlusal tray 
 for the second bicuspid and the same number for the first lower 
 bicuspid right and left. Two sizes of hinged trays for each 
 anterior lower tooth may be made. Eight and left being inter- 
 changeable, only six trays will be required for that region. 
 
 When it becomes necessary to obtain a reliable impression 
 of a properly prepared cavity, the corresponding tray is se- 
 lected and that part of the tray which is contiguous or not 
 hinged, is filled with a small amount of modeling composition, 
 softened in the Bun sen burner. Care is to be exercised not to 
 burn the compound. 
 
 The two hinged and lubricated portions of the tray are in- 
 verted and used as a handle. 
 
 The compound-carrying tray is now carefully brought over 
 the tooth and centered; then with a direct pressure upward or 
 downward, as the case may be, the cavity is filled, and that part 
 of the tooth enveloped in the soft compound. 
 
 Because of the unyielding tray, the impression material will 
 be forced against the margins of the cavity, while the surplus 
 will be expelled buccally and lingual! y. 
 
 The two hinged wings of the tray previously lubricated, 
 are quickly closed upon the buccal and lingual sides respectively, 
 and the surplus of the compound is held against the tooth under 
 pressure. 
 
 A stream of cold water, directed upon the tray, will chill 
 the compound. 
 
 The hinged wing upon the lingual or palatine surface is 
 again inverted, the surplus compound is cut away with a sharp 
 lance; that .surface of the tooth is lubricated with some white 
 vaseline ; a small piece of softened impression material is placed 
 upon the inner surface of the wing of the tray, and while the 
 latter is firmly held in position, the former is closed down upon 
 the tooth surface, and moderate pressure is applied.
 
 TAKING [MPRESSION AND MAKING DIE 
 
 147 
 
 A stream of cold water will accelerate tlie hardening of that 
 sin-face, and the hinged wing upon the buccal surface is sub- 
 jected to the same manipulation; that is, it is inverted, the sur- 
 plus cut away, the tootli surface is lubricated, and a piece of 
 softened impression material is placed upon the hinged surface, 
 when it is again reinverted and forced to place. Again a stream 
 of cold water accelerates hardening of the compound. 
 
 "Whatever surplus of compound may show gingivally, may 
 lie removed with a sharp lance, and we are now ready to obtain 
 an impression of the surrounding teeth, a model from which 
 impression may give us our cavity and its rightful environment. 
 
 It will he necessary to keep the saliva ejector in the pa- 
 
 Fig. 158. 
 
 Fig. 159. 
 
 I-'i-. 158. Complete impression of tooth and cavityembedded in plaster im- 
 pression of adjacent teeth, ready for the packing of amalgam die. 
 
 Fig. 159. Complete impression of tooth and cavity, removed from the mouth. 
 
 tient's mouth, in order to carry off the water used in chilling 
 the compound. 
 
 A unilateral tray for the particular side of the mouth is 
 selected. A mix of plaster of Paris, of the consistency of thick 
 cream, is put into it, and the tray, plus plaster, is quickly car- 
 ried to the side of the mouth and carefully forced to place. 
 
 The plaster is given from five to, ten minutes to set, and 
 a spray of cold air is directed upon it while it is setting, when 
 the cup is removed and the plaster impression carefully broken 
 away from the tooth. The buccal or labial portion is removed 
 first, by placing the index linger of one hand under the plaster
 
 148 CAST GOLD AND PORCELAIN INLAYS 
 
 buccally, and keeping the index finger of the other hand upon 
 the morsal surface of the impression. 
 
 The patient is then directed to open the mouth much wider, 
 the index finger under the buccal side of the impression is ro- 
 tated towards the oral cavity, and usually no difficulty will be 
 experienced in the removal of that part of the impression. 
 
 An upward and downward pressure upon the lingual part 
 of the impression will readily dislodge that portion of it, and 
 so all parts of the plaster may be gathered to be again re- 
 assembled in the cup after they have been allowed to become 
 moderately dry. 
 
 The compound carrying tray will be found in perfect cc~- 
 dition upon the tooth requiring the inlay. 
 
 All evidence of plaster is now removed, and the outer or 
 buccal hinged part of the tray is again inverted, as is the lingual 
 or palatine. 
 
 Grasping these, two hinges, mesio-distally, the rest of the 
 impression will come out and may be brought into full view 
 outside of the buccal cavity. 
 
 Again the two hinges are put back into their respective 
 positions, and we shall have an impression of the entire tooth, 
 for which we are about to make a metallic complement. 
 
 Because of its peculiar position within the plaster impres- 
 sion, the tray carrying the compound impression of the cavity 
 will be immovably fixed. More plaster is added to the plaster 
 impression in order to strengthen its walls; all the plaster is 
 varnished, and we are ready to pack the amalgam into the com- 
 pound impression, so as to form a die, reproducing the tooth 
 that requires an inlay. 
 
 THE MAKING OF THE AMALGAM DIE 
 
 For the purpose of making a die, either a silver or copper 
 alloy may be used. 
 
 The writer has been able to obtain much more clearly de- 
 fined margins and outlines with the copper alloy, and would, 
 therefore, commend it for this purpose. 
 
 It is also much harder and not nearly so likely to become 
 subject to distorting inaccuracy.
 
 TAKING I.MI'IIKSSIOX AND MAKING DIK 141) 
 
 A quantity of the alloy, varying directly as the size of the 
 case, is placed in an iron spoon and carefully heated over the 
 Bunsen flame until the globules of mercury appear upon the 
 surface of the small copper amalgam briquettes. 
 
 The mercury-exuding mass is now thrown into a "Wedgwood 
 mortar, and thoroughly macerated under pestle. This macera- 
 tion is kept up until the mass seems and feels smooth; if the mix 
 appears thick, more mercury must lie added, so that a thin and 
 readily flowing mass may he obtained. 
 
 The Wedgwood mortar is now upset upon a sheet of 
 manilla paper, and with a stout, broad spatula of (ierman silver, 
 or a polished steel knife, the amalgam is spread over the 
 largest possible area of the paper in a thin film, and consid- 
 erable pressure is used to make certain of the smoothness of 
 the mass. 
 
 When this has been attained, the amalgam is divided into 
 three portions; the first portion should be large enough to cover 
 all margins as well as the seat and walls of the cavity, the 
 second portion, about twice the size of the first, and the third 
 portion, about again as large as the second. 
 
 The first portion is now put into a piece of chamois and 
 twioted up into a ball. A part of the mercury is expelled by 
 twisting the chamois, but under no circumstances must too great 
 a pressure be applied, as that would make the mix unfit for use 
 at this stage. 
 
 Pointed instruments, the points which have been rounded, 
 are then used to place the soft amalgam in apposition to 
 every margin, wall and seat of the cavity, and when that 
 has beeen accomplished, smooth flat plugger points are sub- 
 stituted for the pointed instruments, and the amalgam is patted 
 down into every portion and up to every margin of the cavity 
 impression. 
 
 The second portion of amalgam is now put into a piece of 
 chamois, and the chamois containing the amalgam is twisted 
 into a ball. A greater portion of the mercury than was ex- 
 pelled from the first portion of amalgam, is now expelled from 
 the second portion; in fact the latter must be fairly crisp to be 
 fit for use.
 
 150 
 
 CAST GOLD AX1) POKCELAIX JNJ.AYS 
 
 Large ball and egg shaped burnishers are used to place this 
 crisp mass over and into the amalgam already present in the 
 impression. It will be noted that under constantly applied 
 pressure, the newly added mass will take up the excess of mer- 
 cury in the mass first put into the impression. 
 
 Finally, the third portion of amalgam is put into the 
 chamois, and subjected to the same sort of, but slightly in- 
 creased, pressure, so that nearly all of the mercury will be 
 
 
 Fig 160. Model presenting a view of amalgam replica of tooth requiring restora- 
 tion in correct relation to adjacent teeth. 
 
 Fig. 161. Model lubricated with mixture of castor oil and glycerine. 
 
 expelled and the amalgam becomes quite hard and but just 
 workable. 
 
 With large, flat packing instruments this mass is now grad- 
 ually and with constantly increasing pressure and a rocking 
 motion, put into and onto the rest of the amalgam. 
 
 The excess of mercury, if any be present, is now removed 
 by burnishing several layers of tin foil over the flat surface of 
 the mass, and with a flat chisel-end instrument, an irregular
 
 TAKlXi; JAIl'KKSSIOX AND AIAKIXC DIE 151 
 
 recess equal ill depth to about one-third of its greatest diameter, 
 i> sunk into the mass of amalgam. 
 
 Tlie plaster impression carrying the hinged tray and com- 
 pound impression which contains the amalgam which lias been 
 introduced, is now laid aside for at least twelve hours to give 
 the amalgam an opportunity to thoroughly crystallize. 
 
 The next step should be the immersion of the amalgam- 
 carrying impression into water, and the filling in of the rest 
 of the impression with plaster of Paris, when, after three-quar- 
 ters of an hour or one hour's time has elapsed, the impression 
 tray is freed from surrounding plaster, the plaster impression 
 is carefully broken ami cut away, exposing a plaster cast carry- 
 ing the hinged tray and compound. The cast is now immersed 
 
 t-U , 
 
 \ 
 
 Fig. 162. Occluded models of case requiring restoration. Note in. the upper 
 arch the amalgam die in correct relative position and correct occlusal relation to 
 the lower model. 
 
 in water at a temperature of 135 to 140 F. for about two 
 minutes, when the hinged portions of the tray may be easily 
 inverted and all of the compound impression removed from 
 amalgam tooth and cavity. 
 
 "We have now before us a plaster cast securely carrying 
 a complete copper amalgam reproduction of the tooth requiring 
 a gold inlay, and if the directions prescribed above have been 
 studiously followed, the cavity in which the wax inlay is to be 
 formed may be used as a working base upon which the pre- 
 liminary carving may be done. 
 
 A wax bite previously secured from the patient's mouth 
 is now mounted upon the plaster cast that carries the amalgam
 
 152 CAST GOLD AND PORCELAIN INLAYS 
 
 tooth, and the opposing teetli are secured by filling the wax 
 impression on the reverse side of the wax bite with a mix of 
 plaster of Paris. Both upper and lower may now be mounted 
 upon an adjustable crown articulator. 
 
 AYhen the plaster has set, the articulator carrying the 
 models and bites is immersed in hot water, and the wax bite 
 is removed, disclosing the amalgam tooth in the correct relative 
 occlusal position to the opposing teeth. 
 
 All of these opposing teetli are now thoroughly varnished 
 with a thin solution of sandarac, and this is allowed to harden. 
 
 We are now ready to make our wax inlay for the cavity. 
 
 A cone of inlay wax of suitable size is made ready for use 
 by softening it in hot water in the manner described under the 
 heading of making and carving the wax inlay by the direct 
 method. 
 
 The softened cone of wax is forced, as also previously de- 
 scribed, into the lubricated cavity, in this instance, of the amal- 
 gam die instead of the tooth. 
 
 While the wax is under the influence of the finger pressure, 
 it is chilled and held in this position until it has hardened, then 
 the pressure is removed. 
 
 All we are concerned with at this stage of the operation 
 are the margins and seat of the cavity, and the approximation 
 of the wax to this seat and these margins. 
 
 With the proper carvers and flat burnishers, right and left, 
 all but the occlusal surface of the wax inlay is completed at 
 this time. 
 
 A stream of cold water will thoroughly harden the wax and 
 a jet of cold air will dry it. A ball burnisher is now heated in 
 the Bunsen flame and the unfinished occlusal surface is sof- 
 tened centrally; that is, the hot instrument is allowed to enter 
 the wax inlay about half way down into the body of it, care 
 being exercised not to allow the heated instrument to work 
 through the wax onto the seat of the cavity, or up to the mar- 
 gins of it. 
 
 The varnished and faintly lubricated opposing teeth are 
 now allowed to descend or ascend upon the wax in order to 
 designate the landmarks for occlusal carving. 
 
 A close study of tooth anatomy should be made by the in-
 
 TAKING IMPRESSION AND MAKING DIE 153 
 
 lay worker, with a view to correct reproduction of tooth sur- 
 faces in general and the occlusal surface in particular; the 
 sulci and deep fissures, the extreme cusp, elevation, the im- 
 portant marginal ridges functioning in their capacity as guard- 
 ians of the interdental tissues, all these must be carefully 
 reproduced in outline, but not in bulk; in other words, the 
 important tiling to bring about is an exact reproduction of the 
 part of the tooth which is lacking to make it a perfect dental 
 organ, but the complementel portion in wax must be as much 
 greater in all surface areas as the amalgam cavity with all its 
 surfaces, seat, margins and angles, is smaller than the cavity 
 in the tooth. 
 
 This variation between the tooth cavity and the die cavity 
 in size, is but microscopic, and hardly appreciable to the eye, 
 nevertheless, it is sufficient to spell failure for every casting 
 made by the indirect method unless this means is taken to over- 
 come the defect. 
 
 The articulator and models which carry the inlay are put 
 aside until the patient appears for the next sitting. The inlay 
 is removed from the die, mounted on the cork which carries a 
 bankers' pin, the pin being inserted where the sprue wire is to 
 be subsequently attached. 
 
 The wax inlay thus mounted is then submerged in a water 
 bath, the temperature of the water being about 120 F. After 
 a lapse of two minutes it is carefully removed from the pin and 
 placed upon a glass slab; the temporary stopping is removed 
 from the tooth; the cavity is Hushed with warm water; and the 
 \\ax inlay is put into the cavity, a firm and ever increasing pres- 
 sure being exerted in the following directions: 
 
 If the cavity be a disto-occlusal one, in an upper tooth, the 
 pressure must be directed upwards and forward. 
 
 In mesio-occlusal cavities, the pressure must be upward and 
 backward. 
 
 In the upper mesio-disto-occlusal cavities, the pressure 
 must be upward, but the points against which the pressure is 
 exerted must be the marginal ridges of the wax inlay. This 
 can be accomplished by making a V-shaped cushion of the thumb 
 and index finger, or the thumb and middle finger of the right 
 hand.
 
 15-4 CAST GOLD AND PORCELAIN INLAYS 
 
 If the cavity is a disto-occlusal one in a lower tootli, the 
 pressure exerted upon the wax inlay must be directed down- 
 ward and forward. In lower mesio-occlusal cavities, the pres- 
 sure must be downward and backward, and in lower mesio- 
 disto-occlusal cavities, the pressure must be directed downward, 
 and it must be exercised against and upon the marginal ridges 
 of the inlay. 
 
 When the wax thus slightly warmed has been placed in the 
 cavity, and the carefully exerted ever-increasing force is applied, 
 the inlay will begin to yield under this pressure and seat itself 
 against every part and margin of this cavity. 
 
 Presently the wax will cease yielding, but the pressure must 
 be maintained, and a stream of cold water is directed upon and 
 around it to thoroughly harden it. 
 
 With the various carvers and right and left burnishers, 
 all margins are now carefully gone over and the occlusion made 
 perfect. 
 
 The interdental and gingival portions of the wax inlay are 
 carefully burnished with the flat right and left blade burnish- 
 ers, the contact area between the wax inlay and the next tooth, 
 if any be present, is carefully looked to, and the wax is pol- 
 ished with a pellet of cotton sparingly moistened in oil of 
 cajeput. 
 
 An explorer is inserted into the distal part of the inlay 
 and it is carefully removed from the cavity and the mouth, 
 placed upon the palm of the operator's left hand, so that the 
 disto-proximal or mesio-proximal portion of it be uppermost. 
 
 The sprue wire is heated in the flame of the Bunsen burner 
 or alcohol lamp, and inserted beyond the depth of the ring upon 
 it, midway between the buccal and lingual extremities of the 
 inlay. Once the sprue wire has in its heated condition entered 
 the inlay, a gentle stream of cold water is played upon the 
 extreme end of the sprue wire, or better, upon the fingers that 
 hold it until the wire is cold. This must, of course, be done by 
 the assistant; if none be present, the patient's help may be en- 
 listed for the purpose or the tweezers may be used. 
 
 A soft rubber sponge placed at the bottom of a glass of 
 water, serves to efficiently support the wax inlay-carrying sprue 
 until the cotton rolls are applied on either side of the patient's
 
 TAKIXC IMI'UKSSIOX AX!) MAKIXC DIE 155 
 
 tooth; the saliva ejector is placed in position the cavity thor- 
 oughly dried out and filled up with temporary stopping; the 
 patient is dismissed. AYlien we are ready to embed or invest 
 the inlay in the refractory compound, it is removed from the 
 watery sponge bed, by grasping the sprue wire carefully with a 
 pair of tweezers. The wax inlay is dried with a gentle jet of 
 cold air and the sprue wire, plus inlay, is mounted upon the 
 crucible former. Such pits or grooves as may seem necessary 
 to the operator may now be carved upon the wax with a small 
 sharp lance, remembering that it is easier to do this in the wax 
 than in the metallic duplicate of it. 
 
 It may as well be said here as anywhere, that not much, 
 if any, dependence should be placed upon these grooves or pits 
 as retaining factors between an inlay cavity and an inlay, and 
 personally I resort rarely, if at all, to this practice, for reasons 
 to be touched upon later. 
 
 Now, before proceeding to the next step in the construc- 
 tion of a cast gold inlay, may I be permitted to ask the advo- 
 cates of the indirect method, to again read what has been said 
 in regard to directions for taking the impression, making the 
 die, and carving the wax inlay by means of this method. In 
 full justice to the patient, to the art, and to themselves, let them 
 read and let them construct an inlay as they read, and let them 
 implicitly follow directions, and then let them construct an 
 inlay in accordance with their usual procedure; let them then 
 compare both results by putting the finished products into the 
 tooth cavity. 
 
 In the first instance they will have a complemental product 
 which will interplay with all the cavo-surfaces of the tooth with 
 a grateful, frictional, and supporting contact, and as to what 
 they will find in the second one, I am ready enough to leave to 
 their judgment, providing they have examined the first. Up 
 to the present time I have found no other means of making an 
 accurate inlay by the indirect method, except the one minutely 
 described, and when the advocates of the so-called indirect 
 method shall have read and followed these directions, they will 
 admit readily enough that the method, if carried out as to each 
 detail, will bring desirable results, but they will also add that 
 the time spent in obtaining the results is far too great.
 
 156 CAST GOLD AND PORCELAIN INLAYS 
 
 Surely, if they are seeking better results by means of an 
 indirect method, and if their indirect method is not quite ef- 
 ficient, and if all these steps I have described and all these 
 directions I have given do lead to a more perfect result, that 
 is the indirect method which they should adopt. 
 
 On the other hand, there is nothing which they can ac- 
 complish, no result which they will produce, by following every 
 detail of those directions most studiously and indulging in the 
 expenditure of all the time necessary, which may not be dupli- 
 cated perfectly in every detail, in a great deal shorter period of 
 time, if they follow the directions given for the construction of 
 the wax inlay, in accordance with the rules originally laid down 
 by him whom they all call great, who is responsible for the 
 very existence of the cast gold inlay; in other words, if they 
 follow the direct method. 
 
 The cast gold inlay made by the indirect method, which is 
 here described in detail, compares very favorably with those 
 made by the direct method; in fact, it is impossible to differ- 
 entiate them at all. 
 
 It must be remembered that here the indirect method was 
 used only as an accessory to the direct, and that the time con- 
 sumed was far greater than if the direct method alone had been 
 employed. Also, no time had been saved to the patient; in fact, 
 another visit was the result. 
 
 We are forced to the conclusion that the direct method is 
 the rational one, and that they who desire to follow a correct 
 indirect method, and who wish to eliminate guess work, must 
 give that which all indirect methods of doing anything entail, 
 namely, they must give up more time. 
 
 The one advantage the indirect method may claim is that 
 it would be possible to break up one protracted sitting of a 
 patient into two shorter sittings. 
 
 In feeble, convalescent, or exceedingly nervous individ- 
 uals, this method works to better advantage, and those are the 
 conditions it was perfected for and is used in, but it cost more 
 time and effort to produce an acceptable result in this way, than 
 it would to obtain the same result with the direct method.
 
 TAKING IMPRESS 10 X AND MAKING DIE 1 f)7 
 
 SUMMARY FOR CHAPTER IX 
 
 Taking an Impression of the Cavity and Making a Die for Procedure by the 
 
 Indirect Method 
 
 1- Give the reasons why in the writer's opinion this method is unscientific. 
 
 "2. When may it be used in conjunction with the direct method? 
 
 3. Describe the trays devised for use with the indirect method and the 
 
 technic of their application. 
 
 The Making of the Amalgam Die 
 
 1. Why is a copper alloy preferable? 
 
 2. Describe the method of preparing the copper alloy for the packing of 
 the compound. 
 
 3. Describe the method of making the wax pattern from the metal die. 
 
 4. Describe the technic of transferring tho wax pattern from the die to the 
 cavity and the conformation of the pattern to the tooth. 
 
 5. Describe the detail of inserting the sprue wire into the wax pattern and 
 its disposal before investing.
 
 CHAPTER X 
 THE INVESTMENT, OR REFRACTORY, COMPOUND 
 
 As the heading of the chapter implies, the investment is 
 the mass into which the wax inlay is embedded, to form a mold 
 into which, upon volatilization of the wax, the metal may he 
 forced to assume a definite shape. 
 
 Because the metal must be forced into this mold in a liq- 
 uefied condition, and because it requires a great deal of heat in 
 order to liquefy the metals used for inlays, the compounds or 
 substances that make up the investment must be refractory, 
 that is, they must in themselves and in combination with each 
 other possess the property of resisting disintegration under heat 
 of considerable degree. 
 
 AVliile this is an important property of the compound, it 
 is no more so than the properties enumerated below, and unless 
 a compound can meet the requirements stated, it is unfit to be 
 used for the making of molds into which inlays are to be cast. 
 
 Since these castings are to be made under pressure of one 
 kind or another, the compound used should be strong enough to 
 resist such pressure; and since such pressure varies, the com- 
 pound should possess a safety margin of pressure resistance at 
 least double that of the amount required. 
 
 Because of accuracy required in the reproduction of fine 
 lines, angles and margins, the compound must be one that will 
 crystallize in such minute crystal formation as will enable these 
 crystals to move into every line and depression of the pattern. 
 
 At the same time the crystals must be of such shape that 
 the hardened or set mass will present a structure sufficiently 
 porous to carry oft' any gases formed in the mold during the 
 process of volatilization, and during the process of the introduc- 
 tion of the metal. 
 
 Smoothness of the mass must also be considered, and since 
 that is a quality that is usually obtained at the expense of 
 
 158
 
 IXYKST.MKXT, Oil IIEFIIACTOIIY, C< >.\I l'< M" X 1) 159 
 
 porosity, it presented at first an almost insurmountable obstacle 
 in the chain of steps essential to success in the art. 
 
 Finally, the working qualities of the mass, when mixed for 
 use, must be such as to give the user a sufficient amount of time 
 to carefully invest his pattern, which means that when properly 
 mixed, the mass presents the appearance of a cream, smooth and 
 easy (lowing, and free from air cells. 
 
 A great many of the refractory agents suggested themselves 
 to the investigators, many of whom are even now engaged in 
 the problem of trying to compound a more perfect investment 
 material. 
 
 All of them have been compelled to retain as a portion of 
 the mass, a considerable quantity of plaster of Paris as a bind- 
 ing force for the whole. 
 
 Plaster of Paris is manufactured from the mineral called 
 gypsum, which is comparatively soft. 
 
 Chemically, it is a hydrated sulphate of lime, CaS0 4 + 2H 2 0. 
 Its specific gravity is 2.31 and its hardness is from 1.5-2 of the 
 mineral scale. 
 
 The three most frequent varieties of it are known as ala- 
 baster, a marble-like mass usually faintly tinted and translu- 
 cent; a selenate, which is crystallized and transparent; and a 
 variety known as satin spar, which has a pearly opalescence 
 due perhaps to its fibrous foundation. 
 
 ( lypsum has a wide geologic distribution, the extensive beds 
 of the common variety generally occurring as irregular concre- 
 tions in nodular masses, and it is frequently found associated 
 with rock salt. A mineral known as anhydrite or anhydrous 
 sulphate of lime, found near the Harz Mountains and in parts 
 of Nova Scotia, may be converted into gypsum by the addition 
 of water. 
 
 Gypsum contains 21 per cent of water, which can be driven 
 off by heat. It is burned in kilns at a temperature of 250 F., 
 then ground to a fine powder, and as such, it is known as plaster 
 of Paris. This recombines with water, evolves heat, and crys- 
 tallizes at the expiration of a few minutes. 
 
 If, in the burning of the gypsum, the temperature be raised 
 to or about 480 F., and then ground into a fine powder, it will 
 be found to have lost its power of dehydration and in this
 
 160 CAST GOLD AND POKCKLAIX INLAYS 
 
 state, it will not set when mixed with water and it is said to be 
 dead burnt. 
 
 At ordinary temperature, gypsum and plaster of Paris are 
 soluble in water, in the proportion of two and a fraction of 
 the solids to 1000 parts of water, and its point of maximum solu- 
 bility is about 95 F. 
 
 Plaster of Paris shrinks upon being heated, and in itself 
 is therefore an unreliable mass for molds which are to receive 
 high fusing metals, or alloys in a liquefied state. 
 
 Some of the other materials used as refractories are the 
 compounds of silica, alumina, magnesia, and calcium. 
 
 Of these the silica is the most important, for although 
 utterly lacking in tensile strength, it has the property of ex- 
 panding when heated. 
 
 SILICON 
 
 Silicon is one of the nonmetallic elements: symbol Si; 
 atomic weight 28.3(0-16); sp. gr. of crystalline form, 2.49. It 
 may be obtained in two different forms : viz., the amorphous 
 and the crystalline. 
 
 Amorphous silicon presents the appearance of a dull brown 
 powder, prepared by heating silicon with aluminum. It is 
 nonconductor of electricity, and when heated in air or oxygen, 
 its external surface burns brilliantly, and is converted into 
 silica, which fuses from the extreme heat and forms a coating- 
 over the unburned silicon. Deville obtained crystallized silicon 
 in regular six-sided pyramids of a dark steel-gray color. A 
 somewhat impure form is prepared by the Carborundum Com- 
 pany of Niagara Falls by heating coke and sand in an electric 
 furnace. 
 
 Silica, or silicon dioxide, exists both in the crystalline and 
 in the amorphous form. The best examples of the crystalline 
 form are rock crystal, quartz, chalcedony, flint, sandstone and 
 quartzose sand. Silicon in this form has a specific gravity of 
 about 2.9, and is only attacked with difficulty by potash or 
 hydrofluoric acid. The amorphous form exists naturally in opal, 
 and is obtained artificially as gelatinous silica, etc. It differs 
 from the former in its specific gravity, being about 2.2, and in
 
 IXYKSTMKXT, OR REFRACTORY, ('OMPOCXJ) 161 
 
 its being rapidly dissolved by potasli and by hydrofluoric acid. 
 
 Pure silica (a* if occur* in roc]: cri/stal, for c.ramplc) is 
 pcrfcctlii transparent and colorless, and is xnffic'n-ntlij linrd to 
 scratcl (/lass. Tlic }>eal of Hi,- o.ri/lnidrof/en bloirplpe is re- 
 quired for its- fusion, irJicn it melts into a transparent (/lass, 
 capable of bcinf/ drawn out Into electric thread*. Silicic acid 
 may he precipitated by addition of hydrochloric acid to a so- 
 lution of sodium silicate. By exposing- the silicic acid to red 
 heat, pure amorphous silica may be obtained. The solubility 
 of hydrated silicic acid in water accounts for the presence of 
 silicic acid in mineral springs, and in the geysers of Iceland, 
 as well as for its gradual separation from those waters in the 
 form of petrifactions. Silicates are salts of silicic acid (of 
 which several hydrated forms have been obtained) or combina- 
 tions of silicon dioxide and metallic basic oxides. They may 
 he divided into five classes: (1) Orthosilicates, derived from 
 H,Si0 4 ; (2) Metasilicates, from H 2 SiO :! ; (3) Disilicates, from 
 HoSioO-, ; (4) Trisilicates, from H 2 Si 3 3 ; and (5) Basic silicates. 
 They occur abundantly in nature, all the forms of clay, felspar, 
 mica, hornblende, auaitc, serpentine, etc., being compounds of 
 this description. Most of the silicates are fusible, the basic 
 silicates fusing more rapidly than those of which are either neu- 
 tral or contain an excess of acid. Excepting the silicates of the 
 alkalies, there are no silicates which are soluble in water. 
 
 Silicon is largely employed in the manufacture of glass, 
 china and porcelain. The use of silica in giving firmness and 
 rifiiditit to rarions parts of the animal organs is exemplified in 
 its free occurrence in the quill part of tlie feather of birds, in 
 flic shields of certain infusoria, and in the spicnla occurring in 
 sponaes, while its similar use in the vegetable kingdom is seen 
 in its more or less abundant presence in the stalks of the (/rasses,. 
 more particularly in the cereals and in the bamboo. 
 
 Silicon combines with >everal other elements besides oxy- 
 gen, the most important compounds being silicofluoric acid 
 (fLSiF 4 ) and silicon carbide, or carborundum (SiC), which is 
 very hard and used for grinding and polishing. Silicon fluoride 
 (SiF 4 ) is a colorless gas usually prepared by heating together 
 calcium fluoride and strong sulphuric acid. It is decomposed 
 into water silicic acid, and silicofluoric acid.
 
 162 CAST GOLD AND PORCELAIN INLAYS 
 
 CALCIUM 
 
 Calcium (symbol Ca; atomic weight 40.09) is the metal 
 present in chalk, and other compounds of lime. It may be 
 obtained by passing a current of electricity through fused chlo- 
 ride of calcium. It is a yellowish white metal, intermediate be- 
 tween lead and gold in hardness. At ordinary temperatures, 
 it rapidly decomposes in water, forming lime, CaC, while hy- 
 drogen escapes. It forms an oxide, lime, having the composi- 
 tion of forty parts of calcium and x'uieen parts of o.rijgeu. 
 Sulphate of calcium, CaS0 4 , is the chief constituent of gypsum. 
 It is present in most drinking waters, rendering them perma- 
 nently hard. Temporary hardness, due to the presence of car- 
 bonate of calcium or chalk, is removable by boiling. 
 
 MAGNESIUM 
 
 Magnesium (symbol Mg; atomic weight 24.32) is a metal 
 which is very widely distributed over the globe. It is present 
 in magnesite, magnesium carbonate, dolomite, carbonate of lime 
 and magnesia, asbestos, silicate of lime and magnesia, meer- 
 schaum-silicate of magnesia, kainite, and in other minerals. It 
 exists in mineral waters and the sea as sulphate and chloride, 
 the sulphate being known as epsom salts. The metal is made by 
 fusing together the chlorides of potassium and magnesium and 
 fluor spar, and adding metallic sodium with great care. The 
 crude metal is finally distilled and pressed in a semifluid state 
 into ribbon or wire. 
 
 Magnesium has a silver white color, which is tarnished by 
 moist air. It is a very light metal, its specific gravity being- 
 only 1.75. It is readily volatile, and, when lighted, burns in 
 air with an intensely brilliant light, rich in chemical rays. On 
 this account it was, until superseded by the electric light, much 
 used in photography, while in signaling and pyrotechny it plays 
 an important part. 
 
 When magnesium burns in air, it forms a white ash con- 
 sisting of the oxide, magnesia, MgO (which may also be pre- 
 pared by heating the carbonate). The carbonate, MgC0 3 , is 
 found in nature, but for medical purposes it is prepared by
 
 IXYKST.MKXT, Ol! JIKni.UTOltY, CO.M I'Ol ' X I) !(>.'> 
 
 precipitating a soluble magnesium salt with carbonate of soda. 
 Although insoluble in water, this substance readily dis- 
 solves in water containing carbonic acid, and this solution is 
 known as fluid magnesia. The sulphate, MgS0 4 + 7H 2 0, or ep- 
 som salts (an infusion of which witli senna is known as black 
 draught), occurs in nature, anil is well known as a domestic 
 remedy. Citrate of magnesia is the popular name for a granu- 
 lar, effervescing aperient. It consists of a mixture of bicar- 
 bonate of soda, tartaric and citric acids, sugar, and a small trace 
 of epsom salts. 
 
 ALUMINA 
 
 Alumina is the most abundant of the earths; it is the oxide 
 of metal aluminum, the formula being A1 2 O 3 . It occurs in na- 
 ture abundantly in combination with silica, associated with 
 other bases. The most familiar of its native compounds is 
 felspar, a silicate of alumina and potash, K 2 0, A1 2 O 8 , GSiO,. 
 Certain varieties of this, by exposure to the atmosphere, be- 
 come completely disintegrated; passing from the state of hard, 
 solid rock, such as we are accustomed to see in building granite, 
 into soft crumbling earthy masses. ( 'laij consists of a silica and 
 alumina in a state of cl/cmical combination. It never is pure 
 alumina, but tl/e quantitu of silica united to the latter is rari- 
 able. When it is pure, clay is quite irltite, but more frequently 
 da i/ is red. otrina to the presence of oxide of iron; or black, 
 from the diffusion tJirouah it of vegetable matter. 
 
 From alum, alumina is prepared by adding to a solution 
 of the former, water of ammonia, as long as it occasions a pre- 
 cipitate. AVhen alumina is precipitated from a solution con- 
 taining coloring matter, such as logwood, etc., it carries down 
 the color chemically united to the flocculent precipitate; in this 
 way are formed the colored earths called lakes. Alumina in 
 the state of the precipitate, after being gently dried, is readily 
 soluble in acids and in alkalies; but if strongly heated at a cer- 
 tain temperature, it presents an appearance of sudden incan- 
 descence; it loses the associated water, contracts, greatly in 
 bulk, and now forms a tchite soft poirder, not at all gritty, and 
 with difficulty soluble in alkalies and acids. Alumina, as gen- 
 erally prepared, whether hydrated or anhydrous, is soluble in
 
 CAST GOLD AND PORCELAIX INLAYS 
 
 water, possesses no taste, and does not alter coloring matters, 
 but it lias also been obtained in an allotropic hydrated form, 
 which, in the presence of a very small proportion of acetic acid, 
 is largely soluble in water, from which a minute trace of snl- 
 furic acid precipitates it. In the anhydrous state it absorbs 
 water with great readiness without combining with it, so that 
 it adheres to the tongue, and if left parches it. Clay retain* 
 this property; the ends of tobacco pipes are often glazed to 
 prevent adhesion to the lips or tongue. Alumina is not fusible 
 by a forge or furnace heat, but it melts before the oxyKydtogen 
 blowpipe into a clear globule, possessing great hardness. The 
 more coarsely crystallized specimens form the emery which is 
 used for polishing; the transparent crystals when of a blue 
 color, owing to a trace of metallic oxide, constitute the precious 
 gem, the sapphire; and when red, the ruby. Alumina, in com- 
 mon with other sesquioxides, is a feeble base. 
 
 Like alumina, magnesium and calcium are unreliable as to 
 constancy of bulk upon accession of heat, and so were, in and 
 by themselves, not to be favored as constituents of any mass 
 to be used for molds into which too high-fusing metals were to 
 be cast. 
 
 The apparent impossibility of obtaining all these refrac- 
 tories in a pure state was another trying problem which had to 
 be solved before a really worthy compound could be produced. 
 
 It may be safely asserted that all the investment com- 
 pounds at present offered to the profession, contain one or 
 more of the refractories enumerated, in a varying combination 
 with plaster of Paris; some are carefully determined correct 
 relative combinations; some are haphazardly thrown together, 
 mixtures of questionable value, the sale of which should be pro- 
 hibited. 
 
 So much of the success in casting depends upon a depend- 
 able mold that only the very best at present to be obtained 
 should be considered. 
 
 For a long time I used a compound which I mixed for my- 
 self in accordance with the following formula : 
 
 Plaster of Paris % 4 
 
 Silox l% 4 
 
 Graphite flakes (small) % 4 2% 4 1.
 
 i.\\ KST.MI-:XT, on i;i-:n;.\(Toi;y. CO.M i-m MI lu'5 
 
 The process of making this compound was attended with 
 so much inconvenience and the results (because of the unrelia- 
 bility of the products) were so inconstant, that the various com- 
 pounds on the market were carefully tried out, an<l the Tag- 
 gart investment tinally decided upon. 
 
 Such great care is used in the manufacture of this invest- 
 ment that taking the variation in temperature into considera- 
 tion and allowing for these thermal changes, constant results 
 may invariably be attained. 
 
 I have been unable to definitely ascertain just what the 
 proportion of the various ingredients which enter into the mak- 
 ing of this compound are, but the product has, after a period 
 of three years, proved so satisfactory and so thoroughly reli- 
 able in its working qualities, that I unhesitatingly give it first 
 place in the list of those at present urged upon the profession. 
 
 Some common sense precautions must be taken in using this 
 refractory compound, which, in order to be employed for molds, 
 must be mixed with water. 
 
 The powder must be kept in a closed receptacle in a dry 
 place, not exposed to rapid changes of temperature; it must be 
 mixed with water neither too cold nor too warm. 
 
 AVater at room temperature, about 75 F., will do well 
 during the cold weather. This may be had by allowing a 
 pitcheri'ul of the water drawn from the faucet, to stand in the 
 room all day, thus modifying its temperature with that of the 
 room. During the hot months, cold water may be added to that 
 obtained from the faucet and the desired results reached in 
 this way. 
 
 It must be remembered that all these investments are hy- 
 groscopic; they have a great affinity for moisture, and the cans 
 must, therefore, be kept tightly closed. For the same reason it 
 will require less water for a perfect mix during very humid 
 weather than during dry weather. 
 
 The quota of investment powder and water having been 
 made constant by Taggart, the variation of temperature and 
 humidity may be taken care of by the addition of a few min- 
 ims of water during excessively dry weather, and by the 
 reduction of the quantity of water in the same proportion dur- 
 ing the extremely humid weather. In no case is amount of
 
 166 CAST GOLD AND PORCELAIN INLAYS 
 
 variation greater than 20 drops, running from that down to 5. 
 
 The small quantity of graphite flakes used in the investment 
 enables us to obtain a smooth mass without the loss of too much 
 porosity of the mold. 
 
 The things absolutely necessary for a proper mix of invest- 
 ment are these: 
 
 The investment, powder and water, a small scale in which 
 the quantity of each may be definitely determined, subject to 
 variation with atmospheric changes, a large rubber cup kept 
 scrupulously clean, and used for this purpose only, and a broad, 
 flexible, hard rubber spatula. 
 
 The large cup in the scale is used as a scoop and loosely 
 filled with the powder; the surplus is removed by passing the 
 sharp edge of the spatula across its circumference. 
 
 The scale is now placed upon the fulcrum and enough water 
 is poured into the small cup to balance the weight. This is best 
 accomplished by using a rubber bull) water syringe of average 
 size. If the humidity in the air be noticeable to a considerable 
 degree, an even balance will be the correct amount of water re- 
 quired. If the atmosphere be normal, a balance so that the 
 small cup will descend to rest upon the table will be found nec- 
 essary, and this will require an additional 5 drops of the fluid. 
 If the atmosphere be excessively dry, the scale should be evenly 
 balanced and 20 drops of water added to this. 
 
 The plaster in the powder requires its 21 per cent of mois- 
 ture to be thoroughly satisfied. It contains this much in its 
 natural state en ma-sse, and it will not be as good a binder for 
 this new mass unless supplied with the proper quota of moisture. 
 
 The rubber bowl made clean and dry, now receives the 
 water from the small end of the scale; it is best to place the 
 cover of the can or a piece of stiff cardboard over that part of 
 the scale which contains the powder, and holding this cover 
 down upon the mass, the scale is inverted over the bowl, and 
 the water poured into the new receptacle. 
 
 The scale is now grasped in the other hand, the cover is 
 removed, and the powder carefully thrown into the bowl. 
 
 I'sing the spatula, the powder is made to take up the mois- 
 ture by agitating the mass; when that seems accomplished, a 
 minute should elapse before the mix is again touched, as that
 
 1XYEST.MKXT, OR KKFK.UTOK V, CO.MPOrXI) 167 
 
 will give tiie plaster time enough to exhaust its gas making 
 tendencies. 
 
 After the minute of rest, the rubber bowl is seated in the 
 palm of the left hand and the right hand holding the spatula, 
 broad side parallel with front of the body, is now agitated cir- 
 cumfercntially until the powder seems to have taken up all of 
 the water. 
 
 The mass is then spread over the entire inner surface of 
 the cup, iii a thin homogeneous layer. The spatula is dispensed 
 with and the cup is taken up in the right hand, flattened some- 
 what by gentle pressure of the fingers, and gently hammered 
 against the edge of the table or bench, and rotated after each 
 concussion, always remembering to keep the mass spread out 
 as a thin layer over the inner surface of the bowl. 
 
 If the mass is handled in the manner described, any en- 
 closed air bubbles will be brought to the surface and the contin- 
 uous concussion and rotation of the bowl will cause their col- 
 lapse. 
 
 The flakes of graphite will aid in the gliding by of obstruc- 
 tive particles which might otherwise tend to imprison objec- 
 tionable quantities of air. 
 
 The time spent in mixing the compound should amount to 
 fully three minutes, including the one minute given to the ex- 
 haustion of the plaster in its gas producing tendency, unless an 
 automatic mixer is used, in which case, fully five minutes must 
 be given to the mixing process in order to obtain satisfactory 
 results. 
 
 The quantity of water must be increased while using the 
 automatic mixer, and that may be definitely done by obtaining 
 a small steel ball % 6 inch in diameter, and dropping it into the 
 little depression provided near the larger cup in the scale. 
 
 I have been able to obtain much better results by using the 
 mixer, and I have been able to more definitely duplicate my 
 results by eliminating the varying human element in the process 
 of mixing. 
 
 The manner of procedure is as follows: 
 
 The proportions ol' water and powder are measured off as 
 outlined, and put into the cup of the mixing apparatus; the 
 cover is placed tightly upon the cup, and the mass is well shaken
 
 CAST GOLD AXI) PORCKLAIX INLAYS 
 
 Fig. 163. The Taggart automatic investment mixer attached to a lathe 
 
 Fig. 164. The Taggart automatic investment mixer attached to its own motor, a 
 clock with au alarm which rings when the compound is ready for use.
 
 INVESTMENT, OH HEFJt.UTORY, COMPOUND 169 
 
 up for a minute, the tube extending obliquely or acutely, as the 
 ease may be, from the cover of the cup, and is then slipped 
 over the spindle which extends from the apparatus. This spin- 
 dle projects anteriorly and at right angles from the little gear 
 box which is supported on a stand, and slipped tightly over the 
 shaft of the lathe. 
 
 On the upper part of the gear box is another projection 
 into which a small alarm clock of special construction is 
 fastened. 
 
 The tube which extends obliquely from the cover contains 
 a horizontal cut about % inch down its length, and that ter- 
 minates into a cut directly at right angles to it, which cut 
 interlocks with a screw as periodically the spindle is rotated in 
 the sleeve or tube of the cup. 
 
 The periodical interlocking of the screw on the spindle 
 with the right angle cut on the tube of the cup, furnishes the 
 necessary jar which breaks the air bubbles, while the incline 
 of the cup, due to the position of the tube upon the cover, causes 
 the material to be spread in a very thin layer over the inner 
 surface of the cup. 
 
 The little alarm clock, which has been set before operation 
 \\ as begun, will at the end of five minutes, notify in no uncer- 
 tain terms, that the investment is ready for use. 
 
 The power is turned off, and the cup slipped off the spindle 
 and opened. The mix should be found of a smooth creamy con- 
 sistency. 
 
 With a very small round badger brush (the smaller the 
 pattern, the smaller the brush should be) a small quantity of 
 the mix is taken up from the surface of the mass, and placed 
 upon the wax pattern held upon the crucible former, in and 
 around every corner and margin of it, and this must be done 
 with a gentle but continuous stroke, during which the brush 
 does not leave the body of the pattern. AVhen the amount upon 
 the brush has been deposited upon the pattern, the former is 
 made to take up a somewhat larger amount from the surface 
 of the mass contained in the cup. 
 
 Again the brush, carrying the creamy investment, is placed 
 upon the pattern and again it is made to travel in close prox- 
 imity to the wax, depositing along its line of travel the smooth
 
 170 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 fee 
 S
 
 INVESTMENT, oil UEI-'U.U Toll V, C< >.M I'OC XI) 171 
 
 refractory compound, until the wax pattern is wholly enveloped 
 in it. 
 
 AVlien the wax has been entirely surrounded by investment, 
 the crucible former is grasped with the thumb and the first two 
 lingers of the left hand, while a faintly knurled piece of steel or 
 brass, or a medium grain rile, is drawn downward upon the edge 
 of the crucible former. 
 
 The flask is now placed on the crucible former, and the 
 rest of the investing compound is allowed to run into the flask, 
 close to the margin, and away from the pattern. When the 
 ilask has been half tilled, it is rotated smartly back and forth 
 upon and around the crucible former, to insure a complete fill- 
 ing of the flask and prevent the imprisonment of air. The bal- 
 ance or other half of the ilask is then filled with the still fluid 
 mass. 
 
 It must be remembered that the instrument is to be drawn 
 downward only upon the crucible former, and no seesaw motion 
 of the file or knurl against the edge of the base must, under any 
 circumstances, be indulged in, and the exercise of the instru- 
 ment against the crucible former must be exceedingly careful 
 and gentle, lest the pattern be caused to fracture, at the point 
 where the sprue wire has entered to support it upon the base. 
 
 This will cause the finer and smoother particles of the mass 
 to deposit themselves closely to the pattern, and insure a very 
 smooth mold and subsequently a very smooth cast. 
 
 The flask, having been generously filled, the invested pat- 
 tern is now placed upon a glass slab, which in turn is deposited 
 in some place where it will not be likely to be disturbed or 
 jarred, and thus it must be allowed to stand until complete crys- 
 tallization of the fluid investing compound has taken place. 
 
 Complete crystallization of the mold will, in dry weather, 
 take place in 15 to 35 minutes, the time varying with the mass 
 of the compound; in humid weather 45 minutes to an hour may 
 elapse before it becomes advisable to touch the flask or mold. 
 
 The correct instant may be recognized by the grayish white, 
 and silky appearance <>!' the surplus present in the flask. 
 
 With a sharp knife, the blade of which must be longer than 
 the din meter of the flask, this surplus is removed, so that the 
 bottom of the mass is level with the circumference of the metal
 
 172 CAST GOLD AND PORCELAIN INLAYS 
 
 flask, and with this object in view, the surplus is removed with 
 one sweep of the knife. Next the flask is grasped in the left 
 hand, while the thumb and index finger of the right take hold 
 of the crucible former, and turn it upon its seat toward the left. 
 Because of the cone-shaped seat of the sprue within the crucible 
 former, the latter may be easily removed, carefully cleansed 
 with a brush under the running water, dried, faintly lubricated 
 and put aside. With the flask forceps held in the left or right 
 hand, the flask is grasped midway and held over a small Bunsen 
 flame, in order to heat the sprue, that it may be readily disen- 
 gaged from the wax inlay embedded in the mold. This is ac- 
 complished 'by grasping the slightly heated sprue wire with 
 the thumb and index finger, and gently twisting it around and 
 outward. Care must be taken that the edge of the flask is clear 
 
 of any material. 
 
 
 
 SUMMARY TOR CHAPTER X 
 The Investment, or Refractory, Compound 
 
 1. What is the purpose of investment? 
 
 2. What is meant by a refractory compound? Why is such a compound 
 necessary? 
 
 3. What are the necessary requirements of an invcstinent compound? 
 
 4. What is the function of plaster of Paris in an investment? Name the 
 three varieties of gypsum. 
 
 5. Name the other materials used as refractories. 
 
 6. Describe the manner of making the mix. 
 
 7. Describe the manner of investing the wax pattern.
 
 CHAPTER XI 
 
 THE DRYING- OUT OF THE MOLD AND THE BURNING 
 OUT OF THE WAX MODEL 
 
 Until some such automatic heating apparatus as shown by 
 the inventor of the entire process is readily obtainable, each 
 man engaged in the work of restoring broken-down teeth by 
 means of cast gold inlays will have to make the best of the 
 means he has at hand for the burning out process, and a good 
 serviceable appliance can be constructed from a medium-sized 
 Bunsen burner, upon which a spider of six-inch diameter is 
 mounted; over that a piece of latticed steel may be placed, and 
 surmounting this a sheet-steel tube, lined with asbestos, if pos- 
 silile, and provided with a handle at its center. This tube should 
 be about eight inches in height. 
 
 This apparatus should be placed upon a piece of slate or 
 asbestos, and it should be surrounded by a piece of sheet metal 
 as to keep all sudden draughts away. I use a Platcheck furnace, 
 in which is placed a piece of latticed steel, and under which is 
 adjustably placed a powerful Bunsen flame. 
 
 The furnace itself, as is shown in the illustration, consists 
 of two main parts hinged together. 
 
 The lower or under portion, which furnishes the support 
 for the flasks, is provided with legs extending outward and 
 downward from its underside, the spread of the legs being suf- 
 ficient to exclude the possibility of upsetting the furnace when 
 the top or cover is thrown back. 
 
 Both the upper and lower parts are semicircular in shape, 
 and are lined with fire brick. When the furnace is closed, the 
 space inside of it has the appearance of a hollow globe, or very 
 close to it. It may be readily seen that in this way a muffle with 
 a decidedly advantageous radiating surface is obtained. Sup- 
 ported upon a little rim on the upper part of the furnace is a 
 funnel of a three-inch diameter and about eight inches high; 
 
 173
 
 174 CAST GOLD AX1) POKCELAIX INLAYS 
 
 the diameter of the funnel gradually diminshes until it registers 
 two inches at its extreme height. 
 
 Upon the interlaced steel wire, resting upon the fire brick 
 of the lower half of this furnace, the metal flask containing the 
 mold is placed. Here the first step in guarding against too 
 rapid heating must take place. 
 
 The Bun sen burner should be set to one-third of its capacity, 
 
 Fig. 166. Taggart automatic (gas) burner for removing wax pattern from 
 mold. The gas is made to travel through the clock which, after a set period, en- 
 larges the opening and allows the flame to increase. When the flame has reached 
 its maximum and remained at this height for five minutes, it is automatically 
 shut off. 
 
 and placed beneath the furnace. The flask is placed upon the 
 latticed steel wire frame, resting on the inside of the lower part 
 of the furnace, and as far away from the center of the flame as 
 the inner periphery of the furnace will permit. 
 
 The heater is closed and the flask is left there for a period
 
 PKYIXO .MOLD AXD I'.rilXIXd WAX MODEL 
 
 L75 
 
 of ten minutes. If after the time mentioned, we open the fur- 
 nace to examine the flask. \\ e will find very little moisture ris- 
 ing from tin- hod v of it, but we will also find a constant stream 
 
 Fig. 167. Platcheck furnace closed, showing flue, or chimney. 
 
 of fine vapor escaping from the sprue hole or gate in the mold. 
 This is, of course, due to the volatilization of the wax. The flask
 
 176 
 
 CAST COLD AND PORCELAIN INLAYS 
 
 is now moved up closer to the center of combustion, and it is 
 best to evenly divide the distance between the periphery of the 
 furnace and the center of combustion, and place the flask at that 
 
 Fig. 168. The Platchcck furnace for burnino out the wax. Furnace open, 
 showing burner under it and flask upon the wire net ready to be subjected to the 
 flame. 
 
 point. At the same time the burner is turned on to two-thirds 
 of its capacity. Be sure of a slow heat, so that the moisture 
 is evaporated rather than steamed out.
 
 DHYIXtJ MOLD AND BC II X I \< ; WAX MODKL 177 
 
 The furnace is closed and allowed to remain in this con- 
 dition for about five to ten minutes, time varying- with the size 
 of the flask, when the furnace is again opened and the flask 
 looked at. It will be seen that the crucible lias over it a coat 
 of carbon. 
 
 "When the drying- period has passed, the flask is placed 
 directly in the center of the latticed steel wire frame; the Bun- 
 sen llaine will then be immediately beneath it. The furnace is 
 closed and the IJunsen burner is adjusted to its full capacity 
 for one or two minutes. The hydrocarbons will burst into flame, 
 after which time the flame under the furnace is extinguished 
 and the furnace opened, to reveal a mold clear of carbon, or 
 any other deposit, and of a grayish white color, speckled here 
 and there with the iron-gray of the graphite. 
 
 The flask is carefully grasped with the flask forceps, lifted 
 off the steel wire support, and carried onto a seat of asbestos 
 or slate. Either of the foregoing is to be preferred to iron, 
 because both are nonconductors and will, therefore, exclude the 
 possibility of too sudden a thermal change, and probably hair- 
 like fracture of the mold. 
 
 It must be understood that at no time lias the temperature 
 of the flask been raised to a point that would make it red hot, 
 or even beyond that. 
 
 The wax advocated for use in this book will volatilize and 
 disappear at such a comparatively low temperature, that it 
 would be folly to subject the mold and, therefore, the plaster 
 therein, to any uncalled for degree of heat. 
 
 It is well to remember that the less heat we employ, the 
 stronger our mold will be, and the greater its resistance to in- 
 ternal pressure, and the less distortion we shall cause inside of 
 the mold. 
 
 The flask is now allowed to gradually cool down until it is 
 the same temperature as the air in the room, when it will be 
 ready to be put into the seat, on the machine, in order to re- 
 ceive the metal.
 
 CHAPTER XII 
 
 TIIK CA8TIXI! OF THE MOLTEN METAL INTO 
 THE MOLD 
 
 AVe are coming to the elucidation of that part of the tech- 
 nic of the casting 1 of inlays, which has proved the most active 
 battle-ground for the many and various opinions of as many 
 writers upon the subject. 
 
 The hot mold or the cold mold, the expanded mold or the 
 normal mold, questions which, in the minds of some, occupy 
 a place of prime importance in the art of casting, and I would 
 retrace my steps a bit and bring again before you some of the 
 telling points in the sequence of their occurrence in these vari- 
 ous chapters. 
 
 Let us all remember tenaciously that we are doing our work 
 in a room kept at a given temperature; all our things, instru- 
 ments and materials, as well as the probable patient and the 
 tooth, are in that room and subject to that temperature. 
 
 The cavity is prepared and we are ready for the making 
 of the wax inlay. 
 
 The wax is softened and put into the cavity, and it is 
 caused to Iw-rden under pressure; it is chilled, while a force 
 greater than the intramolecular attraction of it, is upon it to 
 prevent any change of bulk or form. 
 
 Once chilled to proper size and frictional fit of cavity, no 
 change of form or bulk of the wax can take place at that tem- 
 perature. 
 
 The carving is completed and the inlay is invested in a 
 compound; the powder and the liquid, which make up this com- 
 pound, are placed in a bowl or mixer, at the same temperature 
 which the wax inlay has been subjected to right along, and 
 which temperature it can not change. 
 
 The compound contains so little of the active plaster, that 
 practically, no heat is evolved during the period of crystal- 
 
 178
 
 CASTIXC .MOI.TKX METAL INTO MOLD 179 
 
 lization of the mass. The wax pattern in tins mold, therefore, 
 remains unchanged. Once the mass is crystallized around the 
 unchanged wax pattern, we arc justified in our fixed belief 
 founded upon sound reason, that, we have a normal mold. 
 
 A fixed belief, founde-d upon sound reason, means nothing 
 short of definite knowledge. \Ve, therefore, know that up to 
 the present point we have done nothing toward creating or call- 
 ing into existence, any condition at variance with these that are 
 essential to keep our wax pattern, and the mold in which it is, 
 unchanging as to bulk or shape. 
 
 The flask is now placed in the proper position, within the 
 furnace, the heat is applied and gradually increased, until the 
 wax has been volatilized completely; and with the application of 
 the heat, comes the change in the size of the mold and flask, 
 which gives at this time a distorted mold. Note the word dis- 
 torted, for this is just what I mean to convey to you; the inlay 
 is not made larger evenly or in the same ratio in all directions. 
 
 Eefractory materials shrink or expand, as the square of 
 the mass, but if we remember that our wax patterns are not 
 cubes, or balls, or just flat surfaces, or star-shaped dreams of 
 even-pointed bliss, we shall realize that perhaps at one point of 
 the circumference of the wax of the mass surrounding an inlay, 
 we may have a compound one-fourth inch thick and one and 
 one-fourth inches high; while at the next point of the circumfer- 
 ence of the mass, it will be three-eighths inch thick and one and 
 one-fourth inches high; at a third point of the circumference, 
 it may be one-half inch thick, and one and one-fourth inches 
 high; while on the crucible side AVC may have it one-fourth inch 
 high around the entire circumference, and one the reverse side 
 of the flask, it may be a solid block of investment one-fourth 
 inch deep by one inch in diameter. 
 
 AY here the compound is thinnest in bulk, it is nearest to 
 the brass flask, and the influence of the metallic ring, as an aid 
 in distorting the compound more at that point, will, in a hot 
 Mask, make itself felt most decidedly. 
 
 If we admit that the expansion of the mold at the thicker 
 part of it is less likely to be influenced by the metal ring (a 
 reasonable admission) , and that, therefore, the expansion of 
 the part of the mold would be more likely to take place in ac-
 
 180 CAST GOLD AXD PORCELAIX IXLAYS 
 
 cordance with the recognized laws which govern the minerals 
 that make up the mass, then we must have an expansion of this 
 mold which is of very marked inequality; in other words, a 
 distortion. 
 
 Into a mold so distorted, these hot flask adherents then cast 
 their metal, and the result is an inlay which is as unequally 
 enlarged as the mold was unequally distorted. 
 
 All the disking and stoning, and cutting and trimming, can 
 not bring this casting back to the exact form required for that 
 cavity, for clearly no means at our command can make this 
 metal assume angles, lines, points and surfaces, the same as to 
 size, proportion, and direction as those possessed by the wax 
 pattern. 
 
 The fact that some men do put these inlays into cavities 
 proves nothing except that they are content with the results 
 they obtain, and that, of course, is no proof of the correctness 
 of their method. 
 
 The men who realize the truth of the foregoing, will, after 
 the complete volatilization of the wax, allow this flask to resume 
 its normal size, and the mold within to come back to its original 
 proportions. This can only be accomplished by allowing the 
 mass and flask to become stone cold; that is, resume the room 
 temperature. 
 
 The cold flask adherents, realizing that the correct com- 
 pound they use for investment is so well balanced in its com- 
 ponents of plaster and silex that the expansion of the latter 
 nullifies the contraction or shrinkage of the former, are content 
 to carefully and thoroughly volatilize the wax and allow those 
 two components to return to their original condition, by allow- 
 ing the mold and flask to rid itself of its heat. Thus they ob- 
 tain, after the volatilization of the wax, a mold of exactly the 
 same size as the wax pattern, which they put into it, and which 
 has now disappeared, and this mold is of the same temperature 
 now, when it is ready for the metal, as it was when it contained 
 the wax pattern. It was unable to alter its shape and propor- 
 tion then; it is unable to remain distorted when allowed to cool. 
 The accession of the heat which caused its unequal distortion, 
 will, by its gradual disappearance, compel the compound to re- 
 sume its normal condition. I feel that I can not be too emphatic
 
 (.'ASTIXC MOI.TKX MKTA1, INTO A1OU> 1S1 
 
 about tliis. Xot only is the cold fla.sk in harmony with the phys- 
 ical laws, but it has proved itself correct in this practical work 
 and clinical experiments. They who rail against it have slipped 
 up somewhere in their technic, and they are putting the blame 
 on the wrong 1 shoulders. 
 
 Let them try again, work out every step carefully, and fol- 
 low directions implicitly. It will pay; for they will obtain re- 
 sults that are correct, and 1 am willing to assume that they 
 are eager for such results. A cold flask it is then, at least for 
 tin- confines of this volume, anil for those who desire to follow 
 the technic outlined herein. 
 
 Perhaps it will be as well to say here, that unless every 
 step of this technic be carried out as outlined, I consider myself 
 absolved from any responsibility. I willingly and confidently 
 promise results, providing the reader will follow instructions to 
 the letter, but I will not submit to any deviation on the part 
 of the reader, nor will I brook any substitutions for portions of 
 this technic; no short road to Rome no better or quicker 
 method in part. If any supplanting of method be done, it must 
 be so supplanted as a whole. 
 
 This technic interdigilates and dovetails in every step or 
 degree, ami it has been carefully worked out to do just that. 
 A change in any part means a disturbance of the equilibrium 
 and indifferent results something to be avoided. 
 
 SUMMARY TOR CHAPTER XII 
 The Drying Out of the Mold and the Burning Out of the Wax Model 
 
 1. Describe a simple heating apparatus for use in the burning out process. 
 -. Describe the Platcheck furnace. 
 
 3. Describe the manner of manipulating the flame to insure the proper dry- 
 ing and burning out without bringing the flask to a red hot condition.
 
 CHAPTER XIII 
 THE METALS FOE THE INLAY WORKER 
 
 Though gold, platinum, silver, copper, and all the metals of 
 the platinum group have their measure of application in inlay 
 work, only gold and platinum will be considered for the pur- 
 pose of this work. 
 
 I want to lay stress upon the fact and have it clearly un- 
 derstood that when I speak of metals at all I speak of them in 
 a pure state, or rather in a commercially pure state. So that in 
 considering gold, it is understood to be pure gold, 24 carat fine, 
 and in considering platinum it is understood to be pure plat- 
 inum, soft platinum, as soft as the refiner can furnish it in sheet 
 or foil state, as devoid of iridium as it can be made. 
 
 We have been in the habit of speaking of metals as royal 
 or noble metals and base metals. Royal metals are capable of 
 being separated from combinations with oxygen by merely 
 heating them to redness. Base metals are those whose com- 
 pounds with oxygen are not decomposable by heat alone. Gold 
 and platinum belong to the royal metals. 
 
 Gold: symbol Au; combining weight 197.7; fusing point 
 2004 F., 1050 C., specific gravity 19.3 to 19.5. 
 
 Platinum: symbol Pt; combining weight 193.3; fusing point 
 3225 F. to 3425 F., 1650 C. to 1775 C.; specific gravity 21.5. 
 
 A quantity of pure gold depending upon the needs of the 
 case, a certain amount of very thinly rolled out platinum, a 
 seasoned charcoal block, a mixture of potassium nitrate and 
 borax, two-thirds of the former to one-third of the latter, which 
 is contained in a suitable receptacle, a pair of brown or ambei- 
 colored glasses, a nitrous oxide blowpipe, a pair of platinum- 
 tipped foil carriers, and an asbestos or slate pad, the latter tc* 
 be preferred, make up the necessary metallurgic equipment for 
 a laboratory where inlays are to be made. 
 
 The gold may be in the shape of heavy sheets or ingots, 
 the platinum must be in either very thinly rolled or foil form. 
 
 182
 
 Ml.TALS FOR THE IXLAV WOKKEIi 
 
 is:; 
 
 A seasoned charcoal block is one which lias been carefully and 
 gradually lieated or roasted over a low heat until the danger 
 of its disruption when subjected to intense heat is eliminated. 
 A >trong copper wire is then wound around the charcoal block 
 and the loose ends of the wire are tied. AVith a suitable instru- 
 ment a depression is made deep enough to hold the required 
 quantity of metal, and care should be exercised to have the walls 
 of this impression or cavity perfectly smooth and to have no 
 loose bits of carbon present. 
 
 If we are now to alloy a certain quantity of gold and plat- 
 inum, we will proceed as follows: the gold, definitely weighed, 
 is so placed in the crucible that all of it lies below the margin 
 of the depression. Before proceeding with the application of 
 
 Fig. n;j). _\ charcoal block with a depression in it to act as a crucible. A. 
 copper wire tied around this block will prevent such accidents as the sudden dis- 
 ruption of it when subjected to great heat at one point. These blocks should 
 be thoroughly seasoned, as explained elsewhere in this book. 
 
 the nitrous oxide blowpipe to the gold, platinum must be pre- 
 pared first by cutting it in very narrow strips, not over VIG or 
 %2 of an inch wide, and as thin as it can be obtained. The nec- 
 essary quantity of this material is now placed upon a sheet of 
 white paper, so that the individual pieces may be easily dis- 
 tinguished. 
 
 AVe are now ready to proceed with our melt. The city gas 
 is opened, and the flame is lit, the nitrous oxide cylinder valve 
 is opened and the gas is allowed to flow into the mixing cham- 
 ber to unite with the city gas to give the necessary heat units. 
 BO as to efficiently bring the metal to the required temperature.
 
 184 CAST GOLD AND POKCELA1X INLAYS 
 
 The hottest part of a nitrous oxide flame is at the first third of 
 its exit from the blowpipe and the successful combustion of 
 nitrous oxide and city gas is one that consists of a continuous 
 pencil of a clear, bluish green name, covered by a short mantle 
 of red rays, sparingly distributed round the bluish green flame 
 at its immediate source, and reaching only for about % to 1 inch 
 of its length. The whole flame for the melting of the metal 
 in the crucible should be about 4 inches long and this necessi- 
 tates the reduction of the supply of city gas to the requisite 
 amount. 
 
 The operator must now don his amber-colored glasses and 
 the flame is now played on the gold contained in the crucible, 
 the flame being no more than 1% to 2 inches away from the gold. 
 
 The application of the flame must be constant, the hand 
 must be steady, and there must be no drafts in the room. The 
 first sign of effective work will manifest itself in a loss of def- 
 inition as to outline and boundary of the various pieces of gold. 
 They will appear to collapse, to give up their identity and will 
 go from a state of redness, from a shapeless to a spheroidal 
 mass into a state of incandescence, thence to a violet-colored, 
 heaving mass, in which the repelling and the attraction of its 
 component molecules seem to be alternating phenomena, fol- 
 lowing each other with a rhythmicity and a periodicity which 
 might be definitely measured if one felt so inclined. 
 
 At this time, a piece of the narrow platinum foil is grasped 
 with the platinum-tipped foil carriers and fed into the still 
 constantly boiling mass of gold, until it has been completely 
 absorbed. This process of feeding the platinum is continued 
 until the required amount of this metal has been taken up by 
 the larger mass, after that the flame is still held over the danc- 
 ing fluid gold and it is kept in a violent state of agitation for a 
 period of time, varying directly as the quantity of metal being- 
 handled, the periods being about as follows: 1 oz. of an alloy 
 containing pure gold and 2% to 5 per cent of platinum must be 
 kept after the entire amount of platinum has been taken up by 
 the molten mass, in a state of constant agitation for at least 
 two minutes. The alloy will be much more homogeneous if this 
 period is prolonged. If the alloy contains a greater percentage 
 of platinum, between 5 and 10 per cent, the period of time re-
 
 METALS FOR TIIK IXJ.AV WOKKKU 1 s ") 
 
 quired for constant agitation should be no less than five min- 
 utes. If the alloy contains a quantity of platinum greater than 
 10 per cent and up to 15 per cent, the period of agitation is 
 from seven to ten minutes. The alloy must be allowed to cool 
 after tliat, must be rolled out into sheets, cut into small sections, 
 again remelted and agitated for from seven to ten minutes. In 
 a certain quality of casting gold used which among other things 
 contains 19 per cent platinum, which platinum in turn contains 
 '2 per cent indium, the mass is fused, the platinum is fed in, 
 then the entire mass is agitated for fifteen minutes, an ingot is 
 made and this rolled out into sheets, then remelted, etc. This 
 process is repeated four times and the period of agitation is 
 longer each time, so that at the fourth time the period lasts be- 
 tween twenty-five and thirty minutes. 
 
 When the period of agitation has passed, the flame is ex- 
 tinguished, the mass is allowed to cool, and it is not to be 
 touched until it has thoroughly crystallized, when it may be 
 picked up with the platinum-tipped foil carriers and placed into 
 a hydrochloric acid bath, and then rinsed with plenty of cold 
 water. If the quantity of metal is an ounce or nearly an ounce, 
 it may be divided into four parts by using the cold chisel and the 
 hammer. The anvil must be clean and a sheet of white paper, or 
 better, cardboard, must be placed upon it. When the mass has 
 IMM-II separated, each individual piece must be first boiled in 
 nitric acid, then washed in water, then melted in the charcoal 
 block with the nitrous oxkle blowpipe, agitated for a minute or 
 so, allowed to crystallize, transferred to the hydrochloric acid, 
 again thoroughly washed in water, and put away for future use. 
 
 No surplus of any casting should be used again, unless it 
 has been refined by thoroughly fusing it and sprinkling it lib- 
 erally with the powders contained in the receptacle holding the 
 potassium nitrate and borax. The melting process from then 
 on is continued as is the period of agitation, as previously out- 
 lined. 
 
 Gold for inlays for patients between twenty-five and forty- 
 iive years of age, where teeth are in fairly normal occlusion: 
 
 Pure gold .............. 4fi5^ grains 
 
 Pure platinum .......... 14 Vd ' '
 
 186 CAST GOLD AND PORCELATX IXLAYS 
 
 Gold for inlays for patients where teeth are in nialrelation 
 and where the stress of occlusion is varying' in direction and 
 very intense : 
 
 Pure gold 456 grains 
 
 Pure platinum 24 " 
 
 Gold for inlays for teeth in normal occlusion: 
 
 Pure gold 492^6 grains 
 
 Pure platinum T 1 /^ " 
 
 Gold for inlays for teeth that are very frail : 
 
 Pure gold 432 grains 
 
 Pure platinum 38V> ' ' 
 
 Pure silver 9 1 /.. " 
 
 Gold for cast bases: 
 
 Pure gold 456 grains 
 
 Piire platinum 24 " 
 
 Gold for saddles: 
 
 (1) Pure gold 384 grains 
 
 Platinum 2% iridium 72 " 
 
 Pure silver 18 " 
 
 Pure copper 6 " 
 
 (2) Coin gold 432 grains 
 
 Platinum 2% iridium 48 " 
 
 SUMMARY FOR CHAPTER XIII 
 The Metals for the Inlay Worker 
 
 1. What metals are commonly used by the inlay worker? 
 
 2. What are the materials and the instruments necessary to make a com- 
 plete metallurgic equipment? 
 
 3. In what form should gold and platinum, respectively, be used? 
 
 4. Describe the making of the melt.
 
 THE CASTIXU OF THE MOLT MX MKTAL INTO THE 
 
 MOLD AX!) A ( '< )XSI DKUATIOX OK TIIU YAKIOUS 
 
 M A( 1 1 1 1 XlvS EMPLOYED 
 
 At this stage of the work we are ready to put our cold flask 
 into the seat of the machine with which the casting is to be done, 
 and before we do that let us consider and carefully examine 
 some of the things that have been said in regard to the casting 
 of gold. AVe shall, however, first establish the truth of the fol- 
 lowing statement: 
 
 "All metal castings are made under pressure." 
 
 It must be apparent to anyone who thinks, that even if no 
 apparatus of any kind is used in forcing metal into a mold, 
 there is still the pressure of the falling metal to be accounted 
 for. It matters not what we call it, gravitation, or anything 
 else, the fact remains that what we are trying to put into the 
 receptacle has some weight, and if this weight is great enough 
 to overcome the resistance of the air in the mold, and if the 
 mold be porous enough to allow that air to escape, then we shall 
 have a casting, and the very fact that we get a casting, proves 
 that the resistance of the air was overcome, and to overcome 
 resistance we must have pressure. 
 
 Of course, the relation between the size of the gate in the 
 mold, and the success of the casting, with what may be called 
 the inherent pressure of the metal, is a factor to be carefully 
 taken into consideration. The gate must be larger in casting 
 by this method than it would have to be if we had the aid of 
 some outside agent to increase the pressure, and confine it to 
 a circumscribed area. 
 
 It is not advisable to use this method in casting any of the 
 royal metals, because of the excessively high fusing point of 
 these metals, and the almost impossible task of keeping these 
 metals at a temperature required, in order to have them fluid 
 
 187
 
 188 CAST GOLD AND POHCELAIX IX LAYS 
 
 enough for a long enough period of time to complete a easting 
 by tliis method. 
 
 It has been and is being employed in casting low-fusing 
 alloys, used in the laboratory for lower dentures. Most men 
 will be familiar with the method; that is, the preparation of 
 the model; the making of the wax pattern, with its two in- 
 verted, cone-shaped extensions at the condyles; the investment 
 of this model carrying this pattern into one-half of a special 
 flask in such a manner that only half of the wax pattern and 
 inverted cone extensions will be embedded into the plaster and 
 sand, the subsequent lubrication of that half of the investment 
 and wax, and the placing and filling with plaster and sand of 
 the other half of the flask, the drying of the flask containing 
 the invested pattern and model; the opening of the flask and 
 the boiling out of the wax; the careful drying out of the mold 
 until the mirror test shows it to be devoid of moisture, and 
 finally the melting of the alloy in a suitable crucible; the as- 
 sembling of the two halves of the flask, and the pouring of 
 the molten alloy into one of the funnel-shaped openings at one 
 side of the flask, until we see the metal rise in the funnel-shaped 
 openings at the other side of the same flask. 
 
 If the side of the flask which contains the funnel-shaped 
 opening in which the metal rises, were longer by, let us say, 
 an inch, than the side which contains the funnel-shaped opening, 
 into or by way of which we pour the metal, we could continue 
 the pouring until the metal on the escape side had risen a full 
 inch higher than the metal on the intake side. If there were 
 no inherent pressure in the metal being poured into the intake 
 side, this could not take place, and it is also true that this pres- 
 sure is as the weight, and is, of course, partly subject to the 
 same laws as those which govern falling bodies. 
 
 I think it is pretty well proved that casting as described 
 above, is pressure casting; and I think also that I can save space 
 and time by simply stating that the method described above 
 is entirely and absolutely unfit for the casting of inlays, without 
 going into any lengthy dissertation as to why this is so. 
 
 What is true of the simple process above described, holds 
 good in dental casting by means of centrifugal force, whether 
 we make use of one of the centrifugal casting machines sold
 
 CASTIXt; .MOI.TKX .MKTAI. MATH INKS KM IM.( ) VKD 189 
 
 for this purpose, or simply swing a bucket containing the mold, 
 and the molten metal in a circle with sufficient rapidity to cause 
 this molten metal to bury itself in the space provided in the 
 mold. 
 
 That this centrifugal force must be converted into pres- 
 sure before it can cause the metal to seek the cavity in the mold, 
 is proved by the fact that all forces finally expend themselves 
 in pressure of one kind or another, so that a casting made by 
 the centrifugal method is essentially a pressure casting, and if 
 this centrifugal force could in any way be definitely confined 
 and doled out in given, definite, and measurable quantities, it 
 would have points in favor of its use. At present I know of no 
 apparatus in which this principle is utilized that could be said 
 to be dependable enough to Avarrant its use in the casting of 
 gold inlays. No claim made by the vendors or manufacturers 
 of these centrifugal casting machines has been sustained. The 
 (|iiaiitity of the force, and hence the amount of pressure used, 
 being unknown, the best one can say of the possible result is 
 that it will be doubtful. I used one of these machines alongside 
 of many other makes, and after careful, conscientious efforts, 
 I was forced to the conclusion that no acceptable inlay can be 
 made by this process. The machine has its use perhaps in the 
 arts and crafts of jewelry castings, and in coarse laboratory 
 work, where things cast may afterwards be filed out to definite 
 measurements, but it is not to be considered for inlay work. 
 
 The most commonly employed centrifugal machine consists 
 of a base with a centrifugal pivot, to which is fastened one end 
 of a coiled spring and a flywheel with a recess in the under side. 
 This flywheel is mounted movably upon this central pivot of 
 the base, and the coiled spring, one end of which is fastened to 
 the central pivot, is attached at the other, or outer, end to the 
 My wheel, and enclosed in the recess of it. Externally to the 
 frame or base is a bar which actuates a leather-covered lever 
 arm which coacts with the flywheel to hold it in a given position 
 after the spring has been wound up. This makes up the en- 
 rlo.-ed mechanism of the machine. 
 
 The exposed part consists of an arm, fastened to the fly- 
 wheel by means of screws, entering a small cylindrical por- 
 tion of this flywheel. A pivot about three-quarters of an inch
 
 190 CAST GOLD AND PORCELAIN INLAYS 
 
 in height, rises from this crossarm and serves as a handle to 
 wind up the spring by rotation of the flywheel. On each end 
 of this crossarm, is a headed rivet upon which a sliding ad- 
 justable arm is carried, and one of these end arms carries the 
 tray which contains the flask and mold, while the other one 
 carries the counterbalance. 
 
 When the mold is ready to be filled, the flask is slipped 
 into the carrier on the end of the mold arm. The spring hav- 
 ing been wound, the adjustable arms are set at right angles to 
 the crossbar, or very nearly right angles. The crucible in which 
 the gold is to be melted is placed upon the carrier immediately 
 in front of the flask. The gold is melted, and when it boils, the 
 flywheel is released, which sets it in motion, which motion is 
 transmitted to the crossarm, and from it to the end placed ad- 
 justable arms, which immediately straighten out, with tremend- 
 ous outward motion, and this forces the molten metal into the 
 mold. 
 
 In a few moments the maximum velocity will have been 
 reached, and from this point, the speed of the machine will 
 decrease. It may be either allowed to spend itself, or it may, 
 after one and one-half minutes be stopped by pushing the leath- 
 er-covered lever against the flywheel. 
 
 The manufacturers of this machine claim that the force 
 may be modified by fewer windings of the spring, and while this 
 is undoubtedly correct, the pressure produced remains indefinite 
 and, therefore, not suitable for our purpose. 
 
 With the greatest care used in every step of the w r ork, all 
 inlays made were more or less irregularly distorted, due, no 
 doubt, to a forced readjustment of the walls of the inside of 
 the mold, this readjustment being actuated by the impact 
 created first, by the violent straightening of the arm, and its 
 consequent slipping upon the pivot, and second, by the impact 
 of the metal against the wall of their frail investing compound. 
 
 While the defective investment may be eliminated, the agi- 
 tated mold remains as a permanent deleterious agent in the pres- 
 ent machine, and it seems doubtful if it ever can be remedied. 
 
 If this machine is to take a lasting place in the art of 
 casting inlays, I would suggest that a device be added to it that 
 would enable the operator to so wind the spring, and so set the
 
 CASTIXC MOLTKX .MKTAL MACHIXKS K.M PLOYED 1 !H 
 
 flask that both the momentum of the flywheel and the shock 
 with which the flask is caused to straighten or throw itself away 
 from the center, may be measured. This is not at all impossible, 
 and simply means a year or so of constant experiment and 
 mathematical deduction. The manufacturers would then have 
 a product which they would be justified in offering to the pro- 
 fession for accurate work, provided, of course, that their experi- 
 ments did not compel their honest conclusion that at its best the 
 machine would be unfit for inlay work. 
 
 Regardless of any assertions to the contrary, most vehe- 
 mently made by the manufacturers of the vacuum machines, they 
 are nothing else than pressure machines; and in order to prove 
 this, it is only necessary to quote a small part of their glowing 
 literature full of little jokes. 
 
 ''Not the slightest fraction of an ounce of artificially pro- 
 duced prt'xxxre is applied at any stage of the casting operation, 
 when an Elgin is the apparatus used. There is not the slightest 
 fraction of an ounce of artificially produced resistance to be 
 oven-nine, because the air in the mold is removed in advance, 
 and is not subject to compression. 
 
 "Pressure is not necessary because there is no resistance. 
 There is no resistance, the air necessarily and naturally is re- 
 moved in advance of the entrance of the metal, through the 
 pores of the investment material which are plenty large enough, 
 no matter how small they may be, to permit the instantaneous 
 passage of the air in response to the pull of a vacuum formed 
 1lic mold, a puU'uif/ force more than double normal at- 
 ic prepare." (Dental Casting, 1912, The Ransom & 
 Randolph Company.) 
 
 If any evidence be needed to prove that the suction ma- 
 chines are pressure machines, the little booklet containing the 
 above quotation, and many other sayings quite as contradictory 
 will supply that evidence gratis. 
 
 Just think of this wonderful pulling force, dragging on the 
 vitals of the mold, and keeping up this drag even after the 
 gold begins to enter, with a force equal to double that of at- 
 mospheric pressure, to wit: thirty" pounds to a square inch. 
 
 Of course as fast as this machine sucks the air through 
 the mold and creates a vacuum, the atmosphere above would
 
 192 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 be inert if it did not push or press the gold into this vacuum 
 much abhored by nature; and because this pull is so strong, 
 in other words, because this sucking apparatus is so voracious, 
 
 Fig-. 170-.-J. The Elgin vacuum casting machine and Masks. 
 
 Fig. I70-B. Same machine as in Fig. 170-J, ready for casting. 
 
 
 
 the abused and harassed atmosphere above must exert this 
 thirty pounds to the square inch pressure nolens volens. 
 
 All this time the molecular integrity of the mold is being
 
 C'ASTIXC MOLTKX .MKTAI/ MACHINES EMPLOYED 1!).'! 
 
 attacked by this plus suction in order to allow the gold to enter 
 without any duress except the double atmospheric pressure, the 
 pull of the plus suction equals. 
 
 It will be well to note that the natural atmospheric pres- 
 sure upon the earth at our level is about tifteen pounds to the 
 square inch, and anything above that is an artificially produced 
 pressure, which makes their statement in the beginning of the 
 quotation, seem very far from an accurate scientific assertion. 
 
 To cite another quotation with the reader's indulgence, 
 but first the digression to recall to your mind that we must 
 thresh these things out to settle them, for at least some time to 
 come, it will be well to quote from the same booklet, page 4, 
 beginning on line 25: 
 
 "In casting by other than the vacuum method, the excess 
 metal in the crucible is the first to solidify, thereby shutting 
 off the pressure. Pure gold, especially shrinks in the process 
 of hardening, and with the excess solidified, and the pressure 
 removed, the metal in the mold contracts to the extent of the 
 shrinkage. 
 
 "\Yith the Elgin, the first portion to harden is the metal 
 against the outer walls of the mold, and the last, the excess in 
 the crucible, while in all other forms of cnstntfi, the process is 
 reversed. 
 
 "In using the Elgin appliance, the excess can be kept mol- 
 ten, and the suction maintained, as long as required for the 
 metal to completely harden in the mold. Simultaneously with 
 the shrinkage taking place in the mold, the vacuum draws metal 
 from ,v//7/ molten r.iccss to fill the vpnce left by the natural 
 shrinkage." 
 
 The colossal impertinence of sending a booklet containing 
 such statements to men who are supposed to have had at least 
 a primary lesson in metallurgy, can only be accounted for in 
 two ways: It may be that the man that wrote this statement 
 in the Koranic booklet really believed he was telling the truth, 
 and it may be that if he knew he was wrong, he figured that 
 none of the men would read it with enough attention to find 
 the pig, and if they did, they would not know the difference 
 anyway. 
 
 I have seen beautiful jewelry, such as elks' heads, cast
 
 194 CAST GOLD AND PORCELAIN INLAYS 
 
 upon an Elgin machine, but I have never yet in my practice, 
 been called upon to insert an elk's head into a patient's tooth, 
 to take the place of an inlay. I have seen Greek letters and 
 coiled springs and scimitars which were sucked into an Elgin 
 and atmosphered twice over again, but none of those things 
 have ever been called upon to measure up with any micrometer 
 measurement. 
 
 It will be well for the student and practitioner to bear in 
 mind that we are called upon to inlay teeth, and to inlay them 
 with microscopic correctness. True, we can appreciate fine 
 jewelry, nice rings, decorated with figures or hieroglyphics, and 
 no doubt, if we ever leave our profession to enter the field of 
 tlie art metal worker, these machines may have their uses, but 
 so far as I have been able to determine, they are failures, and 
 an ordinary little swage, with its air-compressing interior, is 
 to be preferred. 
 
 The vacuum machine is a pressure machine; of that there 
 is no doubt, and if it were not such an inverted pressure ma- 
 chine, it might be useful. 
 
 I take it that the reader will have come to the conclusion 
 that I am an advocate of a direct pressure machine, and this 
 conclusion is sound. I have my reasons, too, for preferring and 
 using and advocating the direct pressure machine, provided it 
 is the right kind. The right kind of pressure machine is one 
 which will perform the following service : 
 
 It must enable one to melt the gold in the crucible of the 
 flask, before the investment in this flask gets hot enough to dis- 
 tort the mold, and this means that it must have an oxyhydrogen 
 or nitrous oxide blowpipe. It must furnish me with a means 
 to definitely know how much pressure I am using for casting, 
 and I must be enabled to sustain that pressure at will; and I 
 must be enabled to apply that pressure at the psychologic mo- 
 ment. 
 
 These things a pressure machine must do or it will be use- 
 less. What other things it may do in addition to those men- 
 tioned, are a matter of refinement of detail and economy of 
 operation, and are of course factors which determine one in 
 the purchase of any merchandise, but they are not absolute
 
 CASTIXt; MOLTKX M KTAL .M ACI ! I X KS K.MI'LOVKD 1!).") 
 
 essentials to perfect results while the first mentioned things 
 are al)solntely so. 
 
 Now, before taking up direct pressure machines, suppose 
 we quickly, but thoroughly, consider some of the phenomena 
 which take place in the casting of gold under pressure. 
 
 The following is a quotation in part from a treatise written 
 by ('. J. Clark, of Chicago, Illinois. 
 
 " Kor countless ages the matter of the earth existed in a 
 molten state, gradually cooling and shrinking until the surface 
 became ridged and the internal molten mass became encapsuled 
 by a crust. As the shrinkage continued, matter was called upon 
 to supply the deficiency, and the crust being solid and rigid, 
 and held by the power of cohesion, the power of the centrifugal 
 force was the greatest at the greatest circumference, and, of 
 course, the portion of the revolving sphere that offered the 
 least resistance (the poles) succumbed to the demands of the 
 internal shrinkage and were drawn inward; and so we find the 
 earth flattened at the poles. 
 
 "The cooling of a metal in a mold, while not exactly similar, 
 is strikingly analogous to the cooling of a planet or the earth 
 on which we live. 
 
 ".Matter is never at rest, the atoms comprising the mole- 
 cules revolving around a common center, forming a miniature 
 solar system, are in a constant state of agitation, moving rapidly 
 around in their medium in ether, and confined in their move- 
 ment to their limited space between their fellows. 
 
 '///c (>nf<T surface of a mass of matter is the first to be 
 susceptible to any thermal change, the effect being transmitted 
 to the center, and if this thermal change of sufficiently liigh 
 degree to change the state of the mass from the solid to the 
 liquid, or gaseous, or vice versa, the surplus is the first to exhibit 
 these manifestations. 
 
 "Let us suppose a cross section of a gold plate is being sub- 
 jected to heat of sufficient degree to induce a change in its 
 physical structure, the atoms of the molecules revolve more rap- 
 idly than before, become more diverging in their tendency, de- 
 scribing a large circumference about their common center, the 
 molecules increase in the same proportionate volume, and their 
 mutual power of cohesion diminishes. This allows the mole-
 
 CAST COLD AND POKCKLAIX 1X1 AYS 
 
 cules to separate more widely, and permits of a greater latitude 
 in which to exercise their mobility. As the atoms are whirling 
 about their common center, the molecules are revolving and 
 revolving also about each other, generating centrifugal force 
 to such an extent as to overcome the force of gravity, and with 
 a tendency towards projection in every direction held in re- 
 straint only by the still active though much weakened power 
 of cohesion. 
 
 "This causes some molecules to be lifted above their fel- 
 lows, and as the heat increases, the mass begins to assume a 
 globular shape or form and presents a panorama of rhythmic 
 harmonious action. 
 
 "Now if the heat be withdrawn, the revolutions of the atoms 
 about their common centers decrease, and as their momentum 
 gradually diminishes, the atoms come into closer proximity, the 
 molecules decrease in volume, the power of cohesion increases, 
 the mutual attraction of the molecules becomes more intense, 
 exhibiting more influence than the force of gravitation, and the 
 congealing mass of metal retains more or less of the globular 
 form, the molecules being caught on the act of falling, much the 
 same as w T ater is caught, and held in the formation of an icicle. 
 
 "The duration of time in which the metal is transformed 
 from a molten to a solid state is exceedingly short, and the fact 
 that the metal retains enough heat to maintain a red color for 
 a time, furnishes no scientific proof that the metal in the mold 
 will shrink for the metal that remains in the crucible and the 
 metal in the mold encounter conditions in hardening which are 
 diametrically opposed. The metal in the crucible is confined by 
 no walls, and the pressure on it being from without inward, has 
 no such effect, as on that confined in the mold, for the reason 
 that the hydraulic pressure that the confined gold is subjected 
 to, forces the metal from the center, outwardly as long as it 
 remains molten, and thus it is pressed against the cooler walls 
 where the crust as described is formed, and which will register 
 a density of 19.45 against 19.16 of that remaining in the crucible; 
 and there is no inherent force or physical property in the metal 
 itself after being cast under pressure capable of suggesting its 
 density to any further degree. 
 
 "So it is physically impossible for it to shrink to any appre-
 
 CASTIXC .MOLTKX M KTAL MACIIIXKS KM !'].( >VKD 1 97 
 
 ciable degree, therefore, if, in the process of making an inlay 
 or a more extended piece by casting under pressure, any dis- 
 tortion occurs, or it is not a facsimile of the wax model, the dis- 
 crepancy must he ascribed to some other factor or cause than 
 the shrinking of the gold alone. 
 
 "If this globule of gold were measured for its specific grav- 
 ity, it would be found that it developed by the mutual attrac- 
 tion of its molecules (cohesion), a density that registers a 
 relative specific gravity of 19.16. 
 
 "Thus, if gold, heated so as to assume the liquid state, be 
 allowed to congeal uninfluenced by any interfering conditions, 
 the only factors entering into the phenomena being mass, co- 
 hesion, heat, molecular mobility, volume and gravitation, it is 
 a physical possibility for the metal to develop, by virtue of its 
 cohesive force, a density that registers a relative specific grav- 
 ity above 19.1(i. In tin- caxtitif/ of metal under pressure, addi- 
 tional factor* enter, and nmst he taken into consideration; thei/ 
 are hydraulic pressure and ireldinfi, the latter bc'nuj induced by 
 /l/e force of hydraulic pressure. 
 
 "If a mold has been prepared in the usual procedure for 
 a cast under pressure, and is in a condition for the reception of 
 the molten metal, a button of gold fused in the crucible mani- 
 fests the same physical phenomena previously described. The 
 atoms will revolve around their common center more rapidly 
 than at a lower temperature, and the molecules will revolve 
 around each other in like manner, and the metal is gradually 
 transformed from the solid to the molten or the liquid state. 
 If force now be suddenly applied to the liquid mass in the cru- 
 cible, a portion of it will be forced by displacement into the 
 mold, and if the pressure be maintained for a time it will be 
 transmitted from molecule to molecule, simultaneously in every 
 conceivable direction, the hydraulic force pressing the mole- 
 cules to all surfaces and angles of the mold. As the molecules 
 at tiie surface of the mass come in sudden contact with the walls 
 of the mold, their movements are abruptly checked, the atoms 
 of the molecules are forced to closer proximity, the molecules 
 decrease in volume and have less latitude in which to exercise 
 their mobility, which instantly induces congealation; and as they 
 are held firmly against the walls of the mold, gaps and crevices
 
 198 CAST GOLD AND PORCELAIN INLAYS 
 
 occur, which are, however, filled by the pressure behind, and 
 with inconceivable rapidity, with new recruits, frenzied and 
 heat maddened, where they meet the same fate as their fellows, 
 crushed and jammed against each other and the walls of the 
 mold until in congealing a rigid wall or capsule lines every sur- 
 face and angle of the mold. 
 
 ''This goes on in the same way until the surface crust thick- 
 ens to the center, all following the same regular order of things, 
 but with no loss of appreciable time in a small mass of gold as 
 might be inferred from the deliberate description. This metal 
 will be found to be of higher specific gravity than when it is 
 allowed to cool under ordinary conditions." 
 
 Here then we have a quotation from a treatise written by 
 one who used as a guide and reference nearly every known au- 
 thority on the subject, and here too, we find as a result of his 
 inquest into the mystery, the definite statement that in casting- 
 gold under pressure the part entering the mold is the first to 
 congeal. A statement which not only emphatically but most 
 effectually contradicts the assertion of an extoller of the virtues 
 of the vacuum process, that only with this machine does the 
 hardening of the mass in the mold take place before the harden- 
 ing of the mass in the crucible. 
 
 As a matter of fact, in all casting of high-fusing metal, with 
 the aid of any pressure exerted upon the molten mass by any 
 special apparatus, the surplus in the crucible is the very last 
 to congeal or crystallize, and that part entering the mold is the 
 first to assume an unalterable shape. 
 
 Since the invention of pressure casting as applied to den- 
 tistry, dozens of pressure casting machines have been offered 
 to the profession and each one was, according to the literature 
 of the maker, the best for the purpose. There is the LeCrone, 
 the Cleveland Dental, the simple little swage, the Sure Cast, 
 the Simplex, the Seymour, in fact there are so many, that the 
 number would compare favorably with the number of different 
 makes of automobiles, and like automobiles, they would all go 
 for a time, and after a fashion. All can puff and snort, and 
 make a noise. The point of interest to the profession is, that 
 these machines ultimately differ widely in the result that one 
 can accomplish with them.
 
 CASTING MOLTEN METAL MACHINES EMPLOYED 199 
 
 Sonic of the pressure machines mentioned supply the nec- 
 essary force, by feeding compressed air through a chamber which 
 opens onto and above the molten mass; others simply allow a 
 little chamber filled with a moist compressible substance to be 
 placed over the crucible which contained the molten metal, the 
 heat of this metal, acting upon the moisture contained in the 
 above substance would convert this moisture into steam, and 
 this steam would supply the pressure necessary to propel the 
 metal into the mold. 
 
 The most reliable of these is one called the Solbrig machine 
 and is marketed here by Ash & Sons. Were this machine sup- 
 plied with a means for definitely controlling and measuring the 
 pressure, it would prove a valuable appliance in one's labora- 
 tory, and be quite suitable for inlay work. As it stands today, 
 it may be used only for casting that requires no definition of 
 fine lines, angles, or margins, where microscopic accuracy in 
 reproduction of those lines, angles, and margins is not an essen- 
 tial factor. I know of no inlay that will permit of such devia- 
 tion, and still be fit for use for any cavity in any tooth. A brief 
 description of this machine will suffice. , 
 
 It consists of the base, upon which the flask containing the 
 mold rests. This flask is received in a shallow ring upon the 
 base. A rigid support rises from the base, and to this support 
 a movable arm carrying an adjustable metal cover, is connected. 
 This adjustable metal cover fits loosely over the flask. When 
 the wax pattern lias been burned out of the mold, the flask is 
 placed into the ring upon the base, and an asbestos disc, satu- 
 rated with water, is placed into the cover. The gold is put into 
 the crucible in the mold, and is brought to a boiling point; the 
 movable arm, carrying the adjustable cover is brought down- 
 ward onto the flask containing the molten metal, and held there 
 for a minute, when the casting is completed. The heat of the 
 metal converts the water in the asbestos disc into steam, and 
 this steam, confined in the small area, induces a tremendous 
 pressure upon the molten mass; just what effect all this pres- 
 sure may have on this mold is a matter which may be calculated 
 by taking the resistance and the amount of the pressure under 
 consideration. Absolutely definite results are impossible with 
 this machine because the pressure is uncontrolled and can not
 
 200 CAST GOLD AND PORCELAIN INLAYS 
 
 be definitely and measurably modified. AVe do not need a ton 
 of dynamite to blast a pebble out of the sandy beach. 
 
 The machine I use for the casting of gold inlays is a direct 
 pressure machine, invented and built for this purpose by the 
 inventor of the process. It is a machine which enables one to 
 bring the gold to a boiling point in the crucible of the flask 
 before the entire mold has been heated to a point of distortion. 
 It makes possible the use of a small nitrous oxide flame, and it 
 gives off an infinitely greater amount of heat concentrated on 
 the bottom of the metal, than can be obtained with a large blast 
 flame of the ordinary blowpipe. It is a machine which enables 
 a man to apply a measured amount of perfectly sustained pres- 
 sure at the very moment when he realizes that he must have 
 this pressure, and the flame is automatically turned off as the 
 pressure is applied. 
 
 I use this machine in conjunction with the entire technic, 
 because it enales me to do my ivork of restoration in such a. 
 manner as to make the probability of recurrent requirement for 
 further effort in that direction very remote, if not altoyther 
 impossible. 
 
 This is what the cast gold inlay, conceived and made avail- 
 able for public use by the discoverer, will do, if we are careful 
 to follow the directions in every step of the procedure. 
 
 It is essential for him who would practice gold inlay work 
 correctly to consider the entire technic as a complete circum- 
 ference of a circle, presenting no break in its continuity. In the 
 center of that circle and responsible for this unbroken circum- 
 ference is the ideal which the inventor conceived and held onto 
 while he thoroughly and carefully worked out every phase of 
 this technic. 
 
 There can be no question upon the statement that all of 
 this revolutionizing principle had its inception in, first, a vivid 
 realization that present methods were inefficient to stem the 
 tide of tooth destruction; and, second, in the birth of the ideal 
 of what should be done in order to effectually stem this tide. 
 If we place this ideal in the center of this circle, and now divide 
 our circumference into its 360 degrees, and run a radius from 
 each degree upon the circumference to the center, we shall be 
 in a better position to understand just how closely dependent
 
 CASTINd MOLTKN MKTAL MAC' H INKS K.M I'LOYKI) 
 
 201 
 
 upon this conceived ideal lias been and must be the entire 
 technic. 
 
 Indexed, with the ideal already fixed in the mind of the in- 
 ventor, it became only a question of time as to when the enor- 
 mous amount of mental activity playing around this ideal, would 
 manifest itself in the expenditure of physical effort which would 
 
 Fig. 171. Taggart machine with flask in position on its base. Charcoal 
 block and nitrous oxide flame playing upon a button of gold. T.o the right is a 
 l:ir^f box containing a mixture of potassium nitrate and borax. The gauge upon 
 the Taggart machine indicates five pounds of pressure. 
 
 in time create in actual physical form what already existed in 
 the abstract, but, nevertheless, causative, ideal of it. And so 
 this ideal, powerful, ivreat and beneficent, and with the approval 
 of all cosmic laws to aid it, occupies the central throne and be- 
 gins to throw out its elements of physical manifestation as
 
 202 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 radii of a circle. One element is the wax, and we see this grow 
 from an obscure indefinite point to a clearly determined actual- 
 ity; another element is the compound, going through the same 
 
 Fig. 172. The Taggart machine raised to permit the use of a number of 
 sizes of larger flasks designed by the author to enable him to make larger castings 
 for extensive cases of restoration requiring large saddles for removable bridge 
 dentures. 
 
 cycle of experience; then came the crucible, its depth, its width, 
 and curvature of its arc, and the relation of this depth to this 
 width and curve, and the sprue, the length of that and the re-
 
 CASTIXC MOI.TKX MKTAI. .MACHINES EMPLOYED 
 
 hit ion of tlie length of that to the pattern \vitliin the mold; and 
 the ilask. the height and the width and the circumference of 
 that; and the relation of these to tin* curve and the depth and 
 width of the crucible and the pattern within the mold; the mixer 
 and the heater; the blowpipe and the mixing chamber for the 
 ga>i s; the regulating of the pressure as to increase and de- 
 crease, and the sustaining of the pressure thus obtained; and 
 the machine as a whole. 
 
 The hundreds upon hundreds of questions which were 
 found and had to be solved, and were solved, not only as indi- 
 vidual problems, but as prohh ms related each to the other which 
 came before, and the one which was to follow; so this work 
 went on until this ideal, sitting, so to speak, in the center of our 
 abstract circle, had sent out these radii toward every degree 
 upon the circumference, and behold! the task was complete. 
 Here is a process so perfect that not a weak point can he found 
 in it, and here too, is a machine so perfect, and accessories so 
 unique, that all intcrplayed perfectly with each other to call 
 forth a perfect result, provided all of it, the process, the ma- 
 chine, and the accessories, are well understood and properly 
 handled. 
 
 It is not to be marveled at that the idea of cast gold inlays 
 swept the profession clean off its feet into a frenzy of hopeful 
 enthusiasm. Here at last was the possibility of doing the right 
 kind of restorative work, and blind indeed we should have been 
 had we failed to recognize it. Here were possibilities so preg- 
 nant with hope for the betterment of the race, dentally con- 
 sidered, so potent in effect upon the future of their well being 
 that it set med as if the glory of truth had at last broken through 
 the meshwork of inefficient and often misleading dogma. 
 
 The profession saw it and gasped at the one stupendous 
 stride that would make creators out of them in place of 
 menders. 
 
 They who followed implicitly all the directions, bent every 
 effort to carry out minutely every detail of the technic, who 
 studied and understood the machine by itself, and in relation 
 to every step which accompanies the use of all the carefully 
 planned accessories, have been rewarded beyond their own 
 hopes and dreams. They have seen a new era rise in dental
 
 204 
 
 CAST GOLD AND PORCELAIN 1XLA\S 
 
 service and dental accomplishment, and with the use of the 
 process, their love for the work has grown and with the growth 
 of their love for the work, the standard of their work has been 
 raised. Dentistry to them is no more a mere profession, a 
 trade, a means of a livelihood. It is a religion to be cherished 
 and throughly studied for the good it will bring to humanity; 
 for the aid it will bring to struggling man, in his efforts to 
 evolve into a perfect being. That is what dentistry means to 
 them; not one of them but will affirm and add to this declaration. 
 
 Fig. 173. To the right is a view of a small Taggart flask and its crucible 
 former which holds the sprue wire. To the left is the author's barrel-shaped flask 
 and its crucible former and the shortened sprue wire. The amount of refractory 
 compound surrounding the wax pattern is more nearly equal in bulk in all direc- 
 tions in the barrel-shaped flask. 
 
 Fig. 174. A special flask, barrel-shaped, made by the author in two sections 
 to be used for large castings. The Taggart machine that takes this flask has been 
 raised from its platform sufficiently to provide the necessary room. 
 
 Is not such an experience an incentive to every student, 
 and every dentist who has not yet done so, to take up this 
 process and study it, and persevere and follow instructions until 
 it has been mastered ! 
 
 The use of this machine is exceedingly simple. It is a ques- 
 tion of knowing what is wanted, of knowing that the machine 
 will do all it is intended for, and of testing the machine before 
 each casting to make sure that all is in order.
 
 CASTING MOLTKN MKTAL MACI I I X KS KM IM.( )VKI) I'D.") 
 
 Upon examination of the flasks designed by Dr. Taggart, 
 it will lx noticed that each one contains a small hole about the 
 si/o of 11 -gauge wire. This serves two purposes; it forms a 
 vent to facilitate the escape of any gas or air which may be 
 present at the time of casting, and which might offer a resist- 
 ance to the ingress of the metal; and it serves to show how 
 well or how poorly the pressure gas may be flowing through 
 the vertical cylinder into the pressure plate, and from there 
 onto the metal. 
 
 Test the machine out as follows: 
 
 Place a piece of rubber dam into the small base of the ma- 
 chine, and seat the llask roundside up into this base; open the 
 valve on the nitrous oxide cylinder, and by means of the reduc- 
 ing valve, regulate the pressure to the desired point. (Three 
 to five pounds pressure is the right amount for casting inlays.) 
 
 See that the packing in the pressure head is not dried out 
 and leaky, and see that the four small holes which allow the 
 gas to pass through down onto the flask, are free from any 
 metal or other obstruction. 
 
 Now bring the arm or lever of the machine forward down 
 upon the flask while you hold the fingers of the other hand 
 around the flask so as to close the hole at the upper part of it. 
 
 The bringing forward and downward of the lever will throw 
 a valve inside of the vertical cylinder which will cause the 
 nitrous oxide to descend through it. If you feel the pressure of 
 the descending gas upon your finger, which closes the hole in 
 the flask, the machine is in good shape and fit to be cast with. 
 Now alternately remove and replace your finger over the flask 
 opening; the hand upon the pressure gauge should keep time 
 with your actions, that is, it should drop to zero as you remove 
 your finger, and reascend to three or five pounds as you close 
 the opening. 
 
 This will show the perfect condition of the machine, and 
 you may rely upon it for the sustained pressure required for 
 successful casting. 
 
 Xo\v release the lever arm and remove the empty flask, sub- 
 stituting for it the flask containing the mold ready for casting. 
 Turn the blowpipe until it is at right angles to the machine, and 
 ignite the city gas, opening the city gas valve until you have a
 
 206 CAST GOLD AXD PORCELAIN ]X FAYS 
 
 llame about four inches long. Xow place a button of clean gold 
 24 carat fine, (be sure it is clean) into a charcoal crucible placed 
 near the flask (put on brown or blue glasses) and open the 
 needle valve on the regulator, which will allow the nitrous oxide 
 to flow into the mixing chamber, through which the city gas is 
 flowing. The mixing of the two gases will produce a very hot 
 blue flame about three-quarters of an inch long, and th.i.s flame 
 is directed upon the button of gold by turning the blowpipe 
 downward directly over it. 
 
 In about thirty to sixty seconds, varying with the amount 
 of gold, the flame will have brought the metal almost to the 
 fusing point. Remove the heated gold to the crucible in the 
 flask and play the flame upon it. The tendency of the mass to 
 assume a spheroidal shape will now appear, and finally the 
 molten metal will present a glowing shape and the mass will 
 be seen to move. The gold may now be called fluid, but it is 
 not yet hot enough for casting. If it were cast at this moment 
 a very sluggish mass would have to be dealt with, and a very 
 imperfect piece of work would be the result. 
 
 This may be avoided by keeping the flame upon the fluid 
 gold until the heat of it has been raised to such a point that 
 the molecules seem to repel one another violently. The molten 
 mass will assume the color of sunlight, with a violet tint in it, 
 the mass will not move from side to side but will rise in the 
 crucible, as if pushed up from beneath, only to drop back again 
 to repeat the performance. 
 
 All this has taken less than a minute and at this stage the 
 lever is brought smartly forward; the plunger and pressure 
 heads descend upon the flask, the blowpipe is thrown to one 
 side, the city gas is shut off, the valve which allows the pressure 
 gas to descend upon the molten metal is thrown open, as the 
 flask is sealed, and the molten metal is forced into the mold and 
 held there under a constant and sustained pressure. 
 
 The nitrous oxide, previously used to aid in melting the 
 metal, backs up and reenters the descending valve to spend its 
 force or pressure upon the congealing mass. 
 
 It is unnecessary to again enumerate all the curious molec- 
 ular movements and atomic agitations which take place on cast- 
 ing. At best, they are theoretic consideration, beautifully
 
 CASTIXC MOLTKX MKTAL MACIIIXKS KMI'LOYKI) 207 
 
 reasoned out; but for the man doing the practical work as out- 
 lined heroin, they need carry no further importance, except to 
 inform him of what actually takes place. 
 
 From forty seconds to a full minute's time should be given 
 for the gas to exercise its pressure against the congealing metal. 
 The level- may then be released by pulling the spring-actuated 
 pin on the upper part of the machine-head forward. The lever 
 is then thrown back, and will carry the pressure head upward. 
 The Mask will, in most instances, be found cool enough to grasp 
 with the hand, illustrating how little actual and distorting heat 
 entered the mold during the melting of the metal. 
 
 1 1' he Mask be uncomfortably warm, it may be grasped with 
 the llnsk forceps, and either thrown into a bowl of water, or held 
 under the cold water faucet, until the mold disintegrates and 
 is washed off. A stiff toothbrush will remove most of the com- 
 pound around the inlay and surplus, and we shall find the cast- 
 ing complete. 
 
 REFERENCE CONSULTED ON THE EXPANSION AND CONTRACTION 
 
 OF METALS 
 
 Clark, D. K. : A Manual of Rules, Tables and Data for Mechanical Engineers, 
 
 1878, *K598. 
 
 Dana, E. S.: Editorial, Am. Jour. Sc. and Arts, 1901, vol. clxi. 
 DuBois, A. J.: Elementary Principles of Mechanics, 1894, vol. ii, K4982.2. 
 Howe, H. M.: Metallurgical Laboratory Notes, 1902, K12780. 
 Hutton, W. S.: Practical Engineer's Handbook, 1896, K5405. 
 Lineham, W. J.: Text-book of Mechanical Engineering, 1894, K4958. 
 Poynting, J. H., and Thompson, J. J. : Text-book of Physics, 1904, K15930.3. 
 Rankine, W. J. M.: Manual of Civil Engineering, 1891, K661. 
 Tlmrstmi, R. H. : Brasses, Bvoux.es, and Other Alloys, 1900, KJ5502.3. 
 Useful Rules and Tables, 1873, K665. 
 Watson, W.: Text-book of Physics, 1905, K15933. 
 
 SUMMARY FOR CHAPTER XIV 
 The Casting of the Molten Metal Into the Mold 
 
 1. Describe the part played by temperature in the inlay technic up to the point 
 of drying out. 
 
 2. What happens when the flask is heated? What effect on the mold has 
 the proximity of the flask to it? 
 
 3. What is the result of casting into a hot mold? 
 
 4. Why is a cold flask necessary and how does it follow the temperature 
 sequence?
 
 1208 CAST GOLD AXD PORCELAIN IX LAYS 
 
 The Casting of Metal into the Mold and a Consideration of the Various Machines 
 
 Employed 
 
 1. What is the principal objection to the use of a casting appliance in- 
 volving centrifugal force! 
 
 2. Give the reasons for and against the choice of a vacuum machine. 
 
 3. What are the essentials of a casting machine involving direct pressure? 
 
 4. How would you prevent the distortion of the mold during the actual 
 casting ,of the inlay? 
 
 5. Describe the tcchnic of casting in a Taggart machine.
 
 CHAPTER XV 
 
 THE CLEANSING OF THE CASTING IN HYDRO- 
 FLUORIC ACID AND IN A SODIUM 
 BICARBONATE BATH 
 
 After the casting lias been carefully and thoroughly brushed 
 free from compound, it is placed in a rubber cup containing 
 hydrofluoric acid. The acid will free the casting from any of 
 the silicate it may still have on it. It would be impossible 
 to remove every evidence of this by the use of the brush only. 
 Owing to the enormous amount of heat to which the metal is 
 subjected under the nitrous oxide flame, it picks up a number 
 of mineral and metallic impurities, which, however, are finally 
 forced to the surface of the casting and the crucible side of the 
 surplus. Particularly does the crucible side of the surplus but- 
 ton become contaminated with interfering agents which it picks 
 up from the silica, and for this reason it is advisable (impera- 
 tive is the word) not to use any gold for casting unless it is 
 absolutely clean. 
 
 It is best to take these surplus buttons and define them be- 
 fore using them again. More of this later. 
 
 When the casting has been in the acid at least several hours 
 (it is sometimes best to leave it in overnight), the cover is 
 removed from the hard rubber acid cup, and the casting is taken 
 out with a pair of tweezers and washed, under the faucet, then 
 brushed with soap and water. 
 
 A test tube about six inches long and three-quarters of an 
 inch in diameter, is filled about one-third of its capacity with 
 a saturated solution of sodium bicarbonate, and the casting is 
 boiled in this solution until every trace of the acid has been 
 neutralized. 
 
 It is important that the acid be neutralized beyond a doubt 
 because of the deleterious effect of the least particle of this acid 
 upon any cement or tooth structure. 
 
 209
 
 210 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Rubber and metal, and the waxes, seem to be tli eonly sub- 
 stances which are not attacked by it; hence the use of the rubber 
 cup as a receptacle for it. 1 bought a hard rubber cup about 
 four inches high, two and one-half inches in diameter at the 
 mouth, and about one and three-fourths indies in diameter at 
 the bottom. It is an ordinary hard rubber drinking cup and 
 may be bought at any rubber goods shop or large drug store. 
 This is used for the hydrofluoric acid. 
 
 
 Fig. 175. Acid cup, support, and stopper for hydrofluoric acid, a, stopper; 6, 
 tapering hard rubber cup; c, piaster of Paris block carrying cups. 
 
 A batch of plaster of Paris was mixed to a creamy con- 
 sistency and poured into a paper box four inches square. Into 
 this mix of plaster, the moistened rubber cup was forced to 
 within one-half inch of the bottom of the box containing the 
 plaster, and the mass containing the cup was allowed to set. 
 
 The next day the paper was removed, and the surface of
 
 CI.KAXSIXt; TIIK CASTlXd Llll 
 
 the plaster was trimmed to a sightly aj>])< arance. After several 
 days the mass had thoroughly hardened and shrunk because of 
 the cone-shape of the cup, and was expelled from its scat. 
 
 A quantity of stearine was allowed to come to a boil in an 
 agateware vessel, and the plaster form was put into it and al- 
 lowed to boil for one and one-half hours. The result was a plas- 
 ter receptacle, hard and smooth, into which the cup could be 
 placed, and which form it was practically impossible to upset. 
 
 AYhen the cup was put into the seat, it was turned toward 
 the right and was made to fit very snugly. About one-third 
 of the cup extends beyond and out of the plaster, so that it may 
 be easily grasped and turned to the left for the purpose of 
 unseating it. 
 
 A block of wood was shaped to loosely fit the mouth of the 
 cup, and into the center of this block and going half way through 
 it, a small brass eye was inserted to serve as a handle. 
 
 A layer of paraffine about one-eighth of an inch was placed 
 over every part of this block, and it was again fitted into the 
 cup. While it was seated, more paraffine was added to the 
 circumference of the block, and this paraffine was allowed to 
 overlap the cup, thus producing a cover which fitted into and 
 over the rubber container of the deadly acid. 
 
 Extreme caution must !>.' exercised in holding this acid, 
 and care should be taken to guard against the inhalation of its 
 irritating and deadly fumes. The deleterious effects from it 
 an- very lasting, and I have had some decidedly unpleasant 
 experiences with it, to which I would not care to have any of 
 my readers subjected. 
 
 Into this cup is poured one ounce of the hydrofluoric acid, 
 which can be procured at a chemist's shop in four ounce wax 
 bottles. The wax cork is then sealed into the bottle, the bottle 
 placed in a wooden box, and put away. 
 
 In the average practice an ounce of this acid will serve its 
 purpose for about three weeks to a month, when it becomes so 
 laden with silicates that it may be pronounced inert from cleans- 
 ing inlays. 
 
 The cup is then removed from its seat in the plaster base 
 and carefully filled with water which runs slowly out from the 
 faucet and is allowed to overflow the cup.
 
 212 CAST GOLD AND PORCELA1X INLAYS 
 
 This so weakens the acid that it will not hurt the basin. 
 When the cup has been thoroughly cleansed, it is replaced in 
 its plaster seat, another ounce of the acid is poured into it from 
 the acid bottle, and the cover is put on as quickly as possible. 
 
 It is well to take a quart glass jar, fill it with water, and 
 put into the water as much bicarbonate of soda as the water 
 will take up. As required, the test tube may be filled and the 
 washed inlays boiled in this solution to completely neutralize the 
 acid. 
 
 SUMMARY FOR CHAPTER XV 
 
 The Cleansing of the Casting in Hydrofluoric Acid and in a Sodium 
 Bicarbonate Bath 
 
 1. Describe the cleansing of the casting from impurities and give the reason 
 for each step. 
 
 2. Describe the making of a receptacle for hydrofluoric acid.
 
 UIAI'TKU XVI 
 
 UKMOVAL OK Til K KXt'ESS OF MKTAL, THE POLISH1XC, 
 AND THE CEMKXTATIOX OK TIIK I XI, AY 
 
 The surplus button is clamped with a vise, and with a fine 
 saw the inlay is separated from the excess by sawing through 
 the sprue, within a millimeter or two of the casting. A garnet 
 paper disc, of medium grit, will remove the rest of the sprue, 
 and medium-grit cuttle fish discs rotated toward the margins 
 of the inlay will prepare it for its final polish. Unless the sprue 
 wire has been attached to any part of the occlusal surface, the 
 occlusal part of the casting is not to be touched with stones, 
 burrs or discs, and it is not to be touched at all until the inlay 
 has been tried in the cavity, and the relative occlusion of it 
 determined. 
 
 The cavo-surl'aces of the inlay arc carefully examined with 
 a magnifying glass, and a diligent search is instituted for any 
 irregularities, such as bubbles, etc., which would, of course, in- 
 terfere with the proper seating of the inlay. If any are found, 
 they may be removed with a very sharp spoon-shaped excavator, 
 or with a Xo. 1 or Xo. 2 round burr, held in the handpiece of the 
 engine. If the area is free from interference, the temporary 
 stopping is removed from the patient's tooth, the cavity is 
 carefully examined to make certain that it is absolutely free 
 from any obstructions, and the inlay is put into the cavity and 
 sent home by tapping it gently, using a stock of hard wood, 
 driven by a few gentle taps from a leather-covered mallet. No 
 undue force must be used; gentleness and perseverance are the 
 agents that will overcome the obstacles usually encountered at 
 this stage. AVhen the inlay has gone to place, all margins are 
 carefully examined, with the aid of a mirror and a fine explorer. 
 If found satisfactory, the mirror and explorer are laid aside, 
 and while the fingers of one hand hold the inlay in position, 
 the other hand manipulates the right, left, and straight, as well 
 as round burnishers, always in the direction with the margins. 
 
 213
 
 214 CAST GOLD AND POKCELAIN INLAYS 
 
 If the directions have been followed, practically no bur- 
 nishing should be required, at least not what is generally under- 
 stood as burnishing. 
 
 There is no occasion for spinning the gold, and the use of 
 the burnishers is indulged in at the margins only to obviate the 
 necessity for discs at these points. Discs sometimes slip and get 
 beyond one's control for a long enough time to mar the perfec- 
 tion of a piece. 
 
 If the inlay proves difficult to seat, it should be removed 
 and again scrutinized with the magnifying glass for any ir- 
 regularities or overhanging ledges. These removed, the inlay 
 is again seated, and the process of gently tapping it is repeated. 
 Because these inlays fit so closely, and frictionally engage the 
 different Avails of the cavity so thoroughly, we are sometimes 
 compelled to seat and reseat them several times before cemen- 
 tation. 
 
 The burnishers must not be allowed to slip off the gold, 
 onto^the tooth; the object is rather to run the burnishers ver- 
 tically over the inlay margins, when these are vertical, and 
 horizontally over them, when they are occlusal or cervical; in 
 other words, when the margins run horizontally across the 
 tooth. 
 
 With the sharp point of a pencil a line is drawn across 
 the heaviest part of the inlay, and this line is continued over 
 the tooth. 
 
 The inlay is removed from the mouth. AVith a No. 2 round 
 burr a recess is drilled on each side of it, as near the margin 
 as the enamel line will permit, and with a burr of the same 
 size a similar recess is drilled in the tooth. This procedure 
 gives a saucer-shaped, or rather semicircular depression, on 
 the opposing margin of the inlay, and a corresponding depres- 
 sion in the tooth. The pencil mark will serve as a guide for 
 vertical direction, while the cavity margins on the cavo-surfaces 
 will determine the direction which the burr will take in the 
 tooth. 
 
 It will be readily realized that when the inlay is again 
 placed in position, the two depressions or recesses on the inlay, 
 will meet the two recesses within the tooth, and an almost cir- 
 cular resistance pinion will result upon the application of the
 
 POLISH IXC AND rK. \1KXTATI OX OK I X LA V I) 
 
 cement. Such resistance pinions arc exceedingly strong and 
 very difficult to obliterate, since they possess the maximum bulk 
 whore tension is greatest. 
 
 The accuracy of the proximate relation of tlie inlay, must 
 he satisfactory; there must be contact with the next tooth, if 
 any be present, if the inlay bo a compound one, and if it be 
 one for anv tooth distally to the first bicuspid, there must be 
 collide! line* instead of contdcl ))ohils. 
 
 If any deficiency be observed at those parts, it may bo 
 rectified by doubling a cylinder of gold foil upon itself, and 
 placing it snugly upon the deficient part of the inlay with the 
 smallest quantity of 'I'l carat solder, this cylinder is joined to 
 the inlay proper, and the bulk of it at that point is increased. 
 
 Tlie necessity for such steps, as described immediately 
 above, will become rarer as the technic is mastered. 
 
 It will be recalled that the margins of the inlay were pol- 
 ished by the use of the burnishers, while it was in the tooth 
 cavity. The rest of it is now finished with line cuttle-fish discs, 
 to be followed by crocus discs. The occlusal surface having 
 been found correct, it is polished with small brush wheels and 
 pumice, and finally with felt wheels, and pointed slender engine 
 burnishers. If there has been a slip-up on the occlusal surface, 
 the inlay is put into the cavity, carefully seated, and the patient 
 is asked to bring the teeth into occlusal relation, while a small 
 piece of thin articulating paper is held over the tooth that con- 
 tains the inlay. In this manner the interfering high points Avill 
 be readily noticed and may be removed. 
 
 The necessity for this procedure also will grow less fre- 
 quent, as the knowledge of both the process and the technic 
 grows with practice. 
 
 AVhen the inlay has been subjected to all necessary trials, 
 when the recesses have been made, and the inlay has been pol- 
 ished, we are ready for cementation. Use the rubber dam 
 whenever at all possible. It is so much easier to keep the field 
 of operation dry, and the cavity thoroughly clean; steriliza- 
 tion of the cavity is so much more readily accomplished; and 
 the operation is so much more of an assured success, that all 
 arguments are in favor of the rubber dam. 
 
 In cases in which it is impossible to use the rubber dam
 
 216 CAST GOLD AND POHCELA1X INLAYS 
 
 (a condition whicli is exceedingly rare) the clamp may be ad- 
 justed on the tooth to be filled, or the one immediately behind 
 or in front of it, if the tooth be an upper one; or the saliva 
 ejector of Nyman may be used, if the tooth be a lower one. 
 These saliva ejectors were designed by Dr. Xyman, of Chicago, 
 and offer an excellent means of keeping the field of operation 
 fairly dry with the aid of cotton rolls. 
 
 Of course, napkins or cotton rolls may be used when the 
 clamps are being relied upon to keep the operating area more 
 or less isolated. 
 
 We will assume that we have been able to apply the rubber 
 dam, and thus are enabled to successfully isolate the tooth we 
 are working on, as well as several adjoining ones. 
 
 The cavity is thoroughly dried, as well as cotton will dry 
 it, a fresh pledget of cotton is dipped into warm alcohol, and 
 the cavity is flushed with this; the walls, as well as the seat, of 
 the cavity are carefully rubbed with this pledget of alcohol- 
 carrying cotton. 
 
 This is kept up for a minute, when a stream of warm air 
 will dry the tooth. A pledget of fresh cotton is now dipped 
 into a solution of warmed bichloride in H 2 2 1-250, and this is 
 put into the cavity and allowed to remain there from three to 
 five minutes while preparations are made for the mixing of the 
 cement. 
 
 A dry cement slab is essential. Any good reliable cement 
 of an exceedingly fine grain and preferably of brown color will 
 do. A broad spatula of German silver or agate or bone should 
 be used, and the cement must be rather thinly mixed, but very 
 thoroughly spatulated. Spread the mix over as large an area 
 as possible; the more you can spread it out, the thinner the 
 layer, the better the mix, the more thorough this incorporation 
 of powder into liquid has been. 
 
 The inlay has in the interim been washed by the assistant 
 or operator himself and dried with warm air. 
 
 The bichloride is removed from the tooth and the cavity 
 is dried with cotton and again flushed with alcohol and dried 
 with warm air. 
 
 A jiffy cement tube is filled with the cement and a thin 
 layer of the mix is spread over the cavo-surface of the inlay.
 
 POLISH INC AND CKMKNTATIOX OF INLAY 1*17 
 
 The contents of the jiffy tube arc expelled, directing them into 
 the cavity, by linger pressure, and the inlay is grasped with a 
 pair of tweezers, or the fingers, and guided to its position over 
 and into the cavity. The greatest care must In- used in seating 
 the inlay at this time, and again gentle tapping rather than 
 sudden force will accomplish the desired end. 
 
 (irasp a pointed, notched hardwood instrument of consider- 
 able strength, in each hand, and holding both of these points 
 upon the inlay, gently rock it into place, while the surplus ce- 
 ment is being forced out. AVhen the inlay is nearly in place, 
 the wood stick from the right hand is laid aside, and the mallet 
 is called upon to further the work until the inlay is seated. The 
 stick is then substituted for the mallet and the inlay is held 
 there for fifteen or twenty minutes, the same position being 
 maintained as nearly as possible. Be sure the inlay is in its seat 
 and do not rock it after that. 
 
 Xo burnishing, no malleting, no polishing, no trimming 
 down of any kind, for at least a day after cementation. When 
 the cement has crystal! i/ed, the rubber dam is removed, the 
 surplus cement around the inlay is removed, and the patient is 
 cautioned against using that tooth or that side of the mouth 
 for the next few hours to come, in order to properly preserve 
 the continuity of the cement while it is hardening. 
 
 Upon the return of the patient for the next sitting the 
 margins may, if necessary, be burnished; the right and left bur- 
 nishers may be used as indicated, or the small engine burnishers 
 may be employed. 
 
 If all directions have been carefully followed, this will 
 rarely if ever be required, but should the necessity arise, it is 
 well to remember that the burnishing is to be done in line with, 
 and not against, the margins of the cavity. 
 
 SUMMARY FOR CHAPTER XVI 
 Removal of the Excess of Metal, the Polishing and Cementation of the Inlay 
 
 1. Describe tin- preparation of the inlay before it is tried in the cavity. 
 
 2. Describe the test fitting of the inlay in the cavity. 
 
 3. In what manner should the margins be burnished? 
 
 4. Describe the making of the resistance pinion. 
 
 5. How would you restore the contact point of an inlay f 
 
 <i. Describe the polishing of the inlay before it is ready for cementation. 
 7. Describe the cementation process.
 
 CHAPTER XVII 
 
 THE SPLINTING OF LOOSE TEETH BY ALLANS 
 OF INLAYS 
 
 The Splinting cf Loose Teeth by Means of the Cast Gold Inlay, and 
 
 the Paralleling cf the Root Canals of Loose Teeth that Are 
 
 to Be Splinted, by Means of Instruments Known as the 
 
 Parallelometer and the Parallelodrill, Respectively 
 
 The splinting of loose teeth lias always been a more or less 
 difficult task for the operator to perform. Particularly does 
 this apply to the splinting of anterior upper or lower teeth. 
 
 The reason for this becomes obvious when we consider the 
 position of the upper anteriors and their longitudinal relation 
 to each other, and when we take into consideration the size and 
 formation of the lower anteriors. 
 
 The first general principle to be observed is that we must 
 never remove enough tooth structure from tho inner part of the 
 tooth to endanger its possibility of playing its part in the con- 
 tinuous flow of vital essence. In other words, we must never 
 ream out or drill a canal so that only a thin bony shell will 
 remain in tha alveolar socket, for if we <lo, not only will the 
 shell be likely to split under stress, but the maintenance of 
 nutrition is a much more difficult thing in a thin layer consist- 
 ing largely of inorganic material, and wherein the major part of 
 the channels of nutrition have been segregated from each other 
 (their anastomoses destroyed), than it would be in a thicker 
 mass in which the tubules still communicate with each other 
 and so carry the vital essence to every cell. 
 
 The problem of establishing a parallel relation between the 
 canals of these teeth, without destruction of too much of the 
 valuable intertwining nutriment carrying tubules, led the writer 
 to the invention of certain instruments which are respective! y 
 known as a parallelometer and a parallelodrill. The use of 
 
 218
 
 SPLlXTIXi; LOOSK TKKTII WITH INLAYS 
 
 I'll) 
 
 Fig. 176. Showing the parallelometer wrench in position on locking stud. 
 You will note that stud is the only one on the parallelometer which has no 
 clamp connected with it. When the distance which the operator wants to main- 
 tain lias been reached, this stud is turned up tightly and the meter is locked 
 beyond any possibility of change. Great care should be taken by the operator 
 to always see that this stud is loosened before attempting to turn the actuating 
 screw of the parallelometer.' This screw has JIG threads to the inch, and could 
 very easily be damaged or jammed, if the locking stud were turned up tightly 
 and an attempt made to turn the actuating screw. 
 
 Fig. 177. In order to make clear the correct position for the various man- 
 drels for different distances, the following cuts are shown for guidance. 
 
 In the above cut, the measuring posts are in position for all measurements 
 from 6 mm. up to and including 10 mm. Six millimeters is the minimum distance 
 that can be measured with this instrument.
 
 220 CAST GOLD AXD PORCELAIN INLAYS 
 
 these instruments is a simple procedure and makes the parallel- 
 ing of any number of teeth in the arch a definite and mechan- 
 ically accurate task. 
 
 Let us assume that we are about to make a splint for the 
 six anterior upper teeth and that all root work has been prop- 
 
 Fig. 178. Measuring posts in same clamps as in preceding cut, but with 
 the distance between them increased to 10 mm. This is the maximum distance 
 that can be measured with the posts in these clamps. 
 
 Fig. 179. Showing position of measuring posts for all measurements from 
 10 mm. up to and including 25 mm. The above is the maximum distance that 
 can be measured with the posts in these clamps. 
 
 erly executed, that the canals have been filled for their gingival 
 half, and that no undue reaming out of the roots has been re- 
 sorted to. We shall use a 15-gauge (Brown & Sharp) 30 per
 
 SPLINTING LOOSE TKKTII WITH INLAYS '2'2 1 
 
 cent iriilio-platinum wire for the cuspids and centrals and a 
 16-gauge wire for the lateral incisor. 
 
 Everything being ready for paralleling the canals of these 
 teeth, we turn our attention to the instrument known as a 
 parallelometer and note: 
 
 Fig. 180. Pleasuring posts in same clamps as in Fig. 179, but with the 
 distance increased to 40 mm. This is the maximum distance that can be measured 
 with the posts in these clamps. 
 
 Fig. 181. When the distance to be measured exceeds 40 mm., the parallelom- 
 eter is reversed and the measuring posts are placed, in the clamps as shown above. 
 These posts, as can be seen, are now 35 mm. apart. The parallelometer may bo 
 extended to 55 mm. , 
 
 1. It consists of two rectangular pieces of metal, slidably 
 adjustable one upon the other, a screw providing the means 
 of motion.
 
 '2'2'2 CAST GOLD AND POKCKLA1X IX LAVS 
 
 2. At fixed distances upon the piece of metal, certain clamps 
 are present, which will upon being locked, definitely hold a 
 given wire in a fixed groove. 
 
 3. The upper surface of the engaging sections is accu- 
 rately graduated in millimeters, a constantly augmenting num- 
 ber of turns of the screw being necessary to traverse a milli- 
 meter space as the first groove upon the table section and the 
 last groove upon the movable section approach each other. 
 This instrument will line up root canals parallel to each other, 
 when they are 7 or 40 mm. apart, and we must bear in mind 
 that : 
 
 First. If we wish to parallel the canals of two teeth which 
 are over 7 mm. and less than 10 mm. apart, we clamp a wire of 
 
 Fig. 182. Measuring posts in same clamps as in Fig. 181, but the distance 
 has been increased to 55 mm. This is the maximum range of the parallelometcr 
 and will reach from any part of the mouth to any other part of the mouth. 
 
 suitable gauge into the two opposite grooves farthest away from 
 the actuating screw. 
 
 Second. When the canals to be paralleled are more than 
 10 and less than 25 mm. apart, we use the end groove of the 
 stable section as our unit point, and the middle grove of the 
 movable section as our point of accommodation or adjustment. 
 
 Third. When the canals to be paralleled are more than 25 
 or less than 40 mm. apart, we use the end groove of our stable 
 section as our unit point, and that groove upon the movable 
 section which is nearest the actuating screw as our point of ac- 
 commodation or adjustment. 
 
 Given a case which requires splinting of the six anterior 
 teeth, we would then proceed as follows :
 
 Sl'UNTINi; I.OOSK TKKTII WITH IX LAVS 
 
 1. The teeth must be thoroughly scaled and polished. 
 
 2. All suppurative conditions must be eliminated. 
 
 o. All the pul])s must be extirpated and the roots filled for 
 their gingival half in accordance with the best technic. 
 
 4. The incisal orifices of the pulp chambers are enlarged 
 by means of stones suitable in shape and size. 
 
 5. Starting with the two cuspids, they will be found to be 
 more than '2') nun. and less than 40 mm. apart, and we shall 
 therefore clamp two hVgauge (Brown & Sharp) steel rods into 
 
 Fig. IS.'!. The above cut shows where the paiallelodrill should be oiled. A 
 drop of oil should be placed in C and D occasionally; the cap at B should be re- 
 moved, and the pinion underneath it oiled; also, the caps at A and A. The latter 
 caps have a left-hand thread. 
 
 The parallelodi ill cannot be steiili/.ed by boiling, due to the fact that certain 
 pinions and parts are made of steel, the drill, however, may be entirely dissembled 
 and easily reassembled, and all parts wiped off carefully. 
 
 A ci-nterin^ post is provided in the set of instruments to assist assembling the 
 parallelodrill when it lias b:-en taken apart to be cleaned. This centering post is the 
 same size as the c, 'liter stud which holds the two drill heads, pinions, etc., together. 
 Instead of aligning the abo\v parts with the center stud, the centering post should 
 be used, and in that way, no harm will be done to the thread of the stud.
 
 224 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 the corresponding grooves presenting themselves upon the op- 
 posite sides of the parallelometer. 
 
 Fig. 184. Distance established between cuspids. The drills are too be the same 
 
 distance apart. 
 
 Fig. 185. Showing the operation of the parallelodrill reaming out two root 
 canals in the two upper cuspids to receive the split pin and tube attachments. Note 
 the position of the operator's left hand in supporting the parallelodrill during this 
 operation. 
 
 \ 
 
 6. We join the actuating screw until the two posts or wires 
 will just enter the root canals of the two cuspid teeth. 
 
 7. Eemoving the instrument from the mouth, we fix the
 
 SPLINTING LOOSE TEETH WITH INLAYS 223 
 
 distance between the two posts by means of the lock nut pro- 
 vided and we record this distance for future reference. 
 
 8. AVe remove the two wires from their respective grooves 
 by opening the clamps and we substitute two short posts which 
 we accurately clamp into the meter, and which will engage the 
 two heads of the parallelodrill. 
 
 9. The drill heads of the parallelodrill are now made to 
 engage the protruding ends of the short posts, and the distance 
 between the drill heads is fixed by turning the lock nut pro- 
 vided. 
 
 10. The parallelodrill is removed from the posts, clamped 
 into the parallelometer and two drills, corresponding in size to 
 the original wires, are now inserted into the drill heads. 
 
 1 1 . The parallelodrill is mounted onto the handpiece of the 
 engine and the drill heads carrying the two drills are brought 
 into line with the canals of the two cuspids. 
 
 12. The power is turned on and the drills are allowed to 
 sink into the two root canals to the required depth. 
 
 1:>. This varies directly as the amount of destruction of 
 the alveolus and the recession of the gum and inversely as the 
 divergence of the roots. 
 
 14. The drills must be sharp, allow for clearance, the hand 
 must be steady and the mind must be fixed upon the task in hand. 
 
 15. It will be found that the canals in the cuspids will be 
 parallel without difficulty and with the least sacrifice of tooth 
 structure. 
 
 We shall now proceed to parallel the right cuspid to the left 
 lateral or rather the left lateral to the right cuspid. 
 
 Taking up the instrument called the parallelometer we re- 
 lease the lock nut which will enable the actuating screw to func- 
 tion, then proceed as follows: 
 
 1. The clamp which holds the wire upon the accommodating 
 section in the groove nearest the actuating screw is opened and 
 the wire is removed. 
 
 2. The space between the right central and the left lateral 
 becomes more than 10 mm. and less than 25 mm. apart. This 
 wire is clamped into the middle grove of the movable or ac- 
 commodating section. 
 
 3. The actuating screw is turned until the two wires will
 
 226 
 
 CAST GOLD AND POIK'HLAIN INLAYS 
 
 be in line with the incisal orifices of the canals of the right cen- 
 tral and left lateral respectively, and will just enter these canals. 
 
 4. The parallelometer is removed from the mouth and the 
 distance between the two wires is noted, recorded, and fixed by 
 turning the lock nut provided. 
 
 5. The clamps holding the wires are opened, the latter are 
 removed and the short drill guides or alignment posts are placed 
 into the grooves and the clamps are locked. 
 
 Fig. 186-J. 
 
 Fig. 186-5. 
 
 Fig. 186. Showing the method of transferring the distance from the paral 
 lelometer to the parallelodrill. 
 
 1. Measuring posts in position after having the distance increased between them 
 by 2y% mm. 
 
 2. Alignment posts have been substituted for measuring posts and tightened 
 up in their respective clamps. 
 
 3. Parallelodrill has been unlocked and the two drillheads superimposed on the 
 pyramidal-shaped alignment posts. The handle of the drill has been turned to the 
 most convenient angle for the work to be done in the mouth, and the two drillheads 
 locked in that position. 
 
 4. The parallelodrill removed from alignment posts with the distance accurately 
 transferred from the parallelometer to the parallelodrilL
 
 SPUXTIXd I.OOSK TKKTII WITH IXI.AYS '' 
 
 6. The parallelodrill is deprived of its drills, the lock nut 
 upon its center is opened, and the two drill heads are made to 
 engage the extending ends of the drill guides or alignment posts 
 which are clamped in the meter. 
 
 7. The distance between the drill heads is fixed by turning 
 the lock nut provided, and the drill head which is to be oposite 
 the lateral incisor is provided with a drill of suitable size and 
 make, while the one which is to coact with the cuspid is made 
 to carry a smooth wire of the same caliber as the drill previously 
 used in paralleling the cuspids. 
 
 8. The parallelodrill is slipped into the handpiece of the 
 engine, and the drill and the guide wire are brought into line 
 with the respective canals. 
 
 !'. The power is turned on and the drill is .allowed to find 
 its way into the canal of the lateral, the guide wire in the Other 
 drill head entering the canal of the cuspid, will provide the 
 means of compelling alignment of left lateral to right cuspid. 
 
 10. The right cuspid canal having been made parallel to 
 the left cuspid canal, at the initial alignment operation, the left 
 lateral will of course be found parallel to the left cuspid. 
 
 11. If we now reverse the process, that is, if we now turn 
 our attention to the left cuspid and right lateral, employ the 
 same technic outlined above, merely transferring our drilling 
 member to the oposite drill head, we may readily bring into 
 parallel alignment the right lateral with the left cuspid, and 
 hence also with the right cuspid, and hence also with the left 
 lateral. 
 
 1 Tn like manner, the canals of the right and left central 
 may be made parallel to the left and right cuspids, respectively, 
 and you who have been working in the dark, guessing at the 
 parallelism of your splint posts have a revelation awaiting you, 
 when you follow the technic outlined above. 
 
 Exactly the same technic would have to be followed, if the 
 lower anteriors were the ones to be worked upon, except that the 
 wires and drills to be used would have to be smaller. 
 
 The average size posts for the four lower incisors is 17- 
 gauge (Brown tv. Sharp), while the cuspids will take a 15-gauge 
 wire of the same standard. 
 
 If now the six anteriors, upper or lower teeth were to be
 
 228 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 splinted, by means of cast gold inlays, and the two cuspids 
 were to be used as abutments for a bridge, as frequently they 
 must be, the procedure would be to substitute tubes for the 
 post, which were to be inserted into the root canals of the cus- 
 pids. 
 
 The technic for paralleling would be the same as previously 
 
 Fig. 187. Distance established between cuspid and lateral on opposite side 
 
 of the arch. 
 
 Fig. 188. Distance established between right cuspid and left lateral. 
 Drills are the same distance apart. 
 
 outlined, except that the posts used in alignment of the upper 
 cuspids would be 13-gauge (Brown & Sharp), while the drills 
 which are to sink the shafts are a No. 12 (Brown & Sharp), and 
 for the lower cuspids 14-gauge wire (Brown & Sharp) would be 
 used to be followed with a 13-gauge drill. 
 
 When the canals in the cuspids have been paralleled, the
 
 .SPLINTING LOOSE TEETH WITH INLAYS 
 
 cavities are cut into the teeth, linguo-distally, occupying a 
 goodly portion of the lingual surface and extended mesially so 
 as to almost reach the labial surface. 
 
 The parallelometer carrying two wire posts 13-gauge 
 (Brown & Sharp) clamped in their respective grooves is now 
 lifted into the parallel canals. The instrument is removed from 
 the mouth, and the distance between the posts is noted, recorded, 
 and fixed by turning the lock nut. 
 
 Two friction angle trays, properly lubricated, are now 
 mounted upon posts and two platinum tubes are slipped over 
 and onto the posts, the wall of these tubes is .007 mm. thick. 
 The trays are moved up the wires until the incisal end of the 
 tubes will disappear into the sleeves of the trays. 
 
 Inlay wax is now melted upon the tray and around the tube, 
 the outer wall of which has been knurled by rolling it under a 
 fine file. The wax is built up into the shape of a small pyramid 
 upon both trays, and the instrument now carrying trays, wax 
 and tubes, is guided back into the root canal of the cuspid teeth, 
 and forced into position. The trays carrying the wax are now 
 brought up so that the wax will be forced into the cavity. A 
 stream of cold air is directed upon the cuspids, while the trays 
 are held in this position, until the wax has stiffened beyond the 
 possibility of change and form. 
 
 The instrument is now removed from the mouth, and with 
 a small, sharp lancet, the surplus of wax is cut or carved away. 
 The clamps which hold the wires in the respective grooves upon 
 the meter arc opened, and the wires, which carry tray, wax 
 and tubes are released. A pin vise, held in the right hand, 
 grasps tin- tube, while the left hand carefully moves the tray 
 downward upon the wire, and finally the tube and wax inlay 
 as one are removed from the wire. With a lancet and proper 
 carvers, the lingual portion of the wax inlay is now carved out 
 into a retentively formed cavity, to be subsequently occupied 
 by an inlay, which carrying a split pin, will engage the platinum 
 tube, and which inlay and split pin, in conjunction with the one 
 upon the opposite side, will be joined to the bridge to serve as 
 attachments for it. 
 
 A graphite post from which the oil has been thoroughly 
 burned out, and which is of the same caliber as the wire, which
 
 230 
 
 CAST (JOLI) AND PORCKLAI X INLAYS 
 
 fitted into the platinum tube, is now inserted into the tube, a 
 sprue wire is heated and inserted into that portion of the wax 
 inlay which is thickest, and farthest away from the platinum 
 tube. The sprue wire is inserted in such an angle that the mol- 
 ten gold, upon being forced into the mold, will not strike the 
 tube as an obstruction, in its travel, but will raher have a 
 chance to attacli itself to it in an enveloping maner. 
 
 Fig. 189. Distance established between left cuspid and right central. 
 Drills are the same distance apart. 
 
 Fig. 190.- Distance established between right cuspid and left central. 
 Drills are the same distance apart. 
 
 The cavities in all the anterior teeth, which are to be 
 splinted together, must be extended mesio-distally in such a 
 manner that the inlays that are to be made for these cavities 
 may be joined to one another with a sufficient quantity of solder 
 to provide the necessary strength, and yet, without that solder 
 coming up to any of the margins, so that there may be no dif-
 
 Sl'LIXTIXC LOOSE TKF.TII WITH INLAYS 
 
 231 
 
 ficulty about the proper care in keeping these margins, between, 
 inlay and cavity, perfectly clean. 
 
 These inlays for the lingual surfaces of the teeth which are 
 to he splinted are most easily made in the following manner: 
 
 A threaded post of the proper diameter is made to pierce 
 a cone of inlay wax; a piece of German silver plate about 30- 
 gauge, and somewhat larger in area than the lingual surface 
 of the tooth, is perforated and slipped onto the wire post, so 
 as to act as a tray for the wax. The wire, wax and tray are 
 now inserted into water 138 F. for about two minutes, and the 
 wire, grasped with the thumb and index finger, the top of the 
 lingers making a rest for the German silver tray, that portion 
 of the wire, which penetrates and extends beyond a cone of in- 
 lay wax, is now placed into the root canal of the tooth, allowed 
 to occupy all the depth provided for it, and the German silver 
 tray is brought up against the wax, thus forcing the same into 
 every portion of the cavity not occupied by the wire. With 
 the tray under pressure, a stream of cold water is directed upon 
 the tooth, until the wax cones become fixed in that position, 
 when the wire and the wax inlay and the tray may be removed. 
 
 With a sharp lancet all the surplus wax is carefully trimmed 
 away, the German silver tray is removed from the wire, and 
 the wax inlay and post are now replaced into the cavity, and 
 with the proper carvers, and flat right and left burnishers, the 
 wax is made to acquire its proper disto-linguo-mesial outline. 
 The post and inlay are now carefully removed from the tooth, 
 and the sprue wire is inserted as previously indicated in such 
 a manner that when the mold is ready to receive the molten 
 metal, the post shall not act as an obstruction to its (metal) 
 free ingress into the cavity. 
 
 In this manner, all the post-carrying inlays for the teeth 
 involved are completed and placed into their respective cavities. 
 If the teeth are very loose they must be supported in proper 
 position before any attempt is made to take an impression of 
 the inlays as assembled. This is best accomplished in the fol- 
 lowing manner: 
 
 With a silk ligature the teeth are drawn into proper rela- 
 tion to each other and firmly tied, the ligature must be placed 
 as near to the incisal edge as possible, without exposing it to the
 
 232 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 likelihood of its slipping, a stick of De Tray's modeling com- 
 pound may be softened and placed upon the labial surface of 
 the teeth, extending from the gingiva up to the incisal third, 
 and reaching around to one-half of the distal surfaces of the 
 cuspids, held in this position, the modeling compound is chilled 
 with a stream of cold water. A plaster impression may now be 
 taken with the inlays and modeling compound in position, and 
 when the plaster begins to set, a stream of cold air should bo 
 
 Fig. 191. Finished splint ready to be inserted. Note the perfect alignment of the 
 posts. (Sketch made by Dr. Leo Stern.) 
 
 directed upon the tray in order to prevent the heat, generated 
 by the crystallization of the plaster, from softening the com- 
 pound or a 1)1 ast of cold air may be played upon the tray. 
 
 When the plaster has hardened, the tray is removed, the 
 labial portion of the impression is lifted off, and usually the 
 improvised modeling composition splint will come with it. The 
 ligature is then removed from the tooth, and as a rule this will 
 cause a loosening of the lingual portion of the impression, which
 
 SIM.IXTIXU LOOSK TKETH WITH IXI.AVS 233 
 
 may now be removed. If the inlays liavc remained in the teeth, 
 each one is removed and placed into its corresponding seat in 
 the impression. 
 
 AVhen all of the inlays have hern assembled in the impres- 
 sion, they are waxed into position, care being taken not to let 
 the wax run onto any of the margins, their final security in posi- 
 tion being attained by waxing a piece of wooden toothpick onto 
 lioth impression and post for each inlay, so that, if we have six 
 inlays in position in the impression, we shall have six posts 
 rising in parallel relation to each other and onto each of these 
 posts shall be waxed a piece of wooden toothpick, the other end 
 of which, shall be waxed onto the impression. With a camel's 
 liair brush, the cavo-surfaces of all the inlays are covered with 
 graphite paste, the refractory compound is mixed to its proper 
 consistency (that of a fairly thick paste) and with this paste 
 the impression is filled, care being taken to apply a little of 
 the paste at a time, using a brush or a small spatula to build the 
 refractory compound into every portion of the impression, and 
 around all parts of the inlays and posts, until a model of suffi- 
 cient size has been secured. 
 
 The refractory compound is allowed to harden sufficiently 
 to prevent displacement of any of the parts during manipula- 
 tion, coincident with the separation or cutting away of the im- 
 pression. This cutting away process must be carefully done. 
 \Ve must bear in mind, that all our efforts are directed to leave 
 the inlays in the same relative position upon the refractory 
 model, which they occupy in the mouth. 
 
 AVhen the impression has been entirely removed from the 
 model, the inlays situated in the model are carefully and thor- 
 oughly cleansed, an examination is made to determine if they 
 are in contact at the points where they are to be joined to one 
 another, and if they are not, they are brought into contact by 
 carefully fitting small pieces of clasp metal, or iridio-platinum 
 into these places; the line of junction is carefully waxed up, 
 while additional refractory compound is placed upon all the 
 exposed parts of the inlays. After this has hardened, the piece 
 may be placed upon the fire for a few moments, when the wax- 
 may be removed, the piece may be replaced on the flame, allowed 
 to heat up for another few minutes, when it is fluxed, and small
 
 234 CAST GOLD AXD POKCELAIX INLAYS 
 
 pieces of solder placed at the points where union is desired. 
 When the piece has been thoroughly heated by the flame the 
 blowpipe is applied and the inlays are soldered together. 
 
 It is advisable to allow the piece to become fairly cool be- 
 fore any attempt is made to take it out of the model. When the 
 proper time comes, this may be done and the now joined inlays 
 are removed from their place upon the model, thoroughly 
 scrubbed with soap and water and thrown into hydrofluoric acid 
 to remain for a period of half an hour or so. They are removed 
 from the hydrofluoric acid, thoroughly washed, and thrown into 
 a bath of warm hydrochloric acid, again removed, thoroughly 
 washed, and boiled in a sodium bicarbonate solution. With lit- 
 tle stones held in the engine handpiece, all excess is now ground 
 away. Care must be taken not to encroach upon any margins 
 during our finishing and polishing operation. 
 
 If our patient is waiting for us to complete the entire opera- 
 tion outlined above, no particular provision for the care of the 
 teeth that are to be splinted need be made except the closing 
 of the various cavities by means of temporary stopping. But 
 if the patient is to be discharged and is to be absent for several 
 days, pending the completion of the splint, some provision must 
 be made to protect and support these loose teeth during that 
 time. 
 
 I have found a most efficient method of supporting these 
 teeth in the following manner: 
 
 The teeth containing the cavities are thoroughly sprayed 
 with warm water. Cotton rolls are applied and the teeth are 
 dried with warm air. 
 
 The saliva ejector is put into the patient's mouth. Small 
 pieces of temporary stopping are softened and formed into 
 cones. The cavities in the teeth are lubricated with eucalyptol 
 compound and a piece of the soft cone-shaped stopping is put 
 into each tooth. 
 
 Staples of round German silver wire of suitable thickness, 
 18- and 20-gauge, respectively, are now held in the flame and 
 when sufficiently heated are allowed to embed themselves into 
 first the left cuspid and lateral, then the left lateral and left 
 central, then the left central and the right central, then the 
 right central and right lateral and finally the right lateral and
 
 SPLINTING LOOSE TEETH WITH INLAYS '2',}') 
 
 right cuspid. It will be noticed that all but the two cuspid 
 teeth carry a double staple. With a heated ball burnisher of 
 suitable size the staples are urged deeply into the temporary 
 stopping and as a final covering one piece of stopping of suffi- 
 cient length is softened, curved, and packed into the cavities 
 against the staples contained in them. With proper plastic in- 
 struments the improvised splint is finished and finally made 
 smooth with a bit of cotton dipped into eucalyptol compound, 
 and the patient is dismissed.
 
 CHAPTER XVIII 
 
 EXTENSIVE RESTORATIONS OF OCCLUSAL 
 BALANCE BY MEANS OF GOLD INLAYS 
 
 Patients have come into my care, the occlusal and proximal 
 surfaces of whose teeth have been badly mutilated, sometimes 
 because of very extensive and very poorly executed amalgam 
 fillings, and often because of marked attrition. 
 
 Where the destruction is obviously a result of poor dental 
 work, the procedure, though tedious enough, is comparatively 
 simple. 
 
 Study models are obtained and record models may be made 
 from these as described, or separate impressions may be taken 
 for the purpose of making record models. 
 
 These impressions should be taken in plaster of Paris, and 
 should be removed from the mouth with great care, because of 
 the necessity of having an exact reproduction of conditions as 
 they exist in the mouth. 
 
 The teeth requiring restoration are marked off on a chart, 
 and these marks are duplicated upon the study models. 
 
 The patient is carefully examined as to age, as to any 
 peculiarity or abnormality which may exist in the mouth, the 
 condition of the gingivfe is carefully noted. The necks of the 
 teeth are examined with minute care, and the occlusion is noted 
 as normal or malocclusion. 
 
 The information is elicited from the patient as to which 
 side is usually used for mastication; what food is usually pre- 
 ferred, and how much time is given to meals. 
 
 The mouth is carefully examined in the periapical region, 
 and all information obtained is recorded for reference. 
 
 The patient may be dismissed and the study of the models 
 begun. 
 
 Each model is carefully examined by itself, and each tooth 
 upon the model, previously marked as requiring attention, is 
 
 236
 
 EXTENSIVE JtKSTOItATIOXS OF OCCU'SAL I5ALANCK 237 
 
 again examined. The cavities may be outlined as suggested 
 heretofore, or the parts requiring attention may be painted in 
 black. 
 
 When the examination of both models is completed, they 
 are brought into occlusal relation with each other, and the ex- 
 tent of the parts lacking upon their occlusal surfaces must be 
 carefully noted. 
 
 The least mutilated of the posterior teeth is now looked 
 for, and when found it is marked with the letter P, indicating 
 that of all the posterior teeth upon these models, it is the most 
 nearly perfect. 
 
 The man who has diligently memorized the directions of 
 stress upon or against the different teeth will not need to make 
 
 Fig. 192. A case of extensive restoration. Occluded study models of the case. 
 Note the enormous amount of attrition, the lack of space between lower teeth and 
 upper ridge, the involvement of all the gingivse. 
 
 the step now described, although I consider it an advantage to 
 do so in every case. 
 
 Each model is placed upon a heavy sheet of drawing paper, 
 and its outline is traced upon the sheet in pen and ink or in- 
 delible pencil. 
 
 The location of each tooth is now designated upon the sheet 
 by drawing a mesial line downward between the centrals, until 
 the pen or pencil strikes the paper and records the mesial line 
 of the outline of the model. 
 
 Next, a line is drawn between the central and lateral, on 
 either side of the model down and onto the paper, then lateral
 
 238 CAST GOLD AND PORCELAIN INLAYS 
 
 and cuspid, etc., until the location or rather, mesio-distal ex- 
 tent of each tooth, lias been recorded. 
 
 With a pair of compasses, the thickest portion of the model 
 is measured, a record is made, and then the width from the 
 buccal surface of the last tooth on one side, to the buccal. sur- 
 face of the last tooth on the opposite side is noted. 
 
 The width from tooth to tooth is now substraeted from the 
 previously obtained figure, and half of the remainder is marked 
 off the outline of the model on each side. 
 
 Example: Outline at widest point, 50 mm. 
 
 Width from buccal surface of last E.M. to last L.M., 40 mm. 
 
 Difference between width from tooth to tooth and width of model, 10 mm. 
 which would mean the marking off .of 5 mm. on the inside of each margin of the 
 outline of the model. 
 
 The measurement from the distal surface of the right cus- 
 pid, to the distal surface of the left cuspid, taken from the 
 model, is compared to the model at that point; the subtraction 
 is made, the result divided in half, and the sum of each half is 
 marked off upon the outline on the paper. 
 
 A perpendicular is now dropped from the point recording 
 the median line of the model to a line connecting the two points, 
 marking the width from right molar to left molar. (See Figs. 
 136 and 137.) 
 
 A line on each side is drawn from cuspid to molar, and a 
 line from cuspid to median point; this will result in a diagram 
 equal in extent to the outside measurement of the teeth. 
 
 The width of molars and bicuspids, bucco-lingually, and 
 cuspids, labio-lingually, is now taken with a compass, and 
 marked off on the paper. From the points upon the paper, 
 which have marked the mesio-distal extent of each tooth, lines 
 are drawn through the diagram showing the location of the 
 teeth. This will result in a series of quadrangular figures, rep- 
 resenting the teeth in the model. This procedure holds for 
 both upper and lower models. 
 
 With the aid of the chart giving the direction of stress, 
 these directions are located upon the sheet, and little arrows 
 are placed to indicate the directions. 
 
 Where the stress is marked, the arrows are doubled; that 
 is, there are two heads to the arrow; the direction in which the
 
 EXTENSIVE RESTORATIONS OF OCrU'SAL 15ALAXCE 
 
 stress is weaker is indicated by a single headed arrow, and the 
 weakest point of stress is indicated by an arrow showing only 
 one line at the head. .Marked infra stress is best indicated by 
 a black mark in the center of the figure denoting the par- 
 ticular tooth. And the quadrangular figure, corresponding to 
 the most nearly perfect posterior tooth, is marked with a P 
 to indicate its location. 
 
 \Ye shall, upon* completion of these -diagrams, and with a 
 history of the case before us, be in a position to intelligently 
 take up the work of restoration. 
 
 If the nearly perfect tooth is an upper one, then restora- 
 tion should begin with the lower tooth, occluding with the nearly 
 perfect upper one, and if the nearly perfect tooth be a lower one, 
 then the process is reversed and the upper teeth occluding with 
 it are restored first. 
 
 Each one of the teeth in the human mouth, except the 
 two upper third molars, and the two lower central incisors, 
 enter into occlusal relations with two opposing teeth, and 
 broadly speaking, three teeth, two uppers and one lower, may 
 be considered as an illustration of a lever, one upper tooth 
 representing the power arm, one the weight, and the lower tooth 
 the fulcrum. As a matter of illustration, the reverse of this 
 proposition holds good; that is, two lower teeth form, respec- 
 tively, the power and weight arm, and the upper tooth the ful- 
 crum. AY hen all parts entering this relation in trinity, are 
 functioning physiologically, we may consider occlusal balance 
 as present. 
 
 When the teeth which enter into occlusal relation with the 
 nearly perfect one have been restored, we shall have an occlusal 
 guide to assist us in bringing about occlusal balance in the en- 
 tire mouth. It will be best to cut the cavities in the teeth upon 
 the models with small chisels, such as are used by sculptors or 
 engravers. AVe shall try as nearly as possible to duplicate the 
 ideal line and margins and planes upon the natural teeth, as we 
 have cut them into the plaster. 
 
 This is not nearly so hard as it would seem; in fact, it 
 will prove much easier than most students would be ready to 
 believe. The reason too, is quite simple and here explained: 
 If we had omitted taking impressions for study models, and
 
 240 CAST GOLD AXD PORCELAIN IXLAYS 
 
 making our diagram of stress, and omitted the outlining of the 
 cavities upon the models, and of cutting these cavities into the 
 models; if we had omitted noting the most nearly perfect tooth, 
 and had attacked the case in hand without study, haphazardly, 
 it is not only likely but quite apparent, that the very extent 
 of the task would have bewildered most of us and our anxiety 
 to bring some order out of chaos would have made us overlook 
 the fine and most essential points in cavity preparation. All of 
 this work of study of the models, and stress, the making of the 
 diagram, the taking of the history, etc., has consumed hour?, 
 and made us familiar with the case. If we omit this, the case 
 is strange to us, and we are strange to the case. The difficulty 
 is added that we are dealing with live tissues, and we are unde- 
 cided just how extensively to cut; in other words, we do not 
 know exactly what to do. But if we have made the careful 
 study, as outlined here, and if we have cut the cavities into these 
 teeth as our knowledge of stress conditions and immunity areas, 
 etc., tell us we must; and if we have planned our restorations 
 upon the models in accordance with the requirements of occlu- 
 sion, and phonetics, and harmony and proportion, and beauty, 
 then we know exactly what we wish to do, and the patient pre- 
 senting, we proceed to do just that thing. 
 
 It is true, we may be hampered and interfered with by con- 
 ditions in the mouth which do not exist on the models, but we 
 bear in mind our result on the model, and we try to duplicate it 
 in the teeth, removing the obstacle as it presents itself. In this 
 way, the result of our work is more nearly likely to approach 
 our ideal of our task. 
 
 It is quite a different matter to cut into live tooth struc- 
 ture than it is to cut into models, and often the ideal is very 
 difficult to carry out, but that is only another reason that the 
 operator should approach the patient only after a complete 
 and exhaustive study of the case, and with a thorough knowl- 
 edge as to what he wishes to do to each particular and individ- 
 ual tooth, remembering always that the ultimate to be desired 
 is harmony and balance in the relation of the tissues present in 
 the oral cavity. 
 
 If no pain or putrescent condition be present to urge the 
 operator's attention and service to any particular tooth, it is
 
 EXTENSIVE KKSTOKATIOXS OK OCCLTSAI, 15ALANCK -4 1 
 
 best to go to the one anteriorly next to the nearly perfect one, 
 and restore that to anatomic and physiologic balance; then the 
 one posteriorly next to the nearly perfect one is taken care of, 
 and third, the nearly perfect one comes in for attention. In 
 this way we have made use of the nearly perfect tooth as a 
 guide throughout the work. It has determined for us the mesial 
 extent of the tooth posteriorly to it, and the distal extent of the 
 tooth anteriorly to it. It lias determined for us the occlnsal 
 surfaces of the two teeth with which it occludes, and now all of 
 the teeth that have been restored serve as a guide for correct 
 n storation, as regards mesio-distal diameter and occlusal sur- 
 face of the nearly perfect organ. 
 
 All this is nothing else but a recognition of the interdepend- 
 ence of all media which enter into inseparable relations with 
 one another to create a perfect organ of incision, prehension, 
 trituration and articulation. 
 
 Doing the work in the manner described, we shall have the 
 advantage of incapacitating the patient on one side of the mouth 
 only, and thus the primary processes of nutrition will not be 
 interfered with, and we shall have our patient more tranquilly 
 submissive to our ministrations, which is a factor conducive to 
 much better results than a patient nervously tensioned to a 
 high pitch and querulous opposition. 
 
 When one side from molars to incisors, upper and lower, 
 has been restored, the other side is taken hold of and treated 
 in much the same manner until it is completed. When the 
 case is finished, two plaster impressions are obtained and models 
 made. The record models are marked with the patient's name, 
 the date, and /.'..I/. , standing for record model. The study 
 models are marked S.M., and the last models are marked F.M., 
 for finished models, and the date of completion of the same All 
 models are, of course, to bear the name of the patient. 
 
 AVhen the loss of balance in mastication is due to other 
 causes than poor dental work, the procedure of restoration is 
 markedly different, and there is considerably more involved. 
 
 We shall not consider the cases coming under heading of 
 traumatic origin, because in one way or another they may be 
 handled by the means already described, or as yet to be de- 
 scribed. It would be a waste of time to devote a special chap-
 
 242 CAST GOLD AXD PORCELA1X 1XLAYS 
 
 ter to restoration by means of inlays of tooth tranmatically 
 injured. 
 
 Since each injury would probably differ from every other, 
 the case would, of course, present a different history, and tho 
 extent of the injury varying, the treatment would necessarily 
 change. "With all that, these cases are subject to the same 
 rules, and should be studied quite as carefully, if not more so, 
 than the ones broken down by poor workmanship. 
 
 So we shall take in the extensive cases of traumatic origin, 
 under the heading of those to be considered as being due to 
 attrition, in reference to teeth. 
 
 Attrition is the act of wearing down the teeth by mastica- 
 tion, because : 
 
 First: The patient may have an end-to-end malocdusion. 
 
 Second : The greatest number of posterior teeth may have 
 been lost in early life, and the entire stress of mastication is 
 thrown onto the remaining anteriors; which stress they can not 
 resist, and hence are worn down by attrition, or 
 
 Third: The osseous system of the patient is out of har- 
 mony in development and calcification (hence resistance), with 
 the muscular structure of the same patient. In other words, 
 there is a predisposition in this particular case, a sort of phys- 
 ical constitutional inferiority, osseously speaking, or a sort of 
 physical constitutional superiority, muscularly considered, as 
 you please. 
 
 Where the cases are most extensive, and involve the entire 
 masticatory apparatus, and they usually do, the treatment is 
 much the same. 
 
 These cases are usually between thirty-five and fifty-five 
 years of age. By this I mean that they are usually thirty-five 
 to fifty-five years old when they seek relief. 
 
 These cases are so extensive, and the treatment so involved, 
 and so much depends upon a favorable prognosis, that no 
 amount of care given to these restorations can be said to be too 
 much. The treatment is, with the greatest care, quite a strain 
 upon the patient's nervous system, and for this reason, if for 
 no other, the patient should be directed to consult a careful 
 internist, a diagnostician of the first rank, and a report should 
 be obtained from him as to the general condition of the patient.
 
 EXTKXSIYK KKSTOIIATIOXS OK OCCI.l'SAI. ]',ALA.\( K -4'.} 
 
 To a large extent the progress of the dental work will de- 
 pend upon the report handed in by the physician. If the gen- 
 eral condition oi' the patient is such that he can withstand the 
 stress of protracted dental operations, a vigorous program may 
 be pursued and the work finished in a much shorter time than 
 if the report about his general condition were to necessitate 
 careful guarding against the least shock to the nervous system. 
 
 It is wise to always bear in mind that these patients have, 
 by virtue of the very condition which brings them to us. received 
 an impulse which started them down hill on the road of health, 
 and that their progn ss in that direction must be checked gently, 
 but efficiently. 
 
 Usually these cases are complicated by peridental irritation, 
 or even active suppuration in the peridental region. 
 
 The gingiva 1 are swollen, congested, bleed readily, and mas- 
 tication is painful; a hypertrophy of the alveolar structure of 
 the mandible and superior maxilla. 1 may be present. 
 
 The muscular structure of the temporo-maxillary articula- 
 tion will be found overdeveloped, if at all out of the ordinary. 
 The mandible is found freely movable in a laterorotary direc- 
 tion. There is usually present a variation in the length of the 
 posterior teeth, the upper ones being shorter than the lower 
 ones, due, no doubt, to the fixed position of the superior maxilla? 
 and the more or less complete passivity of the teeth. 
 
 Very little, if any, t namel is present upon the occlusal 
 surfaces of the posterior teeth, and the incisal portions of the 
 anteriors are altogether devoid of it. The exposed dentine of 
 the anteriors presents a highly polished appearance, while the 
 occlusal surface s of the posteriors present either an unevenly 
 smooth sin-face, or a number of grooves and pits corresponding 
 in location to the normally existing fissures and sulci in, these 
 teeth. Most of these cases will exhibit a reddish stain on the 
 occlusal surfaces. Knife-edged occlusal margins are the rule. 
 
 Regardless of the fact that the naso-mental line has been 
 gradually shortened during the years in which this process of 
 attrition has been going on, we shall find the masseter, and tem- 
 poral, as well as buccinator muscles, tense and thickened, prob- 
 ably congested. 
 
 We shall probably find these patients to be introspective
 
 244 ('AST GOLD AND POIU'ELAIX INLAYS 
 
 to the point of melancholia, uncommunicative, and often eva- 
 sive in answering questions, difficult to enthuse, and they are 
 apt to confuse technical information given to them as the work 
 progresses. 
 
 They are often irritable, always fidgety, and their fingers 
 are usually busy doing something, if only playing against each 
 other. They are most often careless in their manner of dress, 
 and usually simple in their food requirements. 
 
 From several of these cases which came under my observa- 
 tion and care, questioning elicited the information that they as 
 a rule, shunned the opposite sex. The foregoing, plus the diag- 
 nostician's report, will give a rather comprehensive picture and 
 history of these patients. 
 
 If all the facial lines and features of such a patient are 
 normal, and in geometric harmony, the deduction that the masti- 
 catory apparatus was in proper proportion before it suffered 
 from the attrition is permissible, and the other features will fur- 
 nish the means of determining the extent to which this process 
 has advanced. 
 
 Any photograph the patient may have had taken years 
 prior to his visit for relief, would also be of service in this 
 respect. 
 
 If the teeth are still in proper mesio-distal relation to one 
 another, only the occlusal third has been partially or totally 
 obliterated. 
 
 If all mesio-distal relations of the teeth have been de- 
 stroyed, and if the features of the patient, such as fronto- 
 orbital, and orbito-nasal lines be unequal to any great extent, 
 then the deduction that the masticatory apparatus w r as out of 
 harmony with the rest of the features, even before attrition be- 
 gan to wear the teeth down is permissible. The bulk to be 
 added to the teeth becomes a matter of measurement of the 
 various features and experimentation. Whichever is the case, 
 urgent need of the present is to first restore the gingival and 
 peridental area to a physiologic condition, take care of any root 
 canal work which may be necessarj^, and then open the bite by 
 means of a splint, to an extent at least double that which seems 
 to be necessr.ry. 
 
 The patient must wear this splint incessantly for at least
 
 KXTKXSIVK KKSTOKAT10XS <>!' OCC'LTSAI. IJALANTK -4~) 
 
 three (lays. Tins must be insisted upon, and in order to help 
 the patient over his trying time, lie must he kept very busy 
 during the day, must have sleep at night, even if the sleep is 
 to be induced by hypnotics. If the latter are employed, they 
 are followed by the use of laxative-. 
 
 After three days the patient is allowed to remove the splint 
 during meal time. 
 
 The strictest hygienic precautions are employed in keeping 
 the mouth clean, and no deviation from the prescribed regime 
 is permitted. 
 
 It must be remembered that this is a re-creative work that 
 is going on, and that the operator is, if he has the necessary 
 intelligence, in truth a creator of a real primary factor in the 
 human economy. The patient must be made to realize this for 
 his or her own ultimate good. 
 
 Never before, in the history of human error, has it been 
 possible to so utterly wipe out every evidence of this dental 
 shortcoming as it is today. It is very likely that even the minds 
 that conceived this entire process of cast gold inlays, never fully 
 realized the extent of the blessings the process might bring and 
 but for this process our work in these cases would be today as 
 it has been in the past nothing but a poor palliative effort, full 
 of nothing so much as futility. 
 
 CONSTRUCTION OF THE SPLINT 
 
 Plaster impressions are obtained from the upper and lower 
 jaw, and models are made. Three layers of number .001 tin foil 
 are burnished over the upper model, taking in the crowns of the 
 posterior teeth and extending up to the gingival surface of them 
 and beyond, and as far back toward the palate as a plate made 
 for the case would be allowed to go. 
 
 All of the palatal surface of the foil, as well as the part 
 covering half of the palatal surfaces of the teeth, is covered 
 with a sheet of baseplate wax of medium thickness. 
 
 The balance of the palatine surfaces of the teeth and the 
 occlusal surface upon the four posterior teeth is covered with 
 three or four layers of the same baseplate wax and the buccal 
 surface of the foil upon the posterior teeth is coated with one
 
 246 CAST GOLD AND PORCELAIN INLAYS 
 
 layer of the wax, which layer is to reach over and onto, and 
 be melted into, the three or four layers of the occlusal waxes. 
 This wax must he marginally melted onto the foil, so that 
 when the former is removed from the model, the foil will come 
 with it. 
 
 The wax is trimmed to proper outline, and a surplus of foil 
 is allowed to remain, which may he folded hack on the wax. 
 Tliis contrivance is chilled in ice w T ater, and placed in the pa- 
 tient's mouth for determination as to occlusal thickness. It is 
 removed and replaced upon the model, a layer of soft wax is 
 placed upon the occlusal surface and melted onto it, so that we 
 shall have a layer of wax upon that surface about one-half 
 inch thick. The plate is again inserted into the mouth, and the 
 patient is admonished to swallow and close the teeth. The re- 
 sulting impression of the lower teeth on the wax will furnish 
 the necessary guide to place the lower model into proper 
 position. 
 
 This is done, and two pieces of wood, reaching across from 
 model to model, are waxed onto each model, and they are placed 
 in the anatomic articulator. When the plaster has set, the ad- 
 justment screw is fixed, the surplus of the plaster is trimmed 
 off, the two pieces of wood are removed, the articulator opened, 
 and the wax and tin foil are carefully removed and laid aside. 
 
 A careful preliminary study of the models should now take 
 place; undercuts which may interfere with the placing of the 
 splint should be filled up, or otherwise obliterated. 
 
 The lower model is covered with a layer of tin foil, the 
 articulator is closed, and the space between the models is grad- 
 ually reduced until they meet. In this position they should be 
 viewed from every angle; the size of the teeth is carefully noted 
 as regards circumference, and the models are separated to al- 
 low for a height of tooth in proportion to this circumference. 
 It must be borne in mind that these approximate measurements 
 must be double, since we have both models upon the frame. 
 Having opened the articulator to about the extent required, we 
 simply open it again as much, so that if Mo of an inch be miss- 
 ing off the lower teeth, and Mr, to %z off the upper teeth, we 
 would have opened the articulator Mo + Mo and '%% + Me + 
 Mo + Vs2, or 'Kc of an inch. In this condition, the articulator
 
 KXTKXSIYK KKSTOKATIOXS ()! (KVH'SAL IJALAXCE -4 1 
 
 .is fixed so that the space may not accidentally be reduced or 
 raised. 
 
 There is a irood sound reason for opening the articulator 
 to double the extent which the attritional wear calls for ami 
 that is that it will lead to a muscular adjustment in the temporo- 
 
 Fig. 193. Fig. 194. 
 
 FIL;. 193. A view of a splint made for a case of extensive restoration. 
 
 Fiy. 194. Another view of the same splint which, when it was first made and 
 worn, covered all the anterior portion of the jaw, as well as the part now occu- 
 pied by it. 
 
 Fig. 195. 
 
 Fig. 193. The splint in position on the model. Note the amount of space 
 created between upper and lower teeth; twice as much as is really needed, for reasons 
 
 explained elsewhere. 
 
 mandibular articulation, far beyond that necessary for simple 
 toleration of the work when completed, and so the completed 
 work IHMH.U; much lower, gingivo-occlusally, than the splint, the 
 sensation the patient will experience upon removal of splint
 
 248 CAST COLD AND PORCELAIN INLAYS 
 
 and insertion of tlie work, will he one of great relief; and tlie 
 muscles having been adjusted, and liaving become more or less 
 accustomed to the additional amount of stretch will find an 
 enjoyable relaxation in being permitted to flex into a much less 
 tense position. The tendency of too great and hence destructive 
 muscular stress upon the newly placed work, will in this manner 
 be wholly avoided. 
 
 The wax plate backed or lined with tin foil is replaced upon 
 the upper model, the wax is softened somewhat, and a close 
 adaption of it to the model is brought about. Enough soft wax 
 is added to the occlusal surface to take up the space created by 
 the opening of the articulating frames, and a surplus is added 
 so that the teeth of the lower model may, upon the closing of tlie 
 articulator, bury themselves in the soft wax upon the occlusal 
 surface of the splint. 
 
 The foil present upon the lower model will prevent the 
 sticking of it to the wax, and we shall have a more or less accu- 
 rate impression of the lower teeth, as a guide to aid in carving 
 up the occlusal surface of the splint. 
 
 The external, or buccal, surfaces of the wax splint must 
 be allowed to reach over and enclose the buccal surfaces of the 
 lower posterior teeth, so that when the splint is duplicated in 
 vulcanite, it will, when worn by the patient, prevent effectively, 
 first, the biting of the soft tissues, and second, the latero-rotary 
 motion of the mandible. 
 
 This will aid in the fixation of the muscles and compel the 
 patient to exercise a more pronounced intra pressure upon the 
 teeth, which will have a stimulating or rather toning effect upon 
 the peridental and gingival tissues. 
 
 In carving up the occlusal surfaces of the splint in the wax, 
 the anterior teeth, upper and lower are left free from any in- 
 cumbrance, and the entire stress is thrown upon the posterior 
 teeth, upper and lower. 
 
 The splint is removed from the model, Masked and vulcan- 
 ized and finished off, when it is ready to insert into the patient's 
 mouth. After having been worn for three or four days, the ex- 
 ternal or buccal overhanging plates may be considerably short- 
 ened, or even removed, and it will be found that the tendency 
 for too free a lateral motion will have diminished to a great
 
 EXTKNSIVK I;KSTOI;ATIOXS OK QCCLUSAL I--ALAXCK 1'4!) 
 
 degree; it will still be present, hut will not manifest itself until 
 after considerable pressure lias l)eeti spent upon the teeth ill an 
 intra direction. 
 
 The patient must wear this splint; but it may, if so desired, 
 be removed at meal time and at night, although it may be worn 
 by the patient during the night without fear of mishap, if it lias 
 been carefullv constructed. 
 
 The models from which, or upon which, the splint was made, 
 are kept as record models. After the splint lias been worn four 
 days to one week, plaster impressions are obtained and study 
 models are made. 
 
 The models are diagrammed, and the charts of stress direc- 
 tion are made. The models are brought into occlusal relation 
 as it exists in the mouth; this may be done by means of a wax 
 bite, or if any pronounced landmarks be present, these may be 
 used as a guide. 
 
 The models are then mounted upon the adjustable articu- 
 lating frame, the cavities may now be outlined and even formed 
 in the plaster casts, keeping in mind that we are working to 
 restore the teeth to usefulness and anatomic perfection, and to 
 restore to original dimensions the naso-im ntal line. 
 
 If, as said before, the rest of the features are in harmony 
 with one another, the conclusion that the naso-mental distance 
 was originally normal relative to these features, is permissible, 
 and if the remaining features are out of harmony and propor- 
 tion, then a naso-mental line which will be least obtrusive is 
 produced. The average measurements for the normal face, as 
 determined by sculptors and artists for the past ages, give the 
 naso-mental line as ^ :! 4 inches long and the length of the normal 
 nose as 1% of an inch. The normal upper lip when the mouth 
 is closed is % of an inch. The length of the nose is obtained 
 by drawing a horizontal line through the center of the pupils 
 of the eyes and dropping a perpendicular from that line to the 
 tip of the nose. 
 
 The normal face from the center of the pupils should give 
 the diagrammatic reading as illustrated. 
 
 The naso-mental line of the patient is taken and noted down 
 on the articulator and record and study models, as well as the 
 history chart. It will naturally be found that the length of the
 
 250 CAST GOLD AND POKCELAIN INLAYS 
 
 line varies inversely with the extent to which the process of 
 attrition has progressed, that is, the greater the attrition, the 
 shorter the line. 
 
 For the purpose of lucid illustration, we will assume that 
 the naso-mental line of the patient is 2!/> inches long, which in 
 a normal featured individual is % inch longer. 
 
 The articulating frame supporting the models may now he 
 opened until the models are /4 inch apart occlusally, and the 
 frame may be fixed in this position. 
 
 This would be a fairly accurate manner of determining the 
 ultimate amount of space necessary to be gained in order to 
 restore the lost featural balance, but for the restoration of oc- 
 clusal balance much greater care is required. 
 
 Four pieces of German silver plate, 30-gauge, are swaged 
 up to cover the posterior teeth of both the upper and low T er 
 models down to one-half of their length. They are filed and 
 polished so as to present smooth surfaces and margins to the 
 tongue and cheeks. 
 
 The occlusal surfaces are roughened, slightly heated, and 
 covered with a layer of wax /4 inch thick, each piece of metal 
 carrying the more or less soft wax and placed into its respec- 
 tive position within the mouth. A hot instrument is drawn 
 across each wax surface, the patient is directed to place the 
 tongue upon the roof of the mouth, to swallow and close the 
 mouth. A piece of hard rubber or hard wood or metal % inch 
 in thickness is held between the anterior teeth, to prevent too 
 great a pressure from being exercised upon the wax; the lat- 
 ter is chilled, and the upper and lower metal plates will be 
 found to adhere through the medium of the wax. This will 
 really produce two partial splints which must now be so em- 
 bedded in a refractory compound, that the metallic plates will 
 be immovably held, while one surface of the wax shall be ex- 
 posed so that all of it may be removed by boiling the piece in 
 water. 
 
 The space thus produced between the two plates of metal 
 may be filled with several pieces of German silver wire, the 
 whole of it fluxed and soldered with tin until they present a 
 fairly full appearance and smooth surface. 
 
 These metallic plates are now joined, each lower to its cor-
 
 EXTENSIVE RESTORATION S ol (KVl.rsAL IJALANCK -~}\ 
 
 responding upper section, are removed from tlie investment 
 compound, finished, and polished and placed into the mouth; 
 the patient is directed to close the mouth, and it will he found 
 that the naso-mental line is now 2% inches long instead of 2% 
 inches. 
 
 Of late I have joined these plates by vulcanizing rubber 
 between and onto them, in which case the occlusal surfaces of 
 these plates must be considerably roughened, so that the rub- 
 ber will adhere. 
 
 The parts of one partial splint which covers the first upper 
 and lower molars and the second bicuspids are cut out with 
 a burr and saw; this will leave one partial splint fitting over 
 the last molars and first bicuspid. 
 
 AYe are now in a position to begin the reconstruction of the 
 first molars and the second bicuspids. 
 
 If the teeth are still in normal mesio-distal relation, then 
 the amount of building up to be done is easily determined, if 
 we consider the following: From the gingival line up toward 
 the occlusal surface, a tooth may be divided into three parts 
 horizontally, which will give a gingival third, a middle third, 
 and an occlusal third. 
 
 The mesio-distal relation of posterior teeth takes place at 
 the greatest circumference of these teeth, and the greatest cir- 
 cumference of these teeth is invariably to be found at the gin- 
 gival plane of the occlusal third. 
 
 The teeth of the case in hand, being in mesio-distal relation, 
 we conclude that only the occlusal third or less has been de- 
 stroyed by attrition. AYe measure the remaining portion of the 
 teeth, gingivo-occlusally, divide the result in half, and we know 
 how high the tooth should be when restored; this is, of course, 
 to be done before any cavity preparation is attempted. 
 
 If the mesio-distal relation of the teeth has been lost be- 
 cause of this process of attrition or otherwise, the following 
 rules will have to be borne in mind when we are engaged in the 
 correct restoration of these teeth. 
 
 If every surface of a molar, except the occlusal surface, 
 be ground at right angles to the gingival plane of the gingival 
 third, in other words, if taking the circumference of the gin- 
 ival plane of the gingival third as a guide, we ground the
 
 252 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 196. 
 
 Fig. 197. 
 
 Fig. 19S. 
 
 Fig. 199.
 
 EXTENSIVE IlKSTOKATIOXS OK (HVM'SAL UALAXCK 2.").'} 
 
 Fig. 196. An occlnsal view of the models of the same case, 
 the terrible havoc wrought by neg'ert, misunderstanding, and 
 poor work may be more plainly seen. Note carefully the evidence 
 of marked congestion in th:> gingival region of the mandible. All 
 of the upper and lower anteriors, cuspids included, were putrcs- 
 
 CCIlt. 
 
 Fig. 197. The model of the upper teeth of case after six 
 months' treatment. The roots have been placed in a healthy 
 condition and are carrying cast base crowns. A removable bridge 
 supplies the missing teeth on the right side of the mouth, cuspid 
 and molar serving as abutments. 
 
 Fig. 198. The lower model showing c'early the rebuilding 
 of the anterior, and some of the posterior, teeth by means of the 
 cast gold inlay and cast base crowns. 
 
 Fig. 199. The upper and lower models in occ'usion. Note 
 the increase in space on left side, of the mouth, for which the 
 bridge has not yet b;cn made. Note the difference in appearance 
 of the gingival areas. **
 
 254 CAST GOLD AND PORCELAIN INLAYS 
 
 walls of the tooth, so that a wire measurement taken around the 
 gingival circumference will pass easily up and down upon the 
 teeth, we would find that the highest point of the occlusal emi- 
 nences were in line with some point on the gingival circumfer- 
 ence. 
 
 Fig. 200. An occlusal view of a finished case of extensive restoration by 
 means of cast gold inlays and two upper bridges. All lower teeth clistally to the 
 cuspids have been restored with inlays. The anterior teeth have been built up with 
 cast base porcelain crowns. 
 
 Fig. 201. A side view of the same case upper and lower models in occlusion. 
 Note here the added length of the teeth as compared with the models before work 
 was started. The length of the naso-mental line was increased %o inch. 
 
 Now if we bear in mind the fact that the greatest circum- 
 ference of the tooth is at the gingival plane of the occlusal 
 third, and then form a right-angled triangle, the base of which 
 is formed by a line dropped from the highest occlusal eminence 
 to a point of intersection with the line rising from the gingival
 
 EXTENSIVE RESTORATION'S OK OCCLl'SAI. I1AI.AXCK 
 
 circui&Cerence, to the gingival plane of tlio occlusal third, the 
 latter is the line of altitude of the right-angled triangle, while 
 its hypothenuse is I'onned by the direct line dropped from the 
 occlusal eminence to the gingival circumference as illustrated 
 (1-8, Fig. 203) on the chart. 
 
 This holds good for the contouring of the four surfaces of 
 the tooth, in the case of these restorations, the surfaces being 
 practically intact with the exception of portions of proximal 
 areas. The following geometric drawing will aid in determin- 
 
 Litu flvroujfo. 
 
 V 5 / 3 incHe5 lon>r Up 
 
 Fig. 202. 
 
 ing definitely the extent of the mesio-distal restoration re- 
 quired to obtain a normal contact area between the teeth mcsio- 
 < list ally. 
 
 The figures enclosed by the letters BCEF and KHOP 
 (Fig. 203) show two central cubes of two adjoining teeth, as 
 they would rise minus any contour from the gingival plane of 
 the gingival third of the tooth. In adding the proper contour 
 mesio-distally, the mesio-proximal triangle ELF of the pos- 
 terior tooth, dips or extends into the disto-proximal triangle
 
 256 
 
 CAST GOLD AXI) PORCELAIN INLAYS 
 
 bfl
 
 KXTKNSIVK KKSTOKATIONS OK OCCl.l'SA I . MA I .A \( 'K 
 
 Fig. I'n:;. 
 
 It must IK- borne in mind that this chart represents a tooth 
 geometrically. It is, therefore, conventionalized. A variation 
 presents itself in the location of the right angles, as follows: 
 
 In upper molars the right angle presents at the gingival plane 
 of the occlusal third buceally, and the gingival plane of the middle 
 third palatally. 
 
 In lower molars the right angle presents at the gingival )>lane 
 of the middle third buccally. and at the gingival plane of the 
 occlusal third lingually. 
 
 Furthermore, if we lay out the respective right angles of the 
 upper and lower molars and continue the bases and altitudes until 
 they intersect, we will produce squares with sufficient variations 
 in their lines of direction to account for. and to coincide with, the 
 rhomboidal and trape/oidal figures of the gingival planes of the 
 gingival thirds of the respective teeth. 
 
 Fig. 1. Molar crown divided horizontally into thirds. 
 J.I. Occlusal third. 
 BB. Middle third. 
 CC. Gingival third. 
 
 Fig. i'.- Same, with thirds separated. 
 
 AA. Gingival plane of occlusal third. 
 BB. Occlusal plan^ of middle third. 
 CC. Gingival plane of middle third. 
 DD. Occlusal plane of gingival third. 
 EE. Gingival plane of gingival third. 
 
 Fig. 3. Geometric construction of contours of molars. A 
 line drawn from highest eminence of cusp, to a point on the 
 circumference of the tooth at its neck (XT), becomes the hypothe- 
 nuse of a right-angled triangle (XYZ), the right angle of which 
 will lie opposite the gingival plane of the occlusal third. XYZ, 
 the right-angled triangle. XY, the hypothenuse. XZ, base of 
 triangle. A')", altitude of triangle. 
 
 Fig. 4. Geometric solid figure, properly triangulated, from 
 which molar crown may he carved. 
 
 Fig. 5. Same with component sections separated. A. Cen- 
 tral rectangular pillar. B. Mesial wedge-shaped section. C. Lin- 
 gual wedge. D. Distal wedge. E. Buccal wedge. F. Mesio-buccal 
 angle section. Triangular pyramid inverted. G. Mesio-lingual 
 pyramid. H. Disto-lingual pyramid. I. Disto-buccal pyramid. 
 
 Fig. 6. Geometric figure, showing second stage of carving 
 molar crown, the cusps appearing as quadrangular pyramids. 
 
 Fig. 7. Third stage. One-half of crown carved out. 
 
 Fig. 8. Crown completed.
 
 258 CAST GOLD AND PORCELAIN INLAYS 
 
 KMH of the anterior tooth, in such a manner that a quadri- 
 lateral figure IMJL is formed. 
 
 If a perpendicular line HG is dropped between the two 
 teeth, it will bisect this quadrilateral figure, and will also be 
 tangent to the two arcs UV and ST both arcs being parts of 
 two circles the centers of which lie externally to the two teeth 
 involved. 
 
 In the former chart of geometric tooth construction within 
 the two triangles XYZ is seen a dotted line indicating the 
 approximal contour of a molar tooth, and by studying the two 
 charts, the student will know how to determine the extent to 
 
 Tig. 204. The figures enclosed by the letters BCEF and KNOP show two cen- 
 tral tubes of two adjoining teeth as they should appear when dressed down to receive 
 crowns. The mesio-proximal triangle ELF of the posterior tooth, dips, or extends 
 into the disto-proximal triangle KMN of the anterior teeth in such a manner that a 
 quadrilateral figure IMJL is formed. If a perpendicular line HG is dropped between 
 the two crowns, it will bisect this quadrilateral figure and will also be tangent to 
 the two arcs UV and) ST, both arcs being parts of two circles, the centers of which 
 lie externally to the two teeth involved. 
 
 which his approximal contour line should lie within that tri- 
 angle at the point of approximal contact. 
 
 When with a view to all factors involved (diagrams of 
 stress and contour), immunity and re-creation of balance, the 
 cavities in the first molars and second bicuspids have been pre- 
 pared, and the inlays completed and cemented into place, all 
 of which was done while the partial splint remained in position
 
 EXTENSIVE IlESTOIiATIOXS OK ( >C( 'I.CSA I. |;.\ I .A N t 'K 
 
 259 
 
 Fig. 205. 
 
 Fig. 1 is a horizontal section representing the occlusal plane of tho middle 
 third of an upper second bicuspid. The heavy curved lines within the circle repre- 
 sent the mesial and distal surfaces, while the dotted curved lines indicate the form and 
 proportionate height of the buccal and lingual cusps. ABC is an isosceles triangle 
 which has the line AB as the base, and the lines AC and CB the respective sides. 
 The angle ACE is the apical angle, and being bisected by the line CD, this same line 
 will also bisect the lingual cusp of the upper second bicuspid. 
 
 Fig. 2 is a horizontal section representing the occlusal plane of the middle third 
 of a lower second bicuspid. The heavy curved lines within the circle represent the 
 mesial and distal surfaces, while the dotted curved lines represent approximately 
 the buccal and two lingual cusps. EGF is an isosceles triangle, with the line EF as 
 the base, and the lines EG and FG as the respective sides. Tho angle EGF is the 
 apical angle, and being bisected by the line GH, the same line will also bisect the 
 Iniccal cusp of the lower second bicuspid.
 
 260 CAST (10L!) AND POIH'KLAIX IX LAYS 
 
 on the opposite side of the mouth, supplying the definite height 
 to which the teeth being restored were to be raised, that part 
 of the rubber splint fitting over and around the restored area 
 is eased so that it may go to place and rest upon the teeth not 
 yet rebuilt. 
 
 An additional section of the partial splint, belonging to 
 the side in the process of restoration, is now removed with a 
 fine saw; enough is cut out so that the second molars, upper 
 and lower, may be worked upon. When these are finished, the 
 rubber splint is eased up at these areas, and the partial splint 
 
 Fig. 206. Showing how perfectly occlusal surfaces may be carved in the wax 
 and reproduced by means of the casting process. Here the left upper first molar 
 has been exactly copied and reproduced in gold. (Dr. J. Lowe Young.) 
 
 for that side may be put away as part of the record of the case, 
 and the first bicuspid cavities may be prepared and inlayed. 
 The rubber splint is adjusted to make it conform to the new 
 conditions by removing all of the occlusal surface of it on that 
 side. 
 
 It is then placed in the oral cavity and the space previously 
 occupied by the cut end section is filled with a roll of yellow 
 wax, the patient is directed to close the mouth until the teeth 
 on the other side are in occlusal relation with the splint. A
 
 K I;I;STOI;ATIOXS OF OCCLTSAI, IIAI.AXCK 1'lil 
 
 few minutes arc allowed Tor the wax to liarclen. The splint is 
 removed, (lasked, cleaned, packed, vulcani/ed, and polished. It 
 is returned to the patient at the next sitting, when the procedure 
 of restoration is again stalled with the iii>t molars and second 
 bicuspids of the opposite side. 
 
 At this point we may dispense altogether with the remain- 
 ing partial splint, the opposite side giving a reliable occlusal 
 guide. 
 
 Thus we go to the second molars and third, if any he pres- 
 ent, and finally to the first bicuspids, easing the rubber splint 
 from time to time until the first bicuspids have been fully re- 
 stored, when the rubber splint may also be dispensed with. We 
 shall iind now that the naso-mental line has increased in length, 
 that the posterior teeth are in normal inesio-distal relation, and 
 that we have re-created an occlusal balance of the posterior part 
 of the masticating apparatus which will leave nothing to be de- 
 sired, and the perfection of which we never could have even ap- 
 proached without the help of the casting process. 
 
 The following is a quotation from an editorial written for 
 the Dental Items of Interest, May, 1913, by Dr. Ottolengui, an 
 editorial which has the distinction of being timely and true. 
 
 "In the past we have contoured teeth, but we have not con- 
 toured them to the extent implied by the word 'restore.' 
 
 "The contourists have replaced corners, have built up in- 
 cisal edges with fair accuracy, and they have even rounded 
 out the approximal or circumferential shapes of teeth. Hut 
 /lie i/ Jwve woefully failed to even fairly well i mil ate the occlusal 
 surfaces of hienxpid* and molar*. 
 
 "Perhaps never until now has the dental world been fully 
 aroused as to the importance of restoring occlusion. The or- 
 thodontist and the prosthodontist have far outstripped the den- 
 ists in this respect, but the time has now arrived when the den- 
 tist must awaken and grasp the need of making occlusion the 
 fundamental principle of everyday work. 
 
 " Any child would tell us 'teeth are made to eat with.' The 
 great Master so formed these organs that they would not only 
 'eat,' but 'cat' well. The slightest loss of any part of the 
 masticating surface of a tooth, the most minute change in its 
 designed form, diminishes its usefulness as a masticatory or-
 
 CAST GOLD AXD PORC'HLAIX IXLAVS 
 
 Fig. 207. 
 
 Fig. 208.
 
 EXTKNS1YK KKSTOKATIOXS OF OCVIA'SAL I5ALAXCH 
 
 263 
 
 Fig. 209. 
 
 Figs. 207, 208, and 209. Three illustrations of beautiful oc- 
 dusal surfaces. Two lower models above, and one upper model 
 below. Note carefully the second lower bicuspids and second 
 upper bicuspid. Note also the continuity of the disto-buccal cusp 
 of the first upper molar with the mesio-lingual cusp. (Dr. J. 
 Lowe Young.)
 
 >64 
 
 CAST GOLD AXD PORCELAIN IXLAVS 
 
 gaii to just that extent. Reversely, where part or all of the 
 occlusal surface of a tooth is lost through caries, the more 
 nearly the dentist succeeds in restoring its original form, the 
 more perfect does he make the patient's ability to masticate 
 food. 
 
 "Hundreds of articles have been written upon the need of 
 restoring approximal contact as a protection to the gingiva 
 
 Fig. 210. Note the two illustrations 011 the lower portion to the left, with their 
 inefficient occlusal surfaces, and compare the four other illustrations with their 
 definite sulci, cusps, and fissures. 
 
 which normally nils the interproximal space; but a close study 
 of the anatomy of the region will demonstrate that the con- 
 tact of adjacent teeth is only one of Nature's measures for the 
 protection of the gingiva, and not the most important. At the 
 approximal margin of the occlusal surface of molar or bi- 
 cuspid will be found a marginal ridge with its most slanting 
 plane extending around the center of that surface, and there-
 
 EXTENSIVE UESTOItATIONS OF OCCLFSAL I'.ALANCK 
 
 Fig. 211. This illustration .-ind Fig. 212 are shown to call to mind the ways 
 in which attrition manifests itself in different types. 
 
 Note in this illustration a great amount of attrition, and yet very well-defined 
 and rathi-r deep occlusal plones. Note, also, to tlie right a malposition of the bicus- 
 pids and a consequent narrowing of the arch. This may be called a thyro-adrenal 
 tooth. It is the tooth of the dreamer, the poet, and highly artistic architect, the 
 landscape gardener, the artist, more so the impressionist, people of culture, and us- 
 ually people of :_;roat sincerity. 
 
 Fin'. -1-. Another type of the result of attrition. The cusps and planes arc 
 not so deep, not so well defined and the arch is wider. It is the pituito-gunado- 
 adrenal type. It belongs to the individual who lives in conformity to form, works 
 fiyht hours, sleeps eight hours, and plays eight hours, etc.- lie makes no laws, 
 they are made for him. He does not dream or speculate, docs not philosophize. He 
 votes \\ith the mass. He is not the creative type.
 
 266 
 
 CAST GOLD AND PORCELAIN IX LAYS 
 
 Fig. 213. 
 
 Fig. 214. 
 
 Fig. 215. 
 
 A CASE OF EXTENSIVE EESTORATION. 
 
 Fig. 213. The models of the case after inlays were inserted. As may be seen, 
 this case presents considerable malposition of a number of teeth. Note the occlusal 
 surfaces, the distinct cusps, sulci, marginal ridges, and the essential bell shape of 
 the teeth as a whole. 
 
 Fig. 214. Anterior view of models in occlusion. Note the overbite, the ten- 
 dency to tortion of the right lateral. 
 
 Fi. 215. A side view of he same models in occlusion.
 
 EXTENSIVE ItESTOItATlOX.S OF OCCLCSAL J5ALANCK 
 
 207 
 
 Fig. 216. 
 
 Fig. 217. 
 
 Fig. 218. 
 
 A CASE OF EXTENSIVE EESTORATION CONT'D. 
 
 Fig. 216. A lingual view of the models in occlusion. Note the correct inter- 
 digitation of the cusps. 
 
 Figs. 217 and 218. Views of the same models in occlusion, but cut in half to 
 show the inlays more clearly in outline and occlusion.
 
 268 CAST GOLD AND PORCELAIN INLAYS 
 
 fore away from the approxlmal space. These marginal ridges 
 lead down into gutters, which in turn carry the escaping food 
 lingually and buccally, so that in the normal state the contact 
 points need be but small rounded areas, as they are, to prevent 
 food from crowding down against the sensitive and easily in- 
 jured gingiva. Thus the absolute copying of Nature in the 
 restoration of occlusal surfaces of molars and bicuspids not 
 only increases the masticatory efficiency by supplying cusps and 
 fossae, but protects the soft parts and preserves them in a state 
 of health because of the marginal ridges and sulci." 
 
 SUMMARY FOR CHAPTER XVIII 
 Extensive Restorations of Occlusal Balance "by Means of Gold Inlays 
 
 1. Name the two causes of the mutilation of the occlusal and proximal 
 surfaces. 
 
 2. What are the preliminary steps before beginning a case of extrusive 
 restoration? 
 
 3. Explain the method of making a diagram of stress from the model. 
 
 4. Explain the reasons for the choice of the first tooth to be operated upon. 
 
 5. What are the causes of attrition? Name a predisposing cause. Name 
 a secondary cause. 
 
 6. Describe the oral conditions in a case of marked attrition. 
 
 7. How would you determine the amount of gingivo-occlusal restoration 
 to be made? 
 
 8. What steps should first be taken in the actual process of work upon the 
 patient? 
 
 Construction of the Splint 
 
 1. Describe the making of the splint, giving the various steps on the model 
 and in the mouth. 
 
 2. How would you determine the amount of opening of the articulator the 
 case requires? 
 
 3. What is the reason for doubling the amount of the necessary gingivo- 
 occlusal restoration? 
 
 4. What is the naso-mental line and how is it taken into consideration 
 while making the restoration? 
 
 5. Describe the construction of a partial splint. 
 
 G. With the teeth in normal mesio-distal relation, how is the amount of 
 building up determined? 
 
 7. Describe the changes in the full splint while the process of reconstruction 
 proceeds.
 
 (IIAPTKK XIX 
 COLD IXLAYS AXI) TIIK S1MCATHS OR POKCKLA1X 
 
 For cosmetic reasons, too well known to require any lengthy 
 consideration, the cast gold inlay is in itself contraindicated 
 in anterior teeth and even first bicuspids, in such positions as 
 will expose any considerable portion of the gold to the vision 
 of the person with whom the patient conies in contact. 
 
 Yet in a great many cases of broken or worn down an- 
 terior teeth, the cast gold inlay is, from all points of view but 
 the one mentioned, the very best restoration possible; in fact, 
 if it were not for this cosmetic objection, the cast gold inlay 
 would prove the ideal restoration for large areas in anterior 
 teeth, and it must follow that if this one objection can be over- 
 come, we shall, in the cast gold inlay have as perfect a re- 
 creative process for anterior teeth as it has proved itself to 
 be for posterior teeth. 
 
 This conclusion led me to a series of tests and experiments 
 which were not restricted to my own practice at all, but were 
 no doubt carried on by a great number of men who realized the 
 advantage of the casting process and were desirous of over- 
 coming the obstacles to its use in the anterior teeth. 
 
 Except to a very limited extent, I have no means of de- 
 termining just how extensive these experiments of the other 
 men have been, or how successful they have proved, but I am 
 in a position to state that in my own practice, the cosmetic ob- 
 jection to the cast gold inlay in anterior teeth has been entirely 
 overcome by the use of porcelain, or the silicates in conjunction 
 with the inlay. 
 
 Broadly speaking, all but the part exposed to view is re- 
 placed with a gold inlay, and a portion of the gold inlay is so 
 shaped that, with the remaining part of the tooth, it will offer 
 the means of the construction of a simple cavity, which may be 
 inlayed with porcelain or filled with a good silicate cement. 
 
 In cases of marked attrition, where the crowns of anterior 
 
 2C9
 
 270 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Pig. 219. 
 
 Fig. 220. 
 
 Fiff. 223. 
 
 Fig. 222. 
 
 Fig. 224. 
 
 Fiff. 225.
 
 GOLD INLAYS AND THE SILICATES Oil P011CELAIX !_' i 1 
 
 GOLD INLAYS AND PORCELAIN- OR THE SILICATES. 
 
 A NUMBER OF VIEWS OF A LOWER CENTRAL FK VCTURED IN A 
 FALL. 
 
 Fig. 219. Lingual view of cavity. 
 
 Fig. 220. Labial view of cavity. 
 
 Fig. 221. Wax inlay before providing room for porcelain. 
 
 Fig. 222. Wax inlay in position carved out to make pro- 
 vision for porcelain or silicate. 
 
 Fig. 223. Wax inlay ready to be mounted on sprue wire 
 for investment in refractory compound. 
 
 Fig. 224. Labial view of completed operation. 
 
 Fig. 225. Lingual view of completed operation. 
 
 Stress Index: Downward, inward and forward, or INTRA- 
 ALVEOLAR Unguo-mesiaUy.
 
 CAST COLD AX!) I'OIU'KLA 1 X INLAYS 
 
 Fi-. 226. 
 
 227. 
 
 228. 
 
 229. 
 
 Fig. 2.32.
 
 INLAYS AN!) TIIK SILICATKS OH POKCKI.A I X 
 
 A XlMHKK OK VlKWS OF A LOWEK LATERAL RESTORED BY 
 MKANS OK A CAST GOLD INLAY AND SYNTHETIC PORCELAIN. 
 
 Fig. 226. Labio-distnl view of prepared tooth. Note bevels 
 at im-isal, distal, ami gingival margins. 
 
 Fii;-. 2'27. Lingno-iiK -iso-distal view of prepared tooth. \<>te 
 appearance of cavo-surface and the continuity of linguo-incsial 
 and linguo-gingival bevel. 
 
 Figs. 228 and 229. Lingual and cavo-surfacc view of wax- 
 inlay. 
 
 Fig. 230. Wax inlay in position on the tooth, provision made 
 for porcelain or synthetic inlay. 
 
 Figs. ^31 and 232. Linguo-inciso-distal and labio-distal 
 views of the finished operation. 
 
 Stress Index: Downward, inward and forward, or INTRA- 
 
 At.VKOLAR tiiiflil-ti:i xioVll.
 
 274 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fiff. 233. 
 
 Fie. 234. 
 
 Fig. 235. 
 
 Fie. 236. 
 
 Fiir. 237. 
 
 Fig. 238. 
 
 iff. 239.
 
 GOLD IXLAYS AND TIIK SI UCATF.S OH T'OHCKI.A I X 
 
 A XTMBEK (IF VIEWS OP A LOWER LATERAL INVOLVED BY 
 
 FlCAOTKK AM) I)K('AY RESTORED BY THE USE OP A GOLD INLAY IN 
 
 CoxjrxcTiox WITH SILICATE CEMENT, ROOT FILLED. 
 
 Fiu. -'.',:',. Labial view of prepared cavity. 
 
 Fig. 234. Lingual vio\v of prepared cavity. 
 
 Fig. 235. Wax inlay, lingual view. 
 
 Fig. 236. Wax inlay in position on the tooth, wax carved 
 out to provide room for porcelain. 
 
 Fig. 2.'!7. Wax inlay ready for sprue wire for investment. 
 
 Fig. 238. Labial view of finished operation. 
 
 Fig. 2M9. Linguo-niesial view of finished operation. 
 
 This proved a useful and lasting operation of fine appear- 
 ance. 
 
 stress 1 in lex: Downward, inward, forward, or IXTRAALVEO- 
 I.AR lingtut-
 
 CASt GOLl) AND I'OKC'KI.AIX JNI.AVS 
 
 teeth have been reduced to one-third, or oven one-half their 
 length, this manner of restoration has been so valuable that it 
 may be insisted on as the only logical one. 
 
 Where the peridental tissues, and by this are meant all 
 the tissues in the region of the peridental membrane, such as the 
 gingiva, the alveolus, the suspension ligament, and the gingival 
 and subgingival circumference of the tooth, are free from any 
 pathologic invasion, and where the remaining portion of the 
 tooth crown is free from caries, the excision of that portion 
 and the substitution therefor of an artificial substance is a need- 
 less sacrifice of structure and may be avoided by resorting to 
 the cast gold inlay in combination with the silicates or por- 
 celain. 
 
 In this way also any possibility of injuring the tissues in 
 the peridental region is avoided, and the greater longevity of 
 the restored tooth assured. 
 
 This is by no means to be considered as an argument 
 against porcelain crowns in general, or as a condemnation of 
 the porcelain inlay in general; each has its place, and in its 
 place it can not be successfully supplanted by any other res- 
 toration, but there can be no question about its having been 
 employed in cases where the cast gold inlay, in combination 
 with one of the silicates or porcelain could have been used to 
 much greater advantage. 
 
 It will be well to note that in all large restorations of the 
 anterior teeth, the extirpation of the pulp is usually warranted, 
 and most often imperatively indicated, and the reason for this 
 is found in the particular formation of the anterior crowns. 
 AVhen a large portion of these crowns has been lost through 
 caries or attrition, we are compelled by the laws of physics 
 to invade that part of the remaining crown which is greatest 
 in bulk and most likely to resist stress, and thus offers a better 
 seat for our restoration with a view to conservation of the 
 tooth as a whole, and we shall find that this part of the remain- 
 ing crown is usually occupied by the pulp, so that proper root 
 canal work becomes an important factor, and is the first sur- 
 gical operation to be considered in these cases. 
 
 The root canals are filled from the apex down to one-third 
 of the length of the canal, the remaining portion of the canal
 
 (iOLl) INLAYS AND THE S1L1CATKS OK POKCKLA 1 X 277 
 
 reamed out to receive a l."j to 20 per cent iridio-platimim 
 threa<led post, which post becomes a part of the cast gold inlay. 
 The sizes of the posts for the various teeth may be stand- 
 ardized as follows: 
 
 Upper central incisors and cuspids 12 
 
 Upper lateral incisors 14 
 
 Bicuspids single root 14 
 
 Lower central and lateral incisors 16 
 
 Lower cuspids 13 
 
 Lower bicuspids 14 
 
 All these posts may be kept on hand under separate covers 
 in two-inch lengths. The receptacle may be marked on the out- 
 side so as to indicate the contents. 
 
 The following simple rules must be remembered in con- 
 nection with the use of posts: 
 
 1. The post is to aid in making the artificial restoration 
 and the remaining portion of the tooth being restored, one con- 
 tinuous member, the cement being the intermediary agent. 
 
 2. The longer and stouter the post (within the limit) the 
 greater the area of contact surface and the greater the resist- 
 ance to stress. 
 
 3. The length of the post should be at least % the length of 
 the root. Additional contact surface is obtained by threading 
 the post. 
 
 In accordance with all the laws of cavity preparation, and 
 in accordance with the diagram of stress, the cavities are then 
 prepared and the wax inlays are made, which wax inlays must 
 engage the post. This is accomplished in the following manner: 
 
 A cone of inlay wax softened as previously directed, is 
 forced into the cavity and chilled under pressure; with the 
 proper carvers the wax is then trimmed to size and contour, 
 the right, left, and straight burnishers assisting in the opera- 
 tion. A hole is then made in the contoured wax inlay lingually, 
 this hole going right through the wax and leading into the 
 root canal. The hole should be somewhat smaller in size than 
 the threaded post. The latter is grasped in a pair of pliers. 
 slightly heated in the flame of the alcohol lamp or Bunsen 
 burner, and forced into the hole in the wax inlay, and put into
 
 278 
 
 CAST GOLD AXD POBCBLA1N INLAYS 
 
 Fig. 240. 
 
 Fig. 241. 
 
 Fig. 242. 
 
 Fi?. 243. 
 
 Fig. 244. 
 
 Fig. 245. 
 
 Fig. 246.
 
 GOLD INLAYS AND TIIK SILICATES OR PORCELAIN -(! 
 
 A NUMBER OF VIEWS OK A LOWKK LATERAL FKACTUKED IN A 
 FALL. EXTIRPATED PULP. 
 
 Fig. 240. Labial view of cavity. Note bevel and step. 
 
 Fig. 241. Lingual view of cavity. Note bevel and lingual 
 lock stop with depression into pulp canal. 
 
 I'iu. 242. View of wax inlay before providing room for por- 
 celain. 
 
 Fig. 24:-!. Wax inlay carved out to provide for porcelain. 
 
 Fi-. 2H. Wax inlay ready to be mounted upon sprue wire 
 for investment. 
 
 Fig. 245. Mesio-labial view of finished operation. 
 
 Fig. 246. Mesio-lingual view of finished operation. 
 
 Stress Index: Downward, inward and forward, or IXTKA- 
 
 ALVEOLAR linti no-
 
 280 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 248. 
 
 Fig. 249. 
 
 Fig. 250. 
 
 Fig. 231. 
 
 Fig. 2.32. 
 
 Fiff. 253.
 
 GOLD INLAYS AXD THE SII.ICATKS OR 1'OKCKLAIX L.M 
 
 SEVEX VIEWS OF A LOWER CUSPID, PRESENTING ANOTHER 
 TYPE OP RESTORATION-, ALSO A COMBINATION CAST GOLD INLAY 
 
 AND 1'OKCKI.AI.V INSERT. 
 
 Stress Index: Downward, inward, forward, hack and out- 
 ward or INTRAALVEOLAR linguo-mesially and disto-labiaUy.
 
 282 
 
 CAST GOLD AXD PORCELAIN INLAYS. 
 
 Fig. 254. 
 
 Fie. 255. 
 
 Fig. 256. 
 
 Fig. 257. 
 
 Fig. 258. 
 
 Fig. 259. 
 
 Fig. 260.
 
 COLD JXLAYS AND THE .SILICATES Oil l'< (KCKLAIN 283 
 
 . KX YlKWS OK A I5l>KKX-I:0\VX (Ysi'll) RK.STOKK1) "WITH A 
 ('AST (Joi.I) iM.AY AM) A !'()!;< KI.AIX IXSKKT. T]IE 1 1-M'STKATIOXS 
 
 AKK SF.l.K KX1M.AX \T()KV. 
 
 Stress Index: Dmvmvard, inward, forward, back and out- 
 ward or IXTKAALVEOI.AI; li Hi/no- nit xidtiy and
 
 284 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 261. 
 
 Fig. 263. 
 
 Fig. 264. 
 
 Fig. 265. 
 
 Fig. 266. 
 
 Fig. 267.
 
 (iOl.D IKLAYS AND T11K SIUCATKS (lit 1>< >IU 'KLA I X 
 
 A LEFT UPPER LATERAL PRESENTING A MESIO-LABIO-LINGUO- 
 J. \<ISAL DEFICIENCY RESTORED TO USE AND COSMETIC ACCEPTABLE- 
 NKSS BY A CAST GOLD INLAY AND SYNTHETIC PORCELAIN. 
 
 Fig. 261. A mcsio-labial view of prepared cavity. 
 
 Fig. 262. A linguo-mesial view of prepared cavity. 
 
 Fig. 263. Wax inlay in position on the tooth, provision made 
 for synthetic insert. 
 
 Fig. 264. Lingual view of wax inlay. Note extension to 
 the right. 
 
 Fig. 265. Cavo-surface view of wax inlay. Note definition 
 of steps. 
 
 Figs. 266 and 267. Mesio-labial and linguo-mesio-incisal 
 views of finished operation. 
 
 Stress Index: Upward, outward and backward or intraalvco- 
 lar LABIO-DISTALLY.
 
 286 OAST <;<>U> AND PORCELAIN [NIAYS 
 
 the root canal. The wax immediately surrounding the post will 
 soften sufficiently to attach itself to the threads upon it, and 
 after a cold water spray, post and inlay may he removed. If 
 there he any deficiency to the wax lingual I y, the quantity lack- 
 ing may he added to it. Inlay and post are again replaced in 
 and onto the tooth, the carving and hurnishing completed, re- 
 membering that all burnishing must be done in the direction 
 of the margins; the wax is rendered smooth with the cotton 
 pellet moistened sparingly with oil of cajeput, the inlay is 
 carefully but firmly held in position, and with a small lance 
 the facial part, and some of the mesial and distal surfaces of 
 it are removed, leaving a box-like simple cavity, presenting a 
 floor and four walls, the gingival wall being formed by the in- 
 cisal surface of the tooth. The wax inlay is now carefully re- 
 moved, and the sprue wire is inserted mesio- or disto-incisally. 
 The sprue wire is placed in position upon the crucible former 
 and all steps necessary for proper investment and drying out 
 of the mold, the cooling down of the same, and the casting of 
 the molten metal into this mold are gone through as described 
 before. 
 
 Upon completion of the casting, it must be subjected to 
 its various cleansing and neutralizing baths, carefully finished 
 and polished with the various stones and discs. 
 
 If we are to replace the facial portions with a silicate, then 
 the hoxlike aperture is so grooved that a retentive form is 
 obtained; this is easily accomplished by running a small inverted 
 cone burr along the incisal, mesial, and distal line of the floor 
 of the cavity in the inlay. 
 
 If we are to replace the facial portions with a porcelain 
 inlay, then the boxlike aperture in the cast gold inlay must be 
 left in such a condition that no undercuts are present, so as to 
 facilitate the taking of an impression of the facial surface of 
 the tooth and inlav cavitv when the gold inlav lias been cemented 
 
 tf V */ 
 
 to place. 
 
 AVhen the gold inlay has been completed, the rubber dam 
 is applied and the casting is cemented to place. The cement is 
 mixed rather thin but well spatulated and some of it is pumped 
 up into the canal by means of a jiffy tube when the casting- 
 has been forced into position by the fingers, it is tapped gently
 
 COLD INLAYS AND TIIK S1LICATKS OK 1'ORCKLAIN L.N7 
 
 with a leather-covered mallet, driving a dull-pointed instrument 
 held against the lingual surface in a Forward and upward direc- 
 tion. "When the cement begins to set, the portion which lias 
 been Forced into the Facial boxlike aperture, is removed with 
 an excavator, the inlay being held firmly in position until the 
 cement has thoroughly set. The cimple cavity now presenting 
 upon the facial surface of the partly restored tooth may be 
 temporarily tilled with thoroughly softened white temporary 
 stopping. Xo pressure shall he exercised upon this stopping, 
 its function being simply to occupy >pace to prevent the ingress 
 of Food. The rubber dam may now be removed, and further 
 operation postponed For another day. 
 
 At the next sitting, the rubber dam is again applied, the 
 temporary stopping is removed, the boxlike cavity is thoroughly 
 cleaned, removing every trace of cement, a retentive form is 
 produced as directed and the cavity filled with a silicate cement. 
 
 The color of the gold must be taken in consideration when 
 the silicates are employed, for these cements being markedly 
 translucent, will allow the yellow to influence their shade to a 
 great extent, so much in fact, that if a blue surface be required 
 it will be best to place a thin piece of platinum foil upon the 
 floor of the cavity and place the silicate upon that. The silicate 
 must be kept dry for a period of twenty minutes to one-half 
 hour. Some parath'ne wax may then be thrown over it and the 
 rubber dam may he removed. In another fifteen minutes, or at 
 a subsequent sitting, the filling may be polished with fine cuttle 
 lish discs, charged or lubricated with paraffine or cocoa butter; 
 a beautiful restoration will be the result. 
 
 It is essential that the metal of which the gold portion of 
 the restoration is made shall not yield or flow under the maxi- 
 mum of masticatory stress, because if it does the cavity filled 
 with the silicate will alter its geometric lines to an extent great 
 enough to fracture the silicate. For this reason these inlays are 
 cast in a special alloy to be considered later on. 
 
 If a fused porcelain inlay is to complete the facial part of 
 this anterior restoration, the preparation of the boxlike cavity 
 i> somewhat different, its linear extent being greater at the 
 orifice than at the floor, so that each surface of the cavity shall 
 form an obtuse angle of about 100 with the floor.
 
 L'88 
 
 CAST GOLD AND PORCELAIN IX LAYS 
 
 Fig. 2C8. 
 
 Fig. 2(59. 
 
 Fin-. 270. 
 
 Fig. 271. 
 
 Fig. 273. 
 
 Pi"-. 275.
 
 COLD INLAYS AND TIIK SILICATKS Oil PolICKLAI X 
 
 VIEWS OK A RIGHT UPPER CENTRAL PRESENTING A LARGE 
 MESIO-LABIO-LlNGUO-IlNCISAL DEFICIENCY, RESTORED TO USE AN1> 
 COSMETIC ACCEPTANLENESS HY A CAST GOLD INLAY AND PORCELAIN 
 INSERT. 
 
 Fig. 268. Mesio-labial view of prepared tooth. Note the 
 obtuse angle at median line of the gingival seat of the cavity and 
 the acute angle between the mesio-labial wall and mesio-gingival 
 wall. 
 
 Fig. 269. Note depth and definition of all cavo-surface 
 angles, pulp not involved. 
 
 Fig. 27d. Mesio-linguo-gingival view of prepared tooth. 
 Note extension of cavity linguo-gingivally, the acute angle created 
 between the lingual and labial plates. This acute angle extends 
 from the incisal end of the cavity to its extreme linguo-gingival 
 apex. 
 
 Fig. 271. A cavo-surface view of the prepared wax inlay. 
 
 Fig. 272. A lingual view of the prepared wax inlay. 
 
 Fig. 273. Wax inlay in position showing boxlike, or simple, 
 cavity for porcelain insert. 
 
 Figs. 274 and 275. Mesio-labial and linguo-mesial views of 
 the finished operation. 
 
 Stress Index: Upward, outward and backward or intraalveo- 
 lar LABIO-DISTALLY.
 
 290 
 
 CAST COLD AND PORCELAIN INLAYS 
 
 Fig. 276. 
 
 Fig. 277. 
 
 Fig. 278. 
 
 Fig. 279. 
 
 Fig. 281. 
 
 Fig. 282.
 
 COLD IX LAVS .'.XH TIIK Sll.lCATKS OK I'Ol!( 'Kl .A I X 
 
 VIKWS OF A LEFT UPPER CEXTKAI. I'KKSKXTIXG A MESIO DISTO- 
 LAHIO IXCISAL DEFICIKXCY. RESTORED TO USE AXD COSMKTIC Ac- 
 CEPTABLF.XESS BY A CAST GOLD IXLAY AND SYNTHETIC PORCELAIX 
 INSERT. 
 
 Fig. 276. Labial view of the prepared tooth. Note the 
 hovels at the incisalj mesial, and gingival walls. 
 
 Fig. 277. Lingual view of the prepared tooth. Note large 
 bevel linguo-gingivally, and central keyed groove running into 
 root canal which has been filled. 
 
 Fig. 278. Lingual view of the wax inlay. 
 
 Fig. 279. Cavo-surface view and view of prepared labial 
 surface of the wax inlay. 
 
 Fig. 280. Wax inlay in position upon the tooth, wax carved 
 out to provide for porcelain insert. 
 
 Figs. 281 and 282. Labial and lingual views of the finished 
 operation. 
 
 Stress Index: Upward, outward and backward or int-raalvco- 
 
 lur. L\i:io DISTAI.I.V.
 
 292 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 283. 
 
 iff. 284. 
 
 Fig. 285. 
 
 Fig. 286. 
 
 Fig. 287. 
 
 Fig. 288. 
 
 Fig. 289.
 
 GOLD INLAYS AND THE SILICATES OR PORCELAIN 
 
 A Xi MI;KK <>> VIEWS OK A HK;UT I'ri-KK CENTRAL PRESENTING 
 AN KRODED AND PITTED LABIAL SURFACE, A MKSIO- AND DISTO- 
 PROXIMAL CAVITY, AND A LI.XGTAL EXAMKL SURFACE WHICH WAS 
 PERFECT, AS WAS THE IXCISAL EDGE. 
 
 Fi^. 283. Lingual view of prepared tooth. Note grooves 
 liiiyuo -distn lly and linguo-mesially. Note linguo-mesial and 
 linguo-distal acute angles. 
 
 Fig. 284. Labial view of prepared tooth. Note taper toward 
 the incisal edge. Note shoulder at the gingivo-labio-distal ami 
 mesial portions of the tooth or its cervical circumference. 
 
 Figs. 285 and 286. Labial and lingual views of the wax 
 inlay. 
 
 Fig. 287. Wax inlay in position on the tooth and provision 
 made for porcelain insert. 
 
 Figs. 288 and 289. Linguo-incisal and labial view of fin- 
 ished operation. 
 
 Stress Index: Upward, outward and backward, or intraalveo- 
 lar LABIO-DISTALLY. 
 
 The question will come up as to why a complete porcelain 
 jacket crown or a cast base porcelain crown was not made for 
 this tooth, and this must be answered. . 
 
 I believe that all jacket crowns are injurious in so far as 
 tJicif completely cover something that Nature meant should be 
 exposed to aerobic influence. 
 
 Gold is more objectionable than porcelain because it irritates 
 tin lninno,\y of the visual field; bnt a gold jacket crown docs no 
 mo-re than cover up the organ or tooth. 
 
 Cases have come under my observation and treatment where 
 the mere removal of gold and porcelain jacket crowns and some- 
 times the polishing of the remaining portion of the uncovered 
 tooth or teeth, more often the excision of the crowns and substitu- 
 tion of it by a cast base crown, have done away with such func- 
 tional dystrophies of the central nervous system as loss of pati- 
 ence, impaired vision, loss of memory, and general irritability 
 to surroundings which before seemed perfectly congenial.
 
 294 CAST' COLD AND PORCELAIN INLAYS 
 
 1 was gradually forced to formulate the following laws for 
 myself as a guide in practice. 
 
 1. That part of the tooth which, covered with enamel, rises 
 out of the alveolar socket into space is intended to live in, and 
 be subjected to, extra-aerobic currents, and must never be al- 
 together deprived of this apparently m c< xxtiry r< lationship. 
 
 2. One is justified in excising a badly broken-down tooth and 
 I-" r i ring the roots of the tooth with a cast base crown because 
 the root is not in normal cases exposed to extra-aerobic inflit<m-<. 
 
 3. A jacket crown is harmful and unsafe because it robs all 
 that part off the tooth which was left abovG the gum of its bath 
 in the sea of air which surrounded it. 
 
 4. An inlay or type of restoration here shown enables the 
 tooth to keep up its relationship with the air by virtue of the 
 remaining portion of enamel upon the lingual surface. 
 
 5. It will get the quantity of air which it needs through the 
 medium of this small part of itself by simply taking up the air 
 more rapidly, even as a man who has been walking briskly or 
 running gets his quota of oxygen by increasing the rate of his 
 inspirations and expirations. 
 
 6. In inserting a filling or inlay into a tooth, it is safer to 
 cut through the enamel and inlay the dentine than it is to partly 
 cut through the enamel and seal this partly cut enamel surface. 
 
 7. The enamel of the teeth comes from the ectodermic layer 
 and is formed by the evolution of this layer. 
 
 The central nervous system conies from the ectodermic layer 
 and is formed by the involution of this layer. 
 
 8. Constant trophic irritation of any part of the enamel 
 of a tooth will cause a disturbance of the central nervous system. 
 
 9. Depriving a tooth which is left standing in the oral cavity 
 of its required aerobic bath is a constant trophic irritation. 
 
 10. This is the reason that clasps are dangerous and should 
 hardly ever or never be used unless the part of the tooth with 
 which it comes in contact has been inlayed to the full depth of 
 its enamel wall. 
 
 11. Nature knows best, let the tooth breathe.
 
 GOLD INLAYS AND THK SI LICATKS oil I'olK 'KI.A1 N -!!),") 
 
 A matrix may then be burnished into this cavity. aii<l the 
 porcelain fused into this matrix, or an impression is taken of 
 this simple cavity, an amalgam die is made as described before, 
 and the die is mounted in a small swaging cup so that it may be 
 placed in a small Ajax swage, and the matrix swaged into and 
 onto the die. J>efore any attempt is made to remove the matrix 
 from the cavity, direct or from the die, it is best to fill the matrix 
 with a bit of wax and to bring this wax over the margins of the 
 cavity to supply an ordinarily indestructible or unchangeable 
 rigidity to the matrix. 
 
 The matrix, carrying the wax, is then invested in a paste 
 of silex and water, or ground asbestos and water, and care is 
 taken to so tack the platinum around the margins, that it will 
 prove difficult for it to warp; with this end in view the margins 
 may be curled downward so that they be securely held against 
 displacement. 
 
 The thinner the platinum foil used for the matrix, and the 
 greater the care given to the swaging of it, the more perfect a fit 
 will be obtained. For this reason a foil of l/'soo of an inch in 
 thickness is used, and this is carefully adapted to the floor of 
 the cavity with a pellet of cotton, held in the foil carriers, the 
 ends of which should be rounded. The size of the pellet of 
 cotton is gradually increased, until it is large enough to force 
 the platinum foil along the floor of the cavity towards the walls 
 anil margins. 
 
 The writer considers the safety depth or retention depth 
 for these cavities to be no less than 1 mm. and they should be 
 no less than I 1 - to 2 mm. in depth; any depth greater than the 
 latter uselessly endangers the integrity of the foil. 
 
 After the more or less complete adaptation of this foil, the 
 floor and walls of the cavity in the die, the burnishers are used 
 to marginally outline the cavity, the margin of necessity pre- 
 senting a smooth unbuckled appearance. 
 
 The swaging cup holding the die and the matrix, may then 
 be placed in the loose end of the swager, a rubber dam disc is 
 placed over the matrix, and the piston of the swager is struck 
 two or three smart blows with a large horn mallet. 
 
 Upon examination the matrix will be found to have become 
 perfectly adapted to the cavity in the die. As said before, this
 
 296 
 
 CAST GOLD AXD PORCELAIN INLAYS 
 
 Fig. 290. 
 
 Fig. 291. 
 
 Fig. 292. 
 
 Fig. 293. 
 
 Fig. 294. 
 
 Fig. 296.
 
 GOLD INLAYS AND THE SILICATES OR POKCKI.A I X '2 ( ,)~ 
 
 SEVEX VIEWS or ANOTHER TYPE OF RESTORATION IN AN UPPER 
 ci SIMM. THE FORMATION* OF THE CAVITY, THE ACUTE AND OBTUSE 
 ANGLES ARE CLEARLY TO BE SEEN IN FIGS. 290 AND 291. 
 
 Figs. 292, 293, and 294 arc views of the inlay in and out of 
 the tooth. 
 
 Figs. 295 and 296 are views of the finished operation. 
 
 Stress Index : Upward, out and forward and out and back- 
 ward or intraah'colar, LABIO-MESIALLY and LABIO DISTALLY.
 
 298 
 
 CAST GOLD AND I.'OIl('KLAI X INLAYS 
 
 Fig. 207, 
 
 Fig. 299. 
 
 Fig. 300 
 
 Fig. 302.
 
 (JOLD INLAYS AND TIIK SILK'ATKS OK !'OU< 'KLAI N L_'|)|) 
 
 SKVKN YIKWS UK A RIGHT UPPER GYspiD PRKSKXTIM; A I'RK- 
 IIKNSO LABio-Li.\(;ro-.\lK.siAL DEFICIKNCY. 
 
 Note carefully in Figs. 297 and 298 the formation of the 
 cavity and the grooves for retention, and in Figs. 299, 300, and 
 301, views of the wax inlay in and out of the tooth. Figs. 302 
 
 and .'!()3 are views of the finished operat'on. 
 
 Stress Index: Upward, out and forward and out and back- 
 ward or intfdcln !nr, LABIO-MESIALLY and LABlO-DlSTALLY.
 
 300 CAST GOLD AND PORCELAIN INLAYS 
 
 matrix must now be filled with some wax, and tlie wax must 
 overlap the margins of it, so that upon removal of the matrix 
 from the die, no distortion is possible. 
 
 Upon investment of the matrix as described, and upon dry- 
 ing out of this investment, we shall be ready to burn out the 
 wax and to biscuit and fuse our porcelain. 
 
 This one problem has been vexing and irritating the dental 
 profession ever since porcelain first made its appearance as a 
 filling material, and unquestionably the inability of the general 
 man to solve the riddle is responsible for the fact that porcelain 
 is so sparingly used for inlay work, even when strongly in- 
 dicated. 
 
 These men who have been teaching porcelain inlay work 
 and porcelain work in general, the men w r ho have written about 
 its manipulation, its advantages, the indications for its use, and 
 the contraindications, never troubled themselves or the student 
 much about the color problem, and left that to the commercial 
 house to solve, an error fraught with dire consequences to the 
 immediate future of ceramics in dentistry. 
 
 The reason for all this is to be found in the condition that 
 men have been teaching this art without comprehending just 
 how important a part the color problem plays in it, and the 
 men who have been learning the art failed in turn to realize 
 that to their ignorance of the relation existing between different 
 colors and of the results to be obtained when these relations are 
 made use of in various proportions is due their lack of success 
 in porcelain restorations. 
 
 No matter how charitably we may wish to look upon it, we 
 are forced to the conclusion that there has been woeful aimless- 
 ness about this branch of our work; we have tried for years 
 to do something without being in possession of the necessary 
 groundwork knowledge of that which in a great measure would 
 have proved the key to our success. 
 
 Eealizing that other phases of the ceramics as applied to 
 dentistry have been sufficiently enough elaborated upon by other 
 investigators and teachers to be quite clearly understood by 
 those who read this volume, I will here confine myself to a more 
 or less fragmentary, but nevertheless pointed and easily grasped, 
 explanation of this phase of the art, which I feel has been ucg-
 
 (JOLI) INLAYS AND TIIH S1UCATKS OK 1'OIK T.I .A I X 
 
 lected by investigators, and is little, if at all, understood by the 
 general practitioner. 
 
 SUMMARY TOR CHAPTER XIX 
 Gold Inlays and the Silicates or Porcelain 
 
 1. In what cases is the restoration of incisal edges by inlays in conjunction 
 ^sith porcelain preferable to the excision of the tooth? 
 
 2. Describe the preparation of a root canal to receive a post and give the 
 gauges of the posts used in the various teeth. 
 
 3. Give the rules in the use of posts. 
 
 4. Describe the taking of an impression for a silicate insert. 
 
 5. Describe the cementation of the inlay, the choice of color and the mak- 
 ing the silicate filling. 
 
 6. How would you prevent the fracture of the silicate insert in a tooth 
 subject to material stress? 
 
 7. Describe the making of the porcelain insert.
 
 CHAPTER XX 
 THE PHENOMENA OF LIGHT AND COLOR 
 
 The general doctrine of that form of radiant energy known 
 as light is now only a part of the general theory of radiation, 
 which comprises radiant heat and actinic and electric radiation; 
 but since the battle as to the nature of radiation in general was 
 first waged around light itself, it is convenient to consider light 
 as representing all the forms of radiation. 
 
 By elementary observation it is found that light travels (in 
 a uniform medium) in straight lines in all directions; that is, 
 when proceeding from a point or a very small source covers 
 areas which vary as the squares of the distance, and that shad- 
 ows obey a similar law. 
 
 Light is seen some time before the corresponding sound is 
 heard. The most common illustration of this may be found 
 during any thunder storm, the lightning being visible long be- 
 fore the sound of thunder reaches the ear. 
 
 All this points to a rapid propagation of something in 
 straight lines. Is it matter, motion, or condition? 
 
 The simplest explanation was that luminous bodies emitted 
 something material whose impact affected the sensitive eye; 
 that the reflection of light at surfaces was due to elastic rebound 
 of these quick traveling materials. These prenomena might 
 be equally as well explained by waves traveling and being re- 
 flected. 
 
 Sir Isaac Newton could not reconcile himself to the opinion 
 of waves traveling past obstacles and not spreading behind 
 them. This seeming anomaly led him to adopt and develop the 
 corpusecular or emission theory of light. According to this, all 
 luminous bodies emit with equal velocities a number of elastic 
 corpuscles that travel in straight lines, are reflected, and are 
 refracted at the surface separating two media. Rays of white 
 light when refracted are generally dispersed, owing to the con- 
 stituents having different refractive indices. 
 
 302
 
 PHENOMENA ()! I.ICIIT AND COI.OK .'!().'! 
 
 For the ordinary phenomena of reflection and refraction the 
 ('mission theory was sufficiently satisfactory, Imt in order to 
 explain the phenomena of refraction and polarization, the theory 
 became overloaded with a mass of hypotheses. Newton main- 
 tained this theory to the time of Sir David IJrewster. 
 
 The wave theory of light was surest ed by (Irimaldi, Hook 
 and others, used by Huygens (1678) to explain double refrac- 
 tion; it had few sponsors when revived by Young in the begin- 
 ning of the nineteenth century. It was more fully recognized 
 and its phenomena made clear by Tresuel in 181."), and on and 
 until it finally and definitely supplanted the emission theory. 
 
 According to this theory, light consists of vibrations in an 
 all pervading elastic ether, and these vibrations are in direc- 
 tions at right angles to the directions of propagation; and "ra\> 
 of light" are mere lines showing the direction of propagation 
 of (and in isotropic media at right angles to) the corresponding 
 portions of the Avave front. 
 
 The wave theory readily explains refraction; in refraction 
 it assumes that the AvaA T es travel less rapidly in the denser 
 medium (which is found to be true) and it explains the accom- 
 panying reflected AvaA'e; it explains double refraction, polariza- 
 tion, absorption of light, interference, color and complementary 
 colors, diffraction, etc. All these phenomena are explicable as 
 phenomena of rhythmic disturbance of some kind and the 
 wave theory really goes no further than to state this. The 
 rhythmic disturbance may be one of position, wave motion, of 
 stress, of electrical condition, possibly a twist in the ether. 
 Clerk Maxwell holds that every portion of the ether in the path 
 of a beam of light is subject to rapidly alternating stresses 
 transverse to the ray, and is, therefore, in a rapidly alternating 
 electric and also in a rapidly alternating magnetic condition, 
 and the curious relation now known to exist between beams of 
 light and the field of force of a magnet lends support to this 
 theory. The experiments of Hertz tend to prove that all the 
 phenomena of light, radiant heat and actinic radiation are re- 
 duced to phenomena of electro-magnetic radiation between cer- 
 tain limits of wave length. 
 
 Although these facts have no important or direct bear- 
 ing on the subject involved, it may l>e of interest to note that
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 the velocity of light was first found by Himiiis, the eclipses of 
 Jupiter's satellites when they were at the greatest and the least 
 distance from the earth; but it can be measured in the labora- 
 tory by a purely experimental method. The mean of all ob- 
 servations is that light of all wave lengths, travels in vacuo 
 with a velocity of 30,057,400,000 centimeters, or 186,772 meters, 
 per second; in air with a velocity less than this in the ratio 
 of 10,000 to 10,003. The length of waves can be ascertained 
 from measurement at adequate distance to the fringes produced 
 by interference, or by the use of diffraction gratings ruled with 
 a known large number of lines to the inch (40,000 or more). 
 
 The wave lengths of radiant heat, light and actinic radia- 
 tions range from 1/660 cm., or 1/16,500 in. (the longest invisible 
 heat rays lengthwise) to 1/1,300,000 cm., or 1/62,500,000 m. 
 (visible actinic rays; the visible limits are 1/13,042 and 1/25,186 
 cm. The frequency or number of waves per second accordingly 
 range from 20 million per second, the extreme visible limits 
 being 392 to 757 million of millions per second. 
 
 In optical instruments a pencil of rays sometimes deviates 
 from the point through which every component ray of the pen- 
 cil should pass. Spherical aberration results from the spherictiy 
 of length surface or of the mirror used to produce the image 
 of the object. Chromatic aberration is due to the different re- 
 frangibilities of the components of white light. Ref.: Tait, 
 Glazbrook, Stokes, Preston and Wood on Light and Optics. 
 
 REFLECTION AND REFRACTION AND ABSORPTION 
 
 A surface on which a beam of light falls may be either 
 rough or smooth. If it be rough, the greater part of the inci- 
 dent light is irregularly scattered by the innumerable surface 
 facets, to be reflected or dispersed in all directions; if it be 
 smooth, a proportion (never the whole) of the incident light 
 is regularly reflected or turned back in denfiite paths. A smooth 
 dustless mirror is not visible to the eye outside the track of rays 
 reflected from it. If that polished surface be that of a trans- 
 parent substance (like glass) optically denser than the medium 
 conveying the light of it, comparatively little light is reflected : 
 The more oblique the incidence, the smoother the polish, and
 
 PIIKXO.MKXA or I.ICHT AXI> COLOR 
 
 the greater tlie difference between the optical density of the 
 glass and that of the medium in which it is immersed, the 
 greater will be the proportion reflected. Less light, will be re- 
 flected from glass under water than will be reflected from tin- 
 same glass in air. 
 
 If the light travel in a denser medium and strike the bound- 
 ing surface between it and the rarer medium, as where light is 
 ascending through water and strikes its upper free surface, it 
 will, if its obliquity of incidence exceed a certain limit, be al- 
 most totally reflected, the small loss that ensues arising wholly 
 from absorption while no light is transmitted into the air above. 
 
 On reflect ion from polished surfaces we have so far as 
 regards the directions of the reflected rays the following laws: 
 
 1. The incident ray, the normal (i. e., a line drawn per- 
 pendicularly) to the surface at the point of incidence, and the 
 reflected "ray" all lie in one plane, the plane of ".incidence." 
 
 '2. The angle of incidence (the angle which the incident ray 
 makes with the normal to the reflecting surfaces) is equal to the 
 angle of reflection (the corresponding angle between the normal 
 and the reflected "ray"). 
 
 These laws apply equally to ether waves of all lengths, and 
 therefore to light of all colors, no matter what the shape of the 
 surface may be. 
 
 1. Uays which are parallel to one another before striking a 
 plain reflecting surface are parallel after reflection. 
 
 2. If light diverging from or converging towards a point 
 be reflected from a plain mirror, it will appear after reflection 
 to diverge from, or converge towards a point situated on the 
 opposite side of the mirror and at an equal distance from it. 
 
 In curved reflecting surfaces we must trace out the mode 
 of reflection of incident rays from each element or little bit of 
 the reflecting surfaces; and through geometric workings, we 
 arrive at the following propositions: 
 
 1. Parallel rays traveling parallel to the axis of a con- 
 cave paraboloid mirror are made to converge so as to actually 
 pass accurately through, i. e., the geometric forms of the para- 
 boloid; and, of course, if the course of light be at the focus, t he- 
 rays reflected from the mirror emerge parallel to one another.
 
 306 CAST GOLD AND POKCELAIX IXLAYS 
 
 In spherical reflections there is no accurate focus except for 
 rays proceeding from the center and returning to it. 
 
 When these reflections are small as compared to the dis- 
 tance of the center of curvature, they act approximately like 
 parabolic reflectors for parallel rays. 
 
 Rays parallel to the axis, that is, rays from a distant source 
 of light, are reflected so as to pass through the principal focus. 
 Concave mirrors act like concave lenses. 
 
 Refraction 
 
 When a beam of light, traveling in a transparent medium, 
 impinges obliquely upon the surface of another transparent 
 medium, a part of the light is reflected, and a part of it enters 
 the second medium, but in so doing it is refracted or bent out 
 of its former course. The incident, reflected, and refracted rays 
 lie in one plane. 
 
 Snell, in 1621, elucidated the following law of refraction. 
 ''The sine of the angle of incidence bears to the sine of the 
 angle of refraction a ratio which remains constant for any two 
 media, whatever be the angle of incidence. ' ' 
 
 This law of refraction is an immediate deduction from the 
 properties of wave motion; if we assume that the speed of propa- 
 gation of light is different in the different media. When a wave 
 passes over the surface of water, the direction of propagation 
 is perpendicular to the crest or through the wave motion. In 
 like manner we imagine the ray of light to be perpendicular 
 to what is called the wave front, which propagates itself through 
 the medium with the speed of light. So long as the light is 
 confined to one and the same medium, any wave front on which 
 we fix our attention will travel forward so as to ever be parallel 
 to its original position. 
 
 In Fig. 304 let AA'A" represent one of a pencil of rays im- 
 pinging obliquely on the surface B. The wave front may be 
 represented by a line through A perpendicular to the direction 
 of propagation. At the end of a certain time the wave front is 
 at A' ; after another interval of equal duration it is at A". Dur- 
 ing the next equal interval of time, a gradually diminishing 
 breadth of wave is traveling the original medium with the 
 original speed; while a steadily widening portion of the wave
 
 :;o7 
 
 front is entering the second medium. If we suppose the speed 
 of propagation of the disturbance to he less in the second 
 medium, it is clem- {hat the end A. which has been traveling in 
 the second medium, while the end A" has still been in the first 
 medium, must have traveled over a shorter distance. The wave 
 front through .1 will then proceed to move in the second me- 
 dium, so as always to remain parallel to its original direction 
 in this medium, hence the refracted wave front moves on at a 
 less inclination with the interface separating the media than 
 that with which the original wave front impinged upon the in- 
 terface. Again the distance of A" from the surface H, as meas- 
 ured along the ray will be greater than the distance from the 
 
 Fig. 304. 
 
 same surface as measured along the ray, in the ratio of the 
 speeds of propagation in the two media. 
 
 This ratio is the ratio of the sines of the angles of incidence 
 and refraction as given in Snell's law, and is called the refrac- 
 tive index of the second medium as compared with the first. 
 Thus physically, the refractive index of any transparent medium 
 is the ratio of the speed of propagation of light in empty ether 
 to its speed in the medium, the medium in which light travels 
 more slowly, is said to have the greater optical density. 
 
 If we regard A A' to be the original ray traveling in the 
 denser medium being refracted as A" A' A in the less dense 
 medium, we just reverse the direction of the rays without any 
 change in the relation of the angles, except that the refractory
 
 308 (AST COLD AND POIH'KLAIX IX l.AVS 
 
 ray is now bent away from the normal or perpendicular to the 
 surface. Imagine the incident ray in the denser medium to he- 
 come more and more oblique to the interface, the refracted ray 
 will tend more and more to parallelism with the interface, and 
 finally for a definite incidence will pass along it. 
 
 For higher incidence than this critical angle, no refracted 
 ray will pass out; the light will be wholly reflected within the 
 denser medium leaving out of account what is absorbed at the 
 interface. This angle is the angle of total reflection or the 
 critical angle. 
 
 Absorption 
 
 If a ray of sunlight be allowed to fall upon a glass prism, 
 it will be found, on emerging, to be split up into a color band, 
 which is called the solar spectrum. Conversely, these colors, 
 when combined produce ordinary white light; most substances 
 when exposed to sunlight have the power of reflecting one or 
 more of these colors, and of absorbing the rest. Thus, if a 
 ray of sunlight falls on a patch of grass, the grass absorbs all 
 the colors of the white light except the green, which it reflects. 
 These reflected rays meet the eye and convey to it a sensation 
 of greenness; and hence the grass appears as a substance green 
 in color. Similarly a poppy is red, because it absorbs all the 
 rays except the red, which it reflects, and thus assumes a red 
 hue. In the case of a white flower, none of the colors of the 
 spectrum are absorbed; all are reflected. On the other hand, 
 a black cloth absorbs all of the rays and reflects none of them, 
 and so appears black. A red liquid or glass transmits only the 
 rays at the red end of the spectrum and absorbs the others, and 
 so with the other colors. A cobalt blue glass transmits only 
 blue rays, and the extreme red rays, while a glass colored red 
 with copper oxide absorbs the blue and transmits the red. If 
 then these two glasses be placed one in front of the other, and 
 ordinary white light be allowed to fall upon them, the combina- 
 tion permits only the extreme red rays to reach the eye, thus 
 producing a very pure deep red. This method of combining 
 different absorbing media is employed to obtain definite colors 
 in purity; thus white light passing through these cells, one con- 
 taining aniline blue, one chromate of potash, and one copper or
 
 I'liKNOMKXA OF LIGHT AX1) COLOR 309 
 
 sulphate, is successively robbed of its blue, yellow, and red 
 rays, and the emergent light is pure green. 
 
 The absorption of light by gases follows a different law. 
 The white light falls on a cool gas, the gas absorbs only those 
 rays which it would itself emit if incandescent, and leaves dark 
 lines in their places in the spectrum of the light. The vapor of 
 sodium, which is yellow, when incandescent absorbs yellow rays, 
 when cool. On the other hand, if the gas be incandescent, ab- 
 sorption still takes place, but the light of the gas is substituted 
 in the spectrum for the light absorbed, producing a bright 
 yellow band there. 
 
 The color band, called the solar spectrum, is found upon 
 examination, to be crossed by a number of dark lines. If the 
 source of light be changed, the spectrum changes with it. In 
 the spectrum of the white light of a candle, for instance, or that 
 of the oxyhydrogen lime light, the dark lines vanish and we have 
 a continuous spectrum. Again, if light from an incandescent 
 gas 01- vapor be examined, we get, in general, a spectrum con- 
 sisting of a definite number of bright lines on a dark ground. 
 Kvery gas or vapor yields a different and quite characteristic 
 spectrum. The salt of sodium burned in a Bunsen flame, will 
 cause the flame to become yellow, and the spectrum consists of 
 two narrow lines of yellow light. Similarly potassium gives a 
 violet flame, and two bright lines in the red and one in the violet 
 of the solar spectrum. Strontium colors the flame red, and has 
 a number of lines in the red, one in the orange and one in the 
 blue portion of the spectrum. 
 
 Though perhaps having no direct bearing upon the color 
 problem as it concerns our subject, it is of interest to note that 
 these bright lines, in the spectrum of the various substances 
 mentioned, correspond, in position, to certain of the dark lines 
 of the solar spectrum, and it has been established that the dark 
 lines indicate the presence of these metals in question in the 
 sun. As said before, when white light falls on a relatively cool 
 gas, the gas absorbs these rays that it would itself emit in incan- 
 descence. Thus we might have in a room, a source of light 
 giving out all possible waves of light, from red to violet. If 
 this light were led through a screen of sodium vapor, the screen 
 would absorb those rays whose wave lengths corresponded to
 
 310 CAST GOLD AND PORCELAIN INLAYS 
 
 the bright sodium lines in the yellow part of the spectrum. 
 These rays being removed, there would be left two dark lines 
 in their places. This is precisely what happens in the case of 
 solar spectrum. The sun is a source, giving out light of all 
 possible wave lengths; as the light passes through the sun's 
 atmosphere, it encounters, say, the vapor of sodium. This vapor 
 absorbs the rays whose wave lengths correspond to the yellow 
 lines of the sodium spectrum and leaves dark lines in their 
 places in the solar spectrum. By observing these absorption 
 lines in the solar and stellar spectra, the presence of various 
 terrestrial elements have been proved in the sun and the stars. 
 
 The refractive index of a transparent medium is different 
 for different kinds of light. When white light passes through a 
 prism, the different colored rays of which it is composed are 
 bent at varying angles from the original common source of 
 direction. 
 
 They are said to be dispersed. The dispersion for the 
 given prism depends upon the difference of the refractive in- 
 dices of the extreme rays of the visible spectrum. It varies 
 with the substance and the angle of the prism. In general rays 
 of short wave length are more refracted than rays of long wave 
 length, but in some refracting media this law partly breaks 
 down, and the dispersion is then known as anomalous disper- 
 sion. (Ref. : Schellenon, "Spectral Analyses," Marshall Watts, 
 "Spectrum Analysis," Baly, "Specroscopy.") 
 
 The impact of ether waves of a certain particular frequency 
 induces in the eye a particular color. Color then is a sensation 
 and really has no material existence. 
 
 The eye can recognize no other waves save those having a 
 frequency of from 392 to 757 billion per second. Within this 
 range, each number, each frequency has its own color. The ex- 
 treme visible red of the rainbow or spectrum is produced by 
 about 392 billion; the extreme violet by about 757 billion vibra- 
 tions per second. Between these the eye may rest upon certain 
 distinctive colors; and the frequencies corresponding to the 
 respective colors are: 
 
 Red, 492-4; orange red, 484-1 ; orange, 503-3; orange yellow, 
 511-2; yellow, 517-5; green, 570; blue green, 591-4; cyan blue, 
 606; blue, 635.2; violet blue, 685.8; pure blue, 740.5 billion per 
 second.
 
 PHEXO.M KXA OF LICIIT AXI) COLOR 311 
 
 Light due to wave motion of one simple frequency would 
 be homogeneous, or monochromatic, light. If it were visible, it 
 would produce the simplest color sensation. The light of burn- 
 ing sodium is a compound of two yellow lights corresponding to 
 their respective wave frequencies of 508.9 to 510.6 billion vibra- 
 tions per second; and this is the nearest we have as yet reached 
 to monochromatic light. 
 
 The eye takes up any congeries of monochromatic light 
 impinging simultaneously upon the same spot in the retina, 
 anil the resulting sensation is always that of a single color, not 
 necessarily resembling any of the components. 
 
 (irern (uid riolct lif/Jtt blended in different proportions 
 Itmrlucc all ///c niti'nin'diatc blues. Nearly every example of 
 what we call colored light is in reality an admixture of several 
 monochromatic lights. 
 
 White light is usually due to a simultaneous impact of wave 
 motions of all visible frequencies; but the sensation of whiteness 
 may be produced by the simultaneous impact on the retina of 
 two suitable spectral colors such as yellow and ultra-marine 
 blue. 
 
 Colors vary in line, in purity and in luminosity. The hue 
 determines the name. 
 
 The purity or absence of admixture with Avhite light de- 
 termines its richness (i. e., vermilion reflects 80 per cent of red 
 light mixed with 20 per cent of white). 
 
 The luminosity or brightness determines the shade or tone 
 of color. 
 
 Interference with any of these will cause a sensation of the 
 impression produced upon the retina with a corresponding vari- 
 ation in the color. 
 
 The color of transparent objects is due to selective ab- 
 sorption. A red object seen through greenish blue glass ap- 
 pears black; greenish blue glass absorbs the light from the red 
 object. 
 
 Hold the same piece of glass up to the sky, and the red 
 lights which are components of the white light of "day" are 
 cut off; what light passes through will produce a sensation of 
 greenish blue. 
 
 The color of a transparent body will also apparently de-
 
 312 CAST GOLD AND PORCELAIN INLAYS 
 
 pend upon the thickness of tlie layer examined; a thin layer of 
 iodine vapor appears in daylight to be purple; a thicker layer 
 appears blue. 
 
 Before a nonluminous object can be seen otherwise than by 
 transmitted light, it must reflect light; if it does not it will ap- 
 pear black. Pour a colored liquid into a deep black vessel, it 
 Avill reflect no light to the eye of the observer. It absorbs all 
 the light and reflects none. 
 
 Sprinkle a white powder into the vessel onto the surface 
 of the liquid. White light enters the vessel, it is reflected in 
 all directions by the powder, but it is in part absorbed by the 
 liquid and the color of the liquid is revealed. 
 
 Of exactly the same kind is the reflection of light by a solid 
 object. Bodies allow light to traverse them to a very small 
 depth, and then by internal reflection the light is turned back in 
 all directions; absorption comes into play, the result being that 
 the object appears to have a definite color. 
 
 If the light supplied to an object contains none of the kinds 
 of light which it can reflect, the object appears black, or color- 
 less; flowers looked at by the yellow light of burning sodium 
 will appear colorless or black unless the flowers are yellow; 
 surface reflection modifying the result. Color is not always due 
 to selective absorption. A haze is blue if it consists of fine 
 enough particles; these cause repeated reflection and at each 
 reflection the light becomes bluer; because these rays which 
 would have been most refracted (the blue and the violet) are 
 most largely reflected. The color of the sky is that of a haze 
 reflecting light downward. (Ref. : A. H. Church on "Color," 
 1887; and "Colour" by C. T. "Whitmell, 1888.) 
 
 There are three primary colors and these plus a modifier 
 are all the equipment the porcelain worker really needs, lie 
 may for convenience use several shades of the three primaries. 
 
 A primary color is that which can not be made by combining 
 other colors. 
 
 The three primaries are yellow, red, and blue. These may 
 be considered the three colors of creation and they are analogous 
 to light, heat, and shade. 
 
 Yellow represents light, life, and activity; and red repre- 
 sents color or warmth, or richness, if you please.
 
 PHENOMENA OF LIGHT AND COLOR 313 
 
 Blue represents shade or tone. 
 
 The modifiers are white and black, which arc considered the 
 acme of light and shade. 
 
 AYhite or black should not be considered as colors. It seems 
 foolish, and it is foolish that assertions are made, first, that a 
 certain combination of colors will produce white and then that 
 the same combination of colors will result in black. 
 
 For some time a color wheel was a part of school equip- 
 ment, designed to demonstrate that white was a combination of 
 all colors. 
 
 The three primary colors, yellow, red, and blue were placed 
 on the disk, and it was revolved at high speed. But the pri- 
 mary colors on the disk were usually of a light tone, white form- 
 ing a great part of them, and the blending brought about by 
 rapid revolution of the disk resulted in a disk of neutral gray. 
 
 If we combine yellow, red, and blue, in which no white is 
 present, a very dark shade will be produced, and this will be 
 the nearest approach to the absence of all colors, but it will be 
 very far from a true black. 
 
 Any two primary colors mixed in equal parts form a second- 
 ary color. These are three secondary colors: 
 
 Yellow) ~ Red Blue]^, 
 
 ^ [Ureen ,. n mrange -r, , > Purple 
 
 Blue j i el low j Red J 
 
 An important claim set up by some schools that the three 
 secondary colors are the true primaries, must be here combated. 
 
 When a green object is looked at in a strong light until the 
 eye is saturated Avith the color, its complement, red, is produced 
 in the eye, and if the eyes are closed the object will appear a 
 bright red, instead of green, its natural color. The same is 
 true of the others. Purple will produce yellow in the eye, and 
 orange will produce blue. Hence the claim of primaries for the 
 secondaries. 
 
 But a more careful study and observation will show the 
 fallacy of such claim. 
 
 The action of complementary colors is always reciprocal, 
 and the reverse action of these colors is much more marked. 
 
 Red will produce green in the eye much more quickly and 
 brilliantly than green will produce red.
 
 314 CAST GOLD AXD POKCELAIX INLAYS 
 
 Yellow will produce, or, rather, induce purple, and blue 
 will induce orange in the eye much more quickly than the 
 reverse. 
 
 That there is one action of color in light and another in 
 pigment is not correct. The action is the same in both. 
 
 Sanford proves this by the following experiment : 
 
 From a piece of thin looking-glass, cut a couple of little 
 mirrors one-fourth of an inch in width and an inch in length; 
 stick pins in lengthwise through two small corks and glue the 
 backs of the mirrors on to the tops of the corks over the heads 
 of the pins, so they may be stuck into paper and set at any 
 desired angle. Throw the prismatic colors through a prism 
 onto a sheet of white paper on the wall, and place another sheet 
 of white paper on the wall opposite the sheet upon which the 
 colors are shown. To prove that green is a secondary color in 
 light, as well as in pigment, produce it from the adjoining color 
 on each side, blue and yellow. Stick the mirrors one in pure 
 blue, reflecting it onto the white paper opposite; and the other 
 in pure yellow, throwing them together on the opposite paper, 
 the same green shown by the prism will be produced. The 
 same experiment should then be made with the mirrors in yellow 
 and red for orange, and in blue and red for purple. This fully 
 establishes the secondary character of the three colors, for no 
 one who has carefully studied this subject will assert that a 
 color produced by combining two other colors is in any sense 
 a primary one. 
 
 Now try the opposite experiment of producing the blue by 
 combining the adjacent colors on each side "the purple and 
 the green, ' ' and the yellow by combining green and orange, and 
 the red by combining orange and purple, or any other combina- 
 tion you may wish to try. Note the utter failure of the experi- 
 ments and you will be convinced that red, blue, and yellow are 
 the true and only primaries in light and pigments. 
 
 Two secondary colors, combined in equal parts, produce 
 a tertiary color. It may be produced directly from the primary 
 colors, by mixing all three together in the proportion of two 
 parts of one to one part each of the other two; tertiaries are 
 citrine, russet, and olive.
 
 PRIMARIES 
 
 Yellow 
 Yellow 
 
 PJIKXO.MKXA OK J.ICIIT AX1) COLOIt 
 TERTIARY SECONDARY 
 
 Orange - 
 
 315 
 
 Citrine 
 
 Russet 
 
 Blue 
 Blue 
 
 Green 
 
 Orange 
 
 -Purple 
 
 Purple 
 
 Green 
 
 PRIMARY 
 
 -Yellow 
 -Red 
 
 This is as far as the analysis of color can proceed, because 
 if two tertiaries were to be joined for a quaternary, it would be 
 the combining- of the three primaries in almost equal propor- 
 tion, and so we would get an approximate absence of color. 
 
 Only two primary colors are combined simultaneously in 
 the prism or rainbow; for this reason no tertiary colors are 
 present in prismatic or rainbow colors. 
 
 An intermediate color is a color between a primary color 
 and a secondary color, and is made by combining a primary and 
 a secondary in equal parts ; or it may be made directly from the 
 primary colors by mixing two primaries in the proportion of 
 three parts of one to one part of the other. There are six inter- 
 mediate colors: sulphur (yellow-green) ; saffron (yellow-orange) ; 
 nasturtium (red-orange) ; garnet (red-purple) ; campanula (blue- 
 purple) ; and turquoise (blue-green). 
 
 These six intermediate colors arc usually divided into a 
 grade of five shades ranging from the primary to the secondary 
 between which each color stands, and this graduation, together 
 with the multitude of shades of primaries and secondaries, pro- 
 vides an endless variety of color.
 
 316 
 
 CAST GOLD AXD PORCELAIN IXLAVS 
 
 A. 
 
 B. 
 
 C. 
 
 D. 
 
 E. 
 
 F. 
 
 G. 
 
 H. 
 
 I. 
 
 J. 
 
 K, 
 
 L. 
 
 M. 
 
 N. 
 
 0. 
 
 Fig. 305. 
 
 Yellow, primary. 
 Bed, primary. 
 Blue, primary. 
 
 Purple, secondary =: one part S + one part C. 
 Orange, secondary = one part B -f- one part I . 
 Green, secondary one part C + oue part A. 
 Olive, tertiary one part D + one part F. 
 Russet, tertiary one part D + one part E. 
 Citrine, tertiary = one part E -f one part F. 
 Sulphur, intermediate. 3A + \B + W, or 1A + IF. 
 Turquoise, intermediate. 3C + 1J, or IF-flC. 
 Campanula, intermediate. 3(7 + IB, or D + C. 
 Garnet or red purple, intermediate. 37? + 1C. 
 Nasturtium, intermediate. 3-B-f L-l. or IB + 17?. 
 Saffron, intermediate. ?,A + 1B, or 1.1, + 17?.
 
 I'lIKXOMKXA OK UlillT AND COI.OI! .'!17 
 
 Complete Chart of the Prismatic, or Rainbow, Colors 
 
 It will be noted that both in the color guide and in the 
 prismatic chart, indigo does not appear, although it was in- 
 cluded by all colorists from Xewton's time up to 1890, when 
 the discovery was made that, being- a combination of black and 
 blue 1 , indigo never had been present and should not be included 
 in the prismatic colors. 
 
 As will be readily seen, all colors come from the three 
 primary colors, red, yellow and blue. The secondary and inter- 
 mediate colors are formed in the prism or rainbow by a blend- 
 ing of the primary colors; the red and yellow blending together 
 and forming all grades of orange, from red-orange to yellow- 
 orange; and the yellow and blue blending together into all 
 shades of green, from yellow-green to blue-green. Purple is 
 formed both at the top and bottom of the rainbow, by reflection 
 of the red and blue, which are refracted out of a direct line, and 
 consequently reflected on the inner surface of the prism or rain- 
 bow as shown in the chart, the red being reflected from the bot- 
 tom into the blue at the top, thus forming purple. Violet is 
 purple in a diluted form, and as it is a reflected color in the rain- 
 how, and consequently weak, may reasonably be called violet, 
 but is in reality purple. 
 
 The blue is also reflected into the red, and produces pur- 
 ple at the bottom. Colorists, not having looked for this, have 
 failed to observe it, but it may be plainly seen in any bright 
 rainbow. 
 
 The red reflecting into the blue at the top produces all 
 grades of purple between pure purple and red-purple. It will 
 thus be seen that all colors appear in the prismatic or rainbow 
 colors, excepting the tertiary colors citrine, russet, and olive 
 which, being a simultaneous combination of all three .primary 
 colors, cannot themselves exist in the prismatic colors. 
 
 Harmony of Colors 
 
 The way color affects the eye is not only very interesting, 
 but is very important to every person who has eyes. When 
 the eye looks at a color, not the color itself but its opposite, 
 called its complementary color, is absorbed by the eye, and if
 
 318 CAST GOLt) AND 1'OltCKLAlX .IX LAVS 
 
 the eyes are closed, the object will be seen, not in the color 
 the eye saw when open, but in its complementary color. If a 
 red color is looked at until the eye is saturated with the color, 
 and the eyes are closed, the object will be seen, not in red, but 
 in a bright green. If the eye sees a bright yellow until it is 
 filled with the color, it will be seen with closed eyes in a rich 
 purple. Therefore when one color is seen it is important that 
 the next color looked at shall harmonize with the color Nature 
 has formed in the eye, or an unpleasant shock will be expe- 
 rienced and the pleasing sensation of harmony destroyed just 
 as effectually as a clash of sounds shock the ear. 
 
 This creation of the complementary color is not confined 
 to the eye alone, but all Nature capable of reflecting color 
 shows the same action; for example, a yellow sunset reflects 
 purple in all cloud and snow shadows. 
 
 The matter of complementary color is a simple one, not dif- 
 ficult to understand, and everyone should learn it. 
 
 To each color there is one other color which is comple- 
 mentary. A complementary color is one which supplies what is 
 lacking in the other; for example, green, which contains yel- 
 low and blue, lacks red, therefore, red supplies what is lack- 
 ing in green and is its complement, and, vice versa, green is 
 the complement of red. 
 
 In every case complementary colors are reciprocally com- 
 plements of each other. In the color guide, the complementary 
 colors are shown opposite each other. lied and green are com- 
 plements, as are yellow and purple, as well as blue and orange. 
 It becomes a simple matter of remembering these three sets of 
 complements and learning to balance shade for shade, and tint 
 for tint. 
 
 The more delicate these balances, the more subtle and ex- 
 quisite may be the effect of color harmony upon the eye. 
 
 Rule 1. Complementary colors, when placed side by side, 
 brighten each other. 
 
 It is important to understand well the following simple, 
 natural principles. As has been stated, each color produces 
 its complement in the eye. If one looks at red, green is created 
 in the eye. This is not a delusion but a practical fact. If one 
 has seen red, and there is consequently green in the eye, if
 
 P1IKXO.MKXA OF LKJIIT AM) COLoll .')!!) 
 
 the eye turn I'roiu red to green, that is, if the ga/e be quickly 
 shifted from a red to a green surface, tlie green which has been 
 produced in the eye by the red, will add to the green we are 
 looking at and it will appear more brilliant than it would have 
 appeared if the eye had not just been looking at red. This ex- 
 plains the principle of the first rule in the harmony of color. 
 It will thus be understood that if brilliancy of color is desired 
 it must be attained by the application of this principle. Two 
 complementary colors must in some way be so arranged as to 
 appear in juxtaposition. 
 
 Itule 2. Complementary colors, when mixed together, kill 
 each other. 
 
 We must now come to the matter of subduing instead of 
 heightening color, which may easily be done by observing an- 
 other action of Nature. The same color which, if placed be- 
 side a color, will brighten it, if mixed, will kill it. If red be too 
 red, green is the only color that will take the redness out, or 
 subdue it; and, vice versa, if green be too green, red is the only 
 color that can subdue the greenness. 
 
 This fact is of equal force with every other color; red and 
 green are complements and will not only brighten each other in 
 juxtaposition, but will negate each other when mixed together. 
 The same is true of yellow and purple and of blue and orange. 
 
 By observing these rules, any desired effect in the harmony 
 of color may be produced; a color may be heightened by the 
 simple method of placing its complement next to it; or sub- 
 dued (if less brilliancy is desired) by mixing its complement 
 with it. The symphony of practically one color produces the 
 complement in the eye, and if this created complement is not 
 neutralized by the actual presence of the same color, it blends 
 in the eye with the local color and subdues it. 
 
 The range of complementary colors is not wide and com- 
 plex, but very simple and confined strictly to the three pri- 
 maries, the three secondaries and the intermediate colors. 
 
 If a color be a primary, a secondary is its complement. If 
 a color be a secondary, a primary is its complement. 
 
 If a primary color has but a small amount of another pri- 
 mary in it, thus turning the predominating color a little away 
 from the primary, its complement will contain just as much
 
 320 
 
 CAST GOLD AND PORCELAIX 1XLAYS 
 
 INTERMEDIATE COLORS 
 
 Yellow 
 
 Yellow 
 Yellow 
 
 Yellow 
 Yellow 
 
 Campanula' 
 
 -Blue 
 
 (Secondary) (Primary) 
 -Purple - Blue:Red 
 
 Turquoise 
 
 Blue 
 
 (Secondary) Yellow and 
 reen - \ Blue 
 
 Sulphur or Yellow^jreen 
 
 {Secondary) 
 
 reen - Yellow and Blue 
 
 Saffron 
 
 (Secondary) 
 Orange Yellow and Red 
 
 Nasturtium 
 
 arnet 
 
 (Secondary) 
 
 Orange - Yellow and Red 
 
 -Red 
 
 (Secondary) 
 Purple- Red and Blue
 
 PHKXOMF.XA OK LIC1IT AND COLOR 
 
 more of the remaining third primary. For example: It' red has 
 a little yellow in it, turning it toward nasturtium, or red-orange, 
 its complement green, must have just that much more blue in 
 its composition, turning it toward turquoise, or blue-green. In 
 this way the six interim diary colors may be complements. 
 
 A fact to be remembered in the harmony of colors is that 
 white or black added to any one of the primaries, produces two 
 colors of quite opposite i ITect, that always harmonize with each 
 other, as they are virtually light and dark of the same color. 
 
 AYhite added to yellow will produce straw, or cream, color, 
 according to the yellow used: and black added to yellow pro- 
 duces olive, therefore, straw, or cream, and olive produce pink; 
 black added to red produces maroon; hence pink and maroon 
 will always harmonize. 
 
 White added to blue produces azure; black added to blue 
 produces indigo; hence a/ure and indigo will always harmonize.
 
 CHAPTER XXI 
 THE PORCELAIN INLAY 
 
 If we now take up the consideration of the porcelain inlay 
 as a distant operation by itself and not in combination with 
 gold, we shall find ourselves compelled to designate the indica- 
 tion and contraindication for the performance of this operation, 
 and we find that the best general rule that may be laid down 
 would resolve itself into dogmatically stating that porcelain 
 must be used where gold would be objectionable because of 
 esthetic reasons. In other words, all the surfaces of decayed 
 teeth which would upon being restored be exposed to view, must 
 be filled with a material which will not be objectionable to the 
 eye, providing the conservation of the teeth would be brought 
 about to a satisfactory degree. On the other hand, another prin- 
 ciple that might be almost general in its application is in my 
 opinion, well stated in this following sentence: No occlusal sur- 
 face of any tooth which would upon restoration be opposed by 
 a natural dental organ, should be restored by porcelain, when 
 other materials may be had for that purpose. 
 
 I realize that I lay myself open to severe criticism on the 
 part of those who blindly and fanatically follow the porcelain 
 call, but I would call the attention of the practitioner and the 
 student to the fact that properly fused, porcelain is infinitely 
 harder in texture and resistance than the natural tooth enamel, 
 and so under the stress of mastication the latter will suffer by 
 attrition, and the damage created will far outweigh the tem- 
 porary esthetic satisfaction obtained by the operator in com- 
 pleting his operation in the material mentioned. 
 
 It is far better to restore the occlusal surface of natural 
 teeth which have decayed in a material that is somewhat softer 
 or more yielding than the natural tooth enamel, and thus run 
 the risk of having to perform the operation again rather than 
 endanger the integrity of teeth that are in no way involved 
 by decay. It would seem too that porcelain is a material pecu- 
 
 322
 
 THE POItCKLAIX INLAY 323 
 
 liarly adapted to replacing those parts of natural teeth that 
 are in close proximity to the gum tissue, and the reason for 
 that may be found in the fact that porcelain is very dense, and 
 may be fused to a very high polish, so that upon cementation 
 into place, it will present no rough surfaces for any ferment 
 products to attach themselves to and so invade the vulnerable 
 gum tissue area. 
 
 Byram, in an elaborate monograph on the subject of por- 
 celain inlay work, practically concedes to porcelain the realm 
 of the entire mouth, preferring it to any other filling material, 
 but I think that he was mistaken in his deductions and in his 
 conclusions, for the reason stated above. 
 
 The dental porcelains as we use them are composed of 
 silex, kaolin, and feldspar, fluxes and pigments, or coloring 
 matter. 
 
 Silex is an oxide of silicon, an infusible substance insol- 
 uble in all acids except hydrofluoric, slightly soluble in caustic 
 alkalies, and forms about 14 per cent of the basal mass of 
 porcelain. It adds to its strength and gives it a translucent 
 appearance. 
 
 Kaolin or silicon of aluminum, consists of an aluminum ox- 
 ide, silicon oxide and water, sometimes spoken of as disinte- 
 grated feldspar. Through natural decomposition feldspar loses 
 its potassium oxide by the action of water and other agents. 
 Kaolin forms about 4.5 per cent of the porcelain. It is a highly 
 refractory clay when heated alone, but readily unites with 
 feldspar when mixed with it. It supplies the porcelain with 
 stability of form, which permits it to be molded and carved be- 
 fore being fused. 
 
 Feldspar is a duplicate silicate of aluminum and potassium. 
 In other words, it is composed of aluminum oxide, potassium 
 oxide, and silicon oxide, so that it would seem that the differ- 
 ence between feldspar and kaolin is the possession by the for- 
 mer of potassium oxide, and the possession of kaolin of the 
 water of crystallization. Feldspar composes about 82 per cent 
 of the basal mass of porcelain, a highly refractory material, 
 almost infusible in ordinary electric furnaces. 
 
 In order to increase the fusibility of this basal porcelain 
 and make it possible for the general practitioner to use it in his
 
 324 CAST GOLD AXD PORCELAIN IX LAVS 
 
 practice, fluxes are added; such substances as sodium borate 
 (Na 2 B 4 O 7 ); sodium carbonate (Na 2 C0 3 ); potassium carbonate 
 (K 2 CO 3 ), or glass which contains oxides of potassium or sodium 
 forming the greater part. All these fluxes are ground together 
 with the porcelain; then upon fusing a chemical change takes 
 place forming an indefinite compound, from which none of the 
 original ingredients can be removed except by some process 
 which involves the destruction of other ingredients. 
 
 The pigments or coloring matters most commonly used in 
 the manufacture of dental porcelain are precipitated gold, plat- 
 inum, purple of Cassius (the oxide of gold and tin), the oxides 
 of gold, titanium, manganese, and silver. The colors produced 
 by the use of these pigments in varying proportions are hues 
 of red, yellow, blue, green, brown and gray. 
 
 Dental porcelain may be divided into high- and low-fusing 
 porcelain. High-fusing porcelain is one that will fuse above 
 the melting point of pure gold, and low-fusing porcelain some- 
 where below that point. 
 
 By ram states that any enamel body can be fused on pure 
 gold providing enough time is given. Some low-fusing porce- 
 lain will fuse above the fusing point of pure gold, provided 
 the requisite heat to fuse pure gold is obtained rapidly. 
 
 He also adds that while the above distinction seems to meet 
 all practical requirements, it is unscientific and its only value 
 is to make a convenient distinction between the two classes of 
 porcelain for practical usage. 
 
 He also makes the following distinction between high- and 
 low-fusing porcelain: High-fusing porcelains require more than 
 five minutes to fuse, while low-fusing porcelains require less 
 than five minutes to fuse at 2,000 F. It is impossible to fuse 
 any of the high-fusing porcelains at 2,000 F. in five minutes, 
 and it is also impossible to keep any of the low-fusing porce- 
 lains in contact with a heat of 2,000 F. for five minutes with- 
 out becoming overfused. 
 
 He divides porcelain bodies into basal, or foundation, bod- 
 ies, enamel bodies, and glazes. All basal and foundation bod- 
 ies he says are high-fusing porcelains, while enamel bodies and 
 glazes are either high- or low-fusing porcelains. 
 
 The basal bodies are used in crown and bridge work for the
 
 THE PORCELAIN I XI. AY 
 
 construction of hand-carved teeth, and they require a specially 
 constructed furnace in order to maintain the intense heal 
 needed to fuse them. The foundation and enamel bodies might 
 meet the requirements for inlay work and it is best for the 
 operator who intends to perfect himself in this work, to limit 
 his experiments to these latter bodies. These porcelains used 
 for inlay work may be mixed with alcohol or they may be 
 mixed with water. The latter process gives a body more easily 
 carved than the former. 
 
 From an elaborate series of experiments Byram deducted 
 the following: 
 
 1. Porcelain has no definite fusing point. 
 
 2. By prolonging the time of exposing to heat, a thoroughly 
 fused porcelain may be obtained at a comparatively low tem- 
 perature. I do not agree with Byram in this respect; at least 
 I contend that the reasoning of Byram in this instance was in- 
 correct, and that the amount of heat present in the electric fur- 
 nace muffle at the time of the fusing of that porcelain was 
 greater than was indicated upon the pyrometer or other instru- 
 ment used by Byram in determining his degree of heat. The 
 effect of heat upon the porcelain is cumulative, and the vibra- 
 tions of the heat waves in themselves tend to create heat plus, 
 and thus even though the degree indicated upon his instrument 
 was lower than he thought would be required to fuse that por- 
 celain, he must have of necessity been in possession within his 
 muffle of the requisite amount of heat to fuse the mass. So I 
 would rather have it understood by the student that the sec- 
 ond deduction of Byram is not an axiomatic truth. 
 
 3. ''Porcelains fused at a lower temperature and for a 
 longer time will maintain their characteristic color, and will be 
 more homogeneous in texture," which I would rather have read 
 as follows: ''The more carefully porcelains are fused and the 
 more slowly the heat is allowed to permeate them until they 
 reach the fusing point, the more homogeneous will they be in 
 texture, and the more certain they will be in color." 
 
 4. Low-fusing porcelains can be made of high-fusing porce- 
 lain by repeated fusing and grinding; which, while perhaps true, 
 seems to be an anomaly when we consider the fact that each 
 fusing and grinding disposes of part of the flux, and so we
 
 326 CAST GOLD AND POKCKLAIX IX LAVS 
 
 have ultimately the basal bodies or the enamel bodies to deal 
 with, both of which are highly refractory compounds not read- 
 ily subject to fusing. 
 
 5. If a piece of porcelain is thoroughly fused and more 
 porcelain is added and fused, the first layer will be slightly over- 
 fused. In the process of applying porcelain in layers and fus- 
 ing each layer, the underlying layers will be slightly overfused 
 and somewhat lighter in color, which should carry the warning 
 to the student that porcelain restorations should be biscuited 
 until the required amount of bulk, outline, and contour has been 
 obtained, and that the porcelain restoration must be fused only 
 once. 
 
 6. A small mass of porcelain is more readily affected by 
 heat than a larger one, and as the size of the mass of porcelain 
 increases, just in that ratio does the length of time necessary to 
 fuse it increase. 
 
 7. Porcelains containing a large percentage of flux are more 
 easily affected by bubbles than those that are more nearly com- 
 posed of the basal ingredients. Very readily comprehended 
 when we realize that the tendency of all fluxes is to leave the 
 porcelain in the form of gases and that these gases forcing them- 
 selves into and between the molecular spaces of the porcelain, 
 prevent homogenous arrangement of the molecules. 
 
 8. It is more difficult to maintain the characteristic color 
 of low-fusing than high-fusing porcelains when held for a long 
 time at the maximum heat required to fuse them. 
 
 9. Low-fusing porcelains are denser, have greater shrink- 
 age, and less tensile strength than high-fusing porcelains. 
 
 10. By repeated heating of porcelain to the point of high 
 biscuiting, it will finally become fused and maintain its charac- 
 teristic color. 
 
 11. High-fusing porcelains shrink from 15 to 25 per cent, 
 while low-fusing porcelains shrink from 20 to 35 per cent. 
 
 There is an error in the ninth and eleventh deductions 
 which, because of their unimportance to the student, will not 
 be taken up. 
 
 12. A coarsely ground porcelain fuses at a higher tem- 
 perature and shrinks less than one of the same formula finely 
 ground.
 
 THE PORCELAIN IX LAV 327 
 
 13. The amount of shrinkage of any porcelain will in a 
 measure be dependent upon the consistency to which it is mixed 
 and the density to which it is condensed; the thin mixture 
 showing more shrinkage than that of the putty-like consistency. 
 
 14. Underfused porcelain is more opaque. Overfused por- 
 celain becomes lighter and tends to become more transparent. 
 ( )verfused porcelain loses in strength in proportion as the tem- 
 perature is increased. 
 
 15. The tendency of both high- and low-fusing porcelain is 
 to assume spheroidal form when overfused, and if considerably 
 overfuseil they tend to form an amorphous mass of glass. 
 
 ]>yram quotes the following advantages for porcelain as a 
 filling material: 
 
 1. Fillings can be inserted much more nearly harmonious 
 with the natural teeth. 
 
 '2. Porcelain is a poor conductor of thermal changes and 
 a nonconductor of electricity. 
 
 3. The margins of cavities pro peril/ ( ?) filled with por- 
 celain are not readily attacked by caries. 
 
 4. The cement used as a retaining medium giving the fill- 
 ing the greatest adhesion of all of the filling materials except 
 cement. 
 
 ."). The patient is relieved of sitting with a rubber dam 
 adjusted over the mouth for periods of considerable length and 
 of the pain incident to adjusting the rubber dam and cervical 
 clamps for cavities extending beneath the gum. 
 
 6. The nervous strain on both the patient and the dentist 
 is lessened, thereby relieving the patient of the shock which 
 usually follows long and tedious operations. 
 
 7. If a porcelain filling is faulty, it is easily displaced, and 
 the patient knows immediately that the services of a dentist 
 are required. 
 
 Among the disadvantages of porcelain as a filling material, 
 he states: 
 
 1. The friability of porcelain causes it to fracture readily, 
 thereby excluding it from any form of cavity that cannot be 
 so prepared that the overlying margins of the filling material 
 can be formed or else protected from strain. 
 
 '2. It is impossible to bevel the cavity sometimes to protect
 
 328 CAST GOLD AXD PORCELAIN IXLAVS 
 
 the enamel. The relative strength of the porcelain and enamel 
 are approximately the same, so that one cannot protect the 
 other. 
 
 3. It is difficult to match the color of the natural teeth. 
 This always has been and always will be the most serious dis- 
 advantage of porcelain as a filling material and until we under- 
 stand more thoroughly the general phenomena of color forma- 
 tion, we may expect to be disappointed with many of our in- 
 lays. 
 
 4. The cement used as a retaining material may cause a 
 change in the color of the tooth or of the inlay. This, however, 
 may be largely overcome by the application of correct prin- 
 ciples in cavity preparation. 
 
 5. The cement will dissolve unless there is only a thin film 
 used as a retaining medium. This is not so much a disadvan- 
 tage to the skillful operator, for if the margins are defective he 
 will remove the defect by making a new inlay; but to the in- 
 competent or careless operator this will always be a disadvan- 
 tage because any cement now produced will dissolve from the 
 margins of an ill-fitting inlay. 
 
 As to the applicability of porcelain as a filling material, it 
 will, in my opinion, prove confusing to quote Byram on this 
 subject, and it will be best for the student to bear in mind that 
 the writer considers porcelain applicable in simple cavities only, 
 except in the six anterior teeth where compound cavities, that, 
 is, cavities involving more than one surface of a tooth, may be 
 filled with this material. No compound cavities in bicuspids or 
 molars should be filled with porcelain. 
 
 CAVITY PREPARATION 
 
 The preparation of simple cavities for the reception of 
 porcelain inlays has already been outlined in this work. It will, 
 however, be best to reiterate that the walls of these simple 
 cavities must diverge so that the floor of the cavity shall form 
 with the walls of the cavity an angle of at least one hundred 
 degrees. This will insure a more perfect seating of the inlay 
 in the cavity than could be obtained if the walls and floor of the 
 cavity formed a right angle. It must be readily apparent that
 
 THE PORCELAIN' I X I -A Y !')l) 
 
 a platinum or a gold matrix occupies sonic spare, and since the 
 porcelain must be baked in a matrix and that matrix subse- 
 quently stripped off the porcelain inlay, some space will be 
 present between the cavity and the inlay, which space is subse- 
 quently tilled by cement. If then the walls and floor of the 
 cavil v are at a right angle to each other, there will be a cement 
 line showing all around the inlay. If, however, the floor and 
 walls of the cavity are at an obtuse angle to each other, upon 
 the removal of the platinum, the inlay will be allowed to seat 
 itself further into the cavity and because of its wedge forma- 
 tion (of obtuse angle formation) will more closely seal the cav- 
 ity at its external or marginal surface. This will sometimes 
 entirely obliterate any evidence of cement except that the latter 
 will show under a magnifying glass. 
 
 In preparing compound cavities in anterior teeth for por- 
 celain inlays, we have the same factors entering into the cavity 
 preparation which are present in the preparation of cavities 
 for gold inlays; that is: 
 
 1. The surgical or operative factor which means the actual 
 cutting of tooth structure (including the extirpation of the 
 pulp) and the proper filling and treatment of the root canals. 
 
 2. The mechanical or formative factor which means that 
 mode of tooth structure cutting which brings it when cut into 
 the Held of physics, mechanics, geometry, and mathematics. 
 
 3. The alterative factor which means the factor tending to 
 produce a change from decrepit or abnormal to a healthy con- 
 dition because of its restoration to proper physical relation to 
 the surrounding tissues. 
 
 In order to present the three factors mentioned, a cavity 
 for the reception of a compound anterior porcelain inlay must 
 comply with the following requirements: 
 
 It must offer a series of angles and surfaces best suited to 
 resist stress or tendency to fracture of the tooth. 
 
 It must present margins so prepared as to best conserve 
 the enamel structure of the tooth, which in this instance means 
 that the enamel margins must be square and not beveled. 
 
 It must offer a ready access for the making of the matrix 
 or for the taking of the impression, in order to construct a die 
 upon which to swage the matrix.
 
 330 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 It must offer a retentive receptacle and support to the 
 inlay. 
 
 It must offer a series of angles and surfaces best suited to 
 resist the constant tendency to dislodge the inlay. 
 
 It must present margins so prepared that the finished op- 
 eration will conform as nearly as possible to the highest con- 
 ception of beauty of form. 
 
 It must present a form for the reception of the inlay which 
 
 Fig. 306. 
 
 shall bring the various margins into areas of comparative im- 
 munities. 
 
 For the proper instruments, refer to Chapter V, Fig. 8, on 
 cavity preparation for gold inlays, where also will be found the 
 general rules for tooth cutting, etc. 
 
 Dr. F. T. Van Woert, who is an ardent advocate of the por- 
 celain inlay and of the indirect method, published a series of
 
 THE PORCELAIN INLAY 331 
 
 illustrated articles in the I)<'t/t<tl Han* <>f Interest. A number 
 of illustrations and a description of them is here reproduced. 
 
 Fig. 306, A,B, C, and D shows a method of obtaining a sep- 
 aration between two teeth which are to be inlayed. 
 
 A piece of ligature silk is doubled, and by means of a floss 
 silk loop, it is guided through the interdental space below the 
 contact point of the teeth to be separated. A loop is then tied 
 in the ligature silk and the surplus is cut off with a pair of 
 scissors. The silk ligature will absorb sufficient moisture to 
 bring about a separation of the teeth. 
 
 In Fig. 307, A and /?, he illustrates a method of separating, 
 or more or less tilting back to normal two teeth which, because 
 of extensive caries, lean toward one another. He states: 
 
 "There are cases where extensive caries mav have caused 
 
 Fig. 307. 
 
 the leaning of two teeth, say a bicuspid and a molar (Fig. 307, 
 A), or two molars necessitating very extensive separation to 
 place them in anything like a normal position. In such cases, 
 I have obtained most satisfactory results by removing the su- 
 perficial decay and filling the cavities with Calxine cement (a 
 temporary cement), then inserting a small piece of seatangular 
 tent at the point of separation, as shown in Fig. 307, B. 
 
 "I believe this method was devised by Dr. Johnson, of 
 Brooklyn. ]t would be better to experiment with this material 
 before putting it to practical application. It is procurable at 
 most drug stores or at any surgical supply house, and comes in 
 the form of short pencils in a variety of sizes. The expansion is 
 in its diameter and not in its length." 
 
 There is very little occasion for the separation of teeth in
 
 332 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 gold inlay work, and .it should be used with great caution when 
 used at all in any kind of work upon the teeth. 
 
 I have seen many cases of malocclusion and subsequent de- 
 struction of teeth and their supporting and surrounding tissues 
 brought about by over enthusiastic separation prior to inser- 
 tion of contour fillings and inlays. 
 
 These restorations always made the tooth too large mesio- 
 distally, and thus forced all the rest of the teeth in the mouth 
 out of their normal field of residence and excursion. 
 
 Separation can be avoided in most instances by gaining 
 free access to the cavity from the occlusal surface and by sane 
 extension into areas of comparative immunity. 
 
 Fij. S. 
 
 Fig. 308. 
 
 In Fig. 308 Van Woert illustrates the preferred manner 
 of preparation of a simple cavity for a porcelain inlay. 
 
 For half of its depth, the cavity presents walls perpen- 
 dicular to the floor, the other half of the walls being divergent. 
 
 When the inlay is finished, a portion of its inner part is 
 ground off to allow of its being seated, so that the flaring walls 
 will come in contact with the tooth structure and obliterate as 
 much as possible the cement line. 
 
 Dr. Schreier, of Vienna, recommends the making of the 
 matrix of platinum by placing the foil between two layers of 
 goldbeater's skin, thus forming a cradle for the foil and re- 
 ducing the chances of breaking through it in the process of 
 swaging. (See Figs. 309, 310, and 311.)
 
 T1IK POIH'KLAI.V [NLAY 
 
 333 
 
 A very lliin rubber dam will serve equally well as the 
 outer layer, while a pie;-e of thin ( 1 hina silk will take the 
 place of goldbeater's skin as the other part. 
 
 If the matrix is to he formed in the mouth, the foil is 
 placed between the two layers of supporting material and 
 slipped between the teeth, the ruhher dam or outer layer hav- 
 ing been left somewhat longer so that the extended labial and 
 lingual portions of it may be grasped with the fingers firmly 
 around the tooth presenting the cavity. 
 
 With a pair of foil carriers, the ends of which terminate 
 in a ball, pieces of spunk or cotton or small chamois disks are 
 
 Fig. 309. 
 
 Fig. 310. 
 
 Fig. 311, 
 
 now packed carefully, and in sequence, into the cavity covered 
 by the three layers of material, that is, the silk, the foil, and 
 the rubber dam. 
 
 AY hen the foil has been packed into the cavity as deeply 
 as the circumstances will permit, the rubber dam may be dis- 
 pensed with and the packing of chamois disks is renewed to 
 more closely adapt the foil to the tooth. 
 
 The packing is again removed and the almost complete 
 matrix is carefully lifted from the goldbeater's skin or China 
 silk, which, having served its purpose to act as a cradle for 
 the delicate foil, may now also be dispensed with.
 
 334 
 
 CAST GOLD AND POIICKLAIX 
 
 Fig. 312. 
 
 Fig. 313. 
 
 Fig. 314.
 
 THE rORCKLAIX INLAY 
 
 335 
 
 Fig. 315. 
 
 Fig. 316. 
 
 Fig 317. 
 
 Fig. 318.
 
 336 
 
 CAST GOLD AND POttCELAlX INLAYS 
 
 The foil is now carefully replaced into the cavity, the 
 labial and lingual surplus of it is tacked with sticky wax to the 
 respective surfaces of the tooth, the chamois disks, or spunk, 
 or wet cotton in the shape of small balls, are again packed into 
 the matrix and it is thus more and more closely adapted to the 
 floor and walls of the cavity. 
 
 The packing is again removed and the marginal adapta- 
 tion may be best completed with nonmetallic instruments of 
 glass, celluloid, or agate. The very hard tantalum may be used. 
 
 Fig. 319. 
 
 The greatest care should be exercised so that the margins 
 remain intact and present a smooth unbuckled appearance. 
 
 A small cone of inlay wax is softened in dry heat, and by 
 means of a thin broad, plastic instrument, it is carefully packed 
 into the matrix and over the margins of the cavity. 
 
 The tacking of hard wax is now removed from the labial 
 and lingual surfaces of the tooth and the foil liberated. 
 
 A blast of cold air upon the tooth will cause the matrix to
 
 THE PORCELAIN INLAY 337 
 
 loosen from its seat ami it may be removed from the mouth 
 to be carried into the investment. 
 
 The further procedure involved in the construction of the 
 porcelain inlay has been fully described in the previous chap- 
 ter on the gold inlay in combination with silicate and porce- 
 lain. 
 
 Fig. -'Ill* shows a set of eight glass furnishers used in adapt- 
 ing a foil matrix to the cavity in a tooth or in a die. 
 
 Fig. .">!:! shows a set of tantalum instruments designed for 
 this purpose. 
 
 Fig. 314 shows a small platinum tray made by pinching 
 the four corners of a rectangular piece of perforated platinum 
 .'Id-gauge thick. This tray may be used as a carrier or container 
 of the investing material in which the matrix is held. 
 
 Dr. Van AVoert here illustrates (Figs. 315-318) the mixing 
 of the silver amalgam; (1) the invested impression of the cav- 
 ity: (2) the die into which the matrix is to be swaged; (3) an in- 
 >trnment to be used as a swager; (4) this instrument consists 
 of a wooden handle which carries a pointed soft rubber cone, 
 (i the soft rubber end, b the ferrule of metal, c the screw fasten- 
 ing this to the wood. In Fig. 319 is seen the foil reposing be- 
 tween the layers of goldbeater's skin and the application of 
 the hand swager. 
 
 The complete adaptation of the matrix to the die may be 
 brought about in the S. S. White or Ajax swager as elaborated 
 upon in a previous chapter. 
 
 Figs. 320 to 371 are taken from an article published in the 
 /)< ntal Item* <>f Interest written by Dr. Van AVoert, illustrating 
 a simple way of making trays for carrying compound to take 
 impressions of different types of cavities. 
 
 Some years ago Dr. N.ies, of Brooklyn, read a paper which 
 was published in the Dental Items of Interest. 
 
 He attempted in that paper to give to the profession a 
 method of making a porcelain inlay without the use of a metal 
 matrix, thus minimizing to a large extent, the cement line in 
 these restorations. I feel that it will be more just to the doctor 
 to quote his paper minus the introduction, practically in full.
 
 338 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 324. 
 
 Fig. 320. A disto-labial cavity in a central. 
 
 Fig. 321. A strip of platinoid bent at an obtuse angle and perforated so as 
 to hold the compound which is softened in the flame and deposited upon the im- 
 provised tray. 
 
 Fig. 322. Carrying tray and compound between the teeth and forcing the 
 material into the cavity. 
 
 Fig. 323. Lingual view showing surplus of compound at a. This surplus is 
 removed to facilitate removal of impression. 
 
 Fig. 324. Flat straight spatula to aid in p'acing and holding impression 
 material.
 
 THE PORCELAIN INLAY 
 
 339 
 
 
 Fig. 325. A labio-disto-lingual cavity in a lateral. 
 
 Fig. 326. First step in formation of tray. 
 
 Fig. 327. Second piece of metal. 
 
 Fig. 328. Improvised slide made from metal shown in Fig. 327 to fit into 
 that shown in Fig. 326. 
 
 Fig. 329. Showing 328 on 326. 
 
 Fig. 330. Shows 328 carrying compound and taking impression of lingual 
 part of cavity and all of distal part. When the compound has hardened, all sur- 
 plus is removed from the labial surface and this surface is lubricated. 
 
 Fig. 331. Shows 328 carrying compound and sliding down upon 326, when 
 tliis has hardened, the slide is raised and the impression is removed from the tooth 
 in a lino-ual direction. The slide is allowed to descend again until it reaches its 
 destination which is fixed by the compound. This will give an impression of a cavity 
 taking in surfaces of a tooth.
 
 Fig. 334. 
 
 Fig. 333. 
 
 Fig-. 335. 
 
 Fig. 336. 
 
 Fig. 337. 
 
 Fig. 338. 
 
 Fig. 332. A linguo-mesial cavity in a lateral. 
 
 Fig. 333. The tray. 
 
 Fig. 334. The impression. 
 
 Fig. 335. The plastic instruments used as an aid to project the compound 
 into the cavity. 
 
 Figs. 336, 337, and 338. Showing cervical cavity in a cuspid, the partly and 
 completely formed tray.
 
 TIIK POIK'KLAIX 1 X LA Y 
 
 34] 
 
 Fig. 339. 
 
 Fig. 340. 
 
 Fig. 341. 
 
 Fig. 342. 
 
 Fig. 343. 
 
 Fig. 344. 
 
 Fig. 345. 
 
 Fig. 346. 
 
 Ki-s. 339, 340, and 341. Showing a cervical proximal cavity in a lateral and 
 the partly and the completely formed tray for taking impression. 
 
 Fi->. ::i', :\\:\, :M, :\\r>, and ::>.- A cervical cavity in the disto-labial surface 
 of a molar, the partly and the completely formed tray with compound in position on 
 the tooth and the impression of the cavity.
 
 342 
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 Fig. 355. 
 
 Fig. 356. 
 
 Fig. 357. 
 
 Figs. 347, 348, 349, 350, and 351. Same as shown in Figs. 340 to 349 on 
 opposite side of the arch. 
 
 Figs. 352, 353, and 354. A disto-occlusal cavity in an upper molar, the partly 
 and the completely formed tray. 
 
 Figs. 355, 356, and 357. A labio-occlusal cavity in a molar, the partly and 
 the completely formed tray.
 
 THE FORCE LA IX INLAY 
 
 343 
 
 Fig. 358. 
 
 Fig. 3.39. 
 
 Fig. 360. 
 
 Fig. 361. 
 
 Fig. 362. 
 
 Fig. 363. 
 
 Fig. 364. 
 
 Fig. 365. 
 
 Fig. 366. 
 
 Figs. 358, 359, and 360. Another type of disto-ocelusal cavity in a molar. 
 tho partly and the completely formed tray for taking impression. 
 
 Figs. 361 and 362. A mesio-occlusal cavity in a lower molar, and tray for 
 taking impression. 
 
 Figs. 363, 364, 365, and 366. A mcsi.i-'listo- occlusal cavity in a molar, partly 
 and completely formed tray for carrying the compound to take impression of this 
 cavity.
 
 344 
 
 CAST GOLD AND roIIOHLAIX INLAYS 
 
 Fig. 367. 
 
 Fig. 368. 
 
 Fig. 369. 
 
 Fig. 370. 
 
 Fig. 371. 
 
 Figs. 367, 368, 369, and 370. M. O. D. cavity in bicuspid, partly and com- 
 pletely formed tray for taking impression. 
 
 Fig. 371. A handle and sot of trays, or cups, which may be trimmed to suit 
 the case, devised by Dr. Eoacli to facilitate the taking of impressions of various 
 cavities.
 
 THE POKCELAIX IXLAV .'M-.") 
 
 "Ill tiie method of burnishing "-old or platinum foil di- 
 rectly into the cavity there is a nerve-racking tediousness to 
 the operator and patient not to mention pain the frequent 
 tearing of the matrix when almost in place; the uncertainty of 
 having it adapted while heating, and lastly, its fatal defect- 
 that of warping, of yielding to the pressure exerted during the 
 contraction of fused porcelain, are all defects inherent in those 
 metallic matrices. 
 
 "Swaging into a model of the cavity made of amalgam, 
 Spence or Mellotte metal obtained by the impression method, 
 while less trying to the patient and operator, does not relieve 
 the defects that obtain in the porcelain inlay when using a 
 metallic matrix. There is the contraction of the wax not as 
 great as has been stated, I believe with consequent smaller cav- 
 ities in the dies; the contraction of the dies themselves in some 
 of the materials use-d; the additional space occupied by the 
 matrix; the expansion of the matrix when heated. Granting 
 that none of these usual errors have crept in, the matrix, after 
 leaving the die, is still warped in the fusing and contraction 
 of the porcelain. Byram, speaking of labial and buccal and 
 four-wall cavities, says: 'such forms of cavities cannot be pre- 
 pared so that the matrix can be burnished into the cavity and 
 the inlay compensate for the space of the matrix, unless it be 
 constructed with frail margins of porcelain which lack edge 
 strength, and are so thin that change of color is noticeable 
 along those margins.' 
 
 "Nor is there relief found in swaging over the cavity. 
 This method, although permitting a more accurately fitt.ing in- 
 lay than any in use, because of the heavier foil it is possible to 
 use (the thickness making no difference in this method, the 
 thicker matrix offering stouter resistance to the shrinking por- 
 celain, but not enough), does not prevent this metallic matrix 
 also being warped in the fusing. The advantage of swaging 
 should be directly over the first impression of the cavity, tak- 
 ing in oxyphosphate of zinc or copper when possible. 
 
 "It does not matter whether the metallic matrix is directly 
 burnished into the cavity or swaged in or over dies made by the 
 impression method the fatal defect of warping is inherent in 
 both methods. The invested gold matrix has no advantage
 
 346 CAST GOLD AND PORCELAIN INLAYS 
 
 over the uninvested platinum one in the matter of warping. 
 The Price method of burnishing the platinum or gold foil over 
 a stone model and baking in the matrix while it is in place* 
 on the model has the same defect of a warped matrix, due to 
 the fused porcelain contracting while cooling. Xone of the in- 
 vestment furnished for this purpose could hold the delicate foil 
 against the tension of shrinking porcelain. 
 
 "Every metallic matrix takes up an appreciable amount 
 of space, ranging from 1/500 to 1/1000 of an inch, which means 
 an inlay just that much too small and a cement line of that thick- 
 ness to take its place, which often mars the beauty of this work. 
 There is the possible distortion caused by the expanion of the 
 gold and platinum themselves. This may also contribute to a 
 poorly fitting inlay. 
 
 "I have felt that tapered cavity preparation could not al- 
 ways be exact enough to do the work some of us have imagined 
 it did. For the plan to be entirely satisfactory, it is necessary 
 that the margins of the porcelain inlay project beyond the nat- 
 ural surface of the tooth, so that when the matrix foil is re- 
 moved, the inlay will sink down and be just right. Where it 
 is contoured even with the surface of the tooth before the foil 
 was disturbed it would sink below the surface after the foil 
 has been removed, or if built up, it could only be at the center 
 and a peak of cement would result. The difference between 
 diameters of pulpal surface and outside surface might also 
 affect shrinkage unevenly. The smallest deviation from a geo- 
 metric taper might prevent the proper seating of an inlay made 
 by this method. 
 
 "Having briefly mentioned the inherent mechanical errors 
 that obtain throughout the impression and die-making process, 
 which are later inherited by the metallic matrix and its product, 
 the porcelain filling, which also contracts, it must be apparent 
 that some form of matrix is needed that will be free from the 
 errors which the metallic one possesses. A matrix is needed 
 that will take a sharp impression, withstand the intense heat 
 of a high-fusing porcelain, and maintain its shape in this heat 
 without warping; one that slightly expands when set and does 
 not contract, nor on drying become porous; a matrix that will 
 present smooth surfaces, that will not vitrify or fuse at highest
 
 TlIK I'nKCKl.AlX IX LAY !>47 
 
 tension of shrinking porcelain while cooling, and finally, when 
 the inlay is baked, a matrix that can he decomposed, permitting 
 the inlay to he freed from its investment. 
 
 "These qualities must he contained in the ideal matrix, and 
 are embodied in the porcelain matrix that I give you tonight. 
 I give you tonight a matrix that will not warp; that has yield- 
 ing walls; that does not tear; that does not distort; that occu- 
 pies no part of the cavity space; that admits of addition and 
 subtraction of porcelain; and changes of porcelain shades to 
 your heart's content; that allows repair when cracked or 
 chipped; that permits formation of perfect retention cavities 
 and insertion of metallic and porcelain pins and retainers; that 
 has a slight expansion on setting and no contraction on cool- 
 ing; and owing to the stability of the matrix, resists the shrink- 
 ing porcelain, holding it to its margins and walls, thereby pro- 
 ducing a perfectly adapted inlay, thus minimizing the cement 
 line. Let us begin and make an inlay with this matrix. 
 
 " Commence with me by gi nerously separating the teeth to 
 secure space for work. Selecting a German silver or celluloid 
 strip the width of the tooth and about five inches long, bring the 
 ends carefully together and place in its base a piece of soft 
 rubber. Pressing the walls of the strip together, insert this 
 between the teeth to be filled, the loaded end on the lingual 
 side, and then draw it up tightly against these surfaces of the 
 teeth, thus molding it. This I always try to do before trimming 
 the walls of the cavity. We now withdraw it pending our cavity 
 preparation. Isolate the tooth or teeth with a rubber dam; 
 desensitize it in any manner you see fit. 
 
 "I use ethyl chloride put up in metal tubes. I hesitate to 
 mention its use, since one of my dear friends to whom I recom- 
 mended it, almost blew himself up by handling it improperly. 
 Before applying the ethyl chloride, the temperature of the tooth 
 should be lowered by gradually chilling with a pledget of cotton 
 dipped in ether, placed in the cavity and evaporated by a con- 
 tinuous spray of compressed air under high pressure. The tube 
 of ethyl chloride, which in the meantime has been cautiously 
 heated as warm as can comfortably be held in the hand, is 
 opened and the spray is thrown intermittently on the tip of the 
 tooth, gradually working it up toward the neck. The pulp seems
 
 348 CAST GOLD AXD POKCKLAIX INLAYS 
 
 to recede under this treatment and is not injured. I have used 
 this method for many years, and have not known a pulp to be 
 destroyed by it. The process takes but a minute. I mention 
 desensitizing because it is absolutely necessary to cut deeply 
 and freely to obtain frictional surfaces for proper retention. 
 
 ''We now rapidly prepare our cavity with burrs, small 
 stones and polishing disks, doing this work under a powerful 
 glass known as Loope Stereoscopique, which has the great ad- 
 vantage of focusing the vision of both eyes on a single point, 
 and which can be worn over glasses, or glasses can be built 
 into it. After preparing our cavity carefully we drill in a safe 
 place a small depression, which reappearing in our inlay leaves 
 on our inlay a small papilla, which serves as a guide in placing 
 it. Then we paint the cavity with a small camel 's-hair brush 
 dipped in pure white vaseline oil not vaseline or crude petro- 
 leum. In those cases when there is much saliva this coating 
 is, of course, unnecessary. Much has been said against the use 
 of such separating oils, but when one considers the daily food 
 baths of fats and oils that teeth are treated to, I can see no 
 harm in their use. If there is harm in the use of petroleum, it 
 must largely be due to the wax that manufacturers add to give 
 it body. Of course, this objectionable ingredient does not exist 
 in pure vaseline oil. 
 
 "Here we depart from one of the well-known ways of mak- 
 ing an inlay, namely, that of burnishing the platinum of gold 
 foil directly into the cavity. Following the impression method, 
 only so far as taking the impression in wax, or other impression 
 compounds, we proceed to take our impression in a wax which 
 I have had especially prepared for the purpose of taking im- 
 pressions of the anterior teeth, largely without the use of im- 
 pression cups or trays. My object in doing away with the tray 
 where possible is that the space it occupies is often sorely needed 
 to successfully withdraw the impression. The wax I have had 
 prepared is tough, non-elastic, and contracts only slightly, which 
 is easily corrected by the expansion which takes place when we 
 reheat the impression to its workable temperature. It takes an 
 impression as sharp as any, burns up without a residue, and 
 has a high melting point. Other waxes on the market that burn 
 up without a residue are, when warmed, found to be elastic
 
 THE I'OKCKLAIX I \ I .A V ,'U!) 
 
 and sticky, adhering to the teeth; they are brittle when chilled 
 and melt at too low a temperature. 
 
 "I wish to emphasize that it is necessary that a wax have 
 a high melting point, for it permits greater heat to be used in 
 drying the poured impression, which reduces the liability of 
 distortions that frequently obtain when a wax with a low melt- 
 ing point is used. I am partial to the wax impression, and 
 while recognizing that wax expands when heated and contracts 
 when chilled under normal conditions, I am convinced that the 
 conditions that obtain in taking an impression of a cavity are 
 not those that obtain when a bar of w^ax is measured in a water 
 bath without pressure by a micrometer arranged expressly for 
 that purpose. In the case of the impression there is always the 
 forcing into the cavity of new wax by heavy pressure to com- 
 pensate for the shrinkage in cooling. This movement of wax 
 is possible even at normal room temperature. It is admitted 
 that the contraction of gold can be minimized by pressure. The 
 same must be true of wax if clinical results count for anything. 
 
 "To continue, we take a small piece of wax, a trifle larger 
 than the cavity, which we soften in a small bowl of hot water, 
 held close to the patient's face. Now force the wax into the 
 prepared cavity with fingers, next using a steel spade-like blade, 
 which is passed between the teeth for pressure and separation, 
 introducing now the German silver or celluloid strip previously 
 prepared for this purpose, which we tightly draw against the 
 wax, and with strong lateral pressure force the wax into the 
 cavity, making our tooth contour at the same time. When too 
 large, we cut it away and trim with a sharp instrument, always 
 reheating the wax with a hot napkin to remold it. Some of the 
 inlay waxes can be used for impressions. The contraction of 
 these materials is said to be considerable, but I question whether 
 the greater part is not overcome by the forcing of more wax 
 into the cavity as it contracts in cooling, and later when ex- 
 panding the impression by heat. In all bicuspids and molars 
 I prefer a cup to hold my impression material and furnish me 
 means of pressing home my wax. With pressure at right angle 
 we secure perfect adaptation of the impression material to our 
 edges, using preferably cups made for each case of platinoid of 
 28, 30 or 35 gauge.
 
 350 CAST (JOLT) AND PORCELAIN INLAYS 
 
 "The sot soon in my exhibit has kindly been made for me 
 by Dr. F. T. Van AYoert, of Brooklyn. Some of the brass cups 
 devised by Dr. Price have many excellent features. These I 
 have also mounted for your inspection. The use of modeling 
 compounds is not practical with the porcelain matrix, because 
 this matrix material takes time to set and is hardened by heating. 
 Many of the impression compounds, which contain shellac with 
 whiting as a base, swell and form gases when heated, which 
 distort the impression beyond all usefulness before the matrix 
 has had time to set. It shall give you later in my paper, how- 
 ever, a convenient material, Avhich would be ideal could its con- 
 traction be controlled, that can be used with these impression 
 compounds. 
 
 "A splendid impression could also be taken with oxyphos- 
 phates. Before inserting cement in the cavity, test withdraw- 
 als should first be made with modeling compound. After all 
 the undercuts shown to be present have been removed or filled 
 with cement, the cavity is painted with vaseline oil and the ce- 
 ment pressed into the cavity with instruments dipped in alco- 
 hol. The impression should be withdrawn as soon as it is suf- 
 ficiently hard to handle. An advantage of this material is that 
 it can be fractured for withdrawal and later united by addi- 
 tional cement. 
 
 "AVhere it is possible to take the bite and impression to- 
 gether, it is advisable to do so, the wax filling made first and 
 removed adhering to the bite. 
 
 "We proceed in the case of wax impressions with cups to 
 support the frail edges of the impression by embedding it in a 
 plate of softened wax Avhose melting point is lower than the 
 piece which we are investing. This procedure is necessary to 
 prevent these tiny impressions from being engulfed and dis- 
 appearing below the surface of the pouring composition. AA T ith 
 a thermometer as a guide, we place our impression next to a 
 stove and heat it almost to the temperature at which it was 
 when we introduced it into the cavity. This temperature was 
 determined by a bath thermometer immersed in the same cup 
 with the wax. One reading suffices for the whole box of wax. 
 The wax impressions need 110 treatment. The cement impres- 
 sions, however, are covered with a solution of gutta to prevent
 
 THE I'ORCKLAIX 1 X I .A V .'!.">] 
 
 chemical action between tlic matrix material and the impression 
 material. 
 
 44 Wo have now readied the point where we abandon the 
 metallic matrix for the porcelain matrix. It is a porcelain 
 matrix because the materials that enter into its composition are 
 those that enter into the composition of porcelain, namely, sili- 
 cate of aluminum and free aluminum and lime, which on treat- 
 ment with phosphoric acid form phosphate of lime and alum- 
 inum, which gives this mixture setting qualities. The difference 
 between this matrix material and many porcelains is the ab- 
 sence of the feldspar and the llnxes, which are incorporated in 
 the porcelains to increase their fusibility; for example, such sub- 
 stances as sodium carbonate, potassium carbonate, sodium bo- 
 rate, or glass. These fluxes would be fatal to the porcelain 
 matrix, because their presence would cause the aggregates in 
 its composition to vitrify or fuse, thus coat them with an insol- 
 uble glaze, making it very difficult for the decomposing mixture 
 to enter the interstices between the atoms of the matrix to dis- 
 integrate it. The phosphate of lime and aluminum, which is 
 slowly soluble in the decomposing mixture, would be protected 
 by the coating, and would not be acted upon, thus making it 
 impossible to free the inlay. 
 
 "The matrix powders are finely ground, separately mixed 
 in the right proportions, and heated to a bright red heat to 
 expel all water, both free and combined. The mass is then 
 finely ground to impalpable powder and is ready for use by 
 mixing with dilute glacial phosphoric acid. 
 
 "I found this material so difficult to properly prepare, with- 
 out adequate laboratory facilities, that it has been necessary 
 for me to secure the services of a chemist. 
 
 " We are now prepared to pour our matrix. On a glass five 
 by five we place our materials, mixing thoroughly with bone, 
 glass, or gold spatula, to a thick workable consistency. With 
 a tiny brush we pick up this mixture and paint our impression 
 with it, adding thereto until the impression is coated. Now 
 thicken the mixture and fill in the impression with a thicker 
 mix. Wrap the impression in bibulous paper and gently press 
 the mixture against the impression. Leave it in this condition 
 for a few hours to set, after which place it near a source of
 
 CAST GOLD AND PORCELAIN INLAYS 
 
 heat of some kind and allow it to dry for a few hours longer. 
 In the drying the advantage of having a wax that fuses at 
 high temperature is apparent, for it is possible to use a greater 
 heat in drying, hence the better adhesion of the material. Now 
 place the poured impression in or on a stove and gradually 
 heat it, to burn up the wax, continuing this heat until the 
 model is hard. The matrix is allowed to cool, and if too thick 
 is ground down on a carborundum stone. By grinding the 
 matrix as thin as possible the decomposing mixture has less 
 material to penetrate when freeing the inlay; the thinner it is, 
 the more quickly the heat penetrates the matrix and fuses the 
 porcelain. In low-fusing porcelains the grinding has the ad- 
 ditional advantage of so permitting us to form the base that we 
 can direct our porcelains to flow where we wish. 
 
 " 'When the mold is cold, we carefully paint the outer sur- 
 face with a fine camel 's-hair brush right up to the marginal 
 edges of the cavity with a solution of gutta, which I have pre- 
 pared for the purpose of varnishing teeth to protect them from 
 the destructive action caused by the wearing of regulating ap- 
 pliances. This solution I have adapted to the additional pur- 
 pose of varnishing my matrix. It is made from balata gum, 
 from which the resins have been extracted by the usual wash 
 roll process. It is then dissolved in bisulphide of carbon, washed 
 in acetone, filtered and redissolved in chloroform. This makes 
 a pure solution of gutta, with more body and tougher than 
 before obtainable. This gutta has the valuable faculty of swell- 
 ing under heat, and if when filling your matrix any unfused 
 porcelain should happen to accidentally extend beyond your cav- 
 ity margins, the swelling gutta largely dislodges the superfluous 
 porcelain and prevents its adhesion to the outside of the mold. 
 Great care should be exercised to prevent this. After each bak- 
 ing the outer surface of the mold is revarnished. 
 
 "We now prepare to fill the matrix with porcelain. There 
 are numerous ways of doing this, and every man prefers his 
 own, but in this process it is necessary that the first layer in 
 direct contact with the matrix be first fused or glazed. 
 
 "It is highly important with the porcelain matrix that the 
 mold be heated gradually and thoroughly. The porcelain should 
 be fused by receiving its heat from contact with the walls of
 
 THE POItCKLAIN INLAY 353 
 
 the matrix rather than from direct furnace heat exerted on 
 the porcelain itself. If the mold lias been improperly heated 
 the tendency of the porcelain is to ball up and leave the cavity 
 margins, making it necessary to fill in between the inlay and 
 matrix a thing which we should <eek 1o avoid. If the mold 
 is properly heated, the tendency of the porcelain is to cling to 
 it and form a perfect adaptation to the cavity surfaces. To 
 bring about this result a clay hood to cover the matrix while 
 baking is absolutely necessary, for it prevents direct action on 
 the porcelain and enables us to hold back the fusing of the 
 porcelain until the matrix is properly heated. In large con- 
 tours or long cavities a thin film of baked porcelain should first 
 cover the model; then cervical and incisal ends are filled and 
 baked, the intervening space being filled later. Filled in this 
 way, I have found that the porcelain does not shrink away from 
 the interior surface of the mold, but on the contrary clings to 
 the same tenaciously, so that if any shrinkage takes place, it is 
 not at the point where the inlay contacts with the walls of the 
 cavity, but is in the interior, which is later filled in and the 
 piece baked. As it is gradually heated so it is gradually cooled. 
 Additional porcelain is now added Avith brush and spatula, 
 pressing and forming it with fingers and bibulous paper. The 
 addition of gum tragacanth, mixed in the water used to wet the 
 porcelain, is a great help with some high- and medium-fusing 
 bodies. I recommend that medium fusing porcelain be used, 
 because there is no liability of checking from contraction with 
 these bodies, while with low-fusing porcelains there is, unless 
 the cavity is almost filled with quartz. This trouble with low 
 fusing bodies seriously threatened the success of my work until 
 I substituted medium- and high-fusing porcelains. The fact 
 that cracks do not occur with low-fusing porcelains when baked 
 in a metallic matrix is proof that the matrix yielded and was 
 distorted as the porcelain contracted. Did the walls of the me- 
 tallic matrix hold firm, cracks would also be common in this 
 type of inlay. High-fusing porcelains contain a high percentage 
 of silex and kaolin. Both of these materials are virtually con- 
 stant, adding compression, strength, and stability. The high- 
 I'using porcelains having far less contraction than the low-fusing 
 porcelains, it must follow that the men who have been working
 
 354 CAST GOLD AND POKC'ELAIN INLAYS 
 
 with the high -fusing porcelains have made more nearly perfect 
 fitting inlays, for there lias been less shrinkage to their material, 
 and consequently less distortion to their matrices. 
 
 "The piece having been repeatedly carried to a high bis- 
 cuit for contraction and there are men who claim it must be 
 carried to a glaze to secure maximum shrinkage allowance 
 should be made for the lightening of the selected shade by the 
 repeated firings, and a porcelain should be chosen a few shades 
 darker than the tooth. This rule holds with labial cavities, but 
 should not be applied to approximal cavities, where the shade 
 should never be darker than the tooth in the mouth, because 
 when exactly matched in this location it looms darker than the 
 tooth. It should be a trifle lighter. 
 
 "Shaping and contouring should now be done, and there 
 is no safer means than the carborundum disk, grade No. 00. It 
 cuts cleanly and smoothly, and will not chip the inlay. Ruby, 
 garnet, emery, or sand disks should be used in inlay work. If 
 in the final fusing it is not the exact shade you seek, the glaze 
 may be ground off with the same carborundum disk, No. 00, and 
 a better shade of porcelain applied and fused. The inlay can 
 also be removed from the matrix, tried in the mouth, rein- 
 vested and finally glazed. But this takes time. As no porce- 
 lains have a definite fusing point, they should be gradually 
 heated. The thorough heating of the mold should always be 
 done before the point of high biscuit is reached. 
 
 "Earlier in my paper I promised to give you a material 
 that can be used as a matrix mold, to pour into modeling com- 
 pound impressions, to form matrix molds to be used with low- 
 fusing porcelains. This material is no other than the oxyphos- 
 phate of cement that we have had on our shelves the greater 
 part of our lives. It is mixed in the usual way and worked into 
 the compound impression, covered with bibulous paper and 
 pressed home. After setting it is slowly dried over a Bunsen 
 burner and is ready for use. The melting point of this oxy- 
 phosphate is a little over 1,700 F., varying slightly with the dif- 
 ferent cements. As low-fusing porcelains have no fixed melt- 
 ing point, by slowly heating they can be glazed at about 1,600 F., 
 according to my pyrometer. The compound impression should 
 be expanded before using to counteract the shrinkage. In mix-
 
 THE PORCKLAIX INLAY o.V) 
 
 ing the cement, as much powder should be incorporated as pos- 
 sible. I have used Harvard, Ash & Sous' C.A.S., Yyvex and 
 Ames. Other cements may be just as good for this purp<>--. 
 but I have never tried them. This is convenient material that 
 you all have in your offices, and will afford you an opportunity 
 to test for yourself the process I am giving you tonight. If 
 some of you could devise a means of overcoming shrinkage in 
 this material, it would supplant all others as a matrix for low- 
 fusing porcelains in combination with silex. 
 
 "This material product's a beautiful inlay, and there is an 
 immense saving of time in its use. Its shrinkage and the dan- 
 ger of melting it without a pyrometer are its disadvantages. 
 
 "Dr. Price's Stone Model, while perfect for this purpose 
 in many respects, is today almost impossible to dissolve. It 
 also melts below the point of high-fusing porcelains. If he could 
 only overcome these two difficulties, there would be a wider field 
 for this valuable material. 
 
 "Undercuts are formed on the matrix by additions of 
 matrix material that leave depressed recesses for cement, while 
 metallic tubes and pins baked in the inlay can also be usd. 
 Cubical crystals of quartz, a material with'ininimum of expan- 
 sion and contraction, I frequently use to form a crystal sur- 
 face for adhesion of cement. The cement, encircling with crys- 
 tal, not only furnishes an arc action by binding around, Tout 
 also adheres to each particle, and by its own strength gives 
 support to the porcelain that the voids between the crystals 
 might be thought to have weakened. 
 
 "We know that maximum density is maximum strength, 
 yet where compression strength is sought as in concrete work, 
 for instance the maximum of stone properly shaped with a 
 minimum of cement is recommended by experts in that line 
 and should hold true in our work. The crystals of quartz are 
 rolled in a paste of porcelain and placed in the matrix some 
 distance from the margins and as carefully baked as if they 
 formed the inlay. When finished and cooled the voids should 
 be filled with chalk or cement to prevent the porcelain filtering 
 through them and filling them up. 
 
 "The porcelain is now filled in, as experience will guide
 
 356 CAST GOLD AXD POECELAIX 1XLAYS 
 
 you, baked in the prescribed way, and slowly and gradually 
 cooled in the muffle without opening it. 
 
 "When I reached this step in working out my process, I 
 found I had a filling baked in a mold much harder than my 
 porcelain, and how to remove it safely was a problem. The 
 thought of adding a separating medium occurred first, and I be- 
 gan by first coating my mold with amorphous graphite, chalk 
 and finally Higgin's India ink. I very soon found the carbon in 
 this ink burning up in the great heat of my furnace. To pre- 
 vent this I introduced a jet of carbonic acid gas, and later 
 hydrogen, into my furnace through a tube, driving the oxygen 
 out of my muffle, in an effort to prevent the oxidation of my 
 carbon. This process did not work well, and I found my inlays 
 turning green, which caused me to suspect traces of cobalt or 
 copper, and not finding any in the matrix, I concluded that the 
 copper was in the India ink; so I set that process aside and took 
 up the subject of a possible acid solvent. Hydrofluoric acid, 
 with which I had been working, naturally suggested itself, and 
 into this I threw my inlay. In a few hours I discovered that 
 I had etched my inlay, but apparently had produced little or 
 no impression on the^ mold. I then heated the hydrofluoric acid 
 and was delighted to see a softening of the outer surface of 
 the mold. I left it overnight, and the next morning had the 
 pleasure of seeing a trace of my fast-disappearing inlay and a 
 small portion of my mold. I rescued what was left, washed 
 it in clear water, and found that the acid has effected a dissolu- 
 tion of my mold. After finishing the next inlay I carefully 
 coated the exposed surface with melted wax. This I similarly 
 melted in cold hydrofluoric acid, and then I succeeded in dis- 
 integrating my mold, having saved the glazed surface from de- 
 struction by coating. The inside of my inlay, which had no wax 
 or gutta protection, was eaten up by the acid which had been 
 absorbed through the matrix material. This caused me to give 
 up hydrofluoric acid for this purpose. 
 
 "I next tried a mixture of equal parts of nitric and muri- 
 atic acids. Again covering the glazed surface of my inlay with 
 gutta, I immersed it in this solution and gradually disintegrated 
 the mold. The time consumed was four hours, and many un- 
 pleasant odors filled my office and blackened all the metal in it.
 
 THE POKCKLAIX 1X1.AY 
 
 Finally, after many trials, I found the acid that would dis- 
 integrate my mold. I found that a solution of one part hydro- 
 chloric acid to four of water is exceedingly effective, cheaper, 
 simpler, and less dangerous than any of the others. AVe now 
 place the inlay, coated with wax or gutta, in a bottle of cold 
 dilute hydrochloric acid, leaving it when possible over night. 
 If you are pressed for time, the separating process can be has- 
 tened by heating, which will cause disintegration of the mold 
 in a short time. A chimney should be used to carry off the 
 fumes. Even with this weak solution of hydrochloric acid, it 
 is important that the inlay be covered with melted wax or the 
 gutta solution before immersing it, otherwise it will be found 
 that this weak solution has acted on the porcelain and destroyed 
 its luster.* 
 
 "The inlay is now cleaned with small burrs, and brushes 
 dipped in a solution of Bonsit to remove any trace of foreign 
 material from its surface. The inlay is now ready to set.'* 
 
 The process of casting porcelain in a vacuum machine was 
 successfully accomplished by Dr. F. S. Welden. In this process, 
 the restoration is first made in wax, just as in the cast gold 
 inlay; this wax inlay is then invested in a clear white refractory 
 compound, the wax is burned out and the porcelain fused in 
 the crucible of the flask; when the mass is liquid, the valve is 
 opened and the porcelain is sucked into the mold. It is ad- 
 visable to keep playing the flame upon the soft mass to better 
 fill the entire mold. The process never became popular and is 
 now practically obsolete. Further elaboration of this method 
 may he found in September, 1911, issue of the Dental Items of 
 Interest. 
 
 Dr. Stanly Towle, of Fall River, Mass., takes an impression 
 of the cavity for which he is to make a porcelain. He varnishes 
 this impression and then runs a model in inlay wax. He next 
 suspends this model in hydrochloric acid (it seems to the author 
 that hydrofluoric acid should be used) and dissolves the cement. 
 The wax model is now cast in pure gold. He thus gets a re- 
 production of the cavity in pure gold in which lie now T bakes 
 his inlay. 
 
 *I can not conceive any advantage In casting the inlay with wax or a solution 
 of gutta if we are going to subject the acid medium to heat.
 
 358 CAST GOLD AXD PORCELAIN IXLAYS 
 
 There are some advantages and numerous disadvantages in 
 this method. The advantages are the perfect unswaged matrix, 
 the practically obliterated cement line, the ease with which the 
 matrix may be handled without distorting it, and the conven- 
 ience of the patient. 
 
 The disadvantages may be enumerated as follows: 
 
 The frequent checking of the porcelain which comes from 
 the different coefficient of expansion and contraction existing 
 between gold and porcelain. 
 
 The difficulty of seating the inlay when completed, which 
 may be obviated by grinding that part of the inlay which enters 
 the cavity first, but which at best is an empirical procedure. 
 The necessity for chemically removing the matrix, which proc- 
 ess consumes a great deal of time and involves the handling 
 of powerful acids, the fumes of which are very unpleasant, and 
 finally that the method entails a sacrifice of time which is not 
 justified, at least in my opinion, by the results obtained, the 
 latter not being sufficiently superior to those obtained by the 
 use of a very thin matrix material such as 1/2,500 foil of plat- 
 inum. 
 
 For further and more comprehensive elucidation of the 
 porcelain problems that the practitioner may have to face, I 
 am pleased to refer to Byram's "Principles and Practice of 
 Filling Teeth with Porcelain," adding only my own chapter on 
 the coloring problem of this phase of our work.
 
 CHAPTER XXII 
 
 ExnocmxonoxTiA, OR THE DUCTLESS GLAXDS- 
 THEIR EXPRESSIOX IN THE HTM AX MOUTH 
 
 There arc many people who are perfectly well; their daily 
 life is often one of intense physical and mental activity, and yet 
 they rarely, if ever, require therapeutics or mechanical atten- 
 tion. There are others who are miserably ill, mentally and phys- 
 ically, their daily life is one of continued attempt to guard 
 against further encroachment by disease. They are continually 
 under the care of some one ministering to some of their ailments 
 successfully or otherwise. Some people for a period of time are 
 perfectly well, then, for some obscure, and to most observers, 
 unaccountable, reason, sicken or fall seriously ill, to recover in 
 the same obscure and unaccountable manner and continue to 
 live and to work without further interference from disease, for 
 tlifir allotted numbers of years. 
 
 In corollary with the above, there are many people whose 
 dental apparatus is in perfect balance, mechanically expressed, 
 in perfect, occlusion, who never require any dental interference; 
 still others whose teeth were in imperfect condition, as expressed 
 in malocclusion, have had them placed in balance, and subse- 
 quently require an incessant amount of dental interference to 
 keep on repairing and replacing parts of the continually break- 
 ing down apparatus. Some people never pay any attention to 
 the cleanliness or the environment of their teeth, and yet they 
 never need to, nor do they seek dental interference for the alle- 
 viation of any dental disorder. There are others who are con- 
 stantly having their teeth cleaned, their roots scraped and their 
 limns scoured, and still their teeth continue to present new cavi- 
 ties, new breakdowns, new dystrophies. 
 
 Manifestly, the correction of bodily health and tooth health 
 is not clearly understood. 
 
 Many physicians, many surgeons, many dentists will readily 
 
 359
 
 360 CAST GOLD AXD PORCELAIN IXLAYS 
 
 admit the truth of the foregoing' and attest to the statement that 
 they are and have been constantly on the alert for some thing, 
 some truth, the understanding of which would enable them to 
 more effectively handle and efface bodily disorders. 
 
 May it not justly be said, right here, that the cause of med- 
 ical and dental ineffective ministrations has been due to the 
 classification of cases of patients in the aggregate under the 
 heading of certain diseases, when we should have devoted our 
 attention to the close study of the individual constitution of 
 each patient, and so learn to treat an aggregate malady in an 
 individualized way. 
 
 It is a fact that the same disease will express itself differ- 
 ently in different individuals, and yet, if we take up our works 
 on therapeutics, we shall find a woeful lack of individualization 
 of cases calling for treatment. 
 
 Under the heading of "Pneumonia," the pneumonia is 
 treated, under the heading of "Diphtheria," antitoxin is advo- 
 cated. Tuberculosis has its prescribed order of treatment, etc. 
 It is always the disease, almost never the patient. 
 
 We have become so obsessed with the pathologic anatomy 
 of the case that we fail to recognize the ever receding voice of 
 God in the individual, struggling with all the normal that is in 
 him, to overcome the very picture we take as a guide to our 
 treatment. It is so in dentistry, we see the teeth of children 
 decay, and we either remove the teeth and disturb the arch; or 
 we fill the teeth which have decayed, and allow the child to go 
 with the predisposition to decay in the constitution, unrestricted 
 to work its further havoc. 
 
 We see a case of so-called traumatic occlusion and we begin 
 to file and grind the teeth into more or less acceptable stress 
 relationship, paying no attention to the particular "ism" in 
 that particular constitution which caused the arrangement of 
 teeth ultimately bringing about the traumaism that sent the 
 patient to us in search for relief. 
 
 A woman becomes pregnant, bears and gives birth to a 
 child, many of her teeth begin to decay, she loses one or two of 
 them, during the period of lactation, she seeks our advice and 
 help, and we dentists, in almost every instance, fill the decayed
 
 K X DOCK I X ()!)(.) XT I A 361 
 
 teeth and replace the lost ones and dismiss her to go through the 
 same dental ordeal, should she be called upon, in her relation as 
 a wife, to again become procreatively active. 
 
 A case of pyorrhea presenting for relief, the patient is either 
 pyrocided, vaccinated, scaled, scraped, scalded, rubbed and 
 drugged locally, a few teeth are lost, being too far gone; a few 
 are filled, not far enough gone; a few are crowned with golden 
 caskets and the bill paid, the patient is allowed to go and take 
 the pyorrheal potential in his or her constitution, the attack 
 recurs with renewed virulence and renewed destruction. 
 
 Time to change about it seems to me, time to realize that we 
 have not been dealing with the fundamental facts of the cases in 
 our treatment of diseases. 
 
 All the bacteriology we know has not enabled us to eliminate 
 effectively diseases the bacteria of which we know best and are 
 most familiar with. 
 
 Time to realize and to profit from this realization that there 
 are, for example, any number of individuals to whom we could 
 feed sandwiches made up of bread and pneumococci and who 
 would be none the worse for the diet. This is equally true of 
 all germs, not excepting the most virulent of streptococci. 
 
 Some people's teeth will not decay in spite of the lack of 
 any attention on their part, or the dentist's part. 
 
 Some people need but the least exposure to contract all sorts 
 of diseases. Some people's teeth decay in spite of all attention. 
 Some children never have any infectious diseases, some have all 
 sorts of afflictions. 
 
 Wonderful resistance in the apparently immune specimens, 
 lowered resistance in the others. Yes, my friends, but what is 
 this resistance ? Why are some possessed of it and why not the 
 others! Where do they who have it get it, and what do those 
 who suffer lack, in order to make it! 
 
 Patients have become habituated to seek a physician so he 
 may see the disease. Physicians should become habituated so 
 that when they look at and for a disease they should see the 
 patient. 
 
 Patients have become habituated to go to the dentist so he 
 mav look at and after the teeth.
 
 362 CAST GOLD AXD PORCELA1X INLAYS 
 
 Dentists should become habituated so that whenever they 
 look at a tooth decayed or healthy, they should see the patient. 
 
 All this does not mean revolution, neither does it mean a 
 reactionary program, it simply means a broadening of our 
 vision, a more comprehensive understanding, and hence a more 
 effective service in our field of endeavor. 
 
 The endocrines are the organs of internal secretion. 
 
 Endocrinology is the study of the organs of internal secre- 
 tions and the study of the functions of these organs. 
 
 Secretion is a specialized function of certain glands made 
 up of highly specialized epithelial cells (secreting cells) in the 
 exercise of which function, they take up substances from the 
 blood stream and elaborate these substances into products 
 wholly at variance in appearance and effect with the substances 
 which were taken up, and discharge these products by the 
 avenue of special channels or ducts into various organs of the 
 vegetable, animal, or human economy, to effect the physiologic 
 expression of these organs. 
 
 Internal secretion may be defined in the same terms, except 
 that there are no special channels or ducts through which the 
 products elaborated by the ductless glands are conveyed to the 
 various organs; so that these products may be said to find their 
 way into the various parts of the body by directly entering the 
 blood stream. 
 
 The products of the ductless glands or glands of internal 
 secretion have been termed hormones from the Greek Avord, to 
 excite. 
 
 Their influence upon the functions of the various organs of 
 the body is one of augmentation or excitation and, under some 
 circumstances, one of inhibition. 
 
 The potency of these products is practically independent of 
 quantity and wholly interdependent as to quality. In this re- 
 spect, they are very much akin, if not wholly like enzymes or 
 ferments. 
 
 They are in such a fine state of subdivision that they may 
 be likened to electroatomic messengers communicating and 
 carrying orders or directions or aid from the vegetative centers 
 to all parts of the body with which they communicate at all.
 
 KXIHK'KIXODOXTIA l>()i> 
 
 The most important ductless glands as we know them are, 
 first the pineal, a small gland situated at the base of the pituitary 
 body. 
 
 Second, the pituitary body, a v< ry vascular gland, consiM- 
 ing of an anterior, middle and posterior portion, all situated in 
 the sella turcica of the sphenoid bone. It governs periodicity, 
 rhythm, influences growth, nutrition, reproduction, the psy- 
 chosis, and is influenced by the thymus, the thyroid, the gonads, 
 and the adrenals. 
 
 Third, the thyroid gland and the parathyroid bodies. The 
 lirst consists of two lateral lobes, disposed on either side and in 
 front of the larynx and upper three or four rings of the trachea. 
 The parathyroid bodies are arranged on either side of the me- 
 dian line and may be found as low as the seventh traeheal ring. 
 The thyroid is a very vascular body of gland tissue, it is sup- 
 plied by the superior and inferior thyroidal arteries, which form 
 a rich anastomosis. The veins are correspondingly free and 
 numerous, they are valveless and empty into the jugular and 
 innominate veins. It influences nutrition, growth, reproduction 
 and is profoundly influenced by functional and organic disturb- 
 ances of the alimentary canal and the gonads. 
 
 Fourth, the thymus develops as a paired sac-like divertic- 
 uluin of the ventral portion of the third and fourth and possibly 
 the second pharvngeal cleft. This sac-like beginning of the thy- 
 mus is entirely epithelial in structure. It influences metabolism 
 in the child, also the thyroid, the pituitary and the gonads, and 
 is itself markedly affected by pituitary and adrenal disturbances. 
 
 Fifth, the suprarenal capsules, adrenal bodies, are two 
 small, flattened, glandular bodies located in the back part of the 
 abdomen, above and somewhat anteriorly to the upper part of 
 each kidney. They consist of a cortical and medullary portion, 
 they are exceedingly vascular, with abundant lymph supply. 
 The nerve supply is significant, being derived from the solar and 
 renal plexuses and getting branches from the phrenic and pneu- 
 mogastric nerves. Their important connection with the sympa- 
 tlutic is today well known. Dr. Joseph Fraenkel terms the 
 sympathetic nerve "the frozen adrenal" attempting to convey 
 the impression that it is a continuous line, icicle as it were, of
 
 CAST GOLD AXD PORCELAIN IXLAYS 
 
 projected adrenal substance. The adrenals play a most import- 
 ant part in the development of the being; a tremendous part in 
 the mental growth of the being. Virtually, the great center of 
 the autonomic nervous system, they have been called the abdom- 
 inal brain, they control energy and the decorative scheme in the 
 body; they have everything to do with pigmentation, with oxy- 
 genation of the blood; they influence the thymus, the thyroid, the 
 pituitary body and the sexual organs, and are themselves mark- 
 edly affected by thyroidal, pituitary, and gonadial influences. 
 
 Sixth, the gonads, the organs of immortality on the pro- 
 creative plane or better, the instruments whereby man perpetu- 
 ates his species on earth. In children the gonads are markedly 
 influenced by the thymus, the persistency of which will retard 
 adolescence. In children of normal development, the thymus 
 goes out at puberty and the thyroid with its regulating and 
 supervising influence comes in. At that time also, the assertive 
 period of the gonads becoming manifest, they call on the adren- 
 als in the male and on the pituitary in the female to set up an 
 intercommunicating system of harmonic relations, which result 
 in a most intimate interdependence, very apparent in the female 
 during menstruation, pregnancy, childbirth, and lactation, in 
 the male during periods of great physical stress, excitation or 
 copulation or of sublimation of the procreative urge into intel- 
 lectual or intuitional poetic expression, in other words during 
 inversion of procreation to creation. 
 
 The foregoing may be summed up rather crudely as follows: 
 
 Thymus Youth. 
 
 Thyroid Quality and equilibrium. 
 
 Pituitary Bulk and disposition (psychosis). 
 
 Adrenal Energy and decoration. 
 
 Gonads Immortality or procreation. 
 
 Pineal Intelligence, soul or cosmic relationship ( ?). 
 
 The normal, augmented or inhibited activity of one or more 
 or all of these glands is manifested in diverse ways in the human, 
 dental apparatus, and it is to the recognition and the study of 
 these manifestations, that I have given the name of Endocrino- 
 dontia. 
 
 The thymotrop, the thyrotrop, the pituitotrop, the adreno-
 
 K XlKXTi I XOI )( ) XTI A 365 
 
 trop and the gonadotrop are names or designations appended to 
 individuals who exhibit in their makeup, a preponderance of 
 thyinic, tliyroidal, pituitary, adrenal, or gonadial influences, as 
 the case may be. 
 
 Dr. D. M. Kaplan, the director of the laboratories at the 
 Neurological Institute of New York, published an article in 
 Endocrinology, April, 1917. He called this article "An Endo- 
 crine Interpretation of the Dental Apparatus." 
 
 The quotation of this article in full will be illuminating, 
 particularly since I wish to point out what appear to me to be 
 some slight errors in his conception and nomenclature. 
 
 "There is not the least doubt that the glands producing 
 internal secretions exert an influence upon the exterior of the 
 individual. Although the uninitiated still may consider cer- 
 tain individual peculiarites as accidental, the endocrinologist 
 knows which organ, or organs, w r ere instrumental in the produc- 
 tion of these seemingly accidental phenomena. To ascribe a 
 certain bodily appearance to accident is a confession of igno- 
 rance, which, however, is becoming less frequent the more one 
 studies the mystic forces of the endocrines. The study of their 
 functions can not be severed from the study of these glands, so 
 much so, that one may justly call this specialty an investigation 
 of the 'compensatory dynamics of the endocrines in health and 
 disease. ' 
 
 "To understand the compensatory workings of the endo- 
 crines is to know 'internal secretions'; and to be able to trans- 
 late it into terms of physiology and pathology is to know how 
 to handle your patient from an endocrine point of view. There 
 are many external manifestations resulting from the work of the 
 endocrines that have been carefully studied, many that are only 
 superficially known, and still more to be discovered in the 
 future. To the endocrinologist a pigmented mole is not an acci- 
 dent, nor the mustached female of twenty-five, nor the soft pulse 
 at eighty, nor the high blood pressure at thirty, nor the enlarged, 
 noninfected tonsil. ]t is the why and wherefore of a peculiarity 
 that is the constant question before the endocrinologist, and
 
 366 CAST GOLD AND PORCKLAIX INLAYS 
 
 very often the answer is radically opposed to orthodox allopathic 
 thought. Therefore the uninitiated may be perplexed by the 
 stand taken by the student of compensatory dynamics, AY ho 
 argues against the reduction of a high blood pressure in a cer- 
 tain patient, or the removal of the tonsils in another, and yet he 
 may offer very sound reasons for both conclusions. 
 
 "In his endeavor to arrive at the truth, the student of 'com- 
 pensatory dynamics' takes into consideration the fact that cer- 
 tain infections have an affinity or, as I have designated it, a 
 'tropism' for certain glands with internal secretion. For in- 
 stance, it is known to all that mumps is an infectious disease 
 that often attacks the gonads. It has been noted that diphtheria 
 and typhoid have a tendency to cripple the adrenals, so that 
 mumps is known as a gonadotropic infectious disease, while 
 diphtheria is an adrenotropic. 
 
 "There is also a definite tropism between endocrine disturb- 
 ances and the dental apparatus. Ewan "Waller, of Birmingham, 
 England, has very definitely associated the teeth in children 
 with the thyroid function. It seems that the glands with inter- 
 nal secretions play an important role not only in the structural, 
 but also in the physiochemical economy of the individual. A 
 great number of the unclassified subjective disturbances for- 
 merly designated as neurasthenia, neurosis, or hysteria, and 
 lately as vagotonia, can be more justly ascribed to an aberration 
 or a disturbance in the compensatory dynamics of the endo- 
 crines. The thorough investigator of the constitution of an 
 individual in health or disease takes into account the phenomena 
 not only as pictured in our books on diagnosis, but also the time 
 of day or night, the amelioration or intensification of symptoms 
 in the evening, its involvement of the right or left side of the 
 body and he differentiates where the same complaint appears in 
 the juvenile, adult, or senile individual. 
 
 "There are a great many points dismissed by the uninitiated 
 as insignificant, which the endocrinologist employs to advantage 
 in building up a picture of disturbed equilibrium in a patient. 
 The peculiarities of the dental apparatus is one of them. 
 
 " THYRODONTIA. It is a fairly well-established fact that 
 the calcium metabolism is governed chiefly by the thyroid ap-
 
 paratus, and secondarily, by the rest of the endocrines. The 
 alkalinity of the saliva to a certain extent depends upon calcium 
 salts. It is to he seen how a disturbed endocrine equilibrium 
 could bring about dental decay by a disturbance in the calcium 
 metabolism balance, particularly in children who depend upon 
 their thyroid and thymus more than the adult and senile. The 
 calcium being deficient, the acids from food decomposition are 
 not neutralized, and the dentine consequently suffers, this being 
 one of the stages in the complete breaking down of the tooth. In 
 children particularly, a well-balanced thyroid and sound teeth 
 go together. If the thyroid is not performing its duties prop- 
 erly, the tooth to suffer first is the molar. The submaxillary 
 saliva is said to be richer in calcium than the parotid, and in 
 view of the fact that the molars lie behind the duct, their supply 
 of immunizing saliva is less than the front teeth, and hence, in 
 case of calcium deficiency, they succumb first. This is mani- 
 festly apparent in the longer life of the lower front teeth as 
 compared with the upper, the latter not having the constant 
 salivary bath enjoyed by the lower teeth. This is very charac- 
 teristically displayed by the woman with an exhausted thyroid, 
 due to repented pregnancies, who invariably loses her upper 
 incisors. Of course in such women the other endocrines enter 
 into the mechanism conducive to dental loss. 
 
 "To start with, thyroid teeth are distinguished by their 
 slender frame, they are thinner, more transparent, and graceful, 
 and their color tends toward a bluish gray white. Children and 
 married women with such teeth can be saved a great deal of 
 dental trouble by the discreet and timely administration of 
 thyroid extract. The frequency of the therapeutic display de- 
 pends entirely upon the case and the acumen of the physician. 
 
 "In the multipara the dental situation from an endocrine 
 point of view is only partly thyroidal. The interplay and com- 
 pensatory work of all of them are necessary to help her through 
 this physiologic symbiosis. If the woman is deficient in any of 
 the endocrines, she will display not only dental changes, but all 
 kinds of other objective and subjective manifestations depend- 
 ing upon the glands or gland involved. The falling out of the 
 upper incisors independent of decay, bears a distinct pituitary 
 stamp, and one may say that the maxillary sockets become too
 
 368 CAST GOLD AXD PORCELAIN INLAYS 
 
 large in some pregnant women, and that the root is not firmly 
 implanted in such a jaw, at this episode of partial transient 
 physiologic aeromegaly. It is the duty of the discerning physi- 
 cian, as well as the dentist, to guard against irreparable loss, 
 disfigurement and suffering of patients by a timely use of thy- 
 roid extract in cases of dental caries or late eruption, as well as 
 in gestations that promise injury to the teeth. 
 
 " PITUITODONTIA. Many individuals who are free from 
 complaints that would compel them to seek a physician 's advice, 
 are the possessors of teeth characteristic of the acromegalic. 
 The owners of such teeth need not develop aeromegaly, never- 
 theless they must be regarded as potentially pituitary. Chronic 
 frontal headaches and the slightest limitation in the temporal 
 visual fields, require very earnest attention and extremely judi- 
 cious endocrine therapy, for at such a stage one might hold out 
 some hope of deferring the advent of the full-fledged acromegalic 
 picture. Increase in size of the acral parts is the chief objective 
 sign of this disease and the pituitary is the gland responsible for 
 its appearance. 
 
 "It must not be forgotten, however, that not only an in- 
 crease, but also a very marked diminution in size, belong to the 
 activity of the pituitary gland; so that giant and pigmy are 
 endocrinologically related. The same applies to the teeth. The 
 average pituitary dental arrangement shows large square teeth ; 
 oftener than not the upper middle incisors are spaced (trema) 
 and the rest of the teeth may share in their separation, stopping 
 at the bicuspids. On the other hand, marked overcrowding is 
 a feature which also belongs to the department of hypophysial 
 activity, so that one is frequently confronted with a situation 
 requiring gerat care in endocrine interpretation. The gestating 
 female has been referred to before, but it must be reiterated, 
 that the falling out of the incisors, particularly the lateral one, 
 has a double meaning. At present let us not forget that the 
 middle upper incisors are preeminently the teeth closely asso- 
 ciated with direct primary pituitary function. This does not 
 signify that the individual has a pituitary abnormality incom- 
 patible with perfect health; it may show itself in anybody with
 
 KMHH'KINonoXTIA 369 
 
 accepted hypophysial markings, sucli as being V ( M-V tall or very 
 short, having a very large head, particularly in the frontal part, 
 or manifesting a tendency to adiposity in the young or adult, 
 with or without hypogenitalism. It may accompany the fem- 
 inine type of man who shows his abnormality in his teeth only, 
 and his sexual anomaly in his psychoanalysis. 
 
 " GOXADODOXTIA. Individuals with a gonadotropism may 
 give in their history an attack of mumps during childhood. 
 Close relationship between this contagious disease and the gen- 
 ital glands is established by the frequent involvement of the 
 ovary or testis in a complicating inflammatory reaction. It is 
 not necessary that the individual previously having had mumps 
 should present earmarks of a definite gonad disease, he may yet 
 show them in the future or not at all. This depends entirely 
 ui)on the compensatory work of the rest of the endocrines. 
 
 "In all endocrine manifestations not only the soma, but 
 also the psyche is influenced. Besides these psychic attributes 
 most of them show definite somatic stigmata, of course not all 
 of them, the exceptions here as elsewhere serving to establish 
 the rule. 
 
 "In the gonadotropic individual the dental apparatus car- 
 ries a very striking earmark of the tropism. If the middle upper 
 incisors carry a message from the pituitary, the lateral upper 
 incisors certainly do the same from the gonads. So that when 
 the gonads are teratologically ab ovo definitely abnormal, one is 
 sure to find some abnormality in the upper lateral incisors. The 
 relationship, if any, is a crossed one, so that the right upper 
 lateral incisor may point to the left testis or ovary, and vice 
 versa. 
 
 "It is also to be noted that the greater the deviations from 
 normal, the more definite the markings in the dental department, 
 so much so, that the lateral incisors, as a result of a marked 
 gonad defect, may not have erupted at all. Such a dental situa- 
 tion is rare indeed, so is also the clinical condition presented by 
 the patient who has it. Here is a situation that the gynecologist 
 could profit by, and the surgeon add another sign to the sig- 
 nificance of right-sided abdominal pain. Such a pain is usually 
 ovarian, when the left upper lateral incisor is faultily implanted,
 
 370 CAST GOLD AND POECELATX INLAYS 
 
 showing the mesial edge of the tooth anteriorly, and protruding 
 in front of the middle incisor. The teeth presumed to be con- 
 nected with the gonads (upper lateral incisors) carry the stamp 
 of ovarian or testicular abnormality in their size, shape or im- 
 plantation. 
 
 "The ovary should always be suspected where pelvic pain 
 is manifested in a patient whose lateral incisors are abnormal. 
 In the male, small stumpy laterals bespeak sexual impotence on 
 a physical basis, many gonorrheas, prostatic insufficiency, and 
 chronic strictures. In such an individual one may obtain the 
 history of mumps, and if he had a right sided orchitis or epididy- 
 mitis, more often than not his left upper lateral incisor will be 
 differing from the normal, taking his entire dental apparatus on 
 the standard of comparison. 
 
 "On rare occasions the compensatory work of the other 
 endocrines is so well adjusted that the dental anomaly is obliter- 
 ated, and gives no clue to the existing gonadopathy. There are, 
 however, other external signs from an endocrine point of view 
 that would direct attention to the existing state of affairs. As 
 the dental apparatus is the subject of this paper, the other signs 
 will not be discussed. 
 
 "There is a dangerous tendency among endocrinologists to 
 designate with peremptory precision that this or that organ is 
 involved, and is responsible for the endocrine picture. Very 
 often the external manifestations are caused by another gland 
 whose functions it may be to bring about phenomena on the sur- 
 face of the patient, such as, for instance, the adrenal system; and 
 some students may be carried away by this easily demonstrable, 
 superficial appearance, and be led to assign to the objective find- 
 ings the place of first importance; whereas, the adrenals have 
 simply acted in response to a call from some other gland. The 
 gonads always require adrenal help in performing their work, 
 and when they do not come up to the physiologic requirement, 
 be this in the form of under- or overactivity, the adrenals are 
 then called upon for additional assistance, resulting, secondarily 
 only, in manifestations appearing on the skin, mucous mem- 
 branes, hair, etc. The primary, ab ovo, situation can be read 
 from the teeth and the gland responsible for the trouble more 
 often than not, can be unerringly named and proper therapy sug-
 
 KXIHK'RIXOnoXTIA 371 
 
 gcsted. It is remarkable how readily the patient responds when 
 the proper drug is prescribed, hut IK re, as elsewhere, the futility 
 of attempting replacement therapy in some cases must be 
 thoroughly gauged. 
 
 "A young woman suffering from the torture resulting from 
 a complete oophorectomy can not he benefited much by ovarian 
 extracts, be it the whole gland or the luteal portion. In some 
 cases one must be able to read intelligently the symptomatology, 
 and curb as much as possible the pituitary compensation, for in 
 such cases, this is the gland that may be causing much of the 
 subjective discomfort. If the pituitary, however, is not capable 
 of compensation, or is only partly able to assist, the adrenal and 
 thyroid systems are employed to overcome the deficiency. De- 
 pending upon the fitness of these glands one will have a predomi- 
 nating adrenal or thyroid symptomatology. Therapeutic success 
 depends entirely upon our ability to recognize the vicarious 
 execution of functions by glands with a different purpose. 
 
 "ADRENODOXTIA. It is to be conceded that the ability to 
 perform better work requires better tools. In biology this is 
 everywhere evident. P'rom times immemorial the longer and 
 sharper tooth was part of the outfit of the pithecanthropus, 
 whose survival was assured. Such a specimen was perhaps also 
 the hairiest of the tribe. As time advanced and the necessity for 
 using the teeth in offensive and defensive existence became sec- 
 ondary to the special development of the thumb and hands, the 
 chief lighting teeth, the canines, became shorter, and in some 
 very peaceful members of our semisimian ancestors, also less 
 sharp. With the greater use of the hand came the perfection 
 of that part of the brain that serves as the storehouse for memo- 
 ries. These memories became the heritage of the future man, 
 and with the greater specialization of the hand, the teeth were 
 gradually discarded as weapons of defense and offense. The 
 emotions in the state of offensive rage still cause the display 
 of them, although one does not use them. 
 
 "Vasomotor force and the tone of muscles depends upon 
 the proper work of the adrenals. Only when these glands work 
 better than the others, is it possible to think of the enduring 
 prizefighter. When the pituitary is equally well adjusted, one 
 has the heavy weight champion type. But the ability to scrap,
 
 372 CAST GOLD AND PORCELAIN IXLAYS 
 
 whether curbed by education or environment, or not, is indelibly 
 marked in the canines. As one of our ancestors would have 
 learned by experience that his short and blunt canine was no 
 great weapon in a fight and would have become the champion of 
 peace instead of conflict, so also the present man prefers discre- 
 tion to valor because of his inadequate adrenal endowment or, as 
 one may term it, lack of biologic equipment for strife. Whether 
 man or woman, both show in a long sharp canine an atavistic 
 remnant of a bellicose progenitor, and upon proper provocation 
 justify the above contention. 
 
 "Very often the large and sharp canine in a woman be- 
 speaks the aggressive agitator, public speaker, or militant suf- 
 fragette. Some of these women studied from the point of view 
 of biologic balance possess other endocrine markings, showing 
 that they are not women to the full extent that nature intended 
 the average woman to be. The woman whose skin is rough, who 
 finds pleasure in curbing wild horses, who cares not for the 
 duties of home life, and who is an expert administrator (pur- 
 posely using the masculine) must give up a certain amount of 
 natural feminism in order to be able to enjoy and accomplish 
 the above things. Very often with such traits goes a masculine 
 hand, a mustached lip, a large-pointed canine, and a deficient 
 gonadodont. The sexual psychopath could be detected by a 
 study of his dental apparatus, and the endocrine therapist might 
 supply the glandular extract that would give a more natural 
 trend to the twisted psyche of its possesor. 
 
 "The spinster who truly rejoices in her single blessedness 
 does not do so from choice, but rather from her innate prompt- 
 ings. Being less of a woman than her well-balanced sister, she 
 does not require the society of a man, and frequently shows her 
 genuine distaste for such company by an appropriate remark. 
 In her pursuits she wants to dominate and frequently fills with 
 credit a position requiring great virility. She abhors the eve- 
 ning gown, and wears clothes of a masculine type, low heels, no 
 corsets, side pockets, collar, and tie. 
 
 * * The male counterpart with short, stumpy and dull canines 
 gives up some of his primordial male aggressiveness, and be- 
 comes the Jacob instead of the hairy Esau. The kitchen is his 
 place, he can sing in high notes, never a basso, and has the
 
 EXDOCRIXODOXTIA 373 
 
 greatest inward storms when the time comes for him to propose 
 marriage to his heart 's choice. Such a man stands a poor chance 
 of being accepted by a girl well balanced from an endocrine 
 standpoint. It is the one who will not enlist to help defend his 
 country, but will offer a thousand and one reasons why he should 
 not tight, that war is a reversion to barbaric times, etc. Such 
 men are afraid that a gun might go off, and in business are 
 equally nonprogressive. The eternal clerk, messenger boy, cook, 
 and other nonprogressive occupations are theirs. Endurance, 
 progressiveness, discovery go hand in hand with an endocrine 
 system that is pi-rlVct, and a canine tooth that fears not to face 
 antagonism in any shape or form. 
 
 "The adrenodont in its structure gives us a clue to the ad- 
 renal balance of the individual. There is another characteristic 
 of the adrenal tooth, the color. The grinding surface of such 
 teeth shows a marked reddish brown coloration (Chayes), and 
 although softer in texture than the thyroid or pituitary variety, 
 they have a greater degree of endurance (Chayes). Here again 
 is a hint of the ability of adrenal secretion to protect. Old men 
 or women will show short teeth still in a very good state of 
 preservation and most freely marked with this reddish brown 
 pigment. Younger people with such teeth can be assured of 
 their lasting character, and it is astonishing to note how some of 
 them remain intact regardless of the lack of care and the thick 
 wall of tartar that surrounds them. Age or the ability to grow 
 old goes hand in hand with proper adrenal work, of course with 
 the assistance of the other endocrines; and so adrenal markings 
 in the form of pigment insure not only the life of the tooth but 
 also its possessor. Individuals who become patients on account 
 of improper adrenal work may show this peculiarity in their 
 teeth also, the marking here indicating the gland affected as well 
 as suggesting the proper therapeutic course to pursue. 
 
 " THYMODONTIA. The tooth of the baby is bluish porclain, 
 thin at the grinding edge, and translucent in that part. The 
 tooth in some children shows a tendency to scalloping at the 
 grinding edge. This trait may outlast the baby and in rare 
 occasions be found in the adult. The other infantile character- 
 istics may go with it such as a red cheek, an excellent digestion 
 and a tendency to diarrheas. The finding of such teeth in the
 
 374 CAST GOLD AXD PORCELAIN IXLAYS 
 
 adult points to the youth of the individual, regardless of years. 
 In this persistence of juvenile characteristics, one must always 
 weigh the compensation offered by the other glands with in- 
 ternal secretion. 
 
 "The purpose of this communication will have been accom- 
 plished if the physician and dentist will begin to see in the 
 dental apparatus a greater purpose than the sole function of 
 mastication. When fully studied upon lines suggested above, a 
 volume of facts will be discovered that heretofore may have 
 manv times been entirely overlooked." 
 
 Dr. Kaplan calls the entire ductless gland expression as 
 observed in various individuals "compensatory dynamics"; I 
 feel that this term will be misleading. The action of these 
 glands, particularly the adrenals, the thyroid, and the pituitary 
 is dynamic to be sure, but not compensatory in the true sense 
 of the word. If they were compensatory, surgeons might, with 
 impunity, remove any one of these glands and expect the other 
 one or two of them to assume the function of the one removed. 
 
 We know T that this does not take place. As a matter of fact, 
 the remaining glands will be much disturbed in their expression 
 of function. 
 
 So close is the interdependence of these glands in their 
 function, that not one may be hurt or tampered with, without 
 immediately calling forth resentment in the others. 
 
 But interdependence of dynamic expression is not now and 
 ever can be compensatory dynamics, and Dr. Joseph Fraenkel 
 and his associates, to w T hom most of us owe our correct informa- 
 tion on the subject of ductless gland activity, their physiology 
 and function, and their therapeutic use and value, never meant 
 to, and never did, to me at least, convey the information or im- 
 pression that they were compensatory in the sense in which Dr. 
 Kaplan seems to conceive them to be. 
 
 Dr. Kaplan is correct in attributing to the ductless gland 
 chain a marked influence upon the dental apparatus, its forma- 
 tion as to position and quality, hence resistance to destruction 
 by decay. It is well established, beyond the necessity for fur- 
 ther vague experimentation, that the breaking down of dental 
 tissues to wit, teeth and environs, may be modified if not alto-
 
 1 : X DOC R I X QUO X T I A .' ! , ."") 
 
 gether, at least, to sonic considerable extent by ductless gland 
 therapy. I called the attention of the profession to this subject 
 about two and one-half years ago in my thesis on the functions 
 of the teeth. 
 
 Dr. Kaplan is again hasty in his nomenclature. There is 
 no such thing as thyrodontia or pituitodontia or adrenodontia, 
 etc., any more than we could improvise a science of pneumo- 
 dontia or intestiiiodontia; a happier name for his article would 
 have been "Endocrinodontia," because such a name would have 
 covered the subject. 
 
 His remarks regarding the influence of the gonads upon the 
 position of the laterals in the superior maxilla 1 is correct, but 
 that this influence is a crossed one has not been borne out in all 
 experiences, also it must be remembered that this influence is 
 not a direct one but is exerted through the pituitary. 
 
 Thyroidal teeth an 1 long, well-rounded, bell-shaped, and of 
 a beautiful bluish white texture shading into yellow at the 
 cervical margin. 
 
 Pituitary teeth are short or long, not so bell-shaped, more 
 or less square-shaped anteriors are the rule, yellowish gray in 
 color. 
 
 Adrenal or so-called adrenal teeth are small bell-shaped 
 organs rapidly yielding to attritional wear, occlusal surfaces 
 show reddish stains, they resist decay remarkably well, are 
 yellowish white in color, quite yellow at the cervical margin. 
 Erosion of teeth at cervical portions is, to my mind, an adrenal 
 phenomenon and manifests itself in many cases which are poten- 
 tially neoplasmic. The same is true of teeth which seem to 
 possess an inherent principle of immunity. 
 
 Thymic teeth may be thyroidal or pituitary in character 
 with the addition of scalloped, fan-shaped occlusal or incisal 
 surfaces. They are very translucent and of a milky white or 
 bluish white color. 
 
 ^lay we not conclude from all the foregoing that: 
 
 When a little child presents himself to us and the little 
 one's teeth are in malrelation to one another, we ought to know 
 how to correct this situation without harnessing this little mas- 
 ticating apparatus in all sorts of unspeakable and distressing 
 appliances, furthermore, we ought to realize that this very mal-
 
 3/6 CAST GOLD AND PORCELAIN INLAYS 
 
 relation of the teetli is an expression of a constitutional state to 
 be ministered to, not by irritating the structures in the mouth, 
 but by gently recalling to its proper sphere of activity and 
 supervision, the delinquent part of the mechanism, the tempo- 
 rary aberration of which caused the malrelation a thymopitu- 
 itary state. 
 
 When a little one whose teetli decay readily, despite all 
 attention to hygiene, presents himself to us for our attention 
 and aid, we should so minister to the potential man or woman 
 in it as to recall to its proper sphere of activity and supervision, 
 the delinquent part of the mechanism, the temporary aberration 
 of which caused the dystrophy a thymothyroidal state. 
 
 AVhen a little patient whose posterior teeth are in malrela- 
 tion and show reddish stains on the occlusal surfaces, presents 
 himself to us for attention, we should be able to recognize an 
 expression of a thymopituitoadrenal stress and so minister to 
 the little one as to recall to their proper sphere of activity and 
 supervision the delinquent parts of the mechanism, the tem- 
 porary aberration of which caused the dystrophy. 
 
 When a little patient whose teeth in the premaxillary region 
 of the maxilla? are in malrelation presents himself, we should 
 recognize this as aprenatal pituitary state and so minister to 
 the little one as to recall into proper sphere of activity and 
 supervision, the delinquent part of the mechanism responsible 
 for the particular expression. 
 
 AYhen a little patient whose lower anterior teetli are in mal- 
 relation, presents himself, we should recognize this as a post- 
 natal pituitary state and so minister to the little one as to recall 
 to harmonious interplay the delinquent part of the mechanism, 
 answerable for the particular expression. 
 
 A little child who presents himself with his upper laterals 
 in torsion, is possessed of some gonadial disbalance, indicating, 
 perhaps, a senile gonadial apparatus, a prenatal pituitogonadial 
 state and should be so treated as to recall, if possible, to proper 
 sphere of activity and supervision, that part of the mechanism, 
 answerable for the particular expression. 
 
 These few paragraphs may be summed up in the following 
 sentences : 
 
 First, dentition as to time, is a thymopituitary function.
 
 KXIHHMMXOIKIXTIA 377 
 
 Second, dentition as to position, is a thymopituitary and 
 gonado-pituitary function. 
 
 Third, dentition as to quality is a thyropituitary function. 
 
 Fourth, dentition as to resistance is a thyroadrenal func- 
 tion. 
 
 It follows from this that the first permanent molar erupts 
 in normal position in the upper arch when the thymothyroidal 
 apparatus is in balance and when there is no prenatal pituitary 
 disturbance. 
 
 It erupts in normal position in the lower arch when the 
 thymothyroidal apparatus is in balance and when there is no 
 postnatal pituitary disturbance before six years of age. The 
 above holds true in sequence mentioned for the upper and lower 
 temporary set of teeth. 
 
 The bicuspids and second permanent molars and cuspids 
 are most often in malrelation in females, because they erupt 
 at a time of or immediately after puberty or at a period when 
 the pituitary is called upon to adjust itself to and to interplay 
 with the awakened gonadial apparatus, a critical time in the 
 life of a female individual. The same holds true in a male per- 
 son but to a lesser degree. 
 
 The torsion of the permanent laterals indicates an anomaly 
 of the uterus as to position or some ovarian difficulty in the 
 IV male and some testicular disturbance in the male. When the 
 torsion is very decided in the latter, one may safely assume the 
 presence of a varicocele in the patient. 
 
 If the permanent cuspids are forced out of position by 
 apparent lack of space, they point in females to ovarian dis- 
 turbances such as cysts, fibroids, etc. In males they are an 
 indication of recurrent obscure pains in the lower abdominal 
 region with sensitive areas in the region of the groins. 
 
 If these cuspids are markedly prehensile in formation, they 
 indicate an abundance of the sexual urge as mentioned in a 
 previous chapter of the book. 
 
 Individuals whose teeth suffer from erosion at the cervical 
 margins and upon the labial surfaces and which present an 
 enamel surface which is highly polished and of a greenish white 
 hue bid fair to be candidates for neoplasms, particularly so 
 when red-haired.
 
 378 CAST GOLD AXD PORCELAIX INLAYS 
 
 The spacing of the anterior upper teeth is a pituitary sig- 
 nature and often tells a story of headaches, constipation, and 
 other gastric disturbances. 
 
 Teeth, which have undergone marked change in macro- 
 scopic appearance due to attrition, invariably tell, in dark peo- 
 ple, a story of freedom from infectious diseases, outside of 
 perhaps measles and diphtheria or whooping cough, but also 
 point to the predisposition of the person to disturbances of a 
 circulatory nature and afflictions of the lower portions of the 
 large intestines. 
 
 We see cases of mature age which present teeth of marked 
 youthful appearance. "We call them thymic teeth and they tell 
 a story of a pituitary and gonadial battle against a powerfully 
 entrenched thymus, resulting in a compromise, definitely ex- 
 pressed in an occlusal relation between upper and lower teeth 
 which permits of the virtual perpetuation of the incisal and 
 occlusal surfaces characteristic of children's teeth. 
 
 I am convinced that a deep study of the endocrines and a 
 careful therapeutic application of them, would, to a great ex- 
 tent, if not altogether, eliminate the endless dystrophies mani- 
 festing themselves in the oral cavity; and thus obviate the call 
 for a great number of tedious, and for patients, very painful 
 operations. 
 
 I appreciate the fact that many will read this chapter with 
 great skepticism, and I can readily understand why this will 
 be so; but I would ask these readers to abide in faith and 
 read some of the books to be recommended and then carefully 
 observe their patients, question them at length and so learn 
 from their own daily practice to understand the wonderful in- 
 terdependence which exists between the endocrines and the den- 
 tal apparatus and how perfectly they express themselves in the 
 size, texture, quality, and position of the teeth and their envi- 
 ronment. 
 
 The Creative Force at Work 
 
 In the accompanying diagram (Fig. 372) two triangles are 
 seen superimposed one upon the other, making a six-pointed 
 star the Protector of David. It represents the conception I
 
 KxnoriMXonoxTiA .><!) 
 
 have of the I'niversal Spirit or Mind or Soul working upon 
 itself and expanding in consciousness from within outward, so 
 that it begins to manifest itself in various ways on different 
 planes (creation). 
 
 The fact that these triangles are so placed that one pre- 
 sents with its apex downward and the other with the apex up- 
 ward, will mean much to those who have studied occultism and 
 are familiar with the literature on symbolism. 
 
 Fig. 372. 
 
 We see here the large .4 in the center of the illustration. 
 In the apical portion of the A we see an S to represent the Sun, 
 the energizer, the father, he, who with his warmth, animates the 
 Universe. Directly above, we see the point of the star marked 
 PP representing the pituitary beneath which rests the pineal. 
 Within this point of the star, the M represents the Moon with 
 its psychic significance to man.
 
 380 CAST GOLD AXD PORCE.LA1X INLAYS 
 
 The point on the upper left marked T represents the thy- 
 roid and the R within it stands for the restless, ever-moving 
 atmosphere. 
 
 The point on the right, also marked T represents the thy- 
 mus or youth or beginning of man. The V within this point 
 represents the vegetable kingdom, even as the R in the opposite 
 point represents the mineral kingdom with its finely-divided 
 silicious and other mineral particles floating in the ether. This 
 F representing the flowers and trees and leaves upon the trees 
 is symbolic of ever-recurring youth. 
 
 The two points below, the right and left A represent the 
 adrenal bodies or energy made manifest on the human plane. 
 The W's within these points represent the waters of the earth. 
 
 And finally, the point below marked G for gonads, express- 
 ing immortality on the procreative plane. The E within this 
 point represents earth or the place where man must reach a 
 certain stage in his unfoldment in order to be worthy of his 
 Creator. 
 
 Please note the number of intercommunicating lines along 
 which impulses or hormones or whatever we may choose to call 
 them may travel. 
 
 If we now look upon the large central A as the heart of 
 man, we shall have a picture of him as the microcosm within 
 the Universe and we may note how the adrenal, the pituitary, 
 the pineal, the thyroid, the thymus, and the gonads all have 
 their heart valency and how conversely the heart presents its 
 radiant impulses impartially to all of them. 
 
 The vast influence of these glands may be further graph- 
 ically illustrated by lines or arrows going from the six points 
 of the star to all parts of the body. Such as skin, hair, teeth, 
 muscles, ligaments, lungs, liver, bowels, eyes, ears, nose, throat, 
 that is, pharynx, larynx, tonsils, etc. 
 
 The network is so vast and the interdependence so inti- 
 mate that it would require a volume of considerable size to 
 cover the subject. 
 
 I want to again express my sincere obligation to those who 
 before me have worked in this field, and my keen appreciation 
 of their efforts. If I have omitted giving any one their due
 
 EXDOCRIXODOXTIA 381 
 
 credit for any quotation or illustration, I herewith acknowledge 
 my debt. 
 
 To all who would delve more deeply into the various sub- 
 jects treated, I would earnestly recommend the books enumer- 
 ated below. 
 
 References 
 
 BriLDixc Ilr.MAX INTELLIGENCE. By Arnold Loraml, M.D., 1917. 
 
 COSMIC CONSCIOUSNESS. By AH Nemand, Advanced Thought Publishing Co., 
 Chicago. 
 
 COSMIC CONSCIOUSNESS. By Richard Morris Bucke, Innes & Son, Philadelphia, 1905. 
 
 INTERNAL SECRETIONS AND THE DUCTLESS GLANDS. By Swale Vincent, M.D., D.Sc., 
 published by Edward Arnold, London, 1912. 
 
 INTERNAL SECRETORY ORGANS. By Biedl, published by Wm. Wood & Co., 1918. 
 
 HERMENEUTIC INTERPRETATION OF THE ORIGIN OF THE SOCIAL STATE OF MAN. By 
 Fabre D 'Olivet, 1768-1828, (translated into English by Nayan Louise Red- 
 field, 1915), published by G. P. Putnam's Sons, New York City. 
 
 LEHRBUCH DKR ORGANOTHERAPY. By Drs. Wagner Van Jauregg, of Vienna, and Gus- 
 tav Bayer, of Innsbruck, published by George Thieme, Leipzig, 1914. 
 
 LIBRARY OF VALUABLE INFORMATION. D. Appleton & Co., New York City. 
 
 THE STORY OF EXTINCT CIVILIZATION OF THE EARTH. By Robert E. Anderson, 
 
 M.A., F.A.S., 1903-1913. 
 
 THE STORY or PRIMITIVE MAN. By Edward Clodd, 1895-1913. 
 THE STORY OF THE LIVING MACHINE. By H. \Y. Conn, 1899-1913. 
 THE STORY OF THE MIND. By James Mark Baldwin, 1902-1913. 
 
 OLD AGE DEFERRED. By Arnold Lorand, M.D., published by F. A. Davis Co., 1913. 
 
 PRINCIPLES OF LIGHT AND COLOR. By Edwin D. Babitt, published by Babitt & Co., 
 New York City, 1878. 
 
 Six THOUSAND YEARS OF HISTORY. By Edgar Sanderson, A.M.; John Porter Lam- 
 berton, A.M.; Charles Morris, A.M.; and others; published by Thomas 
 Nolan, Philadelphia, 1908. 
 
 THE BRAIN. By Emanuel Swedenborg, vols. i and ii, published by American Sweden- 
 borg Printing and Pub. Soc., New York City. 
 
 THE ECONOMY OF THE ANIMAL KINGDOM. By Emanuel Swedenborg, vols. i and ii, 
 published by American Swedenborg Printing and Pub. Soc., New York City. 
 
 THE SOUL OR RATIONAL PSYCHOLOGY. By Emanuel Swedenborg, published by Ameri- 
 can Swedenborg Printing and Pub. Co., New York City. 
 
 THE CROSS OF THE MAGI. By Frank C. Higgins, F.R.N.S., published by Roger 
 Brothers, New York City, 1912. 
 
 THE ENDOCRINE ORGANS. By E. A. Schafer, LL.D., D.Se., M.D., F.R.S., published 
 by Longmans, Greene & Co-, New York City, 1916. 
 
 THE INTERNAL SECRETIONS. By E. Gley, M.D., (translated by Dr. Maurice Fish- 
 berg), published by Paul B. Hoeber. 
 
 THE NEW STANDARD ENCYCLOPEDIA. Funk & Wagnalls Co., New York City. 
 
 THE THYROID GLAND. By Robert MCCARRISON, M.D., D.Sc., F.R.C.P., published by 
 Win. Wood & Co., New York City, 1917.
 
 382 CAST GOLD AND PORCELAIN INLAYS 
 
 THE PRACTITIONER. SPECIAL NUMBER ox THE INTERNAL SKCRETIONS. Published by 
 "The Practitioner," Ltd., London. 
 
 January, 1915 
 
 THE THEORY OF INTERNAL SECRETION: ITS HISTORY AND DEVELOPMENT. By E. 
 
 Gley, M.D., LL.D. 
 
 THE PHYSIOLOGY OF THE THYROID GLAND. By H. H. Dale, M.A., M.D., F.E.S. 
 THYROID INSUFFICIENCY. By Dr. E. Hertoghe. 
 ENDEMIC GOITRE. By Major Eobert McCarrison, M.D., F.R.C.P. 
 EXOPHTHALMIC GOITRE. By Leonard Williams, M.D., M.R.C.P- 
 THE PARATHYROID GLANDS. By Arthur F. Hertz, M.A., F.R.C.P. 
 THE PHYSIOLOGY OF THE CHROMAFFIN SYSTEM- By D. Noel Paton, M.D., B.Sc., 
 
 F.R.S. 
 
 THE ADRENAL GLANDS. By T. R. Elliott, M.D., F.R.S. 
 PLURIGLANDULAR INSUFFICIENCY, ITS INCIDENCE AND TREATMENT. By Henry R. 
 
 Harrower, M.D. 
 THE FUNCTIONS OF THE PITUITARY BODY. By Swale Vincent, M.D., D.Sc., F.R-S. 
 
 Edin.), F.R.S. (Can.). 
 
 February, 1915 
 
 THE THEORY OF THE INTERNAL SECRETIONS. By Charles E. de M. Sajous. M.D., 
 
 LL.D. 
 
 THYROID INSUFFICIENCY. By Leopold-Levi, M.D. 
 THE PANCREAS. By Carl von Noorden, M.D. 
 THE INTERNAL SECRETIONS OF THE ALIMENTARY CANAL. By W. Langdon Brown, 
 
 M.A., F.R.C.P. 
 THE USE OF HORMONES IN MEDICINE. By Geo. R. Murray, M.A., M.D., D.C.L. 
 
 F.R-C.P. 
 THE USE OF HORMONES IN CHIDREN 's DISEASES. By Herbert Ewan Waller, 
 
 M.R., C.S., L.R., C.P. 
 THE USE OF HORMONES IN GYNECOLOGICAL AND OBSTETRICIAL DISORDERS. By W. 
 
 Blair Bell, B.S., M.D. 
 HORMONES IN RELATION TO DISEASES OF THE SKIN. By J. M. H. Macleod, M.D., 
 
 M.R.C.P. 
 
 INTERNAL SECRETIONS AND THE PSYCHOSES. By Thee. B. Hyslop, M.D., F.R.S.E. 
 THYROID INSUFFICIENCY IN GENERAL PRACTICE. By J. Parlaue Granger, F.R.C.S. 
 THE WORKS OF PLATO. Nottingham Society Edition. 
 
 THE WORKS OF THOMAS TROWARD. Goodyear Book Concern, New York City. 
 THEORY AND PRACTICE OF THYROID THERAPY. By Herbert Ewan Waller, M.D., D.Sc., 
 
 L.R., C.P., published by Wm. Wood & Co., 1911. 
 
 VAGOTONIA. By Eppinger and Hess, monograph series No. 20, published by Nervous 
 and Mental Diseases Publishing Co., 1915.
 
 INDEX 
 
 Absorption, of light, 308 
 
 Acid cup for hydrofluoric acid, 210 
 
 Action, coordinate, mental and physical, 
 
 43 
 Active reciprocal functions of the teeth, 
 
 general, 58 
 special, 59 
 Adrenal bodies, 363 
 Adrenal teeth, 375 
 Adrenodont, 373 
 Adrenodontia, 371 
 Adrenotrop, 365 
 A Citation, period of, in alloying gold 
 
 and platinum, 185 
 Alarm clock attached to investment 
 
 mixer, 168, 169 
 
 Alimentary functions, of the teeth, 60 
 Allopathic thought, 366 
 Alloying gold and platinum, method of, 
 
 183 
 Alterative factor in cavity preparation, 
 
 71 
 
 Alumina, composition of, 163 
 Amalgam die, making of the, 148 
 
 use of in making porcelain insert, 
 
 295 
 
 fillings, poorly executed, as a cause of 
 multilated occlusal surfaces, 
 236 
 
 Amber-coJored glasses, 184 
 Amorphous silicon, 160 
 Anatomic articulator, 246 
 Anatomy, tooth, knowledge of, necessary 
 
 to inlay worker, 152 
 Angle of incidence in reflection of light, 
 
 305 
 
 Angles of bicuspids, 68 
 of cuspids, 67 
 of incisor teeth, 65 
 of molars, 68 
 
 Anterior teeth, cavity tray for, 144 
 of upper jaw, stress index for, 115 
 splinting of, 222 
 Articulator, anatomic, 246 
 Asbestos, ground, and water paste, 295 
 Attrition, a cause of mutilation of oc- 
 clusal surface, 236 
 causes of, 242 
 definition of, 242 
 effects of, 244 
 teeth worn down by, 101 
 types of, 265 
 
 Auditory sense, 26 
 Augmentation, 362 
 Automatic mixer, 167, 168, 170 
 Automatic wax warmer, 131, 132 
 
 B 
 
 Badger brush, 169 
 
 Baly, 310 
 
 Bicuspid presenting a complex cavitv. 
 
 113 
 presenting a compound disto-occlusal 
 
 cavity, 83 
 
 presenting a mesio-disto-occlusal cavi- 
 ty, 87, 91, 111 
 presenting a mesio-occlusal cavity, 85, 
 
 89 
 presenting a mesio-occluso-distal cavi- 
 
 ty, 344 
 
 presenting simple occlusal cavity, 81 
 Bicuspids, angles of, 68 
 surfaces of, 68 
 stress index for, 81-115 
 Bleaching of wax, 127 
 Brass cups, 350 
 Brewster, Sir David, 303 
 Brute Force, 37 
 Buecal cavity in a molar, 99 
 Bulk to be added to teeth worn down 
 
 by attrition, 244 
 
 Bunsen burner for drying mold, 174 
 Burning out the wax model, 173 
 Burnishers, use of, in placing the inlay, 
 
 214 
 Burnishing of margins after cementation 
 
 of inlay, 217 
 
 Burnishing the wax inlay, 154 
 Byram, 323, 325 
 
 C 
 Calcium, composifion of, 162 
 
 metabolism, 366 
 Carbonic acid gas, 356 
 Cardioauxiliarv functions of the teeth, 
 
 58 
 
 Carving of molar crown, 257 
 Carving the wax inlay by the direct 
 
 method, 131 
 
 Cast bases, gold for, 186 
 Cast gold complement for a tooth pre- 
 senting a mesio-disto-occlusal 
 cavity, 120 
 
 Cast gold inlay, 62 (See also Gold inlays) 
 and porcelain for restoration of frac- 
 tured lower lateral, 279 
 
 383
 
 384 
 
 INDEX 
 
 Cast gold Cont'd. 
 
 and porcelain inlay for compound dis- 
 to-occlusal cavity in biscuspid, 
 83 
 
 for mesio-occlusal cavity in bi- 
 cuspid, 89 
 
 and porcelain insert for mesio-labio- 
 
 linguo-incisal deficiency, 289 
 in lower cuspid, 281, 283 
 method of making, 286, 287 
 
 and synthetic porcelain for mesio-dis- 
 to-labio-incisal deficiency in a 
 central, 291 
 
 restoration of lateral by means of, 
 273, 285 
 
 cementation of, 213, 215 
 
 cleansing of, before cementation, 216 
 
 contraindication, 269 
 
 defined, 63 
 
 extensive restorations of occlusal bal- 
 ance by means of, 236 
 
 for complex cavity in a bicuspid, 113 
 in a molar, 105 
 
 for deficiency of occlusal third of mo- 
 lar, 103 
 
 for a disto-buccal cavity in a molar, 
 97 
 
 for disto-occlusal cavity in a molar, 97 
 
 for disto-occluso-buccal cavity in a 
 molar, 107 
 
 for labio- or bucco-occlusal cavity in 
 a molar, 93 
 
 for mesio-disto-occlusal cavity in a bi- 
 cuspid, 87, 91, 111 
 
 for mesio-disto-occlusal cavity and 
 buccal cavity in a molar, 99 
 
 for mesio-disto-occluso-palatal cavity 
 in a molar, 109 
 
 for mesio-occlusal cavity in bicuspid, 
 85 
 
 for simple occlusal cavity in bicuspid, 
 81 
 
 formulae for, 185 
 
 indirect method of making, 139 
 
 mesio-disto-occlusal, 120 
 
 placing of, in cavity, 213 
 
 polishing the, 213 
 
 splinting of loose teeth by means of, 
 218, 235 
 
 seating the, 217 
 
 Cast gold inlays for teeth worn down 
 by attrition, 101 
 
 for lingual surfaces of teeth to be 
 
 splinted, 231 
 
 Casting, cleansing of the, in hydrofluoric 
 acid and sodium bicarbonate, 
 209 
 
 machines, test for, 205 
 
 of metal under pressure, 197 
 
 of molten metal into the mold, ma- 
 chines employed in, 187 
 
 Casting Cont M. 
 
 of molten metal into the mold, 178. 
 Cavities classified, 74 
 Cavity, buccal, in a molar, 99 
 cervical, in a molar, 341 
 cervical proximal, in a lateral, 341 
 complex, in a bicuspid, 113 
 
 in a molar, 105 
 compound disto-occlusal, in a bicuspid, 
 
 83 
 
 disto-buccal, in a molar, 97 
 disto-labial, in a central, 338 
 disto-occlusal, in a molar, 95, 97, 342, 
 
 343 
 
 disto-occluso-buccal, in molar, 107 
 labio-disto-lingual, in a lateral, 339 
 labio-occlusal, in a molar, 342 
 labio- or bucco-occlusal, in a molar, 
 
 93 
 
 linguo-mesial, in a lateral, 340 
 mesio- and disto-proximal, in a cen- 
 tral, 293 
 
 mesio-disto-occlusal, 120 
 in a bicuspid, 87, 91, 111 
 in a molar, 99, 343 
 mesio-disto-occluso-palatal, in a molar, 
 
 109 
 mesio-occlusal, in a bicuspid, 85, 89 
 
 in a molar, 343 
 
 mesio-occluso-distal, in a bicuspid, 344 
 preparation, 65, 76 
 
 for porcelain inlay, 328 
 mesio-disto-occlusal, 121 
 of floor of a, 114 
 
 selection or election of a case present- 
 ing a, 64 
 
 simple occlusal, in bicuspid, 81 
 Cement, crystallization of, 217 
 
 mixing of, 216 
 
 Cementation of the inlay, 213, 215 
 Central, fractured, restoration of, 271 
 left upper, presenting a mesio-disto- 
 Jabio-incisal deficiency, cast 
 gold inlay and synthetic porce- 
 lain insert for, 291 
 right upper, presenting an eroded and 
 pitted labial surface, a mesio- 
 and disto-proximal cavity, 293 
 presenting mesio-labio-linguo-incisal 
 
 deficiency, 289 
 Central nervous system, injury to, due 
 
 to jacket crowns, 293 
 Centrifugal casting machines, 188, 189 
 
 force, 188, 189 
 Cervical cavity in a molar, 341 
 Cervical proximal cavity in a lateral, 341 
 Charcoal block with depression to act as 
 
 a crucible, 183 
 
 Chart of prismatic colors, 316, 317 
 Chisels for tooth structure cutting, 72
 
 [NDBX 
 
 385 
 
 Chromatic aberration, 304 
 Church, A. II., :ili' 
 Clamp and rubber dam, 7.". 
 Classification of functions of teeth, 58 
 Me;i lining of the casting in hydrofluoric 
 acid and in a sodium bicarbon- 
 ate bath, 209 
 Cleansing the cavity before cementing 
 
 the inlay, 216 
 
 Cleveland Dental casting machine, 198 
 Cold flask, as a preventive of distor- 
 tion of the mold, 180 
 Color in relation to the porcelain inlay, 
 
 300 
 
 intermediate, '.\\~> 
 
 of gold when silicates are used, 287 
 of porcelain, 3.14 
 phenomena of, 302 
 Colors, complementary, 318, 319 
 harmony of, 317 
 primary, 312 
 prismatic, 317 
 rainbow, 317 
 secondary. :;i:: 
 
 tertiary. - ; ' 1 
 
 Combining weight of gold, 182 
 Compensatory dynamics of the endo- 
 
 crines, 365 
 
 Complementary colors, 318, 319 
 Complex cavity, defined, 75 
 in a bicuspid, 113 
 in a molar, 105 
 showing planes, 78 
 Composition of wax, 127 
 Compound cavity defined, 74 
 Compound cavities, preparation of, for 
 
 porcelain, 329 
 
 Compound disto -occlusal cavity in bicus- 
 pid, 83 
 
 Compound, formula for, 164 
 investment, 158 
 refractory, 158 
 
 Compound-carrying trays, method of tak- 
 ing impression with, 146 
 Construction of splint for restoration of 
 occlusal balance in cases of at- 
 trition, 245 
 Contact lines, 215 
 points, 215 
 proximal, determination of, between 
 
 molars, 258 
 Coordinate action, mental and physical, 
 
 42 
 
 Coordinate mental efforts, factors induc- 
 ing, 24 
 Copper alloy, use of, in making amalgam 
 
 die, 148 
 
 Copper band for making wax inlay, 136 
 Cosmetic functions of the teeth, 58 
 
 Cosmetic reasons for not using gold for 
 
 the inlay, 269 
 Creation, 47, 379 
 Creative force, 48 
 Crown, molar, carving of, 257 
 Crystallization of amalgam die, 151 
 of cement, 217 
 of the mold, 171 
 
 Cuspid, lower, restored by cast gold in- 
 lay and porcelain insert, 281, 
 283 
 
 presenting cavity, 297 
 upper right, presenting a prehenso- 
 labio-linguo-mesial deficient- v. 
 399 
 
 Cuspids, angles of, 67 
 surfaces of, 67 
 
 D 
 
 David, protector of, 379 
 
 Defensive functions of the teeth, 58 
 
 Dentistry, 50 
 
 Dentition, as to position, a thymopitui- 
 tary and gonadopituitary func- 
 tion, 377 
 
 as to quality, a thyropituitary func- 
 tion, 377 
 
 as to resistance, a thyroadrenal func- 
 tion, 377 
 
 as to time, a thymopituitary function, 
 376 
 
 Depth for cavity, 295 
 
 Developmental functions of the teeth, 
 58 
 
 Die, amalgam, making of the, 148 
 for procedure by indirect method, 139 
 
 Direct method, advantages of, 140 
 
 Direct method of making and carving 
 the wax inlay, 131 
 
 Direct pressure machine, 200 
 
 Diseases, endocrine glands in relation to, 
 366 
 
 Di?to-buccal cavity in an upper molar, 
 97 
 
 Disto-occlusal cavity in a molar, 95, 97, 
 342, 343 
 
 Disto-occlusal cavity tray, 144 
 
 Disto-occluso-buccal cavity in a molar, 
 107 
 
 Distorted mold, due to use of hot flask, 
 179 
 
 Drying out the mold, 173 
 
 Ductless glands, 359 
 
 E 
 
 Elastic membrane surrounding teeth, 
 
 function of, 54 
 
 Elasticity of suspension ligament, 118 
 Klection of the case presenting a cavity, 
 
 64
 
 1NDKX 
 
 Elgin vacuum casting machine and 
 
 flasks, 192 
 
 Enamel seat of inlay, 77 
 Endocrine glands, in relation to diseases, 
 366 
 
 gonads, 364 
 
 pineal, 363 
 
 pituitary, 363 
 
 thyroid," 363 
 
 thymus, 363 
 
 suprarenal capsules, 363 
 Endocrines, 362 
 
 compensatory dynamics of, 365 
 Endocrinodontia, 359 
 Endocrinology, study of, 362 
 Errors and accidents primary causes of 
 
 human ills, 49 
 
 Ether, elastic, in relation to light, 303 
 Eucalyptol compound, 235 
 Evolution, 48 
 
 Excess metal, removal of, 213 
 Exercise of tissues essential, 55 
 Extirpated pulp, 279 
 
 Extirpation of pulp in large restorations, 
 276 
 
 F 
 
 Face, normal, measurements for, 249, 255 
 Feldspar, 323 
 
 Fillings, amalgam, poorly executed, as 
 causes of mutilation of occlusal 
 surface, 236 
 Flask, special, 204 
 
 Taggart, 204 
 
 Floor of a cavity, preparation of, 114 
 Foil matrix for porcelain inlay, making 
 
 the, 333 
 Formative factor in cavity preparation, 
 
 71 
 
 Formula for a compound, 164 
 Fractured central, restored by gold in- 
 lay and porcelain or the sili- 
 cates, 271 
 
 Fractured lower lateral, 279 
 Frail teeth, gold for inlays in, 186 
 Function of elastic membrane surround- 
 ing teeth, 54 
 
 Functions of the teeth, 52 
 active reciprocal, 58 
 general, 58 
 special, 58 
 
 passive reciprocal, 58 
 cosmetic, 58 
 defensive, 58 
 developmental, 58 
 phonetic, 58 
 Furnace, Platcheck, 175 
 Fusing of porcelain, 325 
 Fusing point of gold, 182 
 of platinum, 182 
 
 Gases, absorption of light by, .'!09 
 Gauge of wire for supplemental pins, 
 
 79 
 
 Gelatin impression of a model, 118 
 General active reciprocal functions of 
 
 the teeth, 58 
 
 Geometric construction of molars, 257 
 Geometric landmarks of teeth, 65 
 Gingivae, condition of, in cases of attri- 
 tion. 243 
 
 Glands, ductless, 359 
 Glass, color of, 311 
 Glazbrook, 304 
 Gold, alloying with platinum, 183 
 
 color of, 287 
 
 combining weight of, 182 
 
 for cast bases, 186 
 
 for inlay work, 182, 186 
 
 for saddles, 186 
 
 fusing point of, 182 
 
 inlay, and porcelain or the silicates in 
 
 a fractured central, 271 
 and the silicates or porcelain, 269 
 
 and silicate cement to restore frac- 
 tured lateral, 275 
 formulae for, 185 
 
 specific gravity, 182 1 
 
 symbol, 182 
 Gonadontia, 369 
 Gonadotrop, 3(55 
 Gonads, .'!(! 1 
 Graphite flakes, in investment, 166 
 
 paste, 233 
 
 post, 229 
 Grimaldi, 303 
 
 Grinding the porcelain matrix, 352 
 Gum tragacanth, 353 
 Gypsum, composition of, 159 
 
 H 
 
 Harmony of colors, 317 
 
 Healing art, 49 
 
 Health, function of gums and teeth in, 
 
 52 
 
 general, should be looked after in 
 cases requiring treatment for 
 loss of occlusal balance, 242 
 
 Hertz, 303 
 
 High-fusing porcelain, 324 
 shrinkage of, 326 
 
 Hinged trays for taking impression of 
 cavities, 144 
 
 Hook, 303 
 
 Hormones, definition of, 362 
 
 Hot flask, use of, in casting, gives dis- 
 torted mold, 180 
 
 Hot water as a means of warming wax, 
 131 
 
 Hue of colors, 311
 
 INDEX 
 
 llutchinson 's t '('tli, 60 
 HuyiM'iis. ;;n:; 
 II\ drodiloric iu-i'l. .V>7 
 bath, \^~> 
 
 Hydrofluoric acid, cle:in>in;j of tin 1 cast- 
 ing in, I' 11 ! i 
 making receptacle for, 210 
 
 lly-ienic landmarks of the teeth, 69 
 
 Hygroscopic characteristic of invest- 
 ments, 165 
 
 Hypnotics, use of. iii cases of attrition. 
 245 
 
 Ideal of a task, 4<i 
 Ideal wax tHr inlay work, 130 
 Immune areas of a tooth, 69, 70 
 Impression of the cavity, method of tak- 
 ing, for procedure by indirect 
 method. 1:59 
 of the cavity, method of taking, with 
 
 cumpound trav>, 146 
 trays 339, 344 
 
 wax. direct method of taking, 131 
 Incision, 60 
 
 teeth as organs of, '<- 
 Incisor teeth, angles of, 63 
 
 surfaces of, <i.~i 
 Indirect method of making a cast gold 
 
 inlay, 139 
 
 disadvantages of. Ho 
 .-election of, 139 
 Individual volition, 48 
 Inhibition, .'Mil' 
 
 Inhibitory functions of the teeth, 60 
 Inlay, cast gold, <>2 (x< c Cast gold in- 
 lay ! 
 
 cementation of, 213, 31.', 
 placing in cavity for cementation, 213 
 polishing the, 213 
 porcelain, (see Porcelain inlay) 
 restorations, poorly executed, inhibi- 
 tory to function of teeth, 55 
 wax. making and carving of, by direct 
 
 method, 131 
 work, r>2 
 
 instruments for use in, 73 
 metals for, 182 
 wax suitable for, 129 
 Inlays, metallic, iii 1 
 
 splinting loose teeth by means of, 218, 
 
 235 
 
 Inside of the tooth, 77 
 Instruments for the inlay worker, 73 
 Instruments for making the wax inlav, 
 
 137 
 
 Internal senvtion, organs of, .",(12 
 Investment compound, 158 
 Investment mixer, 168, 170 
 Investment of the matrix in preparation 
 f pon-e'ain in>ert. 295 
 
 1 1 idio platinum threaded p-ts. >i/.es for 
 various teeth. -77 
 
 .lacket crowns, objections to, 2!3 
 .Jiffy cement tube. 216 
 Jiffy tube, 286 
 .Johnson, Dr., 3::i 
 
 K 
 
 Kaolin. ::23 
 
 Kaplan. Dr. I). M.. 3C.5 
 
 Kipling, 4.") 
 
 Labio disto-lingual cavitv in a lateral, 
 
 339 
 
 Labio -occlusal cavity in a molar. ". IL' 
 Labio- or biicco -occlusal cavity, in a 
 
 molar, !." 
 
 Landmarks for occlusal carving, 152 
 hygienic, 69 
 of teeth, geometric, ii."i 
 Lateral, cervical proximal cavitv in a, 
 
 341 
 fractured, restored by gold inlay and 
 
 silicat.' cement. -7~> 
 labio-disto-lingual cavity in a, 339 
 linguo-mesial cavity in. .'lln 
 low: r, fractured in a fall, 279 
 
 restored by cast gold inlay and syn- 
 thetic porcelain, 273 
 Law of refraction, 306 
 Le Crone casting machine, 198 
 Life, in the abstract, 56 
 
 in the concrete. '>*'> 
 Light, absorption of, 308 
 phenomena of, 302 
 reflection, 305 
 refraction, 306 
 wave theory of, 303 
 waves, frequency of, 310 
 Lily-white, '.'-7 
 Lingual surfaces of teeth to be splinted. 
 
 inlays for, 231 
 
 Linguo-mesial cavity in a lateral, 340 
 Loose teeth, splinting of, by means of 
 
 inlays, 218, 235 
 Low-fusing porce'ain, 324 
 
 >hrinkage of, ::i>() 
 Luminosity of color, 311 
 
 M 
 
 Machines for casting of the molten metal 
 
 into the mold, 187 
 Magnesium, composition of, Ifi2 
 Making wax inlay by direct method. 1.". 1 
 Malocclusion, end-to-end, ,-is cause of at- 
 trition, 21^ 
 
 its relation to proper function of the 
 teeth. 54
 
 388 
 
 ixnnx 
 
 Malrelation of teeth, as related to endo- 
 crine glands, 375, 376 
 puberty in relation to, 377 
 Margins, burnishing of, after cementa- 
 tion, 217 
 
 carving of, in wax inlay, 136 
 of the cavity, preparation of, 76 
 Mastication, 60 
 
 teeth as organs of, 52 
 Materials used in refractory compound, 
 
 159 
 
 Matrix, foil, for porcelain inlay, 333 
 for porcelain insert, 295 
 in position upon a molar, 141 
 making wax impression with a, 136 
 metal, making of porcelain inlay with- 
 out, 337-357 
 porcelain, 351 
 
 Measurements for normal face, 249, 255 
 Mechanical factor in cavity preparation, 
 
 71 
 
 Melt, making the, 183 
 Mental efforts, factors inducing coordi- 
 nate, 24 
 Mercury, removal of, from amalgam die, 
 
 150 
 
 Mesio- and disto-proximal cavity, 293 
 Mesio-disto-labio-incisal deficiency in a 
 central, cast gold inlay and syn- 
 thetic porcelain insert for, 291 
 Mesio-disto-occlusal cast gold inlay, 120 
 Mesio-disto-occusal cavity, 120 
 preparation of, 121, 124 
 in a bicuspid. 87, 91, 111 
 in a molar, 99, 343 
 Mesio-disto-occluso-palatal cavity in a 
 
 molar, 109 
 
 Mesio-labio-linguo-incisal deficiency, cast 
 gold inlay and porcelain insert 
 made for, 289 
 
 restored by cast gold inlay and syn- 
 thetic porcelain, 285 
 Mesio-occlusal cavity, 85 
 in a lower molar, 343 
 tray, 144 
 
 Mesio-occluso-distal cavity in a bicuspid. 
 
 344 
 Metal, casting of, under pressure, 197 
 
 castings made under pressure, 187 
 
 molten, casting into the mold, 178 
 
 removal of excess, 213 
 Metallic inlays, 62 
 Metals for inlay worker, 182 
 
 gold, 182 
 
 platinum, 182 
 
 Mineral wax, composition of, 128 
 Model, splint in position on, 247 
 Models, for study of stress index, 116 
 
 necessary for extensive restoration of 
 occlnsal balance, 240 
 
 study, 236 
 
 Models Cont'd. 
 
 study of, in articulatm , -!>' 
 Molar crown divided into thirds, -~n 
 Mn!ar. lower, inesio occlusal i-avitv in a, 
 343 
 
 presenting a cervical cavity in the 
 disto-labial surface, ?>41 
 
 presenting a complex cavity, 105 
 
 presenting a deficiency of ocdusal 
 third, 103 
 
 presenting a disto-occlusal cavity, 95, 
 ::-!', 343 
 
 presenting a disto-occ'usal cavity and 
 a disto-buccal cavity, 97 
 
 presenting a labio-occlusal cavity, 342 
 
 presenting a labio- or bucco-occlusal 
 cavity, 93 
 
 presenting a mesio-disto ocdusal cav- 
 ity. 343 
 
 presenting a mesio-disto-occlusal cav- 
 ity and a bucca! cavity. !i;i 
 
 presenting a mesio-disto-occluso-buccal 
 cavity, 107 
 
 presenting a mesio-disto-occluso-palatal 
 cavity, 109 
 
 reproduction of, in gold, 260 
 Molars, angles of, 68 
 
 determination of proximal contact be- 
 tween, 258 
 
 Mold, casting the molten metal into the, 
 178 
 
 drying out of the, 173 
 
 temperature of, in casting of molten 
 
 metal, 178 
 Molten metal, casting into the mold, 178 
 
 casting of the, machines employed in 
 
 187 
 
 Moore, Tom, 46 
 Mouth, ductless glands in relation to the, 
 
 359 
 Myrica Cerifera, 128 
 
 N 
 Naso-mental line, normal, 249, '2^~> 
 
 restoration of, 249 
 Xewton, Sir Isaac, 302 
 Xit's, Dr., 337 
 Nitrous oxide combined with city L;US 
 
 to give necessary heat tinits in 
 
 alloying, 183 
 
 Xormal face, measurements for, 249, 25.1 
 Xormal occlusion, illustrated, 117 
 Noyes, 7- 
 \ yi nan, Dr., 216 
 
 O 
 
 Occluded mode's of case requiring res- 
 toration, 151 
 
 Occluded study mode's, 237 
 Ocdusal balance, definition of, 239 
 
 extensive restoration of, by means 
 of gold inlays. 2:'.(>
 
 INDEX 
 
 Occlusal balance ('out M. 
 
 preliminary points necessary to res- 
 toration of, -l'i 
 restoration of, view of case showing. 
 
 splint to restore, I'l.", 
 carving, nifthoil of securing land- 
 marks for, 152 
 
 surface of wax inlay, method of ob- 
 taining, 138 
 
 surfaces, illustrations of, 263, 264 
 view of case showing attrition, 253 
 Occlusion, normal, illustrated 117 
 
 traumatic. :!in 
 
 Oceluso-disto-lingual plane, 79 
 Occluso-mcsio-luiccal plane, 7!> 
 On-inlay, 121 
 Operative factor in cavitv preparation. 
 
 71 
 
 Optic sense, 1' I 
 
 Oral conditions in cases of attrition, 243 
 Osseous system out of harmony, cause 
 
 of attrition. I'll' 
 Outside of the tooth. 77 
 Ovary in relation to incisors, 370 
 Oxyphosphate. melting point of, .'!.'> J 
 Ozokerine, 129 
 O/okerite. 128 
 
 Paraffine, composition of, 128 
 
 Parallel rays of light, 305 
 
 Paralleling root canals of teeth to be 
 
 splinted, 218 
 Parallelodrill, 218, 223 
 
 reaming out two root canals with, 224 
 I'arallelometer, 218, 219 
 Parathyroid bodies, 363 
 Partial splints, 250 
 
 Passive reciprocal functions of the teeth, 
 58 
 
 cosmetic, 58 
 
 defensive, 58 
 
 developmental, 58 
 
 phonetic, 58 
 
 Pathologic anatomy, 360 
 Phenomena of light and color, 302 
 Phonetic functions of the teeth, 58 
 Piersol. 7i! 
 Pin vise, use of, in splinting teeth with 
 
 inlays, 229 
 Pineal gland. 303 
 Pins, disadvantage of, 71 
 
 gaui:e wire for. 7!' 
 
 preparation of, 79 
 Pituitary body, 363 
 Pituitary teeth. :;7."> 
 Pituitodontia, 368 
 Pitnitotrop, 364 
 Planes oi' a molar cro\\ n, i'." 
 
 Planes pret'eralde to ]<\it> in preparation, 
 
 of ca\ ity. 7! !' 
 
 Plaster model of teeth, making of, 147 
 Plaster of Paris. l.ljt 
 Platcheck furnace. 17:!. 17.1, 17H 
 Platinum, alloying w jf), <r l, |, l>;; 
 
 comliining \\ejght of. 1>J 
 
 foil for matii.x. !'!.") 
 
 for inlay \\ork, 182 
 
 fusing | mint, 182 
 
 >pecili<- gravity. 182 
 
 symbol, 182 
 
 Polishing of cavitv \\alls. 1 i'."i 
 of inlay. i'i:: 
 of \\ax inlay, 134 
 
 Porcelain and cast gold inlay for res- 
 toration of fractured lateral. 
 879 
 
 and gold inlays, 269 
 applicalde for simple cavities only. 
 
 328 
 
 dental, composition of, 323 
 fusing of, ."!'.") 
 high-fusing, 324, 325 
 inlay. V,. :;.' 
 
 contraindications to, .'li'i' 
 
 foil matrix for, 333 
 
 for complex cavitv in a bicuspid, 
 
 113 
 
 indications for, '.'-- 
 making of, without use of a metal 
 
 matrix, 337, 357 
 
 making wax impression for, 336 
 preparation of cavity for, 328 
 insert and cast gold inlay for mesio- 
 labio-linguo-incisal deficiency in 
 a central, 289 
 and cast gold inlay in a cuspid, 281, 
 
 283 ' 
 for disto-occlusal cavitv in a molar, 
 
 95 
 
 taking impression for, 286, 295 
 low fusing, 324 
 matrix, 351 
 
 or silicates, and gold inlays in a frac- 
 tured central, 271 
 replacing facial portions with a, 286 
 
 Positional symptomatic functions of the 
 teeth, 60 
 
 Posterior teeth, loss of, as a cause of 
 
 attrition, l'4L' 
 
 Postnasai pituitary state, 376 
 Posts, iridio-platinnni. si/.es for various 
 
 teeth, 277 
 
 rules in connection with use of, 277 
 Prehension, 60 
 
 teeth as organs of. .">:.' 
 Prehcnso-labio-linguo mesial deficiency, 
 
 299
 
 390 
 
 INDEX 
 
 Preliminary steps before beginning a 
 rase of extensive restoration, 
 236 
 
 Prenatal pituitary state, 376 
 
 Preparation of an M.O.D. cavity, 121 
 of a cavity, 65, 76 
 of cavity for porcelain inlay, 328 
 
 Pressure machines in casting, 191 
 all metal castings made under, 187 
 direction of application of, for vari- 
 ous cavities, 153 
 effect of, on teeth, 54 
 
 Preston, 304 
 
 Price, Dr., 350 
 
 Price 's stone model, 355 
 
 Primary colors, 312 
 
 Prismatic colors, 317 ' 
 
 Procreation, 364 
 
 Properties of wax required for inlay 
 work, 129 
 
 Protector of David, 379 
 
 Proximal contact between molars, de- 
 termination of, 258 
 
 Puberty in relation to malrelatlon of 
 the teeth, 377 
 
 Pulp, extirpation of, 276 
 
 Pyorrhea, 361 
 
 E 
 
 Radiation, 302 
 
 Railroads in relation to life, 33 
 
 Rainbow colors, 317 
 
 Rapid heating, guard against, in dry- 
 ing out mold, 174 
 
 Reading, influence of, to coordinate ac- 
 tion, mental and physical, 43 
 
 Receptacle for hydrofluoric acid, mak- 
 ing of, 210 
 
 Reciprocal functions of the teeth, ac- 
 tive, 58 
 passive, 58 
 
 Reconstruction of molars and bicns- 
 pids, 251 
 
 Record models, 236, 241, 249 
 
 Reflection of light, 304 
 angle of incidence, 305 
 incident ray, 305 
 
 Refraction of light, law of, 306 
 
 Refractive index, 310 
 
 Refractory compound, 158 
 
 investment .of splint in, 250 
 
 Removal of decay in preparation of 
 cavity, 125 
 
 Resistance pinion, 214 
 
 Restoration, extensive, a case of, 267 
 of occlusal balance, case showing, 254 
 of occlusal balance by means of cast 
 gold inlays, 236 
 
 Roach, Dr., instruments devised by, .'544 
 
 Root canals, paralleling of, 218 
 
 liiibber bowl f.or mixing, l(i(i 
 dam and clamp, 73 
 
 dam, use of, in cementation of the 
 cavity, 215 
 
 S 
 
 Saddles, gold for, 186 
 
 Sandarac for varnishing model, 1.12 
 
 Sanford, 314 
 
 Sealers, 73 
 
 Schafer, 72 
 
 Schcllenon, 310 
 
 Schreier, Dr., 332 
 
 Seating the inlay, 217 
 
 Secondary colors, 313 
 
 Selection of case presenting a cavitv 
 
 64 
 
 of first tooth to operate upon in ex- 
 tensive restorations of occlusal 
 surfaces, 239 
 of proper wax, 127 
 Sense, auditory, 26 
 optic, 24 
 tactile, 31 
 
 Separating tilted teeth, 330, 331 
 Sequence of. thought, 21 
 Seymour casting machine, 198 
 Shade of porcelain, 354 
 Shock to a tooth under stress mastica- 
 tion, 118 
 
 Shrinkage of porcelain, 353 
 Silex, 323 
 
 and water paste, 295 
 Silicate cement and gold inlay to re- 
 store fractured lateral, 275 
 Silicate, replacing facial portions with, 
 
 286 
 
 Silicates and cast gold inlays, 269 
 or porcelain and gold inlays in frac- 
 tured central, 271 
 Silicon, composition of, 160, 161 
 Simple cavity, defined, 74 
 Simple occlusal cavity of upper first 
 
 bicuspid, 81 
 
 Simplex casting machine, 198 
 Slide for carrying compound, making 
 
 of, 339-344 
 
 Sii ell's law of refraction, 306, 307 
 Sodium bicarbonate bath, cleansing of, 
 
 casting in, 209 
 Solar spectrum, 308 
 Solbrig machine, 199 
 Spatula for mixing cement, 216 
 
 for placing and holding impression 
 
 material, 338 
 Specific gravity of gold, 182 
 
 of platinum, 182 
 Spectrum, 308 
 
 Splint, finished, ready to be inserted, 
 232
 
 Splint -ContM. 
 
 for restoration of occlusal balance. 
 
 247 
 I'm- restoration of occlusal balance in 
 
 cases of alt fit ion, !'}."> 
 use of. in cases of attrition to restore 
 
 occlusal balance. iM.~> 
 vulcanite. L'ls 
 Splinting anterior teeth. 222 
 
 loose teeth l>v means of inlavs, 218- 
 
 i':;r. 
 
 Sprue win 1 , insertion of, in inlay, l.~>4 
 
 use of. 124 
 Steanne. 1' 1 1 
 
 Sterilixation of the cavity. 21.1. 21ti 
 Stokes, 304 
 Stress, a factor in restoring occlusal 
 
 balance. lV.7 
 index, of bicuspid, lower, 83, 87, 89, 9 
 
 upper. SI. So, 111, 113 
 of central, lower, 271 
 
 upper. LVS'.I. 291. 293 
 of cuspid, lower, 281, 283 
 
 upper. 297. 299 
 of lateral, lower, 273, 275, 279 
 
 upper. Us.""! 
 of lower teeth. 1 1"> 
 of molar, lower. 93. 95, 103, 107 
 
 upper. 97, 99. 105, 109 
 of upper teeth, 114 
 Structural sympotomatic functions of 
 
 the teeth, 60 
 Study models. 236 
 Suction machine in casting, 191 
 Sulcus reproduced in wax, inlay, 77 
 Supplemental pins, preparation of, 79 
 Suprarenal capsules, 363 
 Sure Cast machine. l!'s 
 Surfaces of bieuspi'i- 
 of cuspids. (57 
 of incisor t eeth, 6.1 
 Surgical or operative factor in cavity 
 
 preparat ion, 7 1 
 
 Susceptible area of a tooth, 69 
 Suspension ligament, elasticity of, 118 
 Swage, simple, 198 
 
 Symptomatic functions of the teeth, 60 
 Synthetic porcelain and cast gold inlay 
 
 in restoration of lateral, 285 
 and cast gold inlay, restoration of 
 lower lateral by means of, 273 
 inlay for a complex cavity in a bicus- 
 pid, 113 
 for 7iiesio-disto-occlusal cavity in 
 
 bicuspid. SSI. !1 
 
 for mesio occlusal cavity in bicus- 
 pid, 89 
 
 insert and cast gold inlay for me-io 
 disto-labial-incisal deficiency in 
 a cent ral. 291 
 
 Task, ideal of a. -\<\ 
 Tactile sense, 31 
 Tag-art, 1 I.". 
 
 automatic burner, 174 
 
 automatic investment mixer, 168, 170 
 
 automatic wax warmer. }''- 
 
 casting machine. 2nl. 2m.' 
 
 flask and its crucible former, 204 
 
 ijreen wax. ideal for inlay work, 130 
 Tait. ::n| 
 Teaching, value of sequence of thought 
 
 in, 21 
 
 Technic for paralleling. I'l'i' -229 
 Teeth, adrenal. 375 
 
 as accessories of vocali/.at ion. 52 
 
 as organs of incision, 52 
 
 as organs of mastication, 52 
 
 as organs of prehension, 52 
 
 functions of, 52 
 
 geometric landmarks of. i',.~. 
 
 in relation to organic disease and 
 anomaly, 377 
 
 loose, splinting bv means of inlays, 
 218-235 
 
 pituitary, .">7o 
 
 stress index for lower, 115 
 
 stress index for upper. 114 
 
 thymic. .".7.~i 
 
 thyroidal. -">7o 
 
 Temperature of mold for casting. 1~S 
 Temporomandibular articulation, 247 
 Tertiary colors. .">14 
 Test for casting machine, 205 
 Thermal shock, elimination of. in ca\i- 
 
 ty preparation, 126 
 Thought, sequence of. 21 
 Thymic teeth, ."i7o 
 Thymodontia. :;7.". 
 Tliymo-pituito-adrenal stress, 376 
 Thymotrop. ."."U 
 Thymus. W. 
 Thyrojidrenal tootli. I'*!") 
 Thyrodontia, .'Ii'ii'i 
 Thyroid gland, 363 
 Thyroidal disbalance, 60 
 Thyroidal teeth. ::7.~> 
 Tilted teeth, separating. 330, 331 
 Time in relation of life, 33 
 Time spent in mixing compound, 167 
 Tin foil burnished on models. 245 
 Tissue must be exercised, 55 
 Toilet of the cavity. 125 
 Tooth anatomy, knowledge of. neces- 
 sary to inlay worker. 15-' 
 Tooth surfaces ami angles. 6.1 
 Touch, sense of, 32 
 Tnule, Dr. Stanly. :'..~>7 
 Transparent objects, color of, 311
 
 392 
 
 1XDEX 
 
 Traumatic occlusion, 360 
 
 Traumatic origin of loss of occlusal bal- 
 ance, 241 
 
 Tray, compound-carrying, 338 
 
 Trays for taking impression, 344 
 
 for use with parallelodrill in splint- 
 ing teeth, 229 
 
 hinged, for taking impressions of cav- 
 ities, 144 
 
 Trituration, 60 
 
 TJ 
 
 Undercuts in the matrix, 355 
 Unswaged matrix, advantage of, 357 
 
 Vacuum machine for casting, 191 
 
 a pressure machine, 194 
 Van Woert, Dr. F. T., 330, 332, 337 
 Varnishing of model, 152 
 Vasoauxiliary functions of the teeth, 
 
 .58 
 
 Vasomotor force in relation to the ad- 
 renals, 371 
 
 Vibration in relation to light, 303 
 Vocalization, teeth as accessories of, o2 
 Vulcanite splint, making and finishing, 
 248 
 
 W 
 
 Waller, Ewan, 366 
 Watts, Marshall, 310 
 Wave theory of light, 303 
 Wax bite, 151 
 Wax, bleaching of, 127 
 composition of, 127 
 
 Wax Cont 'd. 
 
 forcing into cavity, 131 
 impression for porcelain inlay, tak- 
 ing the, 336 
 
 for porcelain insert, 286, 295 
 for silicate insert, taking of, 277, 
 
 286 
 
 use of, in making inlays for splint- 
 ing teeth, 229 
 
 inlay, chilling with cold water, 135 
 for compound cavity, 135 
 for mesio-occluso-distal cavity, 124 
 instruments for making, 137 
 making and carving, by direct 
 
 method, 131 
 
 making of, with matrix, 136 
 polishing of, 134 
 mineral, 128 
 
 model, burning out the, 173 
 ozokerite, 128 
 paraffine, 128 
 
 pattern invested in compound, 171 
 requirements for inlay work, 129 
 selection of, 127 
 splint, 246, 248 
 Taggart green, ideal for inlay work, 
 
 130 
 
 warmer, 131, 132 
 improvised, 134 
 white, 128 
 Weak Hands, 37 
 Wedgewood mortar ,149 
 Welden, Dr. F. S., 357 
 White wax, composition of, 128 
 Whitmell, C. T., 312 
 Wood, 304 
 
 Young, 303
 
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