The pits represented in labial surfaces of these six teeth, were small in diameter, and quite shallow. I noticed that the bicuspid and molars were not thus pitted, and, although badly decayed, the cavities were found in the usual localities.

I removed the old fillings from the cavities (see Fig. I) in the centrals and canines, and excavated very thoroughly; the walls were carefully trimmed for operating with gold, and the margins of cavity shaped into definite lines, either curved or straight.

With a spherical Hindoostan stone adjusted to White's engine I passed over as much of the pitted surfaces as possible, back and forth, up and down, indeed passing the revolving stone in every direction, grinding off the imperfect enamel until the pits. were all obliterated, and a continuity of surface obtained. This new surface I carefully polished with pomice stone and chalk, although there was not a great deal to be done in that direction after the revolving Hindoostan stone had done its work.

The inner portions of enamel seemed to be disarranged by a liberal admixture of dentine, which I accepted as a sufficient reason for the yellowish cast of debris contained in the pits, as enamel does not assume that color when attacked by caries.

There was no unusual disagreeable sensation complained of under the grinding operation; the surface was rendered smooth and perfect, and cold water produced no new sensation.

By a reference to Fig. I, a line may be seen-horizontal—passing the full width of the mouth and just under the incisive edges of the laterals, but cutting off the cusp point of each canine, and about half a line off each central. This was adopted as a new line of incision, which I reached by a vigorous use of a strong flat file, and finished the surface with the revolving Hindoostan stone, rounding up the new cut ends and edges.

The manner in which the labial edges of these cavities were shaped for filing, may be estimated from the following Fig. II. which illustrates to the best of my memory.

Fig.Il

The black sinuous portion illustrating extent of trimming in

dulged in, and the regular lines of demarkation betwixt the black and white portions showing the new margins of cavities after prepared for filling.

It will be noted that there was but a fragment of each incisor left, to appearances; but there was in each one a septum of dentine of repair occupying the original site of pulp chamber, showing that nature had been using her agent, plastic-lymph, to good advantage in protecting the vitality of the tooth against the encroachments of dental caries, otherwise the pulps of both centrals would have been lost, and in all probability the fragments of the crowns would have been broken away, leaving only the roots. As it was, I found the pulps to be not only alive, but healthy, and the dentine not unduly sensitive under the excavator; the pulp of the canine was also alive and in apparent good condition; none of these pulps were exposed.

Having an abiding faith in good retaining points, I sunk them deeply and numerously at those points where confluence of axis might be obtained. In cases of this character, i. e., any case where the general form of the cavity cannot assist much in the retention of a filling, it is my habit to drill a compound retaining pit. By compound pit I mean one made by a rather large drill, but of very slight depth, the depth rarely exceeding the diameter; this target pit forms the stronghold, but is itself supported by two smaller pits that diverge from its inner depth.

To fill these teeth, I used Williams' No. 30 Rolled Gold, (cohesive) for the retaining points and base of filling; using Rectangular Pellets for the body of each filling, and forming surface of rolled No. 30 for finishing.

The appearance of this mouth was greatly improved by the operations given, and I congratulated myself for having cut off the ends of the incisors and canines so extensively, and for so boldly grinding down the imperfect pitted surfaces.

The reader will obtain a just idea of the situation when operations were completed by reference to the following illustration.

Fig.

I apprehend that few gentlemen of the profession will deny that the operations as reported in the foregoing were far better than any pivot teeth, even of the most approved method of adjustment, and infinitely superior to plate of whatsoever character. This case, although embraced in perspective dentistry, was unlike that reported in the May No., '76, of this journal, inasmuch as that one was a matter of malposition and malformation combined, while Miss B.'s case was a complication of malformation and of mutilation. I will add that there was no optical delusion in this instance, as the gold was self-evident prima facia.

NOTES FROM PRACTICE.

BY W. GEO. BEERS, L.D.S., MONTREAL, CANADA.

When, in one of those weak moments which sometimes seize the most cautious of men, I promised to contribute to this meeting, I was more sanguine than now of my ability to face the music of your criticism. I have, indeed, chosen between shirk ing my duty and hastily running together some notes which may. possibly, provoke enough discussion to conceal their own de merits. I am obliged to put them together like a bad case of irregularity, and tell them in a style akin to the disconnected speech of a patient with cleft palate.

I. Replantation of Teeth affected with Chronic Periodon titis.-William Coleman, of London, claims to have introduced this novel operation; though, doubtless, it is as old as Hunter. My experience has been limited to twelve cases. If I were obliged to live the same time over again I should endeavor to limit that experience to one case.

The first case was a lower molar, which, ten days afterwards, I removed with my thumb and forefinger, though it was difficult

Three others were

to extract and almost as difficult to replant. superior bicuspids, which became loose and troublesome in about three months, and wabbled about in a ridiculous manner, finally literally falling from their places. Two centrals, replanted two years and a month ago, still remain firm, but are endured under protest. Last week I saw two other cases, replanted in January, 1874, which are perfectly solid, though changed to an ugly blue color. Another case seems a success in every respect, except that it notes the changes of weather so perceptibly that the owner calls it his "dental barometer." The others I have not seen since they were replanted.

II. Excision of Alveolus after Extraction of Teeth.-In the Canada Journal of Dental Science (peace to its ashes!) I described an important case of this kind and the ultimate victory obtained over Nature in modeling into a regular and even arch one of the best imitations of a horse-shoe that I ever saw behind human lips. Since this "heroic treatment" (as such operations have been called) I have made a common practice of removing, with a cutting forceps, large portions of the transverse processes, or septa, and the outer and inner plates of the alveolus, especially where the lip is naturally short, the gums and alveolus unnaturally prominent, and the prospect is presented that several months' absorption will make the case what otherwise it could not have been,-one suitable for gum teeth. After the extraction of the incisors, cuspids, and bicuspids, cut cleanly across the gum down to the process, as far as you propose to excise; then slip your knife under, and dissect away in one piece. The excision can then be proceeded with, taking care to remove all you cut. I have been surprised to see difficult cases, treated in this way, return in eight or ten weeks with the mouth quite as ready for an impression as it generally is in four months when the alveolus is left to the natural process of absorption. Nothing is done in this operation to increase the inflammation which usually ensues after the extraction of teeth. Astringent washes ought always to be used.

III. One of the quickest Cases of Regulating on Record. done without plates or ligatures, and comprising ideas as old as Hunter and as modern as Tomes. It is mentioned here more as

a novelty than from any desire to recommend its revival. The patient was a healthy young man, about eighteen years old.

It will be observed (see Fig. 1) that the normal centrals lie outside their arch, five-eighths of an inch apart; the left lateral is immediately behind the left central, three-eighths of an inch away, with one side against and partly behind the canine, while the right lateral is crowded by the right cuspid and central. On the left side of the median line is implanted a malformed supernumerary lateral; on the right a supernumerary central, of perfect labial formation, but irregularly concave on its lingual side. Its labial surface is turned toward and touching the supernumerary lateral, thus lying obliquely. Evidently these supernumer ary teeth have displaced the normal teeth. In a measure this is analagous to a transposition of the germs of the teeth, or, at least, quite as difficult to treat, as the distance between the normal centers renders it impossible to either coax or force them into agreeable companionship.

I am aware several orthodox modes of treatment might have been suggested by the practitioner who was to receive a large fee, or by those who serve their fellow-man from considerations of love and charity alone; but, as my patient was neither dis posed nor able to incur large expense, and was, moreover, on the point of having some of the teeth extracted, I proposed to him the risk of a plan, which he accepted.