Page 22 - Craventreatiseonpyorrh00crav

12 PYORRHCEA ALVEOLARIS. ever, to the obscurity of the parts involved, to the hemor- rhage attending operations, and to the extreme sensibility of imposed tissues it is difficult, if not impossible, to determine the degree in which the pericementum or periosteum may be affected. ETIOLOGY. In certain cases inconstancy of gum forming the gingivae is — general, a condition suggesting heredity, but sometimes prob- ably the more frequent—is only a diathesis that has been induced by general debility, thus inviting pyorrhoea alveolaris, / the debility itself passing away on opportunity for recupera- tion of the individual ; the obliteration of a diathesis, however, w ill not carry away with it pyorrhoea alveolaris once estab- T lished. Beyond the gum tissue the invading calculus encroaches upon the periosteum that envelops the bony process forming the orbit of the alveolus or socket ; the immediate effect of this encroachment is to establish periostitis at that point. The congestion of the periosteum may extend slightly within the socket, where, because of the extremely limited space between the cementum of the root and the wall of the socket the peri- ostitis is aggravated, increased vascularity demands more space, which is afforded only by resorption or removal of the involved section of alveolus wall. POCKETING. After the enlargement of a portion of the socket in the manner suggested, the pericementum—for a time at least—loy- ally adhtfreb* fo\t)ra\\&eiqefetum ; the periosteum, although