Page 29 - Craventreatiseonpyorrh00crav

PYORRHOEA ALVKOLAR1S. 19 THE PERICEMENTUM. Just how the pericementum may be affected in pyorrhoea alveolaris is not definitely known. Certainly it cannot main- tain a state of unimpaired health in a continuous bath of pus. In profound " pockets w of long standing the pericementum disappears, commencing at the cervix and extending toward the apex ; later, in some instances, it appears to be have been reasserted at or near to the cervix, which probably is due to accidental or other removal of the incrustation at that point. One fact bearing upon this point should be noted, that the en- during calculus will not attach to the pericementum directly, but encroaching upon that membrane causes it to recede, and the calculus is thus enabled to fix itself directly upon the cementum. By this process the pericementum becomes perma- nently thickened and corrugated near the apex, definitelv marking the chronic stage. This corrugated membrane is not dead because it is sensitive, besides if dead it would slough away ; it can not be induced to reattach itself to the cementum it has abandoned, consequently before a cure may be hoped for the whole or a portion of the detached membrane must be brought away, to the end that a new and active and healthy membrane may be asserted. To Dr. George B. Clement, of Macon, Miss, (to whom re- ference is made in the introductory chapter of this little vol- ume), doubtless belongs the credit of having discovered the cause for the apparent loosening and disappearance of perice- mentum in "pockets" of long standing pyorrhcea cases, and the apparent futility of attempting to induce a resumption of