Page 32 - Craventreatiseonpyorrh00crav

22 PYOREHCEA ALVEOLARIS. ; GKOTTOES. The attention of readers is called to a differentiation from the galleries, one that enhances complications and is very diffi- cult of management by the operator, even should he be fortunate enough to discover its existence ; this, also, is much oftener present than may be suspected—I refer to excavations be tween the roots of molars and two-rooted bicuspids. I have a number of times found a " pocket w extending up the ap- proximal face of a root of a superior molar, and passing in between the roots, having excavated the bony process to such an extent that the inner faces of the roots were exposed for a third of their length. These grottoes are also simple and blind ; the blind passing into the crotch, and terminating there the simple passing entirely through, possibly beginning and ending in " pockets." The inferior molars are also subject to the grottoing process. Pyorrhoea alveolaris is often symmetrical, but quite as often is not, therefore one may infer that it is not always inherited, nor even constitutional. It does not necessarily prevail en sequence, and is not contagious—even from socket to socket in the same jaw. A tooth that is in proper relations with other teeth in the arch may develop chronic pyorrhoea alveolaris upon any aspect, and so continue the sole case of pyorrhoea in that mouth for years. Given an entire phalanx of inferior incisors, each member of which presents an approximal "pocket" on each side, a selection of alternate teeth may be made from such phalanx,