Page 25 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. S them and the dental artery and nerve, the means of supporting that vitality having been previously lost;* in this state the irrita- tion of the dead fangs produces an absorption of the osseous struc- ture of the jaw immediately surrounding them; and occasionally inflammation and suppuration take place in what may be regarded as comparatively an early period of the disease. Mr. Fox advances no direct opinion regarding these affections as they occur in the under jaw, although he must have been well aware of the different structure of the superior and inferior maxil- lary bones, as well as of the different formation of the under and upper teeth. Several of the cases which he relates are, however, affections of the under maxilla, a fact which virtually proves his admission that these afiections are similar. He believes with Mr. Hunter, that In some Instances, the disease may be produced by the obliteration of the duct leading from the nose to the maxillary cavity, even when the teeth are perfectly sound, but advances no satisfactory reason or proof to establish such an opinion. For my own part, I am perfectly convinced, that such an opinion is not consonant with fact, and that those diseases are almost invariably brought on by some previous disease or disorder of the teeth, or of the parts immediately related to them.f As far as my own experience extends, I have never failed, on a minute and careful investigation of the original symptoms, to find this opinion of the causes of the disease satisfactorily con- firmed. All the various affections of the jaw which Mr. Fox has either seen or related, and of which he gives more or less perfect engrav- ings and histories, may be presumed to have taken their origin • The anatomy of the part does not admit of the fangs of the teeth penetrating into the cavity of tlie maxillary sinus, except as the result of disease. The dental nerves and alveolar arteries pass into the teeth directlyfrom the substance of the bone. Did the roots of the teeth penetrate into the antrum, the arterial and nervous twigs which supply tliem, would in the first place have to enter that sinus, and then, covered only by the mucous membrane, make their way into the foramina of the teeth within the cavity. t The effects of external injury form, of course, exceptions to this statement, although it is disease arising spontaneously in the lining membrane of the antrum that the author has in view. b2 I