Page 74 - An essay on the diseasesof the jaws, and their treatment

52 AN ESSAY ON THE cicnt, it is to be feared that every other mode of treatment, includ- ing amputation itself, will be of no avail, but rather tend to acce- lerate the fatal termination of the disease. See cases 4 and 27 in" Principles of Dental Surgery." OF THE TREATMENT OF OSSEOUS, FIBRO - CARTILAGINOUS, SARCOMATOUS, FUNGOUS, AND OSTEO-SARCOMATOUS TUMOURS AND EXCRESCENCES OF THE JAWS. The management of these compHcatcd forms of maxillary dis- ease should generally be the same as that already recommended, although it may often require to be carried to a greater extent, and the additional application of surgical operations ; for such tumours and excrescences must be considered as consequences, and not as causes of the affections of the jaAvs. In such cases it is particularly requisite that all the teeth should be removed from those parts of the jaw whence the disease originates, and from both sides of the tumour, so far as the bony structure of the maxilla is morbidly affected, even though they should be perfectly sound in their bony structure. And it is hardly neces- sary to add, although it is of no small importance, that the utmost care should be observed to use the least possible violence, and to cause as little irritation and pain as possible in performing all the dental operations. If the diseases should be accompanied by (Edematous and sarco- matous tumours, the restoration of healthy action, by the perfect removal of the morbid causes, combined with the other mea- sures recommended, will not unfrequcntly cause them to be re- moved without any other operation ; should nature, however, not be sufficiently active in her curative efforts, they may be extir- pated either by the knife, forceps, or scissors, without any danger of a recurrence.* Should the tumour be of a spongy or osseous na- • The most familiar example of these tumours is the affection called Epulis, and to it these remarks particularly apply. Sir Charles Bell used to insist very strongly, in such cases, on the necessity of removing the alveolar processes, as veil as tlie teeth and enlarged gum, because these three parts are very intimately connected. In his lectures, delivered at the College of Surgeons, his words were:— I