Page 922 - My FlipBook

932 DISEASES OF THE PERIDENTAL MEMBRANE.
necrosis of portions of bone, and for this reason should receive prompt
attention for the purpose of preventing or limiting this very unfavorable
result. This seems to occur mostly in those cases in which the inflamma-
tion has run very high, and in which there
has been, or exists at the time of the escape
of the pus from the bone, a very considerable
inflammation of its substance and of its peri-
osteum, by which the layer of osteoblasts have
become so softened that they are readily sepa-
rated from the bone beneath. In this condi-
tion of things the pus, in making its escape
from the bone, instead of penetrating the over-
lying tissues, raises the periosteum in the same
manner as in subperiosteal inflammations. In
this way separation of the periosteum from the
bone over a considerable surface occasionally
occurs ; and if the parts are suffered to re-
Acute Alveolar Abscess with Pocket • • ii • Tj_' i? •! 1 1 x-
of Pus between the Periosteum uiaiu lu this couditiou tor a Considerable tune,
^^^.oi of^^i;lr" "ecrosis more or less extensive will result. If;
hp ;rf, tooth ;e, pus-cavity beneath qu the otlicr liaud, the pus bc promptlv dis-
the periosteum. ' .^ ^ i"-
charged, so that the periosteum may be again
brought in contact with the parts from which it was separated, not much
harm will follow ; it will readily be-
Fig. 489.
come reattached, and the parts will
heal without difficulty. Separation of
the periosteum is to be suspected when
the tumor of the gum is broad and com-
paratively soft. After discharge of the
pus by means of the bistoury an exami-
nation with a probe will reveal the fact
that the bone is more or less extensively
stripped of its periosteal covering. This
form of abscess, when left to itself, is
prone to discharge at the gingival mar-

FiG. 488.

Necrosis of the lUical Plate of the Alveolar Pro- Acute Alveolar Abscess of a Lower Incisor with
cess from Alveolar Abscess. Pus-cavity between the Bone and the Perios-
teum : II, pus-cavity in the bone; b, pus be-
tween the periosteum and bone; e, lip; d,
tooth ; ', tongue.
gin after having separated the periosteum from the outer wall of the alveo-