Page 942 - My FlipBook

952 DISEASES OF THE PERIDENTAL MEMBRANE. ; ; —
plish this can be given for them, for the reason that all the conditions
cannot be foreseen ; and if rnles were given, the intelligent dental sur-
geon would be likely to follow methods of his own devising in each
case as presented.
The general rule is that the sinus will need no attention after the
abscess has healed. It often makes a very ugly scar ; but if this is
under the chin, it will not be much exposed to view, and if on the neck
may be covered by the clothing. If on the face, however, there will be
disfigurement ; each case must be studied with the view of lessening
this as much as possible. The cord formed by the healing and contrac-
tion of the sinus is always somewhere attached to the bone, and it will
often draw in the tissues in such a way as to be very unsightly. This
is especially the case when the abscess has pointed just under the prom-
inence of the malar bone in front of the attachment of the raasseter
muscle. In this case, if the finger is thrust into the mouth and a pull
made outward against the scar, the round cord by M^hich it is held down
to the bone will be plainly felt. Now a tenotomy-knife may be passed
in through the tissues of the cheek, and while a strong pull is being
made on the cord it may be cut off where it is attached to the bone
this will allow the cheek to come out to its proper fulness at once.
Then a pin may be passed through the central part of the scar and left
lying against the face, to keep it
lio. o04.
jj^ ^j^^^ position until the wound
heals. This little procedure will
greatly diminish the deformity,
ini ^^^^^y but will not entirely eradicate the
"^T^Av ^"^^^^^^^^^^^^^^x ®^^^ (-^^^- '^0^)- ii^ some such
way most of the cases where the
scar is badly drawn inward may
be improved.
Finally, the case must be put in
condition to prevent the recurrence
of abscess. To do this, the con-
tamination of the tissues of the
apical space with poisonous mate-
rial from the pulp-chamber of the
Illustration of Operation for the Remedy of Scar
on the Face caused by Alveolar Abscess. (See affected tooth must be rendered
p. 940. Compare with Figs. 490, 495, and 496.)
impossible ; this is effected by fill-
ing the root-cfinals and pulp-chamber with some enduring material.
The requirements of a material for this purpose are threefold—first,
that it shall be enduring, that it shall neither absorb moisture nor be
sul)ject to solution in any of the fluids of the body ; second, that it shall
be unirritating to tissues with which it may be brought in contact
third, that it shall be capable of such manipulation that the root-canals
can be perfectly and solidly filled with it. Many materials have been
j)roposcd from time to time for this purpose, but of them all only two
seem to me to possess these qualities in a sufficient degree to recommend
them for the ]Mn']5ose ; these are gold and gutta-percha. The gold meets
the first two requirements most perfectly, while the gutta-percha
which was first recommended for this purpose by Dr. O. A. Glidden at