Page 976 - My FlipBook

986 DISEASES OF THE PERIDENTAL MEMBRANE.

reason the use of a strong disinfectant agent in this disease cannot be
recommended, for, instead of building up, theytend to further depress
the tissues ah-eady lowered in tone; therefore in 'their use it is especially
necessary that some agent be combined with them to counteract this
influence. Yet this can be only partially done, because any agent
which will depress life in the form of micro-organisms will also depress
life as it exists in the individual cell in the tissues ; yet experimental
study of the action of remedies shows us plainly that the different anti-
septics depress the life-force of the animal cells and that of the micro-
organisms in a different ratio. Hence there should be discrimination in
their selection. Carbolic acid possesses this depressant power in a very
marked degree. In the combination of carbolic acid with the oil of
cinnamon and the oil of wintergreen the depressant eifect of the car-
bolic acid is reduced to the least degree as to its action on the animal
cells, while retaining its power over the vegetable cells. In this way
we retain that quality of the carbolic acid desired, while we remove its
undesirable properties. In eugenol we have also an antiseptic possess-
ing a minimum depressing power over the animal cells ; hence it is
valuable in the treatment of this aifection. In the bichloride of mer-
cury we have an agent seemingly possessing very peculiar power over
the life of micro-organisms—an agent which in solutions of i to 300 or
1 to 1000 parts seems to destroy the life of these low organisms without
especially influencing the animal cells with which it may come in con-
tact. In studying the effect of these solutions I have been unable to
discover that they produce any marked local depression ; this would
indicate that their depressing power is rather feeble. Carbolic acid used
in the same Avay w^ould cause marked local depression. This quality of
carbolic acid renders it inapplicable, in its unmodified form, for use in
this disease.
In regard to the reparation of the peridental membrane and the
alveolar wall in this disease it may be said that repair rarely or never
takes place after the manner of healing by first intention, but is always
by granulation. Granulation may begin in the tissues overlying the
parts of the root, but the reattachment creeps in from the margin of the
injury where the peridental membrane is intact, or from the extremity
of the pocket above, and slowly covers over the denuded portion of the
root of the tooth. This is usually a slow process, but varies greatly in
different cases. In explanation of this three theories may be entertained
:
First, in those cases in M'hicli the destruction of the membrane is trau-
matic or very recent it may be supposed that the ceraentum covering
the root has not lost its vitality, and that its cells may grow, subdivide,
and throw out processes beyond the surface of the cementum which may
join with the granulations from the soft parts. In this way we can sup-
pose the peridental membrane to be reformed, or rather reattached to
the root of the tooth by first intention. As a fact, we see this occur in
case of incision. Observation shows that this does not occur in the
healing process following this disease. Second, we may suppose that,
the cells of the cementum having lost their vitality, the granulaticms
from the soft tissues grow into the old canaliculi or lacun?e of the
cementum and reinhabit them, and in this way the reattachment is