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TREATMENT OF CHRONIC PERICEMENTITIS. 477
root have beeu irritated, it may be for months, by the products of a
decomposing pulp, a series of degenerative changes may have occurred
in them Avhich require some time to remedy. Sterilization should be
prolonged, and too hasty a stopping of the canal be avoided. In such
cases, after each periodical treatment the canal should be dressed with
:Some stimulant antiseptic : campho-phenique ; oil of cinnamon, or the
.admirable 1, 2, 3 mixture of Dr. Black :
Oil of cinnamon, 1 part
Carbolic acid, 2 parts
;
Oil of wintergreen, 3 "
Repeated applications of tr. aconit. et iodin. are to be made to
the gums.
A source of chronic ai)ical i)ericementitis—frequently not detected
until abscess has formed and discharged, it may be, at a distant point
is found in the death of a pulp from thrombus or jugulation. At some
period the tooth has received a blow, or, it may be, has been moved
too rapidly by a regulating a])pliance, or idiopathic pulpitis has occurred.
Years afterward, a chance examination may reveal a deeper color of
the gum overlying the tooth than over the others; by reflected light it
i^hows an opacity or discoloration of the l)ody of the tooth. It may be
slightly sore to percussion, which elicits a dull sound. ''Dead })ulp" is
diagnosticated ; the tooth is opened under extraordinary antiseptic pre-
cautions and cleansed freely with sodium dioxid—the ideal material in
this instance—dried, and filled at least tentatively with salol.
Another class of cases in which a similar condition of the pulp is
found consists of those in which a pulp has died from repeated thermal
shock received through a metallic filling placed in too close proximity
to it. Although constructive action resulting in secondary deposits is
the usual consequence of such irritation, j^rofound degenerative changes
in the tissue of the pulp frequently occur at later periods. The treat-
ment is the same as in the preceding case.
Unless the degree of antisepsis stated be em])loyed in cleansing the
canals of such cases, an annoying and it may be an obstinate perice-
mentitis is lighted up which is difficult to conquer.
A word of caution should be spoken in regard to the importance of
the removal of inflammatory troubles, particularly the subacute forms,
which aifect the apical pericementum. It is supposed and with good
reason that not only may tumor formations have their beginning in
chronic inflammations various reflex disturbances of sensation and of
;
special sense may be traced to such sources ; but any inflammation
having such an anatomical situation is a smouldering fire which may
under certain systemic conditions become a pathological conflagration.
TREATMENT OF CHRONIC PERICEMENTITIS. 477
root have beeu irritated, it may be for months, by the products of a
decomposing pulp, a series of degenerative changes may have occurred
in them Avhich require some time to remedy. Sterilization should be
prolonged, and too hasty a stopping of the canal be avoided. In such
cases, after each periodical treatment the canal should be dressed with
:Some stimulant antiseptic : campho-phenique ; oil of cinnamon, or the
.admirable 1, 2, 3 mixture of Dr. Black :
Oil of cinnamon, 1 part
Carbolic acid, 2 parts
;
Oil of wintergreen, 3 "
Repeated applications of tr. aconit. et iodin. are to be made to
the gums.
A source of chronic ai)ical i)ericementitis—frequently not detected
until abscess has formed and discharged, it may be, at a distant point
is found in the death of a pulp from thrombus or jugulation. At some
period the tooth has received a blow, or, it may be, has been moved
too rapidly by a regulating a])pliance, or idiopathic pulpitis has occurred.
Years afterward, a chance examination may reveal a deeper color of
the gum overlying the tooth than over the others; by reflected light it
i^hows an opacity or discoloration of the l)ody of the tooth. It may be
slightly sore to percussion, which elicits a dull sound. ''Dead })ulp" is
diagnosticated ; the tooth is opened under extraordinary antiseptic pre-
cautions and cleansed freely with sodium dioxid—the ideal material in
this instance—dried, and filled at least tentatively with salol.
Another class of cases in which a similar condition of the pulp is
found consists of those in which a pulp has died from repeated thermal
shock received through a metallic filling placed in too close proximity
to it. Although constructive action resulting in secondary deposits is
the usual consequence of such irritation, j^rofound degenerative changes
in the tissue of the pulp frequently occur at later periods. The treat-
ment is the same as in the preceding case.
Unless the degree of antisepsis stated be em])loyed in cleansing the
canals of such cases, an annoying and it may be an obstinate perice-
mentitis is lighted up which is difficult to conquer.
A word of caution should be spoken in regard to the importance of
the removal of inflammatory troubles, particularly the subacute forms,
which aifect the apical pericementum. It is supposed and with good
reason that not only may tumor formations have their beginning in
chronic inflammations various reflex disturbances of sensation and of
;
special sense may be traced to such sources ; but any inflammation
having such an anatomical situation is a smouldering fire which may
under certain systemic conditions become a pathological conflagration.
