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CHAPTER XYIII. —

DENTO-ALVEOLAR ABSCESS.

By Hexey H. Burchard, M. I)., D. D. S.

Definition.—In describing the septic inflammation affecting the
tissues of the apical region in the previous chapter, it was stated that a
common result of the inflammatory action was cellular necrosis and pus
formation this condition is known as alveolar abscess or dento-aheolar
;
abscess.
Although alveolar abscess affecting some other portion of the peri-
cementum may and does occur without death of the pulp/ septic infec-
tion and bacterial invasion of the tissues of the periapical region from
infected pulp canals is the most common source and cause of the affec-
tion. The term as technically applied refers to septic apical pericemen-
titis.
Causes of Dento-alveolar Abscess.
The exciting- causes of the disease process will be found in the pyo-
genic cocci and probably other pyogenic organisms which inhabit and
develop in the deepest portions of the putrescent pulp, finding entrance
to the periapical tissues through the apical foramen of the tooth. Dr.
Schreier of Vienna found diplococcus jineumonije to be the excitant of
inflammation in seventeen out of twenty cases of dental periostitis
examined by him.' The ptomains and other waste products formed as
the result of the life processes of these organisms cause poisoning and
debility of the cellular elements of the part. Even granting that the
organisms are present as the exciting cause, there is another factor
involved which determines to a great extent the occurrence, time of
occurrence, and severity of the disease, i. e. the predisposing causes
including under this head the condition of the tissues which favors or
deters the development of the organisms.
Predisposing Causes.—It is unquestionably true that different in-
dividuals will exhibit in their tissues marked differences in the degree
' Cases reported in Proc. Academy of Stomatology of Philadelphia, 1895.
^ esterr.-ungavische Viertelj. fUr Zahnheilh., April 1893.
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