Page 498 - My FlipBook

496 DENTO-AL VEOLA R A BSCESS.

may be very limited in size, only a trifling amount of the perieementum
being destroyed.
It is advisable in these cases, after thorough sterilization of the canals
and dentin by means of sodium dioxid or formalin, to increase the size of
the natural drainage-tube, by enlarging the pulp canal ; a fine Donaldson
Fig. 471. Fig. 472.

Chronic blind abscess of upper incisor, showing Chronic blind abscess u|)On lower tooth,
tendency of pus to progressively destroy peri- showing tendency of pus to sink into
cementum owing to the Influence of gravity. the substance of the lower maxilla
owing to the influence of gravity.
cleanser should pass freely through the apical foramen. The abscess
cavity is now forcibly and thoroughly syringed out with 3 ])er cent,
pyrozone. It is advisable after effervescence ceases to mechanically
withdraw, or aspirate, the contents of the abscess. This may be readily
done by passing the point of a syringe into the canal, filling around it
with gutta-percha and withdrawing the piston, when the contents of the
abscess will flow into the syringe. Any instrument (syringe) employed
for this purpose should soak for hours in an antiseptic before using it
in other cases (a 20 per cent, solution of phenol sodique is an excellent
sterilizing agent) ; the same syringe should never be used for any other
purpose. A small amount of 25 per cent, pyrozone, ethereal, may now
be placed in the canals and pumped into the abscess cavity ; then canals
and sac are dried by means of warm blasts, and a wisp of cotton dipped
in campho-phenique and wrung out is packed in the canal. The
patient reports the day following, and if no discomfort be felt the tooth
remains closed until the following day. If upon opening the tooth no
evidence of exudation is seen, and no effervescence occurs upon applica-
tion of 3 per cent, pyrozone, the drying and dressing are renewed, to
remain about three days. If any evidence of pus be detected, the canals
and abscess are syringed with weak pyrozone, and a small amount