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504 DENTO-ALVEOLAB ABSCESS.

most effective anesthetic ; in a few minutes a sharp fine-pointed lancet is
passed around the growth as far as it can be, and the excised portion
removed. An application of tannin will check the bleeding pledgets
;
of cotton dipped in tr. iodin. are packed against the remainder of the
growth and covered in with cotton and sandarac varnish for twenty-
four hours. Tiiis dressing is renewed from day to day until, if it be a
fungous gum, tlu; margins of the perforation are plainly seen. The
canal is cleansed, sterilized, dried, and filled with salol and gutta-percha,
or with paraffin and gutta-percha, to about half its depth. The re-
mainder of the canal and crown cavity are washed out with 25 per cent,
j^yrozone, and a dressing of temporary sto})ping applied, filling the per-
foration and yet not exercising much pressure upon the soft tissues. In
two days the temporary stopping is removed and the cavity is washed
out with 3 per cent, pyrozone and dried. A piece of No. 60 gold is cut,
larger than the aperture ; this is dipped in chloro-percha and laid over
the perforation. A disk of gutta-percha larger than the piece of foil is
warmed, laid upon the foil, and pressed against it, sealing it to the
cavity walls. The remainder of the cavity is then filled with zinc phos-
phate.
In case the perforation should be nearer the apex of the root the dif-
ficulty is greatly increased. Attempts at passing cleansers to the apical
foramen usually result in pricking the pericementum at the perforation
and a flow of blood follows, filling the canal. The cleansers are bent so
that in passing them to the apex they press against the wall opposite
the perforation ; the apical portion of the canal may be detected and
cleansed after this manner in some cases. The temporary dressings in
these canals should be one of the antiseptic oils, cassia or myrtol. A
dressing of oil on cotton should remain a week, and no attempt at canal
filling be made until all evidences of pericemental disturbance vanish.
A fine cone of gutta-percha is passed, when practicable, into the canal
beyond the perforation ; the remainder of the canal is filled with chloro-
percha, and the silk points covered with gutta-percha. The canal at
the proximal side of the perforation is filled with the solution, by means
of the long dressing pliers, the gutta-percha-covered silk being carried
gently in position while the general mass is fluid, Balsamo del deserto
should apply well in these cases. The canal is filled, or partially filled,
with the material, and a large gutta-percha point introduced.