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CHAPTER XIX.
PYORRHEA ALVEOLARIS.

By C. N. Peirce, D. D. S.

—
Definition. " Pyorrhea alveolaris " is a generic term which, strictly
defined, means a flowing of pus from an alveoUis. It describes merely
a symptom which may be and usually is attendant upon a variety of
disorders. The term is applied in clinical dentistry to a complexus of
pathological conditions which more or less clearly indicate a specific
disease.
History.—That pyorrhea alveolaris is not a recent disease, or one
due to modern constitutional states alone, is rendered evident from the
examination of the skulls of ancient as well as modern races. The
alveolar processes of many crania widely separated both in time and in
locality exhibit marked impairment of structure which bears the closest
resemblance to that presented by processes which were known to have
been the result of pyorrhea during life.
Recorded observations of this disorder date at least as far back as
.1746, when ]\I. A. Fauchard described its essential clinical features, but
failed to designate it by any specific term. Following this, communica-
tions describing the disease were published by Jourdain in 1778, by
Toirac in 1823, and by M. Marechal de Calvi in 1860, in which it was
described as a " conjoint suppuration of the gums and alveoli," pyorrhea
inter-akeoh-dentaire, and gingivitis exjmlsiva respectively.
The most important contribution to the knowledge of the nature of
the disease which had up to that date been made was by Dr. E. INIagitot
in 1867. In his paper he states that the disease is characterized by a
slow but progressive inflammation destructive of the periosteal mem-
brane and cementum, proceeding from the neck to the apex of the root
and involving the loss of the teeth. From the exact seat of the lesion
he designated the disease osfeo-pcriosfiti aJveoIn-dentaire. Soon after the
appearance of the periosteal inflammation, it became complicated with
diseases of the gums and the osseous walls of the alveolus, though
these are never primarily the seat of inflammation. Magitot regarded
the causes of the inflammation as very complex, and to be sought for
not in the teeth and gums, but in certain conditions of the general nutri-
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