Page 156 - My FlipBook

154 DENTAL MEDICINE. ;
to the bone around the spot where the pus will ultimately appear;
the latter following a fistulous track between the diseased tooth
and the surface of the cheek, the fistula remaining open and dis-
charging as long as the inflammatory action continues.
Treatment.—Make a free incision in the gum opposite and
near the apex of the root of the affected tooth. Apply to the
surface of the threatened point of exit of the pus, alcohol, or
spirits of camphor, or paint with collodion, and make gentle pres-
sure by means of a compress of sheet lead or sheet tin, or pads
and bandage, to change the direction of the pus.
Suppuration or Abscess of the Antrum is indicated by a discharge
of pus into the nose, sometimes producing scarcely any discomfort
at other times the severest local and constitutional suffering ; an
aching pain in the cheek, which is hot, flushed, and somewhat
swollen ; also in forehead and, as the symptoms increase, greater
pain, of a throbbing character, with the rigors and fever peculiar
to suppuration ; an expansion of the bone of the upper jaw ; an
elevation of the malar bone, with a very apparent depression be-
neath it ; the molar teeth on the affected side depressed so as to
appear elongated, and to prevent the proper closure of the mouth
;
the palate losing its concavity and becoming
an increase of pus ;
convex ; the nostril of the affected side being encroached upon,
and, in protracted cases, the floor of the orbit of the eye so pushed
up as to force the eye partly from its socket; the sight affected
by the stretching of the optic nerve; the walls of the antrum be-
coming so thin as to afford evidence of fluid-fluctuation on pres-
sure, and crepitus; at length the pus escaping through the cheek,
or into the nose, or burrowing along the side of a root of a tooth
and discharging into the mouth the floor of the orbit giving
;
way and the pus discharging along the lower eyelid.
Treatment.—Make an opening into the antrum, either through
the alveolar cavity of one of the roots of a superior first or second
molar, or through the process between the roots of the first
and second molars, which is the most dependent portion of the
antral cavity, with a suitable trephine, and thoroughly wash out
the cavity with a warm injection of salt 5j to water Oss, and if
there is an offensive odor, syringe with a solution of permangan-