Page 158 - My FlipBook

156 DENTAL MEDICINE.
phagedenic in character, destroying hard and soft tissues by
chemical decomposition. Like alveolar abscess, it may be due
to the death of the pulp, and it may begin as abscess, not being a
primary disease, but always preceded by some other well-estab-
lished and usually chronic affection. In alveolar ulceration a
considerable portion of the peridental membrane is destroyed, and
there is a wasting away of the alveolus and cementum in the
region of the ulcer, whereas in alveolar abscess the peridental
membrane may remain in an inflamed and morbid condition and
the alveolar walls firm and penetrated at one. point to permit of
the escape of the pus. In long-continued alveolar ulceration, as
a result of the disease, calcareous deposits, in the form of gran-
ules, collect on the root from the ulcerated area to the margin of
the gum.
The treatment consists in the thorough removal of the calcic
deposit when present, and the scraping of the root of the tooth
over the entire ulcerated surface, and the application of antiseptic
and astringent remedies, such as listerine, aromatic sulphuric
acid, etc.
Maxillary Abscess may be due to caries or the diseases of the
teeth, or to pathological changes occurring in the structure of the
bone itself.
Treatment.—The treatment of maxillary abscess consists either
in puncture or incision, and the extraction of one or more of the
teeth if they are found to be connected with the origin of the
disease. If free drainage be established by an early incision, the
arrest of the disease is practically secured : it is sometimes neces-
sary to remove a portion of the alveolar process. The presence
of dead bone should be determined, and such removed, with other
offending matter. Free drainage should be maintained until com- «
plete recovery is brought about. The abscess may be opened
under cocaine anaesthesia, a soft rubber drainage tube be inserted,
and the cavity thoroughly irrigated and disinfected with a I to
2,000 bichloride of mercury solution. A safety pin may be
placed at the external end of the tube, and a strip of iodoform
gauze put between it and the skin ; over this the ordinary bi-
chloride gauze dressing may be secured by a roller bandage.