. Journal of radiology . diseased tissue. Partial external alveolectomyready to close. we critically examine the end re-sults of the old operative pro-cedures, we are convinced thatthey have failed in their objec-tive. We have been content,heretofore, with the mere extrac-tion of diseased teeth. The in-efficiency of this procedure, Ithink, has been definitely taken some timeafter the usual methods of ex-traction had been employed dis-closed unmistakable evidence offailure in our efforts to removedisease. Remaining osteomyelitic Page Five PATHOLOGY OF areas, granulomata, etc.,
. Journal of radiology . diseased tissue. Partial external alveolectomyready to close. we critically examine the end re-sults of the old operative pro-cedures, we are convinced thatthey have failed in their objec-tive. We have been content,heretofore, with the mere extrac-tion of diseased teeth. The in-efficiency of this procedure, Ithink, has been definitely taken some timeafter the usual methods of ex-traction had been employed dis-closed unmistakable evidence offailure in our efforts to removedisease. Remaining osteomyelitic Page Five PATHOLOGY OF areas, granulomata, etc., havebeen definitely shown in severalcases when all the teeth had beenremoved ten, fifteen or eventwenty-five years were proven at , the systemic reac- MOUTH—SHEARER and weeks with a foul discharge,which oozed from the reddened,inflamed gums and respondedslow ly to any form of addition to the local disturb-ance, systemic reactions frequent-ly occurred, which were mani-. Flg. 7—Replacement of the muco-periosteal flapinto proper position. tions following these procedures,especially when the extractionshad been numerous, and the cur-ettements extensive, were at timesalarming, as shown by the casecited by Billings above. Thetooth sockets drained for days Page Six fested by chills, fever and lassi-tude, which would last for in the leucocyte countwas common. It required monthsfor the alveolar process to becomesmooth enough for the comfort-able wearing of a plate. PATHOLOGY OF These failures and complica-tions can be easily explainedwhen we appreciate that in treat-ing chronic dento-alveolar ab-scesses and their contiguous dis-eased areas we are dealing withchronic osteomyelitis of the jawbone and that the major portionof the pathology is in the boneand not in the tooth. As I havesaid many times in former papersmere extraction disregards thefundamental principles of bone OUTH—SHEARER ions thought in the light of ma
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