Surgery and diseases of the mouth and jaws; a practical treatise on the surgery and diseases of the mouth and allied structures by Blair Vilray Papin 1871-

Author:Blair, Vilray Papin, 1871-
Language: eng
Format: epub, pdf
Tags: Jaws, Mouth -- Diseases, Mouth -- Surgery
Publisher: St. Louis, Mosby
Published: 1913-03-25T05:00:00+00:00

into, and helps fill, the bone gap with bone tissue, the whole being covered with normal mucous membrane. If the flap is removed, the bone cavity can be lined only with granulations which result in scar tissue surface; and if a deep depression persists, it is a catch-trap for food particles. If the granulations lining a bone cavity or covering a "surface are unhealthy, they should be removed along with any diseased bone, and the cavity treated as already outlined.

SPECIFIC INFECTIONS.

Actinomycosis. —If a necrosis is due to actinomycosis, after treating the local infection, the patient is to be given large doses of potassium iodid or copper sulphate for an extended period. Potassium iodid is the older treatment, but based upon observations made at the experimental agricultural station in Wisconsin, Bevan first treated this disease in man with copper sulphate and reports very good results. 1 After removing the granulations, the cavity might be packed with gauze, wet with weak copper sulphate solution.

Tuberculosis of the Jaw-Bones.— Tuberculosis of the upper and of the lower jaws run radically different clinical courses. The viru-lency of the infection increases in proportion to its distance from the orbit. Metastatic infection of the body of the maxilla runs the same mild course as does a tubercular infection in other bones. Infections of the upper alveolar process and palate are more severe, while in tuberculosis of the body of the lower jaw the disease is aggressive, and unless checked by very radical treatment, usually terminates fatally within two or three years.

The treatment of infections of the maxilla is the same as that of other bones. The cavity is curetted and obliterated, with either living tissue or some bone plombe. Infection of the palate or alveolar process usually takes place within the mouth. It will usually yield to curetting and repeated applications of lactic acid.

In the lower jaw infection from the mouth follows a somewhat similar course as infection of the upper alveolar process and palate, but is more malignant. Unless due to an extension from a tubercular ulcer of the tongue, it is, however, less malignant than a metastatic infection of the body of the lower jaw, which latter usually occurs somewhere along the lower border. In metastatic infection of the mandible, there may be a hard swelling, usually followed by persistent trismus, but with little pain and few constitutional symptoms. Later there will be softening and fistula, with caries and necrosis of the bone. There will be early infection of the lymph nodes and later of the other soft tissues of

1 For dosage and toxic symptoms of potassium lodid and copper sulphate see textbook on materia medlca.

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