GABIES OF THE SOCKET BO^ES. 161 



and injecting detergents; but in a far greater number 

 the treatment has been unsuccessful.* Yet we believe 

 that if, in addition to trephining, the teeth had been 

 extracted, and a communication established between 

 the sinus and the mouth, the results would haye been 

 more favorable. 



"Monsieur Delafond, in his memoir on the evulsion 

 of the teeth, published in 1831, says the operation of 

 trephining is only practicable in the case of the three 

 first grinders, it being necessary in the case of the three 

 last to make an incision through the zygomatico-maxil- 

 laris muscle and the nervous plexus which is formed 

 on it. We, on the contrary, claim that the fifth pair 

 of nerves will be injured in operating on the three first 

 teeth, but that there will be little injury to the muscle 

 in the case of the three last." 



The memoir concludes as follows : 



"Caries Attacking the Maxillary Bone after the Ex- 

 traction of the Teeth. When caries of a tooth has in- 

 duced consecutively interstitial suppuration of the 

 spongy tissue of the socket, it is possible that, even 

 after the extraction of the tooth, the disease may at- 

 tack the bone. Then, more than ever, may we dread 

 the tumefaction of the tissues and sarcomatous altera- 

 tions, which are ordinarily the result of persistent sup- 

 puration in the areolae of the spongy substance of the 

 bones. To prevent these dangerous consequences, the 

 socket should be cauterized with the actual cautery, 



' " Sinuses that may have formed by the matter from ab- 

 scesses in, the alveolar processes eating its way through the wall 

 of the alveolus, and which may open either on some part of the 

 face or within the mouth, are seldom treated with the success 

 one could desire." Prof. George Varnell. 



