12 REPULSION OF TEETH. 



mouth and with one hand in the oral cavity with the fingers 

 resting upon the alveolar border on the lateral side of the 

 tooth to serve as a guide, push the scalpel along between 

 the bone and soft tissues until it emerges from the gums 

 alongside the affected tooth and extend this incision back- 

 wards and forwards until the soft tissues are completely de- 

 tached from the alveolar wall over the entire area of the 

 diseased member. With a light, narrow bone chisel cutaway 

 and remove the entire external alveolar plate throughout 

 the extent of the tooth, from the oral margin of the trephine 

 opening into the mouth cavity. Hold the chisel so that the 

 outer edge is inclined from the affected tooth toward the 

 adjoining one, thus making a bevelled channel through the 

 alveolar plate which tends to loosen and detach the section 

 of the alveolar wall to be removed without injury to that 

 adjoining. Drive the chisel for a short distance only on one 

 side and then apply it to the other side in order to detach 

 but small pieces of bone at one time avoiding the detachment 

 of large sections of the plate at once and having it extend to 

 neighboring alveoli. With gouge and chisel remove all 

 remnants of bone over the lateral side of the tooth laying it 

 completely bare as shown in Plate III. The soft tissues of 

 the part should not be disturbed beyond the removal of the 

 circular piece over the disk of bone removed by the trephine 

 and detatching them from the portion of bone to be chiseled 

 away. When the tooth has been bared so that every part of 

 its lateral surface can be seen or felt, the punch may be placed 

 against the end of the fang, a few firm, quick blows given 

 with the mallet, so directed that the force is in a line with 

 the long axis of the tooth, driving it into the mouth where 

 it is seized by the forceps or the hand and removed. If it 

 is not readily and safely dislodged in this way, place the 

 heavy bone chisel against it and with the aid of the mallet 

 comminute the tooth by breaking it transversely and splitting 

 it longitudinally, in which process the fragments are gener- 



