CARIES OF THE SOCKET BOXES. 161 



and injecting detergents; bnt in a far greater number 

 the treatment has been unsuccessful.^- Yet we believe 

 that it\ in addition to trephining, the teeth had been 

 extracted, and a communieation established between 

 the sinus and the mouth, the results would have been 

 more favorable. 



" Monsieur Delafond, in his memoir on the evulsion. 

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

 trephining is ouly practicable in the case of the tliree 

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

 last to make an incision through the zygomatico-maxil- 

 laris muscb and the nervous plexus which is formed 

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

 of nerves will be injured in opeii^ting on the three first 

 teeth, but that there will be little injui'y to the muscle 

 in the case of the three lasL" 



The memoir concludes as follows : 



^'Caries Attacking the MaxiTlarij Bone after tlie Ex- 

 traction of the Teetlu — 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 extmetion 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 I'esult of persistent sup- 

 puration in the areoloB of the sj^ongy substance of the 

 bones. To prevent these dangerous consequences, the 

 socket should be cauterized with the actual cautery, 



* " Sinnses that may have formed by the matter from ab- 

 scesses in the alveolar processes eating its way through the wall 

 of the alveoiris. and which may "open either on some part of the 

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

 one could desire." — Proj\ George Vfi'mell^ 



