REPULSION OF TEETH. 15 



punch. The first is to be averted by care in having the 

 chisel sharp, by observing the precaution of making a 

 bevelled cut through the bone, by using only moderate 

 blows and driving the instrument alternately for a short 

 distance on each side. The second danger of extensive 

 fracture may be averted by being cautious to see after each 

 stroke on the punch that it has not slipped inward along 

 the median side of the tooth, pressing the internal plate 

 away from the tooth and tending to produce a longitudinal 

 fracture nearly or quite as long as the dental arcade. 

 Careful digital exploration in the mouth may discover this 

 fracture while still "simple" but a stroke or two more will 

 convert it into the very much more serious "compound" 

 fracture opening into the oral cavity. Keeping one hand 

 constantly in the mouth at the point of impact is always 

 desirable as a precautionary measure. 



Transverse fracture of the tooth while yet in situ by 

 means of the bone chisel, as above described, is a great safe- 

 guard against this injury by lessening the force required in 

 repulsion and by the removal of the tapering fang, which 

 then leaves a more secure base for the punch to act upon. 

 It should never be forgotten that the impact from the punch 

 must always be as nearly parallel to the long axis of the 

 tooth as is possible. 



The fracture of the superior maxilla and bony palate is 

 not so probable as the preceding and is preventable by mod- 

 erate care in the denuding of the tooth before punching, by 

 comminution of the tooth in proper cases, by the careful ad- 

 justment of the punch and applying the force in the proper 

 direction. 



Literature. Odontomes, Sir Bland Sutton, Jour. Comp. 

 Med. and Vet. Arch, Vol. XII. p. i ; A Clinical Study of 

 Odontomes, W. I^. Williams, Am. Vet. Review, Vol. XV, 

 p. I ; Notes on Odontomes, do ; Am. Vet. Rev. Vol. XXIII, 

 p. 82 and Oest. Mon. Thierheilkunde, Bd. XXIV, s. 122. 



