12 REPULSION OF TEETH 



The soft tissues of the part should not be disturbed 

 beyond the excision of the circular piece covering the disk 

 of bone removed by the trephine, and the detaching of 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, and the organ driven into the 

 mouth where it is seized by the forceps or the hand and 

 removed. If the tooth be 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 generally loosened from the alveolar walls 

 and can then be readily removed with the aid of the gouge, 

 or heavy dressing or splinter forceps. The repulsion of in- 

 ferior grinders is generally rendered more safe by dividing 

 them transversely with the chisel at one or two inches from 

 the fang and prying out the detached piece. The operator 

 then has a square end against which to place the punch. 

 The shortening of the tooth also facilitates pushing it into 

 the mouth as it does not jam against the superior grinder. 

 Remove carefully all fragments of tooth or of loosened bone, 

 cleanse and disinfect ^the wound, pack with antiseptic gauze 

 and dress daily. 



In cases where a fistulous opening remains after repulsion 

 of molars without the removal of the alveolar wall, or if a 

 tooth has been drawn by means of the forceps and the 

 alveolus fails to heal, the bony plate should be removed in 

 the above manner and the alveolar cavity thus opened freely 

 for inspection and remedial measures. 



Dangers. Wounding of the adjoining tooth is to be 

 avoided chiefly by carefully locating the fang of the affected 

 one and placing the instrument as exactly as possible over 



