REPULSION OF TEETH n 



it is desired to repel, is to make a curved incision at the 

 antero-inferior angle of the masseter muscle commencing 

 about one inch above the border of the inferior maxilla, just 

 behind and parallel to the parotid duct. Follow the duct 

 until the inferior attachment of the masseter is reached, and 

 then turn backward along the inferior masseter border for 

 a sufficient distance. Detach the inferior maxillary attach- 

 ment of the masseter as far as may be required and turn up 

 the semicircular flap thus acquired, laying the surface of 

 the bone bare. 



After properly locating the region of the tooth fang, the 

 trephining may proceed. By this method the operator 

 avoids wounding the yth nerve to produce paralysis of the 

 lower lip, and also reduces to a minimum the resulting scar, 

 and has the best access to the field for trephining. 



The bone of the operative area having been properly 

 bared, the trephine opening completed, and the soft tissues 

 over the course of the tooth detached from the trephine 

 opening into the mouth cavity, the operator should proceed 

 to remove the external alveolar plate as indicated in Fig. 2. 



With a light, well sharpened, narrow bone chisel cut 

 away and remove the external alveolar plate over the entire 

 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 center of the affected 

 tooth toward the adjoining one, thus making a bevelled 

 channel through the alveolar plate tending to loosen the 

 isolated section of bone by driving it outward. Drive the 

 chisel for only a short distance on one side, then upon the 

 other, and thus break the alveolar plate away in small sec- 

 tions and avoid an extension of the fracture to neighboring 

 alveoli and damage to adjacent teeth. Care should be taken 

 that the bone chisel is sharp, otherwise extensive fractures 

 of the bone occur. With gouge and chisel remove all rem- 

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

 completely bare as shown in Fig. 2. 



