REPULSION OF TEETH. 13 



detached at its point of insertion and two parallel incisions 

 carried upwards a short distance, permitting the raising of 

 a flap or what is generally best, a curved incision is made 

 along its antero-inferior border parallel to the parotid duct 

 and satellite vessels and just anterior to them (or posteri- 

 or if preferred) and the muscle lifted up and drawn back- 

 wards sufficiently exposing the parts. 



With a light, narrow bone chisel cut away and remove 

 the external alveolar plate over the entire extent of the 

 tooth, from the oral mai gin 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 

 tending to loosen the isolated section of bone by driving it 

 outwards. Drive the chisel for a short distance on one 

 side, then upon the other, and thus break the alveolar plate 

 away in small sections 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 may occur. With 

 gouge and chisel remove all remnants of bone over the 

 lateral side of the tooth laying it completely bare as shown 

 in Plate II. The soft tissues of the part should not be dis- 

 turbed beyond the excision of the circular piece, correspond- 

 ing to 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 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 



