246 
W. L. WILLIAMS. 
Two spherical tumors presented one on either ramus of 
inferior maxilla, each about four or five inches in diameter, cen¬ 
tering in alveolar cavity, at position of second pre-molar. The 
tumors were hard, evidently of bone, and were painful to touch. 
Mastication was imperfect, painful and accompanied by frequent 
quidding. 
Exploration of tooth crowns revealed nothing noteworthy. 
The tumors were freely trephined at about their center, and 
in one of these there was found some pus, containing particles 
of food. 
In both tumors apparently healthy tooth tissue was encoun¬ 
tered, which, after clearing away the investing bone so that a 
clear view could be had, proved to be healthy, naturally-formed 
molars, disposed almost longitudinally in relation to inferior 
maxilla, the fang pointing forwards and slightly declined, the 
crown backwards, slightly ascending. 
The viciously-disposed teeth, after comminution with chisel 
and mallet, were removed, when the temporary crowns were 
found still undisturbed projecting into the mouth. Water could 
be thrown through trephine opening into mouth, and to insure 
recovery the removal of temporary crowns was determined 
upon, and the tumor cavity, extending up against these, it was 
presumed that a slight tap on the punch from below would 
promptly send the persistent crowns into the mouth. In this, 
however, we were promptly disappointed, and only succeeded 
in dislodging the crowns after some quite hard hammering. 
When the crowns finally came away, and were examined, 
it was found that the alveolar processes had in part come away 
with them, there being perfect fusion between crown and alve¬ 
olus, so intimately blending as to render it impossible, with the 
naked eye, to say where the one ceased and the other began. 
The case made a slow but complete recovery. 
It seems fair to conclude that adhesions of a much less 
degree might, by infringing upon the rapidly forming permanent 
tooth, cause aberrations in its structural growth, and thus lead 
to the formation of well marked odontomes. 
