92 
\V. L. WILLIAMS. 
be affected with odontoid enlargement until we had definitely 
learned its form and size, otherwise we might cause extensive 
and serious fractures of alveolar walls, palate, or other bones, 
but advised instead that the tooth be comminuted. 
Recent experience in our clinics leads us to amend our rules. 
We now, in cases of erupted teeth which we suspect as being of 
an aberrant type, in the so-called tooth fistulse, in those causing 
empyema of the facial sinuses and generally in those cases of 
serious dental diseases in young horses, trephine down upon 
the fang of the affected member, using a % to ]/& in. trephine, 
laying bare the entire fang, freeing it from its bony covering by 
gouge, chisel and forceps, then with chisel cut away the exter¬ 
nal alveolar wall the full width of the tooth from the trephine 
opening down into the oral cavity, thus laying the tooth bare 
on its external surface from end to end and side to side. We 
then comminute the member to such degree and remove the 
parts by such measures as circumstances may indicate by for¬ 
ceps, punch, or gouge, through mouth or laterally through the 
cheek. 
We find several great advantages from our method of oper¬ 
ating. 
1. Simplicity. By proper control of haemorrhage every step 
of the operation is plainly in sight, and the result of each move 
is clearly seen. It is easier, neater, and less painful to the ani¬ 
mal than violent removal with heavy forceps or by means of the 
punch. 
2. We avoid more certainly than by any other procedure 
injury to adjacent teeth which may necessitate further removals. 
3. It causes less injury to the bones. A piece equal in area 
to the lateral surface of the tooth being removed clean, the other 
surrounding bones being left intact and unharmed, while by the 
usual methods extensive fissures and fractures are common. 
Especially is this true of operations on the inferior molars, 
where serious fractures at times occur, leading to tedious recov¬ 
ery, or even death of the patient, with litigations for malprac¬ 
tice or other disagreeable complications. 
