94 
W. L. WILLIAMS. 
6. If fistulse persist after operating by the usual method, the 
removal of the alveolar plate by the above plan, causes recovery 
to take place, except when due to damage to a neighboring 
tooth, to a retained fragment of tooth, etc. 
7. When oro-nasal fistulse exist through alveolus or bony 
palate by which food passes from the nose to the mouth, as oc¬ 
curs frequently with odontomes, this line of treatment generally 
brings about prompt and radical cure by destroying the chief 
obstacle to recovery, which consists in the bony plates propping 
apart the molars on either side of the vacant alveolus. If this 
external plate is removed the two molars bordering upon the 
emptied alveolus approach each other far more rapidly and 
effectively. We must rely upon cicatricial contraction in 
wounds of bones in the same manner, though different degree,, 
as in other tissues. 
It may be of interest to state that in trephining the facial 
bones we invariably excise the skin flap over the area of bone 
to be so removed and generally make the skin wound greater 
than the trephine opening in the bone, while in removing the 
alveolar plate from the trephine hole to the mouth we operate 
subcutaneously or subperiosteally. The flap over trephine open¬ 
ing is constantly in our way, becomes sensitive, causes the 
patient to resist dressing, and shuts out light and air, so valu¬ 
able in a wound which we do not expect to keep aseptic. The 
injuries to the tissues in bending the flap in dressing facilitates 
infection, which is further favored by the increased wound area in 
the flap method which adds the area of the flap to the superfi¬ 
cial wound. No blemish remains after the excision of a circu¬ 
lar flap of 1 y 2 to 2 inches. 
“ The sample copy of Review is much liked. —I en¬ 
close P. O. money order for subscription.”— IV. N. Babcock , 
V. A., Scott , N. Y. 
“I Appreciate the Review Very Much and would not be 
without it; think every veterinarian who wishes to keep up with, 
the times should take it.”— IV. E. French , Daytona , Fla. 
