Lectures on operative dental surgery and therapeutics . or remote, also as tomedicinal treatment employed, mercurial or otherwise,—as these have a marked tendency to mislead in obscureforms of disease. Failing, however, to obtain satisfactoryinformation, the trouble may be surmised as originatingfrom one of two causes, viz., intrinsic calcification of thepulp, or an osseous formation on the root, ^ calledexostosis. The teeth are sometimes affected by the mechanicalirritation of calcifying bodies within the pulp— endos-tosis—and the calcification of the periosteum—exos-tosis,—conditions which f
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Lectures on operative dental surgery and therapeutics . or remote, also as tomedicinal treatment employed, mercurial or otherwise, —as these have a marked tendency to mislead in obscureforms of disease. Failing, however, to obtain satisfactoryinformation, the trouble may be surmised as originatingfrom one of two causes, viz., intrinsic calcification of thepulp, or an osseous formation on the root, ^ calledexostosis. The teeth are sometimes affected by the mechanicalirritation of calcifying bodies within the pulp— endos-tosis—and the calcification of the periosteum—exos-tosis, —conditions which frequently cause neuralgia invarious organs and regions. In the first—endostosis, —the usual symptoms augment 186 without any clearly defined indication, until they simulatethose of exostosis. When this occurs, no outward causeof pain can be discovered; but, if an examination of thetooth be made after extraction, nodules and tubercles ofsecondary dentine will be found in the nerve canal, actingas an irritant by pressure upon the pulp. a-.. Fig. 70. Enlarged diagram (split section) showing at a tubercles or nodulesof secondary dentine. In other instances, the development of secondary dentinemanifests itself as granules interspersed throughout thesubstance of the pulp. If the nerve canal be foundclosed with osseous formations, the cause of troublewill probably be at the apex of the root; and the hopethen of successful treatment must lie in its excisionthrough the alveolus, or, as a last resort, the tooth maybe replanted. These operations have been described indetail in a previous lecture. The difficulties to be contended with in the extractionof teeth affected by the kindred form of disease— exostosis—are shown in the diagrams, which are drawn from speci-mens in my possession. 187 Exostosis is a hypei-trophied condition of the ceraentum, developed from, and intimately connected with, the perios-teal membrane. It may be described as nodular and dif-fuse. The former