Image from page 209 of "Injuries and diseases of the jaws : the Jacksonian prize essay of the Royal College of Surgeons of England, 1867" (1884)
Authors: Heath, Christopher, 1835-1905
Publisher: Philadelphia : P. Blakiston, Son & Co.
Contributing Library: Columbia University Libraries
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yst. On the other hand, however, it must beremembered that teeth may be wanting without being con-nected with any disease; thus I am acquainted with a familywhow have the hereditary peculiarity of a single bicuspid 19: dentigeroUkS cysts. tooth oil eacli side. When a cyst is sufficiently expandedfor the wall to yield under the finger with tlie characteristicparchment-like crackle, there can he no difficulty in itsrecognition, but without this it is impossible in all cases todistinguish between a cyst and a slow-growing solid tumour.Under these circumstances, it is well to insist upon thepropriety of making an exploratory puncture in all caseswhich are not obviously solid growths, and have sprouted sothat their nature can be certainly recognized. The puncturebeing made within the mouth will be of no moment shoulda more severe operation subsequently be necessary. The accompanying engraving (fig. 88) shows a cyst of thelower jaw occurring in a man aged thirty-four, who was under Fig. 88.
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my care in 1878. The swelling began nine years before, andwas of the size of an ordinary orange, round, very hard, andfixed to the angle of the lower jaw on the right side. Itsedges were well (hdined, there was no fluctuation nor pulsa-tion, except that of the facial artery, which was stretched TREATMENT OF DENTIGEROUS CYSTS. 193 over the tumour. Externally the tumour appeared to besolid, but examined from the mouth, the anterior part of thewall yielded slightly to firm pressure. On puncturing fromthe mouth through the bony wall I entered a large emftycavity lined with soft tissue, which on microscopicalexamination showed portions of hyaline cartilage and carti-lage with a faintly fibrous matrix, surrounded by andgradually passing into oval and spindle cells. The bonywalls of the cyst were broken down and partially cut away,and this proceeding was repeated a fortnight later. Thetumour gradually diminished as suppuration Avent on,several pieces of bone being removed, and, six weeks aft
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