Local and Remote Sequelæ of Infection in the Parodontal Sulcus

Abstract

(1) It is shown in this paper that the infecting organisms in the parodontal sulcus are confined to the surface, but may be forced into the blood and lymph stream by traumatic interference.

2. Local and general disturbances may therefore arise both as a result of the absorption of soluble toxic matter from the pocket into the tissues and also as a result of this traumatic introduction of organisms into the blood-stream.

3. The effect of toxic absorption on the local tissues is destruction of the attachment of the tooth-pyorrhœa.

4. The remote effects of toxic absorption may be a similar destruction of the connective tissue generally-arthritis and fibrositis. The liver and kidney may suffer since they excrete the toxic matter, and other susceptible tissues may also be involved.

5. Traumatic bacteræmia may produce local bone necrosis or “dry” socket. Acute suppurative lymphangitis produces the “pyorrhœtic abscess”.

6. The remote effect of bacteræmia may be to produce osteomyelitis (e.g. of the tibia) or to convert a simple endocarditis into the bacterial type.

7. The mechanism of bone absorption and deposition in response to irritation is discussed.

8. Methods of eliminating parodontal infection are referred to and the importance of complete elimination is stressed. It is shown to be not incompatible with the conservation of the teeth.

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