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Gas Gangrene Following Tooth Extraction, with Subsequent Recovery: Report of a Case
Incidents of Practice snug contact with the ridge when the denture is seated. Wax each tooth securely in the desired position before cutting another tooth from the cast. Place the substitute for each normally placed natural tooth in exactly the same position. Complete the set-up along these lines. Never cut more than one tooth at a time from the cast. 6. Complete the denture, or dentures, in vulcanite or some other material that can be readily refitted to the mouth as resorption may require. 7. Extract the remaining teeth and begin trying in the dentures as bleeding subsides. Remove any excess denture material, grind the teeth and trim the alveolar margins as may be necessary until the denture becomes stable. With some experience, this result can usually be obtained without the aid of im pression paste or denture powder for the first night, or at all during the healing period. In from three to ten weeks, a bite-impression refit is likely to be necessary. There should usually be another in more or less than a year. The refitting includes the addi tion of a labial rim as Nature makes room for it. If you will attempt this comparatively simple process, you will be well pleased at the appreciation of patients, and by the sat isfaction of seeing them come in with their natural teeth and walk out an hour or so later with perfectly “natural” artificial sub stitutes in the mouth.
Gas Gangrene Following Tooth Extraction, with Subsequent Recovery: Report of a Case B y A r t h u r H . B e e b e , M .D ., Stillm an V a l ley, 111.
History.— W. McN., a farmer, being treated for chronic valvular heart disease by extraction of infected teeth, had a bicuspid extracted August 5 from a necrotic base. Un eventful progress continued for five days, when, August 11, while assisting with chores, he extracted a fragment of bone with his finger. Three days later, August 14, he went to bed with a dry throat and a myocardial collapse. Read before the Staff of St. Anthony’s Hos pital, Rockford, 111.
Examination and Treatment.— The physi cian summoned treated his heart. There was no evidence of gas infection. Twenty hours later, on orange-sized lump developed below the angle of the jaw, crepitant and rapidly progressing. There was a mild delirium in creasing in severity. The heart was rapid, pounding and irregular. Two hours later, 4 m. units of gas antitoxin was given; four hours later, 20 m. units of gas antitoxin, and ten hours later, another 20 m. units; a total of 44 m. units. After the first dose of anti toxin, the patient sweated profusely. He was in severe delirium, with very erratic heart action, and passed urine in large quantities. Six hours after the last dose of antitoxin, there seemed to be some slight improvement in the mental condition. The gas infiltration by then had extended well down the shoulder into the arm and over the back and chest. At that time, oxygen was injected into the tissues, deep and superficially, in advance of the infiltration of gas, and all around the area, blocking the advance of the gas bacillus. Outcome.— Twenty-four hours later, there had been no further advance in the gas infil tration. There had been constant lessening in the thickness and crepitation of the gas areas. The physical and mental condition was greatly improved. From that time on, with careful guarding of the heart muscle, there was steady improvement in all respects. On the fifth day, all signs of gas poisoning had disappeared, the eliminating organs were functioning normally and the heart was im proving and recovering from the severe strain. Two weeks later, the patient was re leased from bed, with good heart action and ready to have more teeth extracted. Summary.— Recovery from gas bacillus infection, caused by infection of a finger, followed the use of 44 m. units of gas anti toxin and the blocking off of infiltrated areas by oxygen injections. Pathologic Report (Dr. Padgett).— There was no leukocytic infiltration. There was a large exudate, a decreased blood supply, with toxins causing multiple thromboses with re sulting degeneration of striated muscles, ne crosis and death of red cells and early cir culatory collapse. There was little or no rise in temperature.
Gas Gangrene Following Tooth Extraction, with Subsequent Recovery: Report of a Case B y A r t h u r H . B e e b e , M .D ., Stillm an V a l ley, 111.
History.— W. McN., a farmer, being treated for chronic valvular heart disease by extraction of infected teeth, had a bicuspid extracted August 5 from a necrotic base. Un eventful progress continued for five days, when, August 11, while assisting with chores, he extracted a fragment of bone with his finger. Three days later, August 14, he went to bed with a dry throat and a myocardial collapse. Read before the Staff of St. Anthony’s Hos pital, Rockford, 111.
Examination and Treatment.— The physi cian summoned treated his heart. There was no evidence of gas infection. Twenty hours later, on orange-sized lump developed below the angle of the jaw, crepitant and rapidly progressing. There was a mild delirium in creasing in severity. The heart was rapid, pounding and irregular. Two hours later, 4 m. units of gas antitoxin was given; four hours later, 20 m. units of gas antitoxin, and ten hours later, another 20 m. units; a total of 44 m. units. After the first dose of anti toxin, the patient sweated profusely. He was in severe delirium, with very erratic heart action, and passed urine in large quantities. Six hours after the last dose of antitoxin, there seemed to be some slight improvement in the mental condition. The gas infiltration by then had extended well down the shoulder into the arm and over the back and chest. At that time, oxygen was injected into the tissues, deep and superficially, in advance of the infiltration of gas, and all around the area, blocking the advance of the gas bacillus. Outcome.— Twenty-four hours later, there had been no further advance in the gas infil tration. There had been constant lessening in the thickness and crepitation of the gas areas. The physical and mental condition was greatly improved. From that time on, with careful guarding of the heart muscle, there was steady improvement in all respects. On the fifth day, all signs of gas poisoning had disappeared, the eliminating organs were functioning normally and the heart was im proving and recovering from the severe strain. Two weeks later, the patient was re leased from bed, with good heart action and ready to have more teeth extracted. Summary.— Recovery from gas bacillus infection, caused by infection of a finger, followed the use of 44 m. units of gas anti toxin and the blocking off of infiltrated areas by oxygen injections. Pathologic Report (Dr. Padgett).— There was no leukocytic infiltration. There was a large exudate, a decreased blood supply, with toxins causing multiple thromboses with re sulting degeneration of striated muscles, ne crosis and death of red cells and early cir culatory collapse. There was little or no rise in temperature.