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From the clinical point of view, it may be stated that alveolar pyorrhea cases are to be classified as those of topical and those of general characters. The term alveolar pyorrhea' is the designation applied to the cases of topical character but it is also extended to cover those of general nature. However, one is essentially different from the other. It is true indeed that both topical and general alveolar pyorrhea cases give similar clinical findings in the parodontal tissues but the pathogenic causes for them are quite different from one another. Alveolar pyorrhea cases of general character occupy over 80 % of occurrences and a curative effect becomes apparent only when remedy is administered for a topical alveolar pyorrhea in conjunction with a general one, whereas topical alveolar pyorrhea has nothing to do with general alveolar pyorrhea and as removal of the topical causes is sufficient to bring about a cure, it may be regarded as a kind of gingivitis due to mechanical stimulus. Of various causes responsible for alveolar pyorrhea of topical character, mention first of all is made of dental calculi. It has been accepted as an established fact of long standing that dental calculi are responsible for the so-called alveolar pyorrhea. However, as a result of researches conducted by the author for years, it seems that these calculi have no direct influence on the incidence of alveolar pyorrhea but are only secondarily related to it. A survey of 100 cases of alveolar pyorrhea has revealed the fact that 77 were found with dental calculi and 23 with none at all. Although the majority were thus found with dental calculi, it was the remaining 23 cases that were alveolar pyorrhea cases of severe degree. Of 100 patients with dental calculi, 31 were alveolar pyorrhea cases, 37 were gingivitis cases and 32 were found normal. Based on these facts above, it may be concluded that the presence of dental calculi in the oral cavity does not always cause alveolar pyorrhea cases. The reason why it has been held that dental calculi are directly responsible for the incidence of alveolar pyorrhea may be that dental calculi are found in the mouth of alveolar pyorrhea patients to a high degree. In explanation of the above fact that dental calculi are found among the alveolar pyorrhea patients to a high degree, Professor Jiro Kanno, Department of Biochemistry, Nihon University School of Dentistry, holds that alveolar pyorrhea patients are in a state where they are apt to be suffered from dental calculi. It may be a possibility that dental calculi in the mouth induce an inflammation of gingivae and thus promote the progress of alveolar pyorrhea. It has been found the curative state of alveolar pyorrhea remains the same whether dental calculi are removed or otherwise. Other causes are found among the inadequate gold crowns, gold inlays, clasps of artificial teeth, abnormal alignment of teeth and

Observations on Alveolar Pyorrhea and its Therapeutics in the Clinical Light