Critical evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following high-pressure gas and micro-particle abrasion.
Authors: Dixon P M, Savill D, Horbyl A, Reardon R J M, Liuti T
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Infundibular caries represents a significant pathology in equine maxillary cheek teeth, potentially progressing to dental fracture or apical infection, yet the clinical efficacy of the widely recommended treatment protocol—high-pressure aluminium hydroxide micro-particle abrasion followed by composite restoration—had never been rigorously evaluated. Dixon and colleagues examined 55 carious infundibulae across 40 extracted maxillary cheek teeth, treating them with high-pressure abrasion and filling defects with endodontic restorative material, then assessing outcomes using computed tomography and direct sectioning. Only 46% of treated infundibulae achieved complete cleaning and filling, and this success was restricted almost entirely to shallow defects (mean 9.6 mm); when peripheral defects around restorations were factored in, just 18% of cases were free from gross defects, whilst 54% of infundibulae—particularly those with deeper caries averaging 18.3 mm—retained food debris and carious material in apical regions. These findings should prompt equine practitioners to reconsider current infundibular treatment strategies, particularly for deep lesions, and to manage owner expectations accordingly; alternative or supplementary approaches may be warranted for cases where carious involvement extends beyond the reach of high-pressure abrasion systems.
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Practical Takeaways
- •High-pressure abrasion cleaning followed by composite restoration is ineffective for deep infundibular caries (>~10 mm); expect treatment failure in majority of deeper lesions due to residual food debris and carious material at depth
- •This technique may only be reliable for shallow infundibular caries; deeper lesions require alternative treatment approaches or extraction should be considered
- •Current anecdotal success claims for this treatment are not supported by objective evidence; practitioners should counsel clients appropriately about realistic outcomes and likelihood of peripheral defects
Key Findings
- •Only 18% (7/39) of restorations were free of gross defects after high-pressure micro-particle abrasion and composite restoration
- •46% (18/39) of restored infundibulae were fully cleaned and filled, all with shallow defects (mean 9.6 mm deep)
- •54% (21/39) of infundibulae retained food debris and/or carious material in apical locations, with deeper defects (mean 18.3 mm) showing poorest cleaning efficacy
- •High-pressure aluminium hydroxide micro-particle abrasion is effective only for shallow carious infundibulae, not deeper lesions