Endodontic Treatment of a Maxillary Incisor Tooth in a Chimpanzee (Pan troglodytes).

Chimpanzees (Pan troglodytes) with teeth severely damaged by dental caries and/or periodontal disease are often managed with medication and/or tooth extraction. A common endodontic treatment for severely decayed teeth in a 26-year-old female chimpanzee is reported. The left maxillary central incisor tooth had lost its crown, probably due to trauma that was not recent, and it had a fistula most likely due to chronic apical periodontitis. The diagnosis was confirmed radiographically before treatment. To treat the infected root canal, endodontic treatment used in humans was adapted for a chimpanzee. After the treatment, the tooth was sealed using an adhesive resin composite. At 11-years post-treatment, there were no signs of recurrence of the lesion or of failure of the tooth seal. The results of this case report suggest that common endodontic treatments used in humans are also effective in chimpanzees.

Microscopic Alterations of the Dental Pulp in Surgically Extracted Teeth of Dogs.

Microscopic alterations in the dental pulp of dogs have not been extensively studied. The aim of this study was to investigate microscopic alterations of the dental pulp in dogs' teeth. One hundred and ten surgically extracted teeth (20 incisors, 23 canines, 28 premolars, and 39 molars) from 74 dogs, of different ages, with a history of chronic periodontitis (66 dogs), periapical abscesses (2 dogs), pulpitis (2 dogs), oral cavity neoplasms (2 dogs), dens invaginatus (1 dog), and dental fractures (1 dog) were included. Eight-one maxillary and 29 mandibular teeth were included. Coronal, radicular, and coronal plus radicular calculus were present in 28.2%, 17.3%, and 54.5% of the teeth, respectively. In total 78 teeth (71%) had pulp alterations, including fibrosis (26%), calcification (14%), necrosis associated with the absence of odontoblasts (14%), presence of predentin and dentin inside the cavity (8%), odontoblastic hyperplasia (3%), pigmentation (3%), pulpitis (2%), and pulp stones (1%). Forty-nine (60.5%) of the maxillary teeth and all of the mandibular teeth had pulp alterations. The premolars were most affected, and the molars least affected, by pulp alterations. Pulp fibrosis, calcification, and necrosis were observed in teeth irrespective of the distribution of dental calculus.

The Epidemiology of Infundibular Caries in Donkeys in Inner Mongolia Autonomous Region of China and Associated Risk Factors.

Infundibular caries (IC) affects donkeys of all ages and causes pain, difficulty in mastication and weight loss. The study aimed to determine the epidemiology of IC in donkeys and examine the potential risk factors associated with the disease development. A total of 2118 donkeys in Inner Mongolia were sampled. The first section of the survey was performed by veterinarians and included the oral health of the donkeys. A survey on the donkey's signalment, diet, and husbandry was also conducted. The risk factors associated with IC were assessed using multivariable logistic regression analysis. Univariate analysis of 11 variables assessed revealed that only four factors, including age, type of forage, pasture time and water source, increased the risk of IC. The findings of this study enhance our knowledge of the management and prevention of IC in donkeys.

A Semi-Automated Method for Measuring Biofilm Accumulation on the Teeth Using Quantitative Light-Induced Fluorescence in Dogs and Cats.

Oral health conditions (eg, plaque, calculus, gingivitis) cause morbidity and pain in companion animals. Thus, developing technologies that can ameliorate the accumulation of oral biofilm, a critical factor in the progression of these conditions, is vital. Quantitative light-induced fluorescence (QLF) is a method to quantify oral substrate accumulation, and therefore, it can assess biofilm attenuation of different products. New software has recently been developed that automates aspects of the procedure. However, few QLF studies in companion animals have been performed. QLF was used to collect digital images of oral substrate accumulation on the teeth of dogs and cats to demonstrate the ability of QLF to discriminate between foods known to differentially inhibit oral substrate accumulation. Images were taken as a function of time and diet. Software developed by the Cytometry Laboratory, Purdue University quantified biofilm coverage. Intra- and intergrader reproducibility was also assessed, as was a comparison of the results of the QLF software with those of an experienced grader using undisclosed coverage-only metrics similar to those used for the Logan and Boyce index. Quantification of oral substrate accumulation using QLF-derived images demonstrated the ability to distinguish between dental diets known to differentially inhibit oral biofilm accumulation. Little variance in intra- and intergrader reproducibility was observed, and the comparison between the experienced Logan and Boyce grader and the QLF software yielded a concordance correlation coefficient of 0.89 (95% CI = 0.84, 0.92). These results show that QLF is a useful tool that allows the semi-automated quantification of the accumulation of oral biofilm in companion animals.

Dental caries in wild primates: Interproximal cavities on anterior teeth.

Dental caries has been reported in a variety of primates, although it is still considered rare in wild populations. In this study, 11 catarrhine primate taxa (n = 339 individuals; 7946 teeth) were studied for the presence of caries. A differential diagnosis of lesions in interproximal regions of anterior teeth was undertaken, since they had been previously described as both carious and non-carious in origin. Each permanent tooth was examined macroscopically, with severity and position of lesions recorded. Two specimens were examined further, using micro-CT scans to assess demineralization. Differential diagnosis confirmed the cariogenic nature of interproximal cavities on anterior teeth (ICATs). Overall results show 3.3% of all teeth (i.e., anterior and posterior teeth combined) were carious (n = 262), with prevalence varying among species from 0% to >7% of teeth affected. Those with the highest prevalence of ICATs include Pan troglodytes verus (9.8% of anterior teeth), Gorilla gorilla gorilla (2.6%), Cercopithecus denti (22.4%), Presbytis femoralis (19.5%), and Cercopithecus mitis (18.3%). ICATs make up 87.9% of carious lesions on anterior teeth. These results likely reflect dietary and food processing differences among species, but also between the sexes (e.g., 9.3% of all female P. troglodytes verus teeth were carious vs. 1.8% in males). Processing cariogenic fruits and seeds with the anterior dentition (e.g., wadging) likely contributes to ICAT formation. Further research is needed in living primate populations to ascertain behavioral/dietary influences on caries occurrence. Given the presence of ICATs in frugivorous primates, their diagnosis in archaeological and paleontological specimens may shed light on diet and food processing behaviors in fossil primates.

A Randomized Controlled Trial Assessing the Effects of Feeding High Water Soluble Carbohydrate (WSC) Oaten Hay Versus Low WSC Oaten Hay on Equine Peripheral Dental Caries.

Equine peripheral caries (PC) can cause significant dental pathology and appears to be increasing in prevalence and recognition in many areas [1, 2]. Previous studies have identified risk factors for the condition including the feeding of oaten hay [3]. It was hypothesized that this may be due to the higher water soluble carbohydrate (WSC) or "sugar" content of the hay. A randomized control trial involving 30 horses on three properties was completed. The horses were randomly assigned to two groups: high WSC (H-WSC) or low WSC (L-WSC) oaten hay and were then sedated and intraoral photographs and endoscopy were performed for baseline levels. They were maintained on this assigned hay source for three months when they were again sedated, examined, and photographs and endoscopic videos recorded. Horses with significant PC were then changed to meadow hay (previously shown to be lower risk for PC [3]) for seven months and re-examined to assess for recovery. Images and videos were anonymized and graded for PC, and the PC grades of the teeth before and after intervention were compared using a Fisher exact test. Thirteen horses fed L-WSC hay and 15 fed H-WSC hay completed the study. Of horses fed the H-WSC oaten hay, 60% deteriorated and of horses on L-WSC oaten hay, 53.8% improved in PC grade over the trial, however, the difference was not statistically significant (P = .274). All three horses available for recheck after changing to meadow hay improved.

An Epidemiological Study on Orodental Disorders in 3,791 Working Donkeys in Egypt: Prevalence and Risk Factors.

Orodental disorders are common in equidae and can lead to serious clinical complications. This study determines the prevalence rate (PR) of orodental disorders in working donkeys in Egypt and their potential risk factors. During 4 years, 3,791 donkeys were examined in six Egyptian governorates. Full case history and thorough clinical and oral examinations were performed. Radiography and oroendoscopy were undertaken whenever possible. All data were statistically analyzed using Poisson generalized linear models to compare PR among governorates, sex, years, body condition score, and age groups and to determine the potential risk factors. Of 3,791 examined donkeys, 954 donkeys (25.17%) had orodental disorders. The PRs of acquired disorders were 9.81% sharp enamel points, 5.86% buccal ulcers, 4.88% hook, 4.70% overgrown teeth, 4.19% periodontal disease, 3.11% ramp, 2.60% dental caries, 2.37% dental calculus, 2.30% diastema, 2.06% step mouth, 2.00% soft tissue injuries other than buccal ulcers, 1.77% worn tooth, 1.37% loose tooth, 1.29% exaggerated transverse ridge, 1.24% fractured teeth, 0.82% missing teeth, 0.69% wave mouth, 0.50% molar table angle change, and 0.45% wolf tooth overgrowth. The PRs of the congenital disorders were 1.90% displaced teeth, 1.37% deviated teeth, 0.58% retained teeth, 0.16% overbite, 0.16% underbite, 0.11% supernumerary teeth, and 0.11% premolar cap. The risk factors significantly associated (P < .05) with the orodental disorders were age and sex of the animal, geographic location, and year of examination. This study provides a database for future studies on orodental disorders and for designing effective preventive and therapeutic strategies for these disorders in donkeys.

Recent developments in equine dentistry.

Equine dentistry is a rapidly developing clinical specialty. It has benefitted from key advances in anatomical and physiological research, development of equipment and instrumentation, utilisation of standing sedation and anaesthesia protocols, a change towards minimally invasive surgical techniques, and the introduction of restorative and endodontic techniques translated from techniques used in human and canine dentistry. Anatomical research has provided further insight into the endodontic system of incisors and cheek teeth and how it changes throughout development with age. Studies of the periodontium have demonstrated a rich vascular supply and repair capacity. Routine dental visits are increasingly being performed utilising sedation and clinical instruments for routine examinations. Equipment has become more efficient, battery-operated and miniaturised giving benefits to both equine dental maintenance work and advanced techniques, assisting the transition to minimally invasive techniques, and the development of endodontic and restorative dentistry. Diagnosis has also benefitted from advances in equipment such as patient-side digital radiography systems, high definition oroscopy, and small diameter flexible fibrescopes that are capable of visualising inside a pulp canal. Dental units combining endodontic high- and low-speed drills, suction and air or water flush are becoming increasingly used and adapted for equine use. Sedative combinations and standing anaesthesia protocols have meant that revisions of traditional techniques, as well as novel techniques, can be performed with almost no requirement for general anaesthesia. Equine dentistry can only continue to advance in this way if there is early identification of dental disease through clinical oral examinations, leading to a system based on prophylaxis, as in human dentistry. This necessitates a change in attitude of the public and industry in general to a proactive approach, with early intervention based on examination and diagnostic findings of practitioners and not necessarily based on the clinical signs displayed by the patient.

A microbiome analysis of equine peripheral dental caries using next generation sequencing.

BACKGROUND: Although, peripheral caries (PC) affects almost half of UK horses, no comprehensive microbiological study has been performed on this disorder. As a high proportion of oral bacteria cannot be conventionally cultured, molecular microbiological techniques such as Next Generation Sequencing are required to examine the complex oral bacteria community. OBJECTIVES: To identify the microbiota involved in equine PC, including comparing microbiota at the more commonly and severely affected three caudal cheek teeth with the less commonly affected three rostral cheek teeth. STUDY DESIGN AND METHODS: Equine dental plaque samples were collected from the palatal aspects of cheek teeth of 63 horses. DNA was isolated and amplified using PCR, targeting the V4 region of the 16S rRNA gene and Next Generation Sequencing of these gene amplicons was performed. The acquired data were processed and analysed using Mothur and R. RESULTS: Streptococcus species was the genus most commonly associated with equine PC, whereas Gemella species was the genus most associated with the control group. In a further analysis where the rostral and caudal cheek teeth were compared with each other and with the control group. Veillonella species was the most commonly associated genus with PC of the rostral cheek teeth, Streptococcus species was the most associated genus with the caudal cheek teeth, and Corynebacterium with the control group. MAIN LIMITATIONS: Some bacteria can have multiple heterogeneous copies of the 16S rRNA gene, which can affect the estimation of their relative abundance. CONCLUSIONS: Similar to caries studies in other species, acidogenic and aciduric microorganisms including Streptococcus species were found to be associated with equine peripheral caries.

Peripheral caries and disease of the periodontium in Western Australian horses: An epidemiological, anatomical and histopathological assessment.

BACKGROUND: Peripheral caries may cause significant oral pain and pathology and is very prevalent within the Western Australia horse population. Associations with periodontal disease have been indicated; however, further work is needed to assess the anatomical and histological aspects of the conditions, to better understand the pathophysiology. OBJECTIVES: To assess the anatomical and histopathological changes associated with equine cheek teeth peripheral caries and disease of the periodontium to better understand the pathogenesis and any association between the conditions. STUDY DESIGN: Cross-sectional epidemiological and histological study. METHODS: A survey of 500 Western Australia horses was performed to assess the prevalence of peripheral caries and associations with other dental pathologies within the Western Australia horse population. Histopathological assessment was also performed on four extracted cheek teeth affected by peripheral caries and on three interdental areas from an abattoir specimen affected by peripheral caries and interdental feed accumulation. RESULTS: There was a significant association between peripheral caries and cheek teeth interdental feed accumulation and gingival recession. This association was significantly stronger in the mandibular cheek teeth than the maxillary cheek teeth and also in horses with moderate or severe peripheral caries compared to horses with mild peripheral caries. Histopathological examination found caries lesions consistent with those found in humans above the gingival margin. Sub-gingivally, however, the cementum and periodontal structures were normal. In the samples with concurrent peripheral caries and deep feed-pocketing, there was significant gingival recession; however, only mild or no histopathological changes occurred in the gingiva. MAIN LIMITATIONS: Small sample size for histopathological assessment. CONCLUSION: Horses with peripheral caries, and in particular, horses with mandibular cheek teeth with peripheral caries are significantly more likely to also be affected by disease of the periodontium than horses without peripheral caries.

Equine peripheral dental caries: An epidemiological survey assessing prevalence and possible risk factors in Western Australian horses.

BACKGROUND: Peripheral dental caries is defined as macroscopic destruction of the calcified dental tissues and can cause considerable dental pathology and pain. It appears to occur at a high prevalence in Western Australian horses. At present, risk factors for the condition are poorly understood, making treatment and prevention difficult. OBJECTIVES: To assess the prevalence of and potential risk factors for peripheral caries in Western Australian horses. STUDY DESIGN: Cross-sectional, epidemiological study. METHODS: A survey of 500 Western Australian horses was administered in two sections. The first section was completed by the owner and referred to the horse's signalment, diet and husbandry conditions. The second section was completed by veterinarians and focused on the horse's oral health. A multivariable logistic regression model was used to assess risk factors associated with peripheral caries. RESULTS: Peripheral caries was present in 58.8% (95% confidence interval [CI] 54.5-63.1%) of surveyed horses. Breed was significantly associated with peripheral caries, with Warmbloods (odds ratio [OR] 0.44, 95% CI 0.24-0.82; P = 0.009) and Western breeds (OR 0.38, 95% CI 0.19-0.78; P = 0.008) being less likely to have peripheral caries than Thoroughbreds. Dietary risk factors included oaten hay (OR 2.90, 95% CI 1.87-4.53; P<0.001). A meadow hay-based diet was protective (OR 0.47, 95% CI 0.27-0.80; P = 0.005). Horses with access to quality pasture all year were less likely to have peripheral caries than horses without access to grazing (OR 0.31, 95% CI 0.15-0.66; P = 0.002), as were horses on groundwater compared with horses on rainwater (OR 3.35, 95% CI 1.65-6.78; P = 0.001), drinking water (OR 2.03, 95% CI 1.14-3.62; P = 0.016) or dam water (OR 3.53, 95% CI 1.08-11.53; P = 0.037). Peripheral caries was positively correlated with periodontal disease (OR 4.53, 95% CI 2.91-7.06; P<0.001) and feed packing (feed present between the teeth without significant periodontal pocketing) (OR 1.94, 95% CI 1.32-2.85; P = 0.001). MAIN LIMITATIONS: Not every owner of eligible horses seen during the study period agreed to participate. An epidemiological study is unable to show causality. CONCLUSIONS: Western Australian horses have a high prevalence of peripheral caries. Management factors that may help to prevent or reduce peripheral caries include more access to quality pasture, use of groundwater, feeding on meadow hay and avoidance of oaten hay.

Evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following debridement with dental drills and Hedstrom files.

An ex-vivo study was performed on vertically mounted equine maxillary cheek teeth that had caries of 30 infundibulae, using high and low speed contra-angle dental drills and Hedstrom files to debride infundibular food debris and carious dental tissues. This technique effectively debrided 27/30 infundibulae with a mean depth of 19mm (range 9.4-34.3mm) as assessed by computed tomographic (CT) imaging. The debrided infundibulae were treated with sodium hypochlorite, EDTA and a bonding agent, and then then filled in layers with endodontic restoration materials. Further CT imaging and direct examination of sectioned restored teeth showed 6/30 infundibulae, including three that were incompletely debrided, to have defects between the restoration and the infundibular wall/apex. Twenty-one of the remaining 24 infundibulae contained air bubbles, largely within restorations. It is concluded that the use of drills and Hedstrom files is effective in debriding carious infundibulae but improved techniques and materials are required to more effectively fill infundibulae with restorative material.

Epidemiological survey on equine cheek tooth infundibular caries in the United Kingdom.

Infundibular caries (IC) is an important equine dental disorder that can cause premature wear, fractures and apical infection of affected maxillary cheek teeth. No accurate prevalence values for IC are available for UK horses. The feeding of high levels of concentrates is believed to increase its prevalence, but no objective information is available on such possible environmental risk factors. The aims of the study were to document the prevalence of IC in UK horses, assess its distribution and severity between infundibulae and teeth in affected horses and examine for potential risk factors for its development. Using well-defined criteria for grading and recording IC, 25 experienced personnel across the UK completed a questionnaire on their patients. Frequency of IC occurrence was compared between individual teeth and infundibulae using McNemar's tests. Potential risk factors for IC presence were examined using univariable logistic regression prior to building a multilevel multivariable model. Of 706 horses examined, 45.5 per cent had IC, which was most commonly present and most severe in the Triadan 09s (>10>08>06>07>11), with 13.4 per cent of all rostral and 10 per cent of all caudal infundibulae affected. The prevalence of IC was significantly associated with increasing age; the lowest IC prevalence was found in South West England.

Diagnoses and Treatment of Dental Disorders in a Research Colony of Macaca fascicularis: A Case Series.

During daily routine oral examinations in a research colony of nonhuman primates (NHPs, Macaca fascicularis), a variety of oral-dental lesions were identified. A dental care program was established based on these findings. Based on the presence of dental clinical signs and their severity, 31 animals were triaged to be examined and treated by a veterinarian. Clinical examination consisted of visual inspection using a periodontal probe/explorer and full or partial mouth dental radiographs. Treatment was performed during the same procedure. Some animals had a follow-up examination including radiographs months later. Four common dental diseases were diagnosed: periodontal disease, caries, tooth fracture, and tooth attrition. Less frequent were dental abscess, enamel hypomineralization, gingival hyperplasia, hypercementosis, tooth luxation, tooth dysplasia, root resorption, abrasion. Less severe periodontal disease was treated conservatively. If severely affected, teeth were extracted. Well-circumscribed caries without endodontic involvement were treated by composite restoration. Teeth with extensive caries and pulp involvement were extracted. Teeth with exposed pulp were treated via extraction or orthograde root canal treatment. In this case series, 27 (87%) of 31 NHPs exhibited at least 1 moderate to severe dental lesion that required treatment. The presumable improvement in welfare and weight of oral/dental lesions for the overall health status in research NHPs encourages us to continue this program prospectively.

An epidemiological survey on the prevalence of equine peripheral dental caries in the United Kingdom and possible risk factors for its development.

BACKGROUND: Equine peripheral caries (PC) is an increasingly recognised disorder that causes premature wear of teeth and dental fractures and thus has major welfare implications. Little information is available on its prevalence or severity in UK horses and there are no proven associations with any risk factors. OBJECTIVES: To document the prevalence of PC over a wide area of the UK, assess its intraoral distribution and severity in affected horses and examine for potential risk factors for its development. STUDY DESIGN: Cross sectional study. METHODS: Experienced personnel were recruited for a UK wide dental survey on their patients during dental examinations. Established guidelines were used for grading PC. Frequency of PC occurrence was compared between teeth and dental arcades using McNemar's tests. Potential risk factors for PC were screened using univariable logistic regression prior to building a multivariable model. RESULTS: A total of 706 horses were examined by 25 participants, showing a 51.7% prevalence of PC (365/706). Some regional differences in prevalence were found. The PC primarily affected the cheek teeth with the 12 caudal being significantly more commonly affected than the 12 rostral cheek teeth. Most of the hypothesised risk factors including age, breed, sex, time at pasture and feeding of silage (haylage) were unproven. A limited association with moderate levels of concentrate feeding was observed. The presence of concurrent dental abnormalities were significantly associated with the likelihood of having PC. MAIN LIMITATIONS: Not all regions in UK were included and there may be inconsistencies between examiners. CONCLUSIONS: Peripheral caries is common in British horses, primarily affecting the caudal cheek teeth. There was limited evidence of an association between feeding and PC. The association between PC and concurrent dental disorders indicates that these should be addressed in affected horses.

Caries, Periodontal Disease, Supernumerary Teeth and Other Dental Disorders in Swedish Wild Boar (Sus scrofa).

Between January and December 2013, the dental and periodontal health of 99 Swedish wild boars (Sus scrofa) was investigated. Sampling occurred in conjunction with routine hunting at six large estates in the southern and middle parts of Sweden. All six of the estates use supplemental feeding. The weight of the animals, their sex and their dates of death were noted. Age was estimated using tooth eruption and tooth replacement patterns. The oral cavity was inspected and abnormalities were recorded on a dental chart modified for wild boars. The findings included supernumerary teeth, absence of teeth, mild class II malocclusion, severe tooth wear, periodontitis, calculus, caries, tooth fractures and the presence of enamel defects. Swedish wild boars suffer from different dental lesions and the impact of supplemental feeding on dental and periodontal health is still to be investigated.

Impact of diet on incisor growth and attrition and the development of dental disease in pet rabbits.

OBJECTIVES: To assess the impact of four rabbit diets (hay only; extruded diet with hay; muesli with hay; muesli only) on length and curvature of cheek teeth and eruption and attrition rates of incisors. MATERIALS AND METHODS: Thirty-two Dutch rabbits, randomly divided into four diet groups, had length and saggital plane curvature of the first cheek teeth measured radiographically at 1, 9 and 17 months. Eruption/attrition of the left upper incisor was directly measured at weeks 30, 32 and 35. RESULTS: Eruption rates matched attrition rates in all groups, but were higher in the hay only group than in both groups fed muesli. By month 9, a greater degree of tooth curvature was present in rabbits fed muesli only than in those fed hay only and extruded diet with hay. After 17 months, rabbits fed muesli only and muesli with hay had longer lower first cheek teeth and larger interdental spaces between the first two molars than rabbits fed extruded diet and hay and hay only. Three rabbits fed muesli only developed evidence of dental disease. CLINICAL SIGNIFICANCE: Presence of increased tooth length, curvature and interdental spaces indicated early dental pathology in rabbits fed muesli. Muesli diets cannot be recommended for pet rabbits.

Critical evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following high-pressure gas and micro-particle abrasion.

Infundibular caries of the equine maxillary cheek teeth is an important disorder that can lead to dental fracture or apical infection. Treatment by removing food debris and carious dental tissue from affected infundibulae using high-pressure abrasion with aluminium hydroxide micro-particles, followed by filling the cleaned defect with endodontic restorative materials is a recommended treatment. However, although anecdotally considered a successful treatment option, there is currently no objective evidence to support this claim. Forty maxillary cheek teeth (CT) that contained 55 infundibulae with caries (mainly grade 2) were extracted post-mortem from 21 adult horses. Five of the CT were sectioned prior to treatment to facilitate visual examination of the carious infundibulae. The remaining carious infundibulae were cleaned using high-pressure abrasion with aluminium hydroxide particles and five CT were sectioned to assess the efficacy of this cleaning process. The remaining 30 CT containing 39 carious infundibulae were then filled with a composite restorative material. The efficacy of this restoration was assessed by computed tomography imaging followed by direct visual examination after sectioning the teeth. Only 46% (18/39) of restored infundibulae, all with shallow (mean 9.6 mm deep) defects, were fully cleaned of food debris and carious material, and filled with restorative material to their full depth. Of these 18, 11 had peripheral defects around the restoration, leaving just 18% (7/39) of restorations without any gross defects. The remaining 54% (21/39) of infundibulae (mean depth of infundibular caries defect, 18.3 mm) still contained food debris and/or carious material in more apical locations, with infundibulae with the deepest caries defects being the least effectively cleaned. The findings of this study indicate that high-pressure micro-particle abrasion is only effective in cleaning food debris from shallow, carious CT infundibulae and consequently, the majority of subsequent infundibular restorations are imperfect.