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.
The available information on the morbid anatomy of ankylosing spondylitis is largely concerned with the late stages when the joints have undergone bony ankylosis. The object of this paper is to draw attention to the changes which occurred in a readily accessible 56 THE JOURNAL OF BONE AND JOINT SURGERY FIG. 3 THE MANUBRIO-STERNAL JOINT IN ANKYLOSING SPONDYLITIS) I VOL.
In one set of experiments the harvesting was done on the 5th day and in the other on the 6th day. Might this not account for wide variation in the uptake of thymidine? DR. DAVEY In the first group of experiments we did not find any marked difference in the results, whether cultures were harvested at day 5 or day 6, but this is clearly very late in lymphocyte culture time and there tended to be a fairly wide variation. It is late even for antigen stimulation, and I think that in some of the cultures the pH had dropped so much that we were getting rather slight effects. Of the fourteen in Grade II, eight had persistent pain as a result of pressure on a metatarsal remnant, four had discomfort attributed to wound infection, one had persistent hallux rigidus on one side, and in one the cause of pain was not obvious.
Review of the Results of Excision of the MetatarsalIn the fifteen in Grade III, the poor results were attributed to irregular resection of the metatarsals in nine, inappropriate operation in three, and no obvious cause in three.The fact that in 80 per cent. of feet operated on symptoms were abolished and the wearing of normal shoes made possible makes this procedure one of the most reliable in the treatment of rheumatoid arthritis.
Discussion
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