Chemical and microbiological characterization of artisan inoculants used for the fermentation of traditional dairy products in Epirus area (Greece).

The artisan production of a variety of dairy products is a historical tradition since antiquity, which is still practiced nowadays, in the area of Epirus, (northwestern Greece). The common denominator of these products, regardless of the final form of the end product, is the fermentation of raw milk by the use of dried artisan inoculants made of the dehydrated rumen of small ruminants, mainly lambs. The aim of this research project is to study the microbiological parameters as well as certain technological parameters (chymosin activity and lipolytic activity) of these inoculants. The results revealed a wide biodiversity of microorganisms such as Lactobacilli, Lactococci, Leuconostoc, Pediococci, Streptococci, Bifidobacteria, Enterococci, Clostridia and coliforms. Chymosin activity and lipolytic activity were found to be higher in artisan inoculants than in the commercial ones.

Microbial challenges of poultry meat production.

Food safety and shelf-life are both important microbial concerns in relation to broiler meat production. Focus is mainly placed on the absence or control of potentially pathogenic microbes such as Salmonella spp. and Campylobacter spp. but, from the commercial point of view, other spoilage bacteria also play a role as potential threats. Regarding food safety, the primary target should be the production of pathogen-free live animals, thus allowing slaughter plants to keep the processing line free of those microorganisms. Consumers believe that quality of foods from organic production is superior to foods from conventional production. The aim of the present study was to evaluate and compare the bacterial quality of chicken meat from organic and conventional production on the basis of traditional meat quality criteria. Fresh free grazing broiler carcasses were purchased directly from rural households (n = 80) and fresh retail chicken parts from conventional broiler carcasses from the local supermarkets in the region of Epirus (Poultry Producers Association. Arta) (n = 200). The samples were microbiologically tested for the presence of bacteria such as: Salmonella spp., Listeria monocytogenes, Staphylococcus aureus, Enterobacteriaceae, Escherichia coli, Campylobacter spp., and C. perfringens. Total count of aerobic mesophilic bacteria was also determined. Bacteriological tests were performed by means of standard methods of isolation and identification of individual species of bacteria according to ISO requirements. API-tests (bioMerieux) and Vitek 2 Identification System (bioMerieux) were used for biochemical determination. High levels of microbial contamination and occurrence of pathogenic bacteria at then fresh free grazing broiler carcasses reflect the poor hygienic quality of the slaughter conditions in the rural households.

Aerobic and anaerobic microbiology of the immersion chilling procedure during poultry processing.

The development of treatments to reduce bacterial numbers on poultry carcasses is important for the overall hygienic quality of birds. The important washing effect of the immersion chilling procedure is discussed. Systematic monitoring of fecal bacterial indicators as well as some classic pathogens was performed at selected critical points in a water chiller ecosystem. Clostridium perfringens, fecal coliforms, Enterococcus sp., and Streptococcus sp. were found in all water chiller samples. The temperature of the chiller ecosystem varied according to location: Escherichia coli and Salmonella sp. were found at 16 degrees C, compared with the 4 degrees C location, where these species were found in lower numbers. Moreover, the psychrotrophic bacterium Pseudomonas was found only at this last location. The temperature of the water during the immersion chilling procedure was unfavorable for the growth of Campylobacter sp., whose presence was always strictly associated with a pH close to 6. Spore forms of C. perfringens were persistent in all locations and seemed to be a reliable indicator of contamination of the water chiller ecosystem.

Retrospective multicenter study of an anodized, tapered, diminishing thread implant: success rate at exposure.

Performance of a new tapered, threaded implant at exposure was evaluated retrospectively using conservative assessment criteria. The criteria used were intended to ensure that an implant in the early stages of failing as well as those implants that have clearly failed would be identified as such. These results reflect an evaluation preliminary to comparing the performance of the implant at exposure and its performance (i.e., success rate) observed after longer periods (i.e., > or = 1 year) of loaded service. Data from 663 patients treated in the setting of the authors' private practice offices were evaluated to assess the performance of the implant under representative "clinical practice" usage conditions. The implant success/failure criteria were prospectively defined and applied to data obtained in a masked fashion from patients' records. Neither the dentist nor personnel involved in the analysis of the data were aware of which patients were qualified for and included into the study. Of 1100 implants available for evaluation, 15 implants failed at or before exposure. The success rate at exposure was 98.6%. There was no correlation between the anatomical region in which an implant was placed and the incidence of implant failure. Implants placed in fresh extraction sites and/or grafted sites appeared to be more likely to fail at exposure. Conversely, the failure rate of implants placed using a single-stage surgical procedure was comparable to that of implants placed using a conventional two-stage surgical methodology. Immediately loaded implants experienced a success rate comparable to that of implants placed using conventional two-stage surgical procedures. Factors under the clinician's control may play a substantial role in determining implant performance at exposure.

Long-term efficacy of hydroxyapatite-coated cylindrical implants.

A two-site clinical study of hydroxyapatite-coated cylindrical titanium alloy implants was undertaken to evaluate their efficacy. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly postrestoration prophylactic examinations and annual comprehensive patient visits. Implant failure criteria included mobility, peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain on palpation. Soft tissue indices were monitored as part of the study. Postrestoration implant performance was analyzed using life table methodology. From the 316 implants restored in 154 patients, 11 implants in 8 patients failed before prosthetic attachment, for a surgical success rate of 96.4 percent. Four implants failed during an observation period extending up to 85 months after completion of prosthetic treatment. The Cutler-Ederer life table success rate after 6 years was 97.8 percent. No significant adverse events were reported during the observation period. Results of this investigation suggest that hydroxyapatite-coated cylindrical titanium alloy implants are an effective treatment modality.

Single-stage surgery for implant placement: a retrospective study.

Single-stage implant placement surgery offers patients a number of advantages. These include reduced cost and time commitments and greater comfort, function, and convenience. This article reports on the results of using a single-stage technique with 58 patients fitted with 240 implants. No implant failures were detected in any patients prior to the final attachment of a Dolder bar. Among the 27 patients and the 125 implants followed for a longer period of time, 99.2% exhibited no signs of implant mobility or pain. Indicators of gingival health and oral hygiene ranged in quality from acceptable to ideal.

Efficacy of threaded hydroxyapatite-coated implants placed in the posterior mandible in support of fixed prostheses.

A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants when used to support fixed prostheses in the posterior mandible. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly postrestoration prophylactic exams and annual comprehensive patient visits. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Postrestoration implant performance was analyzed using life-table methodology. From the 2,062 implants restored in 720 patients in the parent study, a total of 423 implants in 195 patients were included in the posterior mandibular data subset. Thirteen implants failed at or before second-stage surgery for a surgical success rate of 96.9 percent. Prosthodontics was completed, and one or more postrestoration annual follow-up visits occurred for 314 implants as of the interim analysis cutoff date. Fourteen implants failed during an observation period extending up to 62 months after completion of prosthodontic treatment. One failed implant was removed, whereas the 13 remaining implants are functional despite having been identified as failures under the protocol criteria. The Cutler-Ederer life table success rate after 5 years was 92.2 percent. Results of this investigation suggest that threaded hydroxyapatite-coated implants are effective when placed in posterior mandibular regions in support of fixed prostheses.

Efficacy of threaded hydroxyapatite-coated implants in the anterior mandible supporting overdentures.

A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants when placed in the anterior mandible to support overdentures. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly postrestoration prophylactic exams and annual comprehensive patient visits. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Postrestoration implant performance was analyzed using life-table methodology. From the 2,062 implants restored in 720 patients in the parent study, a total of 660 implants in 174 patients were included in the anterior mandibular overdenture data subset. Twelve implants in 8 patients failed at or before second-stage surgery for a surgical success rate of 98.2 percent. Five implants failed during an observation period extending up to 72 months after completion of prosthodontic treatment. The Cutler-Ederer life table success rate after 5 years was 97.8 percent. No significant adverse events were reported during the observation period. Results of this investigation suggest that threaded hydroxyapatite-coated implants are effective when placed in anterior mandibular regions in support of overdentures.

Efficacy of threaded hydroxyapatite-coated implants placed in the anterior mandible.

A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants in anterior maxillary regions when used to support fixed prostheses. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly post-restoration prophylactic exams and annual comprehensive patient visits. Of 2,062 implants restored in 720 patients in the parent study, a total of 95 implants in 54 patients met the criteria for inclusion into this portion. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Post-restoration implant performance was analyzed using life-table methodology. No failures were observed before prosthodontic rehabilitation. Three implants failed during an observation period of up to 5 years after completion of prosthodontic treatment. The Cutler-Ederer life table success rate after 5 years was 93.4 percent. Results of this investigation suggest that threaded hydroxyapatite-coated implants are safe and effective when placed in anterior maxillary regions to support fixed prostheses.

Interim clinical study report: a threaded, hydroxylapatite-coated implant--five-year post-restoration safety and efficacy.

An ongoing prospective clinical trial is being conducted at three study sites to evaluate the safety and efficacy of a threaded, hydroxylapatite-coated implant (Steri-Oss Inc., Yorba Linda, CA) in a patient population reflective of the investigators' overall population of implant candidates. The 2062 implants placed and restored among 720 patients over the five-year period up to the study interim analysis cut-off date (November, 1994) include over 600 implants and 200 patients at each study site. Mean age and sex distribution of patients were comparable among the study sites. Study design attributes included well-defined patient selection criteria, standardized study procedures, standardized measurement and observation methodology, complete data accountability, and rigorously applied implant success/failure criteria. Thirty-five implants were considered failures at exposure, and the surgical success rate was 98.3%. Of 65 implants that failed post-restoration, three were removed, while 62 remained functional and in service. The five-year post-restoration follow-up success rate, determined by means of life table methodology, was 96.0%. By region, the five-year life table success rates post-restoration were 94.3% in the anterior maxilla, 96.6% in the posterior maxilla, 97.2% in the anterior mandible, and 95.6% in the posterior mandible. Adverse events occurred in association with less than 1% of the implants placed.

A five year clinical evaluation showing optimum results in dental implants.

Implant dentistry has made great advances since its inception several decades ago. As a result, predictability and success have reached high levels. Nonetheless, efforts continue to further refine implant design, materials, and techniques to reduce even the small percentage of failures that still occur. As part of this effort, the authors for the past six years have conducted clinical trials of Steri-Oss threaded titanium implants and HA-coated implants. The results have been consistent with the body of implant research reported since the 1970s. Optimum implant performance is realized when a well-designed system such as those tested is utilized in association with astute clinical judgment.

The sinus lift procedure: an alternative to the maxillary subperiosteal implant.

Technical advances now allow implants to be placed when pneumatization of the sinus has left insufficient bone to engage an endosseus implant. Augmenting material, such as a mixture of resorbable hydroxylapatite and demineralized freeze-dried bone, is grafted into the sinus cavity. This creates a new alveolar ridge to support endosseous implants.

Dental implant treatment in a severely compromised (irradiated) patient.

When faced with a patient with relative medical or psychological contra-indications, the practitioner may be tempted to withhold dental implant treatment because of the risks. Yet, for some highly motivated but compromised patients, the potential benefits of implant treatment can be an overriding consideration. In the case presented here, a 56-year-old patient who had undergone two series of radiation therapy and surgery for recurring cancer of the tongue was treated first with a subperiosteal, and, when the subperiosteal was removed after six years, the patient was treated with endosseous implants. This treatment significantly improved the patient's life without further negative effect on her medical condition.