ABSTRACT
Aspergillosis is the primary fungal disease affecting captive penguins globally. Its diagnosis remains challenging, and currently no tests are both sensitive and specific for the detection of early infection. The present study evaluated a recently developed Aspergillus lateral-flow device (AspLFD) for the detection of Aspergillus spp. antigen in plasma and glottis mucus from captive penguins. In a pilot retrospective study, banked frozen plasma samples from captive penguins were reviewed: samples from 11 gentoo penguins (Pygoscelis papua papua) and 4 king penguins (Aptenodytes patagonicus) fulfilled the inclusion criteria and were used in the analysis. Positive plasma AspLFD test results were found in 80% (four of five) of the aspergillosis-positive cases tested. All of the aspergillosis-negative cases tested negative (10 of 10) on the AspLFD test. In a cohort prospective study, paired plasma and glottis swab samples were opportunistically and nonrandomly collected from captive gentoo penguins. In total, 26 penguins were tested. In the negative control group, AspLFD test was negative on plasma and swab in 100% of birds (14 of 14). In the aspergillosis-positive group, AspLFD test was positive on plasma samples from 33% (4 of 12) of birds, on swab samples from 50% (6 of 12) of birds, and on either plasma or swab samples from 75% (9 of 12) of birds. The AspLFD is currently used for the diagnosis of aspergillosis in humans and also shows promise for use in penguins. Larger prospective studies are recommended.
Subject(s)
Aspergillosis , Spheniscidae , Humans , Animals , Prospective Studies , Retrospective Studies , Aspergillosis/diagnosis , Aspergillosis/veterinary , AspergillusABSTRACT
Rugby league has a relatively high injury risk, with the tackle having the greatest injury propensity. The number of tackles players engage in, prior to injurious tackles may influence injury risk, which has yet to be investigated. Therefore, this study investigated if rugby league players are involved in more tackles (as either tackler or ball carrier) (i) in the 10 minutes, or (ii) 1-min periods prior to an injurious tackle-event, (iii) differences for ball carriers vs. tacklers, and (iv) forwards vs. backs. Video analysis was utilised to quantify the number and rate of tackles in the 10-min periods prior to 61 tackle-related injuries. One thousand two hundred and eighty 10-min periods where players were not injured, were used as matched-controls. Generalized mixed linear models were used to analyse mean total and rate for tackles. Injured players were involved in significantly fewer tackles during the 10-min period, yet significantly more tackles during the final minute prior to the injurious tackle-event, compared to non-injured players. There were no differences between ball carriers vs. tacklers during the 10-min period. Both injured position groups were involved in significantly more tackles in the final minute. Additional match data sources are needed to further inform injury preventive strategies of tackle events.
Subject(s)
Athletic Injuries , Football , Humans , Football/injuries , Rugby , Athletic Injuries/epidemiology , Athletic Injuries/etiology , Athletic Injuries/prevention & controlABSTRACT
An egg of the critically endangered flapper skate Dipturus intermedius was successfully incubated to hatching in captivity in what is believed to be a first for the species. Water conditions (temperature, salinity, flow rate) were recorded, with mean water temperatures ranging from a monthly mean of 8.3 ± 1.2 to 13.2 ± 0.3°C and salinity from a monthly mean of 30.5 ± 1.2 to 36.6 ± 2.3 ppt. Hatching occurred after 534 days, suggesting that flapper skate eggs take c. 5700 growing degree-days to incubate to hatching. The egg's prolonged embryonic development raises concerns about flapper skate eggs' vulnerability to anthropogenic disturbance.
Subject(s)
Skates, Fish , Animals , Embryonic Development , Salinity , Temperature , WaterABSTRACT
Hypervitaminosis D was diagnosed in a giant anteater (Myromecophaga tridactyla) and a large hairy armadillo (Chaetophractus villosus) being fed a commercial insectivore diet. Clinical findings included weight loss, reduced appetite, vomiting, and suspected abdominal discomfort. Hypercalcemia (3.68 and 2.04 mmol/L total and ionized calcium, respectively) was detected in the anteater, and plasma 25(OH)D levels were measured and found to be 808.7 and 379.4 nmol/L for the anteater and armadillo, respectively. Dietary change resulted in a reduction of 25(OH)D levels in both animals and resolution of hypercalcemia in the giant anteater. Dietary analysis of the commercial insectivore food revealed levels of vitamin D3 higher than the data-sheet values. This case report demonstrates that hypervitaminosis D in Xenarthra can be associated with significant clinical signs.
Subject(s)
25-Hydroxyvitamin D 2/blood , Nutrition Disorders/veterinary , Vitamin D/blood , Xenarthra , Animals , Armadillos , Diet/adverse effects , Diet/veterinary , Hypercalcemia/diagnosis , Hypercalcemia/etiology , Hypercalcemia/veterinary , Male , Nutrition Disorders/diagnosis , Nutrition Disorders/etiologyABSTRACT
Pallas' cat [Otocolobus (Felis) manul] experiences a high mortality rate from toxoplasmosis. During the period 2006-2016, the overall mortality rate for this species from all causes during the first year of life was 71.59% in European Association of Zoos and Aquaria institutions, with the most significant infectious cause from systemic toxoplasmosis (20.6%) as confirmed by postmortem examination and histopathology. Clindamycin was used starting in 2014 in two collections that had previously experienced 100% mortality rates by toxoplasmosis in kittens less than one year of age, covering key Toxoplasma gondii exposure periods for kittens (n = 17) as a prophylactic measure. This protocol resulted in a 67.03% (95% confidence interval 41.76-78.61%) reduction in the first year mortality rate over a two-year period to 5.88% in those animals treated.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Clindamycin/therapeutic use , Felidae , Toxoplasma/drug effects , Toxoplasmosis, Animal/drug therapy , Animals , Animals, Zoo , Toxoplasmosis, Animal/mortalityABSTRACT
A 9-yr-old, entire female captive rock hyrax ( Procavia capensis) was presented with a 1-wk history of sialorrhea. On clinical examination, a mass was identified, encompassing the rostral mandible and intermandibular area, with associated mucosal ulceration, marked gingival recession, and loosening or loss of adjacent teeth. Skull radiography and cytology of fine-needle aspirates of the mass were suggestive of squamous cell carcinoma. Based on a suspected poor prognosis, the animal was humanely euthanized. Postmortem histological examination of samples confirmed a diagnosis of oral squamous cell carcinoma with invasion of mandibular bone. Neoplasia is uncommonly reported in hyraxes, which has led to the assumption that they may share mechanisms of cancer resistance with elephants, their closest extant relatives. This is the first report of squamous cell carcinoma in this species.
Subject(s)
Carcinoma, Squamous Cell/veterinary , Hyraxes , Mouth Neoplasms/veterinary , Animals , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/pathology , Euthanasia, Animal , Female , Mandible/pathology , Mouth Neoplasms/etiology , Mouth Neoplasms/pathologyABSTRACT
Supraorbital salt-excreting glands are present in at least 10 avian orders and are largest in marine species, including penguins. Diseases of the avian salt gland have been described infrequently. From September 2015, five captive northern rockhopper penguins ( Eudyptes moseleyi) were presented over a 6-wk period for unilateral or bilateral supraorbital swellings. In September 2016, two cases recurred and two additional cases were identified. Histopathology demonstrated salt gland adenitis with extensive squamous metaplasia. Blood plasma testing demonstrated marked vitamin A and E deficiencies within the colony. Prolonged frozen storage of feed-fish was implicated as a cause of vitamin depletion; reducing storage times and addition of dietary supplementation prevented recurrence.
Subject(s)
Animals, Zoo , Bird Diseases/diagnosis , Lymphadenitis/veterinary , Salt Gland/pathology , Spheniscidae , Vitamin A Deficiency/veterinary , Animals , Bird Diseases/chemically induced , Bird Diseases/therapy , Female , Lymphadenitis/chemically induced , Lymphadenitis/diagnosis , Lymphadenitis/therapy , Male , Metaplasia , Recurrence , Scotland , Vitamin A/blood , Vitamin A Deficiency/chemically induced , Vitamin A Deficiency/diagnosis , Vitamin A Deficiency/therapyABSTRACT
Mycobacterium avium subspecies paratuberculosis (MAP) is a cause of contagious and typically fatal enteric disease, primarily affecting ruminant and pseudoruminant species. During a MAP outbreak in a captive collection, six of nine adult Mishmi takin ( Budorcas taxicolor taxicolor) showed marked weight loss over 1-3 mo, followed by an acute deterioration. Fecal culture and microscopy failed to identify MAP shedding. Necropsy findings included grossly normal intestines and marked enlargement of mesenteric lymph nodes. Histological findings included multibacillary granulomatous enteritis, mesenteric lymphadenitis, and periportal hepatitis. MAP was confirmed by culture of intestinal and lymph node tissues from the index case. Results of antemortem serological testing using an indirect ELISA (ID SCREEN® Paratuberculosis Indirect) were corroborated by findings at necropsy or survival of the outbreak. Mishmi takin appear to show high MAP susceptibility and a rapid disease course compared with domestic ruminant species.
Subject(s)
Animals, Zoo , Disease Outbreaks/veterinary , Mycobacterium avium subsp. paratuberculosis/isolation & purification , Paratuberculosis/epidemiology , Ruminants , Animals , Enzyme-Linked Immunosorbent Assay/veterinary , Female , Male , Paratuberculosis/diagnosis , Paratuberculosis/microbiology , Paratuberculosis/pathology , Scotland/epidemiologyABSTRACT
Eleven cases of dilated cardiomyopathy have been diagnosed and treated in captive Livingstone fruit bats ( Pteropus livingstonii) in the United Kingdom over the past 7 yr. All but one case received treatment with a diuretic plus an angiotensin-converting enzyme inhibitor (ACEI), and, or pimobendan. One case is still under treatment with pimobendan alone, following diagnosis before onset of clinical signs. Diuretic treatment consisted of furosemide at a dose rate of 0.5-5 mg/kg, one to three times daily, and, or spironolactone at a dose rate of 1-4 mg/kg, once or twice daily. When used, the ACEI imidapril was given at a dose rate of 0.24-0.38 mg/kg q 24 hr, and pimobendan at a dose rate of 0.2-0.5 mg/kg bid. This report is intended to provide anyone seeking to medically manage heart failure in Pteropus species, particularly P. livingstonii, with a review of drugs and doses that have been used.
Subject(s)
Cardiomyopathy, Dilated/veterinary , Chiroptera , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Animals , Animals, Zoo , Cardiomyopathy, Dilated/drug therapy , Cardiotonic Agents/therapeutic use , Diuretics/administration & dosage , Diuretics/therapeutic use , Female , Furosemide/administration & dosage , Furosemide/therapeutic use , Imidazolidines/administration & dosage , Imidazolidines/therapeutic use , Male , Pyridazines/administration & dosage , Pyridazines/therapeutic use , Spironolactone/administration & dosage , Spironolactone/therapeutic useABSTRACT
Cases of femoral head and neck excision arthroplasty are infrequently reported in reptiles, and details of surgical technique and clinical outcome in chelonia are lacking. An adult female leopard tortoise (Stigmochelys pardalis) was presented with chronic non-weight-bearing lameness of the left hind limb. Examination and radiography were consistent with coxofemoral luxation, and as a result of the chronic presentation, surgical intervention was recommended. A cranial approach to the joint via the prefemoral fossa afforded good surgical exposure. A depressed lytic acetabular lesion was noted during the procedure, postulated to be a result of abnormal wear from the luxated femoral head. A fiberglass prop was used during recovery to allow extension of the limb without full weight-bearing. Lameness persisted postoperatively, but limb usage significantly improved.
Subject(s)
Arthroplasty/veterinary , Femur/surgery , Hip Dislocation/veterinary , Turtles , Animals , Arthroplasty/methods , Female , Hip Dislocation/surgery , PseudarthrosisABSTRACT
Background and Aims: The use of whole-body cryotherapy (WBC) for athletic recovery is becoming increasingly popular despite the lack of evidence supporting the dosage parameters in its implementation. The aim of the current study was to investigate the dose-response effects of WBC following match-play in elite rugby league players. Methods: We observed endocrine (salivary cortisol and testosterone) and biochemical (creatine kinase) responses following three separate post-match recovery periods in elite rugby league players. Comparisons were made between a single exposure (3 min at -120°C to --135°C) of WBC to two consecutive exposures (2 × 3 min), to a control (no exposure) during the recovery trials. Recovery characteristics were measured 36 h prematch, immediately postmatch, and 60 h postmatch. Results: Cortisol concentrations remained unchanged in its pattern of response during the postmatch recovery periods across all WBC doses. Testosterone concentrations increased significantly (p < 0.0005) at 60 h, in the WBC2 trial. The Testosterone:Cortisol ratio increased significantly (p < 0.0005) at 60 h in the WBC2 trial, while during the WBC0 trial it did not recover to baseline levels. No significant effect on creatine kinase concentration was observed, although a statistical trend was shown in WBC2 for improved reduction of this marker at 60 h. Conclusions: These findings suggest that two, consecutive exposures to WBC immediately following fatiguing rugby league competition appear to stimulate an increase to the anabolic endocrine profile of participants by 60 h post-match, and may reduce the CK concentration. Coaches and athletes should consider the treatment dosage of WBC when used to optimize the desired response following a high-stress environment.
ABSTRACT
After an anterior cruciate ligament (ACL) injury, people need secondary prevention strategies to identify osteoarthritis at its earliest stages so that interventions can be implemented to halt or slow the progression toward its long-term burden. The Osteoarthritis Action Alliance formed an interdisciplinary Secondary Prevention Task Group to develop a consensus on recommendations to provide clinicians with secondary prevention strategies that are intended to reduce the risk of osteoarthritis after a person has an ACL injury. The group achieved consensus on 15 out of 16 recommendations that address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. We hope this statement raises awareness among clinicians and researchers on the importance of taking steps to mitigate the risk of osteoarthritis after an ACL injury.
Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament Reconstruction , Osteoarthritis, Knee , Humans , Anterior Cruciate Ligament Injuries/surgery , Osteoarthritis, Knee/prevention & control , Osteoarthritis, Knee/complications , Exercise , Secondary PreventionABSTRACT
CONTEXT: The Osteoarthritis Action Alliance formed a secondary prevention task group to develop a consensus on secondary prevention recommendations to reduce the risk of osteoarthritis after a knee injury. OBJECTIVE: Our goal was to provide clinicians with secondary prevention recommendations that are intended to reduce the risk of osteoarthritis after a person has sustained an anterior cruciate ligament injury. Specifically, this manuscript describes our methods, literature reviews, and dissenting opinions to elaborate on the rationale for our recommendations and to identify critical gaps. DESIGN: Consensus process. SETTING: Virtual video conference calls and online voting. PATIENTS OR OTHER PARTICIPANTS: The Secondary Prevention Task Group consisted of 29 members from various clinical backgrounds. MAIN OUTCOME MEASURE(S): The group initially convened online in August 2020 to discuss the target population, goals, and key topics. After a second call, the task group divided into 9 subgroups to draft the recommendations and supportive text for crucial content areas. Twenty-one members completed 2 rounds of voting and revising the recommendations and supportive text between February and April 2021. A virtual meeting was held to review the wording of the recommendations and obtain final votes. We defined consensus as >80% of voting members supporting a proposed recommendation. RESULTS: The group achieved consensus on 15 of 16 recommendations. The recommendations address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. CONCLUSIONS: This consensus statement reflects information synthesized from an interdisciplinary group of experts based on the best available evidence from the literature or personal experience. We hope this document raises awareness among clinicians and researchers to take steps to mitigate the risk of osteoarthritis after an anterior cruciate ligament injury.
Subject(s)
Anterior Cruciate Ligament Injuries , Knee Injuries , Osteoarthritis , Humans , Anterior Cruciate Ligament Injuries/prevention & control , Consensus , Osteoarthritis/prevention & control , Secondary PreventionABSTRACT
BACKGROUND: Numerous translocations of Eurasian beavers have occurred with little implementation of standardised health screening. Pre-release health screening enables the selection of individuals with the best survival prospects and reduces potential health risks, but this is by-passed during unofficial releases. Beaver reintroduction to Britain has been haphazard and currently disjunctive populations of varying status exist. METHODS: This observational cross section study investigated the health status of three beaver populations, with 90 live beavers tested for a range of pathogens comprising 56 from Tayside (unofficially released Scotland), nine from Knapdale (officially released Scotland) and 25 from Devon (unofficially released England). In addition, a further 32 cadavers were screened (25 from Tayside and seven from Knapdale). RESULTS: All beavers were in good physical condition, did not harbour any non-native disease or parasites of concern and demonstrated remarkably low levels of any disease or parasite exposure. CONCLUSION: Beavers are establishing and adapting well to British landscapes and are not acting as reservoirs of significant zoonotic diseases. Official, licensed reintroduction programmes may appear overly convoluted; however, reputational damage of unofficial releases should be considered, along with the health and welfare of the animals involved and collateral damage to other wildlife, domestic animals and humans.
Subject(s)
Health Status , Introduced Species , Rodentia , Sentinel Surveillance/veterinary , Animals , Cross-Sectional Studies , United KingdomABSTRACT
The Scottish Beaver Trial (SBT) reintroduced the Eurasian beaver (Castor fiber) in 2009 using wild-caught Norwegian beavers. This included a six-month prerelease quarantine in Devon, England. The International Union for Conservation of Nature (IUCN) and government guidelines for health screening were followed, including testing for Leptospira species. Unlicensed beavers, from Germany, were also identified in Scotland (Tayside) and Devon (later forming the River Otter Beaver Trial (ROBT)) and were health-screened under licence. Due to positive Leptospira species results and lack of prerelease screening in ROBT and Tayside, beavers from Germany and Norway (range sources) were screened. One hundred and fifty-six samples from 151 beavers were analysed by Leptospira species quantitative PCR (qPCR) (n=73 kidney (postmortem)/urine samples (antemortem)) or microscopic agglutination test (MAT, Leptospira pools 1-6) (n=83 serum samples). No beavers from Norway (95 per cent confidence interval (CI) 0-5.6 per cent, n=52), Tayside or SBT postrelease (95 per cent CI 0-4.6 per cent, n=63) tested positive. Seven beavers from Germany and Devon were positive. This gives an overall 9.3 per cent (95 per cent CI 5.2-15.1 per cent) exposure level, of which 4.6 per cent (95 per cent CI 1.9-9.3 per cent) suggested infection on a positive qPCR (n=1) or MAT titre of at least 1/400 (n=6), although none had abnormal physical, biochemical or haematological changes. This study suggests that Leptospira species infection in wild Eurasian beavers occurs at a low level, has no sex bias and does not appear to cause significant morbidity or mortality.
Subject(s)
Conservation of Natural Resources , Leptospira/isolation & purification , Leptospirosis/veterinary , Rodentia/microbiology , Animals , Female , Leptospirosis/epidemiology , Male , United Kingdom/epidemiologyABSTRACT
Hantaviruses are RNA viruses (order Bunyavirales, family Hantaviridae) found in rodent, bat and insectivore reservoir-hosts and have been reported as an emerging significant zoonotic risk in Europe. As part of two native semiaquatic rodent restoration projects, tissue and urine samples were tested for hantavirus from water voles (Arvicola amphibius) (n=26, in 2015) and Eurasian beavers (Castor fiber) (n=20, covering 2010-2015) using a pan-hantavirus nested real-time PCR test. Kidney and lung samples were also analysed by light microscopy after haematoxylin and eosin staining of formalin-fixed paraffin wax sections. Individuals selected included those forming the source of release animals and from those already free-living in Britain in areas targeted for release, to identify existing reservoirs. For water voles all tested individuals were from Britain (n=26); for beavers some were from Britain (Scotland) (n=9) and some were samples from wild Norwegian (Telemark region) (n=6) and German (Bavaria region) animals (n=5) that formed the source of accepted wild populations currently present in Scotland. All samples tested from both species were negative for hantavirus RNA and showed no significant histopathological changes suggesting that reservoir infection with hantavirus in water voles in Britain and Eurasian beavers present in Britain, Norway and Bavaria, Germany, is unlikely.
Subject(s)
Arvicolinae/virology , Hantavirus Infections/veterinary , Orthohantavirus/isolation & purification , Rodentia/virology , Animals , Female , Hantavirus Infections/epidemiology , Male , United Kingdom/epidemiologyABSTRACT
OBJECTIVES: Conduct a comprehensive epidemiological study of match injury characteristics (incidence, severity, causes, diagnostics, and temporal trends) in professional rugby league. DESIGN: Prospective cohort design. METHODS: Data was captured over the 2013, '14, and '15 seasons, collected via an online-reporting survey tool, and underpinned by nominal group technique-agreed definitions. Injury details were provided by club medical staff in accordance to the survey fields from all European Super League teams (e.g. injury occurrence/return dates, diagnosis, mechanism, recurrence). All time-loss injuries have been reported. RESULTS: Injury incidence of 57 injuries/1000h has been observed over the three-year period, with an average of 34days missed per injury. The final 20-min period was the most significant period for injury occurrence, and higher incidence of injury/1000h played was during the start of the season in February, although an absolute injury risk for injury frequency was shown in April due to the greatest playing time. Forward positions reported the highest injury incidence whilst tackle activities were the most frequent mechanism of injury. Concussions and hamstring strains (5 injuries/1000h) were the most commonly diagnosed injuries, although the knee joint region (10 injuries/1000h) was the most frequently injured area. CONCLUSIONS: In light of the most common injury diagnoses, mechanisms, identified seasonal risk, and time of match, the data should look to inform player preparation in terms of physical conditioning and tackle technique in order to optimise player welfare and availability for participation.
Subject(s)
Athletic Injuries/epidemiology , Football/injuries , Adult , Brain Concussion/epidemiology , Europe/epidemiology , Humans , Incidence , Injury Severity Score , Knee Injuries/epidemiology , Longitudinal Studies , Male , Prospective Studies , Risk Factors , Sprains and Strains/epidemiology , Time FactorsABSTRACT
BACKGROUND: Avian aspergillosis presents a significant threat to captive penguin populations. Currently, a lack of objective prognostic factors limits disease staging, objective reassessment throughout treatment, comparative evaluation of treatment regimes, and appropriate timing of euthanasia. OBJECTIVE: The study objective was to investigate absolute and relative plasma protein fractions by agarose gel electrophoresis (EPH) as predictors of survival in Gentoo penguins (Pygoscelis papua papua) under treatment for aspergillosis. METHODS: One hundred and eighty-three EPH profiles from individual clinical cases were examined retrospectively. Animal survival to 90 days post sampling was established from clinical records; birds either survived (n = 146) or died within 90 days (n = 37), and time to death was recorded. RESULTS: Fourteen variables showed statistically significant differences (P < .05) between surviving and dying birds. Receiver operating characteristic curve analysis identified total albumin concentration (albumin + prealbumin) and albumin-to-globulin (A:G) ratio as having strongest discriminatory values (95% CI) at 0.788 (0.710-0.866) and 0.784 (0.696-0.871), respectively. Albumin (concentration and percentage of total protein) displayed moderate discriminatory value but additionally a weak positive correlation with time to death (95% CI); r = .353 (0.033-0.608) and .424 (0.116-0.658), respectively. CONCLUSIONS: Optimized test cutoffs for total albumins, albumin (concentration and percentage of total protein), and A:G ratio achieved moderate sensitivity and specificity, strong negative predictive values, but weak positive predictive values due to a low prevalence of death. Selection of appropriate test cutoff values may provide valuable adjunctive prognostic tools for clinical decision-making when the prognosis is difficult to assess clinically.
Subject(s)
Aspergillosis/veterinary , Bird Diseases/blood , Blood Proteins/analysis , Spheniscidae , Animals , Aspergillosis/blood , Aspergillosis/physiopathology , Bird Diseases/microbiology , Bird Diseases/physiopathology , Electrophoresis, Agar Gel/veterinary , Female , Male , Prognosis , Retrospective Studies , Survival AnalysisABSTRACT
The goal of preserving the natural dentition has long provided the foundation for clinical decision making in dentistry. Current trends in implant dentistry have weakened this paradigm as many practitioners have moved quickly to adopt implant dentistry as a new standard of care; however, the rapidity of this shift is a cause for concern among others. Many short-term studies have reported favorable data supporting the growth of single-unit implant dentistry, but the lack of standardized outcome evaluations and broadly conceived dimensions of performance makes it difficult to compare these reports. Thus, even with the exciting new treatment options implant dentistry offers patients and practitioners, all due consideration should first be given to treatments aimed at preserving and restoring compromised teeth before pursuing extraction and replacement. This article examines this premise from five perspectives: form, function, survival, management of complications, and quality of life.