Faculty Bibliography

The purpose of this article is to detail the primary challenges faced by large dental institutions as they incorporate digital dentistry into their mainstream workflow. Integration of digital technology is easier in private practices with smaller patient volumes and fewer trained staff required. Additionally, in private practices, scanning, designing and milling frequently occur in a single location, which does not require an external digital data transfer. However, large dental institutions must overcome several barriers which are uniquely generated by their large-scale operation. Numerous individuals must be comprehensively and efficiently trained to operate the advanced technologies. The digital software must seamlessly integrate with existing software and an internal infrastructure must be established capable of handling massive data inputs. High-volume production in large dental institutions requires the involvement of external laboratories to meet demand. This outsourcing presents a new challenge of safe digital data transfer in accordance with patient privacy and protection regulations set forth by governing agencies. It is vital for large dental institutions to recognise the unique challenges thrust upon them as they attempt to incorporate a digital workflow. With proper forethought and planning an appropriate infrastructure may be established allowing for a smooth and safe transition to the digital era.

The clinician's selection of an implant system is influenced by many variables. Ideally, the decision should be based on scientific evidence, but often these decisions are based on economic considerations or influenced by the experience of a trusted peer. The purpose of this paper is to describe the influence of implant neck features (shape and surface) and abutment connection (diameter that matches or is smaller than the implant's platform) on hard and soft tissues around single-tooth implants placed into healed ridges with adequate hard and soft tissue thickness. In an effort to reduce the number of variables, only two-piece implants fully placed at bone level or beneath were taken into consideration. The goal is to provide additional guidance for clinicians on the decision-making and implant-selection processes.

The oral rehabilitation of adolescent patients with amelogenesis imperfecta (AI) is complex due to the presence of mixed dentition with altered eruption sequence. In this manuscript, the interdisciplinary treatment approach for adolescent patients with AI is discussed. The types and timing of treatments at various stages of growth are described through a literature review on this topic. AI is an inherited condition that disturbs the development of the enamel structure. Because of the presence of mixed dentition, definitive treatment options often have to be delayed until eruption of permanent dentition is complete, requiring careful treatment coordination and proper sequencing between different dental disciplines starting at a young age. Adolescent patients require prosthodontic treatment design that can be adapted to the changes in arch shapes, sizes, interarch relationship, and esthetic needs. AI patients are often challenged with both excessive and limited restorative spaces within the same arch due to the abnormal growth patterns, enamel structure, tooth size, and tooth shape. Therefore, careful determination of the required restorative space is critical to ensure optimal prognosis. This clinical report discusses treatment recommendations, timing of various treatment modalities, and involvement of appropriate interdisciplinary teams for managing adolescent patients. This article is protected by copyright. All rights reserved.

AIM/OBJECTIVE:The aim of this study is to assess the influence of e-learning on dental education as perceived by predoctoral dental students. MATERIALS AND METHODS/METHODS:In an institutional review board (IRB) approved protocol, a 14-question survey was created and electronically distributed to second-, third-, and fourth-year dental students. The participation was considered voluntary and all responses were anonymous. RESULTS:The survey targeted 1,130 predoctoral students, of which 255 (22.6%) responded. Of the respondents, 124 students (48.6%) preferred traditional lecture mixed with online learning, while 46 students (18%) preferred only the traditional lecture style. The top three electronic resources/applications, which students perceived as having the greatest impact on their learning, were: YouTube, Bone Box, and Google. The responses also indicated that 76.5% of the students gave high credibility (scores of 4 and 5) to electronic resources recommended by faculties. Sixty percent of students spent 1 to more than 4 hours per day on electronic resources for academic performance. The most important factor for online applications influencing academic performance was "organization and logic of content" (54%). E-learning had a significant perceived effect (scores of 4/5) on didactic understanding (65.1%) and on clinical understanding (71.4%). Students observed that faculties estimated to be under 50 years of age were more likely to incorporate e-learning into courses (52.6%) and more likely to use social media for communication (41.6%). CONCLUSION/CONCLUSIONS:The results indicate that e-learning may successfully be used in a dental school's curriculum to enhance students' perceptions of fundamental concepts and to enable students to apply this knowledge to clinical cases. CLINICAL SIGNIFICANCE/CONCLUSIONS:E-learning has recently been proposed as a basic supplementary tool to enhance medical and dental education. It is crucial to determine dental students' preferences regarding social media, online applications, and databases in order to incorporate e-learning into dental school courses.

The peri-implant soft tissue seal consists of a connective tissue cuff and a junctional epithelium that is different from the arrangement of periodontium around a natural tooth. However, the peri-implant soft tissue complex lacks Sharpey's fibers, thus offering less resistance to clinical probing and biofilm penetration compared to the natural dentition. Therefore, the proper restorative emergence profile design is essential to facilitate favorable esthetic outcomes and maintain peri-implant health. The aim of this article is to review the currently available evidence related to the design of subgingival (critical and subcritical) and supragingival contours of the implant restorative emergence profile (IREP) as well as provide a flowchart for decision-making in clinical practice. Theoretically, the subgingival contours of the crown/abutment complex should mimic the morphology of the root and the cervical third of the anatomic crown as much and as often as possible. However, this is highly dependent upon the three-dimensional spatial position of the implant relative to the hard and soft tissue complex, in addition to the location of the definitive restoration. Frequently, a convex critical contour is required on the facial aspect of a palatally or incisally positioned implant to support an adequate gingival-margin architecture. Conversely, if the implant is placed too far facially, then a flat or concave contour is recommended. In instances where soft tissue support is not needed, the subcritical area may be undercontoured to increase the thickness, height, and stability of the soft tissue cuff.

OBJECTIVES/OBJECTIVE:The aim of Working Group 4 was to address topics related to biologic risks and complications associated with implant dentistry. Focused questions on (a) diagnosis of peri-implantitis, (b) complications associated with implants in augmented sites, (c) outcomes following treatment of peri-implantitis, and (d) implant therapy in geriatric patients and/or patients with systemic diseases were addressed. MATERIALS AND METHODS/METHODS:Four systematic reviews formed the basis for discussion in Group 4. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary. RESULTS:Bleeding on probing (BOP) alone is insufficient for the diagnosis of peri-implantitis. The positive predictive value of BOP alone for the diagnosis of peri-implantitis varies and is dependent on the prevalence of peri-implantitis within the population. For patients with implants in augmented sites, the prevalence of peri-implantitis and implant loss is low over the medium to long term. Peri-implantitis treatment protocols which include individualized supportive care result in high survival of implants after 5 years with about three-quarters of implants still present. Advanced age alone is not a contraindication for implant therapy. Implant placement in patients with cancer receiving high-dose antiresorptive therapy is contraindicated due to the associated high risk for complications. CONCLUSIONS:Diagnosis of peri-implantitis requires the presence of BOP as well as progressive bone loss. Prevalence of peri-implantitis for implants in augmented sites is low. Peri-implantitis treatment should be followed by individualized supportive care. Implant therapy for geriatric patients is not contraindicated; however, comorbidities and autonomy should be considered.

OBJECTIVE: This work aims to present a pilot study of a non-destructive dental histo-anatomical analysis technique as well as to push the boundaries of the presently available restorative workflows for the fabrication of highly customized ceramic restorations. MATERIALS AND METHODS: An extracted human maxillary central incisor was subject to a micro computed tomography scan and the acquired data was transferred into a workstation, reconstructed, segmented, evaluated and later imported into a Computer-Aided Design/Computer-Aided Manufacturing software for the fabrication of a ceramic resin-bonded prosthesis. RESULTS: The obtained prosthesis presented an encouraging optical behavior and was used clinically as final restoration. CONCLUSION: The digitally layered restorative replication of natural tooth morphology presents today as a clear possibility. New clinical and laboratory-fabricated, biologically inspired digital restorative protocols are to be expected in the near future. CLINICAL SIGNIFICANCE: The digitally layered restorative replication of natural tooth morphology presents today as a clear possibility. This pilot study may represent a stimulus for future research and applications of digital imaging as well as digital restorative workflows in service of esthetic dentistry.

The aim of this qualitative research study was to identify and categorize criteria for simulation teacher quality preferences as reported by dental students. Second-year dental students at New York University College of Dentistry in 2015 were given a two-question, open-ended survey asking what qualities they liked most and least in a simulation or preclinical teacher. Responses were collected until data saturation was reached. Key words in the responses were identified and coded based on similar relationships and then were grouped into defined categories. A total of 168 respondents out of the target group of 363 students (46.3%) provided 1,062 written comments. Three core themes-character, competence, and communication-emerged from 16 defined categories, which were validated using references from the educational literature. The theme of character encompassed eight of the defined categories (motivation, available, caring, patience, professionalism, empathy, fairness, and happiness) and accounted for 50% of the total student responses. The theme of competence comprised five categories (expertise, knowledgeable, efficient, skillful, and effective) and represented 34% of all responses. The communication theme covered the remaining three categories (feedback, approachable, and interpersonal communication) and contained 17% of the responses. Positive and negative comments in the category of motivation accounted for 11.2% of all student responses. Expertise was the next highest category with 9.3% of the responses, followed closely by 9.1% in the category of available. Among these students, the top five attributes of simulation teachers were motivation, expertise, available, caring, and feedback. While the study did not attempt to correlate these findings with improved student performance, the results can be used in the development of assessment tools for faculty and targeted faculty development programs.

STATEMENT OF PROBLEM: An electronic quality assurance (eQA) program was developed to replace a paper-based system and to address standards introduced by the Commission on Dental Accreditation (CODA) and to improve educational outcomes. This eQA program provides feedback to predoctoral dental students on prosthodontic laboratory steps at New York University College of Dentistry. PURPOSE: The purpose of this study was to compare the eQA program of performing laboratory quality assurance with the former paper-based format. MATERIAL AND METHODS: Fourth-year predoctoral dental students (n=334) who experienced both the paper-based and the electronic version of the quality assurance program were surveyed about their experiences. Additionally, data extracted from the eQA program were analyzed to identify areas of weakness in the curriculum. RESULTS: The study findings revealed that 73.8% of the students preferred the eQA program to the paper-based version. The average number of treatments that did not pass quality assurance standards was 119.5 per month. This indicated a 6.34% laboratory failure rate. Further analysis of these data revealed that 62.1% of the errors were related to fixed prosthodontic treatment, 27.9% to partial removable dental prostheses, and 10% to complete removable dental prostheses in the first 18 months of program implementation. CONCLUSIONS: The eQA program was favored by dental students who have experienced both electronic and paper-based versions of the system. Error type analysis can yield the ability to create customized faculty standardization sessions and refine the didactic and clinical teaching of the predoctoral students. This program was also able to link patient care activity with the student's laboratory activities, thus addressing the latest requirements of the CODA regarding the competence of graduates in evaluating laboratory work related to their patient care.