Faculty Bibliography

PURPOSE/ OBJECTIVES/UNASSIGNED:The aim of this study was to evaluate the impact of race-blind admissions policies on the recruitment and enrollment of a single, university-based, pathway program. METHODS:Programmatic data were used to conduct a retrospective cohort study of applicants to the pathway program, Saturday Academy at New York University College of Dentistry, during the period of race-conscious admissions practices (2023) and after the implementation of race-blind admissions policies (2024). Chi-squared, Fisher's exact, and Z-tests were used to compare demographic characteristics reported by program applicants and enrollees. RESULTS:No statistically significant differences were observed in the demographics of the applicant pool between 2023 and 2024, as it related to gender, ethnicity, race, use of federal/ state assistance programs, or first-generation college status. No statistically significant differences could be observed between Saturday Academy enrollees in 2023 and 2024 as it related to gender and use of federal/ state assistance programs. There was a 46.2% (p = 0.002) decrease in the proportion of Hispanic students and a 74.4% (p = 0.001) decrease in the proportion of Black students admitted to the program in 2024. Also in 2024, there was a 119.8% (p = 0.004) increase in the proportion of Asian American students admitted, and the proportion of students who self-identified as first-generation college students increased 27% (p = 0.03). CONCLUSION/CONCLUSIONS:The effective federal ban on race-conscious admissions practices is likely to compromise the ability of pathway programs to significantly contribute to the development of a healthcare workforce that is representative of the demographics of the US population.

OBJECTIVES/UNASSIGNED:This study aims to examine the impact of the COVID-19 public health emergency on state-level dental service utilization, focusing on endodontic care; and to understand how benefit design and coverage influence healthcare disparities in oral health. METHODS/UNASSIGNED:The data comes from the 2019-2021 Centers for Medicare & Medicaid Services (CMS) unredacted Transformed Medicaid Statistical Information System (T-MSIS). State-level coverage was collected from state Medicaid program provider manuals. We analyzed service utilization rates overall and by demographic factors such as age, sex, and race/ethnicity. Chi-square tests were used to test for significant differences in the rates across the years and within each group. Clustered-robust standard error models were used to predict the odds of receiving an endodontic service. RESULTS/UNASSIGNED:The COVID-19 pandemic significantly disrupted dental service utilization across the United States, with a marked decrease in preventive and routine dental care. Utilization of endodontic services experienced less of a decline during the pandemic and a significant increase post-pandemic, compared to other dental services. States with more comprehensive Medicaid dental benefits design had significantly higher rates of endodontic service utilization for children and adults. Among children, increased age, female gender, and non-Hispanic Black race/ ethnicity were significantly associated with lower levels of endodontic service utilization. Among adults, rural residence designation was significantly associated with lower levels of endodontic service utilization. CONCLUSION/UNASSIGNED:The study highlights the critical role of benefit design in ensuring dental service utilization, particularly during public health emergencies. Oral health stakeholders must recognize the potential long-term consequences of delayed dental care and remain innovative in providing care under limited circumstances.

PURPOSE/OBJECTIVES/OBJECTIVE:The aim of this study was to assess predoctoral dental students' satisfaction with faculty-created educational content, aimed at reducing perceived barriers to achieving clinical competency in endodontics. METHODS:This mixed-methods study was conducted with third (D3)- and fourth (D4)-year dental students at New York University College of Dentistry. Focus groups were held to collect qualitative data after initial drafts of clinical instructional videos were made. Surveys were then sent to four randomized groups of D3 and D4 students to collect quantitative data regarding satisfaction with final versions of the instructional videos. RESULTS:Qualitative data indicated that D3 and D4 students valued different things when evaluating the instructional videos. D3 students were likely to express positive feedback about background information and the explanation of fundamental concepts. Alternatively, D4 students were more likely to express positive feedback about the enhanced visualization that filming through the clinical operating microscopes afforded. Both groups were adept at pointing out inconsistencies between the presented video content and their formal, didactic curriculum. Quantitative data indicated that all respondents (100%) would be willing to watch these videos if they were integrated into their dental school curriculum. Student respondents indicated relatively equal preferences between having the videos published on YouTube/social media (51%) or on an NYU-affiliated platform (49%). CONCLUSION/CONCLUSIONS:Students expressed satisfaction with faculty-created educational videos, with D3 and D4 students valuing different aspects of the content. Partnering with dental students helps ensure that created content is reflective of students' curriculum and responsive to their preferred learning styles.

INTRODUCTION/BACKGROUND:The purpose of this study was to evaluate long-term outcomes of nonsurgical retreatment (NS-ReTx) procedures performed by a single endodontist in private practice. METHODS:This retrospective cohort study evaluated NS-ReTx procedures performed between the years 1986 and 2019, meeting the following inclusion criteria: minimum of 1-year follow-up and preoperative, postoperative, and follow-up radiographs available for analysis. Procedures were evaluated clinically and radiographically, and treatment outcomes were reported. A subset of cases included cone-beam computed tomography (CBCT) images and CBCT-assessed periapical healing was reported for these cases. The effect of clinical factors on radiographic healing was assessed using a Cox proportional hazard regression model. The Kaplan-Meier method estimated the probability of tooth survival at each year of follow-up. RESULTS:A total of 241 NS-ReTx procedures from 202 patients met the inclusion criteria. The median patient age at time of NS-ReTx was 54 years. Molars were the most frequently treated tooth type, 57.68%. Radiographic healing at the median follow-up time, 9.14 years (n = 231) was 64.07% healed (148 of 231), 7.36% healing (17 of 231), and 28.57% unhealed (66 of 231). An additional 10 teeth were extracted before any radiographic follow-up. CBCT-assessed periapical healing ("strict" criteria) was 65.63% over a median follow-up time of 9.18 years. Tooth survival following NS-ReTx was 93.3% at 5 years and 85.3% at 10 years. CONCLUSIONS:The study demonstrates that radiographic periapical healing and treatment success improve over time and that tooth survival following NS-ReTx is favorable long-term.

INTRODUCTION/BACKGROUND:Medicaid is the largest source of health coverage in the United States and provides dental benefits to eligible low-income families. Federal policies establish minimum dental service requirements for children, while states have flexibility regarding the coverage of dental services for adults in any capacity. The objective of this study was to evaluate endodontic procedure coverage, reimbursement, and dentist participation for Medicaid beneficiaries. METHODS:This retrospective, cross-sectional study evaluated child and adult dental Medicaid benefits in 2021. For children, 18 endodontic procedure codes were evaluated; 16 were evaluated for adults. Mapping was used to depict state-level coverage of procedures. Logistic regression analyses were conducted to evaluate the odds of procedural coverage. RESULTS:For children and adults, initial root canal therapy was the most routinely covered endodontic procedure category; and molar teeth were the least likely tooth type to be covered. States were more likely to have established payment policies for vital pulp therapy procedures for children than for adults. For children and adults, geographic region was significantly associated with Medicaid coverage of endodontic procedures. Endodontic procedure reimbursement rates ranged from $7.00 to $1113.87 (median, $251.00). Overall, adult procedures tended to have lower reimbursement rates than child procedures at the category level but had a higher overall median reimbursement rate. Median endodontist participation for child dental services was 24%. CONCLUSIONS:Gaps in endodontic coverage exist for Medicaid beneficiaries. Endodontic treatments for molar teeth, vital pulp therapy, and regenerative endodontic procedures are the least consistently covered.

BACKGROUND:Clinical approaches for pediatric patients requiring endodontic treatment have been associated with specialty type. AIM/OBJECTIVE:The purpose of this study was to elucidate the nuanced clinical decision-making process for endodontic treatment of pediatric patients' permanent teeth. DESIGN/METHODS:A qualitative design was used to explore the experiences and decision-making of general dentists, pediatric dentists, and endodontists. Clinicians practicing in the United States were recruited to interview using purposive sampling methods. A framework, thematic analytic approach was used to evaluate the data. RESULTS:In total, 26 dentists participated in the study: 7 general dentists, 11 pediatric dentists, 6 endodontists, and 2 dual-trained specialists. Overall, clinicians reported that caries on permanent first molars were the most common reason that pediatric patients required endodontic treatment. Access to care was influenced by practitioner clinical training and knowledge; patient behavior; and financial considerations. Treatment planning was influenced by parents, referrals, and clinical philosophy. CONCLUSIONS:The findings explain how clinician decision-making and system-level factors influence access to care for pediatric patients in need of endodontic treatment and propagate oral health disparities. Barriers to accessing care were most limiting for children and adolescents from low-income households and were likely to result in premature tooth loss.

BACKGROUND:Evidence suggests that pediatric patients requiring endodontic treatment in the permanent dentition are often a "missed population". AIM/OBJECTIVE:This study surveyed pediatric dentists and endodontists about the frequency with which they encounter pediatric patients requiring endodontic treatment, their training, practice patterns, and decision-making considerations for the treatment of immature permanent teeth. DESIGN/METHODS:analysis. The level of significance was set at 0.05. RESULTS:The response rate was 13.1% (n = 840). The frequency of clinicians encountering pediatric patients requiring endodontic treatment for permanent teeth did not differ significantly by specialty. Pediatric dentists and endodontists reported statistically significant differences in their practice patterns related to the performance of vital pulp therapy (p < 0.001) and procedures for necrotic immature permanent teeth (p < 0.001). Among specialists, apexification was more frequently performed than regenerative endodontic procedures (REPs) (p < 0.001). When asked to consider clinical and patient factors related to the treatment of necrotic immature permanent teeth, pediatric dentists most frequently responded that they were "unsure" of their preferred treatment. CONCLUSION/CONCLUSIONS:Standardized clinical knowledge and management of immature permanent teeth between specialties may improve interdisciplinary care for pediatric patients.

BACKGROUND:Dental schools aim to train and support a diverse dentist workforce. Among all faculty, full-time and part-time faculty who identify as members of historically underrepresented groups are 13.9% and 8.4%, respectively. The recruitment and retention of faculty is a known challenge, with growing faculty vacancies at dental schools. This study explored dental student perceptions of academic careers, specifically focusing on Black and Hispanic predoctoral students. METHODS:From August to November 2022, we conducted focus group with second-, third-, and fourth-year predoctoral dental students who identified as Black or Hispanic using a semi-structured interview guide that was developed for this study. Data were analyzed using inductive thematic analysis. RESULTS:Four themes emerged: (1) students perceived academic dental dentistry as inclusive but not diverse spaces for Black and Hispanic people; (2) academic dental careers were perceived as secondary careers; (3) academic dental careers were perceived as a career option with a lack of autonomy and less income, compared to clinical practice in other settings; (4) students expressed a lack of knowledge about pathways to academic dental careers. Despite these challenges, students expressed interest in academic dental careers and noted being inspired by younger faculty members. CONCLUSION/CONCLUSIONS:Dental schools must do more to encourage dental students to consider careers in academic dentistry. Pathway programs, mentoring, and the presentation of academic careers as a viable career option for students by faculty should be further emphasized practices. Increasing the diversity of faculty members is also key. Students cannot be who they cannot see.

BACKGROUND:Historical reports of unpredictable outcomes associated with vital pulpal therapies, particularly direct pulp capping (DPC), have contributed to clinicians' skepticism of the procedure. Contemporary reports highlight more predictable outcomes of vital pulpal therapies, inclusive of DPC. There is a dearth of reported patient-centered outcomes of these procedures. METHODS:Insurance claims were used in an observational, retrospective cohort study to evaluate outcomes of DPC performed on permanent teeth. Statistical analyses included Kaplan-Meier survival estimates and Cox proportional hazards regression. Log-rank tests were used to evaluate unadjusted differences in survival. Cox proportional hazard regression was used to evaluate the adjusted hazard of adverse event occurrence. RESULTS:The analytic cohort included 4,136 teeth from 3,716 patients. DPC procedures were identified in public-payer (85.5%) and private-payer (13.4%) insurance claims databases. After DPC, procedure survival rate was 83% and tooth survival rate was 93% during a mean follow-up time of 52 months. Molar tooth type, same-day permanent restoration placement, and amalgam restoration type were significant positive predictors of procedure (DPC) survival. Age was not a statistically significant predictor of procedure survival after controlling for tooth type, gender, time to restoration, and restoration type. Nonmolar tooth type and younger age were significant positive predictors of tooth survival after DPC. Failures were most likely to occur within the first year. CONCLUSIONS:DPC has favorable patient-centered outcomes and contributes to long-term tooth survival. PRACTICAL IMPLICATIONS/CONCLUSIONS:The favorable patient-centered outcomes of DPC bolster calls to consider cost-effectiveness and access to care for endodontic procedures.