NYSDJ August/September 2021

Are Your Patients Tuning into YouTube? the new york state dental journal

AUGUST/SEPTEMBER 2021 | Volume 87 Number 5

PRESIDENT Kevin Henner

Inside:

All in for the Profession

2021 Legislative Roundup

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the new york state dental journal

Volume87 Number 5

August/September 2021 16 Numbers are Not Enough A strong association depends upon fully engaged members assured of the value of their membership. A conversation with Kevin A. Henner, D.M.D., 141st president of the New York State Dental Association.

20 The Educational Quality of Aphthous Ulcer Content on YouTube Dorin Yakubov, D.D.S.; George F. Raymond, D.D.S. YouTube is both an entertainment site and information platform. And while it may provide some useful information, there is limited evidence that much of its content is reliable.

23 Minimally Invasive Coronally Advanced Tunnel: A Novel Surgical Technique for Treatment of Multiple Recession Defects Cover: Kevin Henner, who will lead NYSDA for the next year, is determined to use his time broadening the base of the Association and encouraging every member to participate.

Photo by David Roth, Jovon Photography

2 Editorial

Asset protection and recovery 6 Attorney on Law

Legislative wrap-up 10 Association Activities

Joann Pauline George, M.D.S.; Divya Khanna, B.D.S., M.D.S. A novel, minimally invasive technique for treating multiple recession-type defects is evaluated and is found to successfully achieve advanced root coverage, excellent aesthetics and significant improvement in periodontal parameters.

Case series

30 Gingival Cyst of the Adult Samuel M. Fleisher, B.A.; Scott M. Peters, D.D.S. GCA usually affects people in the fifth and sixth decades of their life, with a slight predilection for females. Authors describe simple surgical procedure, resulting in low chance of recurrence. Case report and literature review

32 Nasopalatine Duct Cyst Jamie Larmie, B.S.; Louis Mandel, D.D.S. Report details unusually positioned nasopalatine duct cyst that extended posteriorly to involve significant portions of anterior hard palate. Surgical resolution helped confirm NPC diagnosis.

36 General News 38 Component News 44 Read, Learn, Earn 46 Classifieds 51 Index to Advertisers 52 Addendum CE stars

The New York State Dental Journal is a peer reviewed publication. Opinions expressed by the authors of material included in The New York State Dental Journal do not necessarily represent the policies of the New York State Dental Association or The New York State Dental Journal.

EZ-Flip version of The NYSDJ is available at www. nysdental.org and can be downloaded to mobile devices.

Use your smartphone to scan this QR Code and access the current online version of The New York State Dental Journal.

editorial

What You See is not What You Get Dental practices’ most valuable asset remains uninsurable.

I

insurance adequately covers the repair or replacet happens. Devastating events damage or ment of the tangible building structure, equipment destroy dental practice assets, both tangible and and supplies. intangible. Available insurances currently cover Recent COVID-related practice restriction cases only physical damage to tangible structures, equiphighlight one key aspect of current inadequate covment and items you can see and touch, and limited erage for solely intangible asset damage. During the intangibles only when concurrent with such physiearly pandemic, dentists cal damage. This framework filed a torrent of business inleaves coverage gaps for The insurance industry terruption insurance claims intangible losses, such as for the intangibles, lost busilost income unrelated to must reassess its role in ness income and extra exphysical damage and, more compensating dentists penses. Dentists argued that importantly, for damage to mandated COVID practice a practice’s most valuable for intangible asset losses. restrictions or closures of asset, intangible goodwill. their premises, in whole or In order to protect denin part, constituted direct physical loss under their tists’ risk and return on their financial investment policies in order to trigger intangible coverage. The in their practices, insurers need to develop intaninsurers typically denied these claims, countering gible business interruption insurance that compenthat the policy language specifically required a trigger sates dentists for loss of not only what you see but, of “physical loss or damage” or permanent alteration also, all the intangible losses dental practices incur to the premises in order to engage coverage. These in devastating events. denials led to extensive litigation and the first case to make its way to a U.S. Court of Appeals, which Devastating Events and Current Coverages ruled in favor of the insurer.[1] The court concluded The events that damage practice assets vary from natural disasters and cyberattacks to, most recently, that the business interruption policy never intended, COVID-related government-mandated restrictions. and the insured did not purchase, coverage unrelated We can classify these events into three categories to actual physical loss.[2] This result signals the need with respect to the type of damage incurred: solefor insurance carriers to develop a coverage for solely ly physical damage; solely intangible damage; and intangible losses that insurers can successfully fund physical damage with intangible asset losses, inand dentists can afford. cluding practice goodwill.

Hurricanes, floods, fires and some cyberattacks In the event of solely physical damage, with no cause easily proven physical damage, with associatconcurrent intangible loss, commercial property ed intangible loss. Commercial property insurance

2 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

THE NEW YORK STATE DENTAL JOUR­NAL

adequately covers the tangible damages. As long as the insured proves actual physical damage, business interruption insurance covers the intangible lost income and extra expenses, such as continuing rent, mortgage payments, utilities, payroll, taxes and debt repayment for a limited period, depending on the specific policy and exclusions.

However, no coverage currently compensates dentists for lost practice goodwill.

What You Cannot See Practice goodwill represents the level of trust and loyalty in the existing relationships of owner dentists with patients, staff and the community. It includes the intangibles that enhance future earnings, such as reputation, brand and dentists’ business methodologies related to patient records, recall systems and non-compete agreements with key employees. Financially, it represents the likelihood patients will stay with a practice through ownership transitions, ensuring the continued revenue stream and cash flow of a going concern. Analytics place the average value of a practice’s goodwill at 60% to 80% of the total appraised practice value, usually the most valuable practice asset.[3] What You Get When an event forces a practice to cease operations for an extended period or mass evacuations temporarily or permanently displace a significant percentage of a patient base, it reduces the likelihood that such a practice’s patients will return. In 2017, authorities evacuated more than six million residents in response to Hurricane Irma.[4] The reduced cash flow impairs practice owners’ ability to service their debt and drastically reduces the practice value.

Consider the risk of investment of a dentist who purchases an existing practice for $500,000. The intangibles, including goodwill, will typically range in value from $300,000 to $400,000. In the event of a natural disaster and a complete destruction of the practice, such as seen in severe hurricanes, business interruption insurance would only cover the loss of the $100,000 to $200,000 of tangible assets and limited lost income and expenses. Where the disaster prevents the dentist’s return to the same location, displaces current patients or significantly alters the demographics in the area, it could irreparably damage the practice goodwill and leave the devastated dentist with a $300,000 to $400,000 negative return on investment. If the dentist had successfully increased the goodwill value after the purchase, and prior to the damage, it would magnify the dentist’s loss. Assuming the dentist financed $400,000 (or 80%) of the original practice purchase, the dentist then must struggle to repay the balance of the debt to the lender without the goodwill generated cash flow and risk default.

The Goodwill Coverage Gap Challenge Practice goodwill remains uninsured, primarily because indemnitybased insurances, such as current business interruption policies, lack reliable methodologies to classify and evaluate the value of intangible damages.[5] Other barriers to the development of intangible business

EDITOR Chester J. Gary, D.D.S., J.D.

MANAGING EDITOR Mary Grates Stoll

ADVERTISING MANAGER Jeanne DeGuire

ART DIRECTORS Kathryn Sikule / Ed Stevens

EDITORIAL REVIEW BOARD Frank C. Barnashuk, DDS. Clinical Assistant Professor, Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY. David A. Behrman, DMD. Chief, Division Dentistry/OMS, Associate Professor of Surgery, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY. Michael R. Breault, DDS. Periodontic/Implantology Private Practice. Schenectady, NY. Alexander J. Corsair, DMD. Periodontic/Implantology Private Practice. Rockville Centre, NY. Joel M. Friedman, DDS. Associate Clinical Professor Dental Medicine. Columbia University College of Dental Medicine, New York, NY. Jennifer Frustino, DDS, PhD. Director, Oral Cancer Screening and Diagnostics, Division Oral Oncology and Maxillofacial Prosthetics, Department of Dentistry, Erie County Medical Center, Buffalo, NY. Michael F. Gengo, DDS. Board-certified Endodontist, Clinical Assistant Professor, Department of Endodontics, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY. G. Kirk Gleason, DDS. General Dental Practice, Clifton Park, NY. Kevin Hanley, DDS. Orthodontic Private Practice, Buffalo, NY. Violet Haraszthy, DMD, DDS, MS, PhD, Professor, Chair, Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY. Stanley M. Kerpel, DDS. Diplomate, American Board of Oral and Maxillofacial Pathology, Associate director, Oral Pathology Laboratory, Inc. Attending, section of Oral Pathology, New York Presbyterian, Queens, NY. Elliott M. Moskowitz, DDS, MSD. Diplomate American Board Orthodontics; Clinical Professor.

Department Orthodontics, NYU College Dentistry; Orthodontic Private Practice, New York, NY. Eugene A. Pantera Jr., DDS. Past Director, Division of Endodontics, Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY. Robert M. Peskin, DDS. Dental Anesthesiology Private Practice. Garden City, NY. Pragtipal Saini, BDS, DDS, MSD. Private practice. Scarborough, ON. Robert E. Schifferle, DDS, MMSc, PhD. Professor Periodontics, Endodontics and Oral Biology.

School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY. Jay Skolnick, DMD. Board-certified pediatric dentist. Attending dentist, Rochester General Hospital. Private practice, Webster, NY.

PRINTER Fort Orange Press, Albany NYSDJ (ISSN 0028-7571) appears four times a year in print: January. March, June/ July and August/September. The April and November issues are available online only at www.nysdental.org. The Journal is a publication of the New York State Dental Association, 20 Corporate Woods Boulevard, Suite 602, Albany, NY 12211. In February, May, October and December, members have online access to the NYSDA News. Periodicals postage paid at Albany, NY. Subscription rates $25 per year to the members of the New York State Dental Association; rates for nonmembers: $75 per year or $12 per issue, U.S. and Canada; $135 per year foreign or $22 per issue. Postmaster: Please send change of address to the New York State Dental Association, Suite 602, 20 Corporate Woods Boulevard, Albany, NY 12211. Editorial and advertising offices are at Suite 602, 20 Corporate Woods Boulevard, Albany, NY 12211. Telephone (518) 465-0044. Fax (518) 465-3219. E-mail info@nysdental.org. Website www.nysdental.org. Microform and article copies are available through National Archive Publishing Co., 300 N. Zeebe Rd., Ann Arbor, MI 48106-1346.

The New York State Dental Journal AUGUST/SEPTEMBER 2021 3 ●

interruption coverage include the insurance industry’s financial capacity to provide coverage to the limits required, especially for catastrophic losses, and dentists’ ability to afford, or willingness to pay, the high premiums such coverage could command.

Parametric insurance may offer a reasonable solution to the intangible insurance dilemma. These policies do not require precise damage calculation and do not attempt to indemnify the insured for actual losses. Rather, the insurer bases payout on a pre-agreed trigger and pre-defined schedule.

Parametric coverage uses algorithms to predict the probability of an event, such as a natural disaster occurring, and offers a guaranteed payout after a qualifying event. For example, a policy could agree to pay a stated percentage (50% to 100%) of a predefined limit for losses from a designated-strength storm, flood, earthquake, etc., within a designated geographic area.[6] In addition, the parametric coverage would not replace but only fill gaps and supplement current traditional business interruption insurance. This more flexible structure enables more predictable payout amounts, which will allow both insurers and insured dentists to better manage their costs.

The current U.S. trend toward larger, consolidated, multiestablishment dental practices[7] accentuates dentists’ need for

affordable intangible business interruption insurance. As practice size and number of dentists per practice increase, this consolidation will continue to raise the percentage goodwill value represents of total practice values. Inadequate intangible asset insurance coverage for an increasing goodwill asset widens the coverage gap for devastating event damages. It increases the risk of defaults and bankruptcies on personally guaranteed practice acquisition loans and significantly depletes practice owners’ return on investment. As entrepreneurs, dentists risk their personal and professional financial futures on their practice investment.

Insurance carriers must offer affordable coverage of dental practices’ most valuable asset in order to protect this investment.

D.D.S., J.D.

REFERENCES 1.

2.

3.

THE MOST TRUSTED LAW FIRM FOR DENTISTS

4.

5.

6.

7.

Godes S. State of Law for Business Interruption Insurance Coverage for COVID-19 Claims. https://btlaw.com/insights/blogs/policyholder-protection/2021/state-of-the-law-forbusiness-interruption-insurance-coverage-for-covid19-claims. May 14, 2021.

8th Circuit Court of Appeals decision, Oral Surgeons, P.C. v. Cincinnati Insurance Company. US District Court Appellate Case 20-3211, Filed 7/2/21.

Brown F. The Value of Goodwill. https://www.dentaleconomics.com/practice/article/16391649/the-value-of-goodwill. Accessed 8/22/21.

Solana K. Florida dentists begin cleanup after Hurricane Irma. ADA News, September 18, 2017, p. 26.

Schmalbach M. Parametric insurance the key to insuring intangible assets: RYSKEX. https://www.captiveinternational.com/news/parametric-insurance-the-key-to-insuringintangible-assets-ryskex-3367. Sept. 3, 2020.

Brettler D, Gosnear T. Parametric Insurance Fills Gaps Where Traditional Insurance Fails Short. https://www.insurancejournal.com/news/international/2020/01/09/553850.htm.

Accessed 7/24/21.

Wall T, Guay A. Very Large Dental Practices Seeing Significant Growth in Market Share. http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0815_2.ashx August 2015.

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The New York State Dental Journal is planning to devote its January 2022 issue to the topic “Increasing Workforce Diversity in Dentistry,” an examination of the impact improved diversity among practitioners may have on reducing oral health disparities across population groups. We are looking in particular for papers that explore improvements in recruiting methods to address opportunity gaps, strategic outreach to underrepresented groups and the legal aspects of dental school admission practices.

Interested contributors are asked to submit their papers electronically to the managing editor by Nov. 1, 2021.

Address papers and queries to Mary Stoll, mstoll@nysdental.org; (800) 255-2100.

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Legislative Postmortem NYSDA scores positives in current State Budget in an otherwise anemic legislative session.

T

Lance Plunkett, J.D., LL.M.

he 2021 legislative session turned out to be rather slim on priority dental issues, a distinct turnaround from the success tallied at the end of the 2020 session last December (the teledentistry legislation). However, the State Budget for 2021-2022 proved to be the highlight of this year’s session for NYSDA. With the ongoing novel coronavirus (COVID-19) pandemic crisis triggering a potential multi-billion-dollar shortfall in state revenues, the governor had proposed across-the-board one percent reductions in Medicaid reimbursements, including all dental services. In addition, the NYSDA Dental Demonstration Project (DDP) appeared doomed, as cuts to such optional funding items were being threatened and the DDP was never mentioned in the governor’s budget or any early legislative budget proposals.

Nevertheless, NYSDA prevailed, eliminating all cuts to Medicaid reimbursements and securing funding for another year for the DDP. Other highlights coming directly from the State Budget include: • Telehealth can now be delivered anywhere the patient is in the state by a qualified healthcare provider from anywhere in the United States.

6 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

• All changes to the excess malpractice insurance program were eliminated and the program continues for just another year as usual.

• Medicaid expense reports from the New York State Department of Health will now be issued quarterly instead of monthly.

• The Department of Health “Family Plus Health Program” is replaced by the Department of Health “Basic Health Program,” and dental and vision services will now be part of the Basic Health Program, with the Commissioner of Health determining exactly what services will be covered and with no cost-sharing allowed for dental services.

• Residential healthcare facilities must spend 70% on direct resident care, which is defined to include spending on dental services, among many other spending items.

NYSDA was also able to have the New York State Senate unanimously pass S.6694 (Harckham), the NYSDA bill to amend the Dental Practice Act so that dental hygienists certified to use nitrous oxide and local infiltration anesthesia may do so to assist a dentist with any dental procedure. Currently they may only do so for dental hygiene procedures. It also allows

NYSDA

Directory

OFFICERS

registered dental assistants to place and remove temporary restorations. Unfortunately, the Senate passed the bill on June 9 and there was not enough time to move the bill out of the Assembly Higher Education Committee for a vote by the full Assembly. The Assembly adjourned its session on June 11. Assemblyman John McDonald indicated the identical Assembly bill—A.7754-A (McDonald)—would go forward in the 2022 legislative session.

Health Centers and HEROs The New York State Senate and Assembly unanimously passed A.1587 (Gottfried)/S.2127 (Rivera) to allow schoolbased health centers to choose between being paid via Medicaid managed care or Medicaid fee-for-service. The NYSDA Council on Dental Benefit Programs had reviewed this bill and determined NYSDA should monitor it but take no position in either support or opposition. This bill has still not been sent to the governor for his action.

And the Legislature did manage to successfully pass the Health and Essential Rights (HERO) Act—the acronym is a nice invention. On May 5, Gov. Cuomo signed it into law [A.2681-B (Reyes)/S.1034-B (Gianaris)] as Chapter 105 of the Laws of 2021. You can read details on the law in my column in the June/July New York State Dental Journal.

Since then, the United States Occupational Safety and Health Administration (OSHA) adopted its Emergency Temporary Standard (ETS) for Healthcare Workers to deal with COVID-19 workplace protections. These two items form a strange matrix. The New York State Department of Labor has stated that persons subject to the OSHA ETS are exempt from the HERO Act. However, most dentists (but not all) are not subject to the OSHA ETS. Dentists who screen people entering their offices for COVID-19 and turn away those who screen positive for the virus are exempt from the OSHA ETS. The State Department of Labor has been asked if it would be possible to authorize exemption from both the OSHA ETS and the HERO Act, but it has not responded positively so far and such a double exemption is not literally part of the HERO Act, which covers all infectious airborne diseases and not just COVID-19. NYSDA will be watching this issue closely, but for now, those dentists who are exempt from complying with the OSHA ETS need to comply with the HERO Act. The NYSDA definition-of-dentistry bill was introduced

by Assemblyman Peter Abbate as A.7195 and Sen. Andrew Gounardes as S.6383. Both bills remove language that has been misconstrued by the New York State Education Department to effectively eliminate the maxillofacial area from dentistry and limit dentists to the teeth and mouth.

Kevin A. Henner, President James E. Galati, President-Elect Anthony M. Cuomo, Vice President Frank C. Barnashuk, Secretary-Treasurer Steven Gounardes, Speaker of the House Mark J. Feldman, Executive Director

163 Half Hollow Rd., Ste 1, Deer Park, NY 117297 1758 Route 9, Halfmoon, NY 120659 667 Stoneleigh Ave., Ste 301, Carmel, NY 10512 3435 Main St., UB School of Dental Medicine, Buffalo, NY 14214 351 87th St., Brooklyn, NY 11209 20 Corporate Woods Blvd., Albany, NY 12211

BOARD OF TRUSTEES Craig S. Ratner, Immediate Past President Paul R. Leary, ADA Trustee NY – Maurice L. Edwards 2 – Mitchell D. Mindlin 3 – Steven L. Essig 4 – Wayne S. Harrison 5 – Margaret Madonian 6 – Luis T. Mauleon 7 – Theresa Casper-Klock 8 – Kevin J. Hanley 9 – Christopher M. Tota N – Frank J. Palmaccio Q – Viren L. Jhaveri S – Guenter J. Jonke B – Amarilis Jacobo New Dentist Liaison James A. Wanamaker

7030 Hylan Blvd., Staten Island, NY 10307 80 Maple Ave., Ste 206, Smithtown, NY 11787 30 East 60th St., Ste 401, New York, NY 10022 30 West End Ave., Ste 8, Brooklyn, NY 11235 Emblem Health, 1873 Western Ave., Albany, NY 12203 8 Medical Arts Ln., Saratoga Springs, NY 12866 600 Oswego St., Ste B., Liverpool, NY 13088 501 N. Cayuga St., Ithaca, NY 14850 33 William St., Ste 1, Auburn, NY 13021 959 Kenmore Ave., Buffalo, NY 14223 34 Frankford St., Hawthorne, NY 10532 875 Old Country Rd., Ste 101, Plainview, NY 11803 14031 Cherry Ave., Apt. 18, Flushing, NY 11355 2500 Nesconset Hwy Bldg 24A, Stony Brook, NY 11790 824 E. 181st St., Bronx, NY 10460 1579 US Rte20, Skaneateles, NY 13152

COUNCIL CHAIRPERSONS Council on Awards

John Liang 2813 Genesee St., Utica, NY 13501

Dental Benefit Programs

Alyson K. Buchalter 388 Avenue X, Ste 1J, Brooklyn, NY 11223

Dental Education & Licensure

Keith S. Margulis 3424 Kossuth Ave., Ste 2A, Bronx, NY 10467

Dental Health Planning & Hospital Dentistry

Sean McLaren 522 E Moreno Dr., Rochester, NY 14626

Dental Practice

John P. Demas 8814 Fort Hamilton Pkwy, Brooklyn, NY 1120

Ethics

Nick J. Vittoria 859 Connetquot Ave., Ste 1, Islip Terrace, NY 1175

Governmental Affairs

Richard L. Rubin 6605 Pittsford Palmyra Rd., Ste W3, Fairport, NY 14450

Membership & Communications

Claudia Mahon-Vazquez 18 Biltmore Dr., Shoreham, NY 11786

Nominations

Craig S. Ratner 7030 Hylan Blvd., Staten Island, NY 10307

Peer Review & Quality Assurance

Christian E. Mathiesen 154 West Ave., Saratoga Springs, NY 12866

Professional Liability Insurance

David J. Reed 1998 Empire Blvd., Webster, NY 14580

OFFICE Suite 602, 20 Corporate Woods Blvd., Albany, NY 12211 (518) 465-0044 | (800) 255-2100 Mark J. Feldman Lance R. Plunkett Michael J. Herrmann Grazia A. Yaeger Laura C. Stedman Mary Grates Stoll Jenna Bell Betsy Bray

Executive Director General Counsel Assistant Executive Director Finance-Administration Assistant Executive Director Marketing and Communications Assistant Executive Director Managing Editor Director of Meeting Planning Director of Health Affairs

The New York State Dental Journal AUGUST/SEPTEMBER 2021 7 ●

Neither bill advanced out of the Higher Education Committee in either the Assembly or Senate.

Wrong-Headed Decision Speaking of the Education Department misconstruing legislation, the single biggest governmental affairs issue in 2021 has been the March 9 opinion of the Education Department purporting to analyze dental scope of practice to exclude any testing for COVID-19. This opinion was issued despite both the governor and the New York State Department of Health already recognizing that dentists can, under the New York State Public Health Law, perform laboratory tests that are CLIA-waived (Clinical Laboratory Improvement Amendments Act) if the dentist is registered with the Department of Health’s Physician Office Laboratory Evaluation Program (POLEP). Many point-of-care COVID-19 tests are CLIA-waived, and a significant number of dentists were already registered with POLEP before COVID-19 came into existence.

NYSDA responded to the Education Department that this incorrect and poorly researched and analyzed opinion could not be followed, as it required doing actual harm to patients.

In any event, the federal government has overruled the Education Department and continues to authorize dentists to perform

COVID-19 testing and to administer COVID-19 vaccinations under the federal Public Readiness and Emergency Preparedness (PREP) Act. Nevertheless, the inability of the Education Department to intelligently regulate the profession of dentistry is an issue that will not go away and will need NYSDA’s full attention going forward.

Even a relatively innocuous legislative session still contains its pearls, and regulatory issues took center stage this year in any case. Many items are already being reviewed by NYSDA for the 2022 legislative session, including the proposed single-payer New York Health Plan Act. That bill is being studied by multiple NYSDA councils to form a policy position as to how the plan intends to treat dentistry, which the plan includes. If that plan advances in the Legislature in 2022, NYSDA will be ready. It is a bill where no predictions can be made, because the singlepayer concept has an intellectual life of its own, despite having only been tried in this country in a failed effort in Vermont.

Obviously, the New York bill tries not to replicate the problems experienced in Vermont.p The material contained in this column is informational only and does not constitute legal advice. For specific questions, dentists should contact their own attorney.

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The New York State Dental Journal AUGUST/SEPTEMBER 2021 9 ●

Association Activities CHANGING OF THE GUARD NYSDA’s 2021-2022 officers are officially sworn into office at annual meeting of House of Delegates in August in Jersey City, NJ. They are, from left, Secretary-Treasurer Frank Barnashuk, Speaker Steve Gounardes, Vice President Anthony Cuomo, President-Elect James Galati, President Kevin Henner. They will be joined on Board of Trustees by Brendan Dowd, who was elected ADA Trustee at the meeting to succeed Paul Leary.

Photos by Christine Terrio

NYSDA’s newest Board members are from left: Maurice Edwards,

Immediate Past President Craig Ratner, far right, bids farewell

New York County; Theresa Casper-Klock, Seventh District; Gunter

to retiring Board members. They are, from left: David Shipper,

Jonke, Suffolk County.

New York County; Jay Skolnick, Seventh District; Paul Markowitz, Suffolk County; Past President Payam Goudarzi.

Extend a Hand to Colleagues in Pain Grant Program Helps Dentists in Recovery DURING THESE UNCERTAIN TIMES, those who misuse or abuse alcohol and/or other drugs, are particularly vulnerable. The stress from social isolation and other COVID-19-related life changes can lead to or worsen substance use and misuse. The Dr. Thomas H. Sullivan Substance Abuse Grant Program provides financial assistance to chemically dependent dentists whose professional careers, families and very lives are threatened by substance abuse and addiction. Grants provided through this program assist in the payment of initial treatment costs associated with in-patient services. If you would like to help your colleagues who are suffering from alcohol or drug use/abuse, consider making a tax-deductible contribution to the Dr. Thomas H. Sullivan Substance Abuse Grant Program, c/o the New York State Dental Foundation, 20 Corporate Woods Boulevard, Suite 602, Albany, NY 12211.

10 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

Association Activities NYSDA Expands Dental Program to Columbia University, Providing Essential Care to Underserved Communities NYSDA IS EXPANDING its Dental Demonstration Project (DDP) program to the Columbia University College of Dental Medicine, a move made possible by support from Democratic State Senator Timothy Kennedy of Buffalo.

The DDP is a state-funded initiative that was launched by NYSDA in 2015 to benefit underserved communities across New York State.

Its primary mission is to match underserved patients with “dental homes” near to where they live. The program aims to increase access to dental care, home health utilization and oral health literacy, and decrease the use of emergency departments for dental-focused problems.

Before the COVID-19 pandemic, the DDP hosted events for people of all ages that highlighted the importance of disease prevention and the benefits of following good dental hygiene and regular dental care. These events evolved into collaborations with Community Dental Health Coordinators (CDHCs) and moved to a telehealth model.

That new workforce has been instrumental in connecting families to dental services, oral health education, telehealth dental assessments, and appointments for oral care and follow-up.

“Our work with Columbia University will expand the successful outreach initiatives we’ve implemented in other regions of the state, like Western, NY,” said Betsy Bray, director of health affairs for NYSDA. “Teledental visits allow the CDHC to assist families manage and keep dental appointments, review oral hygiene and cavity prevention and triage their dental problems. We plan to continue to use teledental services to engage school-aged children and their caregivers. Additionally, the CDHCs will work to rebuild the participation of the community partners lost during the pandemic.”

The DDP strives to close the gap on unmet dental needs and link families to resources in their local community. The Columbia University College of Dental Medicine is a primary provider of vital oral health care services to underserved patient populations in New York City neighborhoods.

The DDP utilizes CDHCs in key areas for project planning, implementation and follow-up with patients. Ms. Bray said CDHCs are essential in ensuring patients continue to access dental care.

The New York State Dental Journal AUGUST/SEPTEMBER 2021 11 ●

Association Activities Learn How to Respond in Overdose Emergency THE NEW YORK STATE DENTAL ASSOCIATION is hosting two virtual opioid overdose rescue training programs being presented by the New York State Office of Addiction Services and Supports (OASAS). According to the National Institute on Drug Abuse, deaths from drug overdoses in the United States increased by 30% from October 2019 to October 2020.

The courses are being presented on Oct. 6, from 6-8 p.m., and on Nov. 5, from 1-3 p.m. Both courses are being given at no charge. Participants will receive two continuing education credits. Overdose reversal kits containing naloxone will be mailed to all attendees who complete a training course.

Attendees will learn about Opioid Use Disorder, in addition to: • How to recognize and respond to an opioid overdose • How to administer and obtain naloxone • How to talk to your patient about opioids • Safe prescribing practices and resources for prescribers Visit NYSDA’s website at https://www.nysdental.org/ member-center/ce/oasas-opioid-overdose-rescue-training to register for a training course.

UB Implant Study Club: Thursdays, 6-9pm Annual new member fee: $1295, Returning member $995, CE HRS: 24 Oct 21: Bio-horizon Lecture and Hands-on Nov 18: Graft/Suturing hands-on, Seb Andreana, DDS, MS Dec 16: Oral Pathology for the Implant Dentist, Jose Tapia, DDS, MS Feb 17: Controversies in Implant Dentistry, Seb Andreana, DDS, MS May 19: Prama System hands-on training Mar 24 & Apr 21, 2022 programs TBA Live Zoom Lectures: Wednesdays 6-8pm Dentists/doctor $45, RDH/DA $35, CE HRS: 2 Oct 6: The Worn Dentition, Marshall Fagin, DDS Oct 20: The 3 E’s of Periodontics, Frank Scannapieco, DMD, PhD Nov 10: Flap Mgmtt in Regenerative Perio Surg, Nicola Valente, DDS Nov 17: Selecting Adhesive Cements, Robert Yetto, DDS Dec 8: Internal Anatomy of Teeth, Lucila Piasecki, MSc, PhD Friday, Dec 3, 2021, 9am-3pm, UB Center for Tomorrow UB Dental Alumni $195, Nonmember $225, CE HRS: 6 Digital Imaging, Design and Manufacturing Technologies: Technology Looking for Application? Gerald Grant, DMD, MS, Univ of Louisville May 6, 2022 Annual UB Dental Hygiene Symposium Fri, June 3, 2022, 9Westin Buffalo, NY John J. Cunat Educational Fund annual lecture It’s Been a Long Two Years – Updates in Orthodontics for the Clinician, Glenn T. Sameshima, DDS, PhD, Herman Ostrow School of Dentistry, University of Southern California UB Dental Alumni $235, Nonmember Dentist $275, CE HRS: 6

(716) 829-2320 www.BuffaloCE.org 12 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

Fourth District Names New ED THE FOURTH DISTRICT DENTAL SOCIETY has a new executive director. Lisa Hicks assumed her post in in early summer, taking over following the retirement of Lynn Martin.

Ms. Hicks most recently served as executive director of the Fast Break Fund, a small nonprofit active in the Capital District that provides recreational programs for children Lisa Hicks with special needs throughout the year and summer camp scholarship awards to underprivileged children.

She also is the proprietor of Shelf Help, a professional organizing business that assists residential customers needing help during a move or transition.

A graduate of LeMoyne College in Syracuse, Ms. Hicks started out as a special events coordinator. Also notable is her time at Syracuse University, where she assisted in the Men’s Basketball Office for legendary Coach Jim Boeheim.

The mother of three lives in Clifton Park.

NYSDA’s Committee on Chemical Dependency Announces Name Change THE COMMITTEE ON CHEMICAL DEPENDENCY is now the Committee on Substance Abuse and Well-Being. The new name reflects the committee’s broader mission of assisting members suffering from substance abuse and addiction, as well as those with mental health and wellness concerns. Members of the committee, trained in the treatment of addiction, understand that substance use disorders often co-occur with mental health and anxiety disorders and are, therefore, treated as one disease.

The committee consists of members from each of NYSDA’s 13 component dental societies, many of whom have first-hand experience with the devastation of addictive illness and mental health disorders. All members of the committee receive relevant ongoing didactic training and work together with the committee’s peer assistance coordinator, Bob Herzog, to respond to those seeking help. Dr. Herzog is a certified interventionist and has established relationships with experts in addiction medicine and treatment facilities throughout the country.

If you, a colleague or family member is struggling with substance abuse or addiction, help is a confidential phone call away.

Contact Dr. Herzog at (716) 830-3055 or Jacquie Donnelly at NYSDA at (518) 689-2750.

Visit the Committee’s website for additional information: https://www.nysdental.org/mentalhealth

Association Activities NYSDA Mourns the Death of Two Past Presidents

Dr. Joseph Lavinio

DR. JOSEPH S. LAVINIO JR., D.M.D.,

DR.

who served as president of the Dental Society

WESTCOTT, D.D.S.,

ROBERT

C.

of the State of New York (NYSDA) in 1974,

president of the Den-

died April 10 in Fort Lauderdale, FL, where he

tal Society of the State

had been living. He was 80 years old.

of New York (NYS-

Dr. Lavinio was an oral surgeon. He

DA) in 1996, died

and dental partner, Anthony DiMango,

Sept. 2 in Queens-

practiced together in Bay Ridge, Brooklyn,

bury. He was 91. Fol-

for over 30 years. Early in his career, at

lowing his presidency,

his partner’s urging, Dr. Lavinio joined

Dr. Westcott served

the Second District Dental Society, volun-

as executive director

teering for numerous positions within the society, culminating in his installation as president in 1983.

Dr. Robert Westcott

of the Fourth District Dental Society.

In 2005, Dr. Westcott received NYSDA’s highest

Outside of the society, Dr. Lavinio devoted many years to voluntary

honor, the Jarvie-Burkhart Award, for his many con-

service for persons with developmental disabilities and mental illness

tributions to the profession and mankind. Particularly

through Catholic Charities of Brooklyn. At other times in his professional

noteworthy was his role in the founding of a pediatric

life, he was an attending oral surgeon at Lutheran Medical Center, Kings

mobile dental program under the auspices of the Glens

County Hospital, Cabrini Health Care Center in Manhattan and Bay Ridge

Falls Hospital, where he was a member of the board for

Hospital in Brooklyn. Among offices he held were president of the Catholic

20 years and Board Chairman. The dental van, which

Dentist’s Guild and the Italian Dental Society.

traveled to underserved rural communities, became a

Next to dentistry, his passion was the performing arts. He served on the

model for pediatric mobile programs elsewhere.

Board of Trustees of the Brooklyn Opera Association in the 1970s and was a

A graduate of the University of Pennsylvania

member of the Opera Index in New York City, which sponsored new singers.

School of Dental Medicine, Dr. Westcott served four

Dr. Lavinio grew up in Brooklyn, the son of a physician. He was a

years in the Navy Dental Corps before opening his solo

graduate of Villanova University and the University of Pennsylvania School

dental practice in Glens Falls, his hometown. He was

of Dental Medicine. He served an oral surgery internship at Kings County

extremely active in organized dentistry, his community

Hospital in Brooklyn, completed a year of graduate studies in oral surgery

and his church, First Presbyterian.

at New York University College of Dentistry and an oral surgery residency at Kings County.

Dr. Westcott is survived by his wife of 70 years, Lillian “Sisty” Westcott, and their five children: Deborah,

Dr. Lavinio is survived by his brother, John, also an oral surgeon, and partner of 16 years, Richard Samu.

Robert, Paul, Brad and Mark; 10 grandchildren; and seven great grandchildren.

NYSDA Receives National Recognition THE NEW YORK STATE DENTAL ASSOCIATION captured two ADA Membership Awards this summer for its improving membership numbers. The Association was cited for “most improved active membership retention rate” and “greatest net gain of new dentists” among components with 7,500-plus active licensed members.

The New York State Dental Journal AUGUST/SEPTEMBER 2021 13 ●

Association Activities In Memoriam SECOND DISTRICT Howard Kudler Columbia University ‘60 35 Woods Lane Boynton Beach, FL 33436 July 10, 2021

John Mallon Georgetown University ‘54 70 Shoreway Drive Rochester, NY 14612 April 2, 2021

NINTH DISTRICT Jeffrey Gershon University of Pennsylvania ‘81 357 Harrison Avenue Harrison, NY 10528 June 28, 2021

NASSAU COUNTY Charles Frankel Tufts University ‘68 1097 Old Country Road, #203 Plainview, NY 11803 June 3, 2020

Ira List New York University ‘70 37 Rochelle Drive New City, NY 10956 April 18, 2019

Alvin Sarnoff New York University ‘52 160 Islander Court Longwood, FL 32750 February 11, 2018

Lonnie Slapar SIXTH DISTRICT Dennis De Stefano University at Buffalo ‘76 RR 1, #110F Equinunk, PA 18417 July 3, 2021 SEVENTH DISTRICT Donald Munger University of Pennsylvania ‘62 PO Box 91, Deer Run Groveland, NY 14462 June 19, 2021

University of Missouri-Kansas City ‘87 106 Torrey Pine Drive Rochester, NY 14612 May 23, 2021 EIGHTH DISTRICT Richard Loomis University at Buffalo ‘55 690 Bartlett Carry Road Tupper Lake, NY 12986 June 10, 2021

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Communicate easily with ready-to-go campaigns, reminders, texts, emails, and postcards Make your office more efficient with online patient forms Offer online booking and touchless payment processing Build a strong online reputation with Dental Reviews Pro And more solutions to grow your practice

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Head, Neck and Oral Pathology

Do you know where to send a patient with a possible head, neck or oral pathology?

Oral and maxillofacial surgeons (OMSs) are experts at evaluating, diagnosing and treating pathological conditions of the head, neck and mouth. An OMS is trained to provide both surgical and non-surgical management of such conditions.

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1/3/19 10:46 PM

Photo by Dana Kaplan

Since early childhood, Dr. Henner’s second home has been the water, which he frequently covers in his boat, including commuting between his home in Melville and house on Fire Island.

Numbers are Not Enough A strong association depends on fully engaged members assured of the value of their membership.

A conversation with Kevin A. Henner, D.M.D., 141st president of the New York State Dental Association.

The overarching theme of Dr. Kevin Henner’s presidency is membership. But his approach to infusing the lifeblood of the Association differs in some aspects from past and present efforts.

In his first presidential address, delivered in August at the annual meeting of the NYSDA House of Delegates, Dr. Henner described his objectives as follows: “First and foremost, we need to engage the active but silent members who just exist in their offices and play no role in creating the value of organized dentistry…Second, we need to focus on diversity…And when I speak of diversity, I’m talking about differences in ethnicity, gender, generations, specialties, practice settings and so much more. We want the leaders of those diverse groups to become our leaders. We are, after all, all dentists, sharing the common ground of our profession.”

Dr. Henner is uniquely situated to carry out one of his objectives.

He will be the first NYSDA president to preside over the Association’s observance of Black History Month in February. A resolution passed by the 2021 House charges NYSDA with recognizing Black History Month in its publications and by engaging an “African-American Speaker of Excellence” to deliver a CE-credited address.

16 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

Dr. Henner understands that attracting new members is just the first step. The second and, perhaps, more critical move is to establish in the minds—and experience—of all members the value of their association. And at no time has that value been more apparent than during the COVID-19 pandemic, when NYSDA was challenged with—and succeeded in—keeping its members fully informed about the virus and its ramifications and obtaining permission to reopen dental offices long before other businesses were allowed to. Again, from his speech before the House of Delegates: “When I say membership, I’m not talking about it as a council, or the realization of increased dues on a spreadsheet or our market share but, rather, the value of belonging to our Association and organized dentistry, which was incredibly evident during the last 18 months….We have learned a lot over the last year— how to function and manage in a crisis, how to adjust to rapid change, and so much more.”

To that end, Dr. Henner pledges to keep open the lines of communication within the Board, the councils and the membership. “Engaged members,” he said, “are critical to the success of the Association.”

Dr. Henner proudly poses with his children Jacob and Allie and granddog Pippin.

Photo by David Roth/Jovon Photography

aplan

Dr. Henner’s recreational pursuits include tennis.

A 1990 graduate of Tufts University School of Dental Medicine, Dr. Henner has been employed for 31 years in the private practice of dentistry in Deer Park on Long Island. His involvement in organized dentistry—ADA, NYSDA, Suffolk County Dental Society—has been equally long. Previous to being elected president of NYSDA, he held the top elected post at SCDS. While he’s been an active participant in a variety of committees, commissions and councils, Dr. Henner found his niche— and his passion—working in the area of professional ethics and professional liability. He joined the NYSDA Council on Ethics in 1999, as a representative of SCDS. In 2006, he was named council chair, which was followed by appointment to be NYSDA’s representative to the ADA Council on Ethics, Bylaws and Judicial Affairs (CEBJA). He was appointed CEBJA Chair in 2012 and served for one year. He is currently a presenter of the NYSDA/New York State Dental Foundation Ethics and Professionalism mandated course and the NYSDA/MLMIC risk management course. He lectures before SCDS on Ethics and Code of Conduct and is a facilitator at the University at Stony Brook School of Dental Medicine for the American College of Dentists Ethics Scenarios.

Dr. Henner holds membership also in the American College of Dentists, the Pierre Fauchard Academy (2022 Distinguished Service Award winner) and the International College of Dentists. A member of the Board of the Greater Long Island Dental Meeting, he was GLIDM Chair in 2013.

What follows is more information about Dr. Henner, gleaned from a recent conversation.

The NYSDA President with his significant other, Ann Migione. Ms. Migione is a middle school English teacher.

When not on the water or tennis court, Dr. Henner hits the links. He describes himself as a serious, competitive golfer.

Photo by Dana Kaplan

And he’s an avid gardener, filling his yard with annuals, perennials and vegetables.

Photo by Dana Kaplan

The New York State Dental Journal AUGUST/SEPTEMBER 2021 17 ●

Where did you grow up?

I grew up in Dix Hills, which is part of Suffolk County, Long Island. I also had the benefit of spending my summers on an amazing national seashore called Fire Island. Two very close locations, only about half an hour apart, but totally different scenery, mentality and truly a blessing, thanks to the vision of my parents, Dr. Sidney Henner and Dr. Carol Henner. My father, now deceased, was a graduate of NYU College of Dentistry and an ADA Life Member. My mother, valedictorian when at NYU, traveled many different paths, ending in an approximate 30-year career as a clinical psychologist.

I have two amazing older brothers. The eldest, Robert, is a dentist practicing down in West Palm Beach, FL. My middle brother, Michael, is a dermatopathologist in Orlando, FL. What about the rest of your immediate family?

I’m a proud father blessed with two children. Son, Jacob, is 26 years old, a graduate of the University of Pennsylvania and just incredible. He works as an infrastructure engineer for a financial technology firm in New York. He’s truly brilliant.

My daughter, Allie, 22, is also a phenom in my eyes. She is a graduate of Washington University in St. Louis and also brilliant on so many levels. Even during the pandemic, with a hiring freeze nationwide, Allie secured an amazing job in UX (user experience) design and moved to Austin, TX, with my granddog, Pippin. Hard to admit that both of my kids are so much brighter than I ever was or ever will be but, oh my God, they are truly the reason I have the strength I do.

Where did you go to school?

I grew up in the Half Hollow Hills school district in Dix Hills, NY. I attended college at Hobart and William Smith in Geneva, in the absolutely gorgeous Finger Lakes region of New York State. I graduated with a B.S. in chemistry and went on to earn my dental degree from Tufts University School Dental Medicine. I did some other work during those years, including research with kidney transplantation and biochemical pesticides.

I had the benefit of joining my father’s practice upon graduation. My brother was there as well. My father was an amazing dentist, with an incredible ethic and, certainly, clinical talent. He was not involved in organized dentistry to the level I have been, but he was known as an amazing mediator, with very long experience on the Suffolk County Peer Review Committee.

What have we learned from the COVID-19 shutdown?

Much of what I’ve learned from the whole COVID-19 experience is not terribly unique and should, I believe, be obvious. As an organization, we need to have more effective and broader-reaching communication and contact with our members. Membership is so important, yet so many of us don’t understand its true value— and that includes members whose sole involvement is to make their yearly dues payment. We’re back to work in our offices because of organized dentistry and its efforts. The inherent value in that is priceless. Somehow, we need to communicate that to both members and nonmembers.

Dr. Henner’s boat, a center-console sport fisherman, is outfitted for deep sea fishing. Once on the Atlantic, he hunts for tuna and shark, always sharing his catch with others so nothing goes to waste.

Photo by Dana Kaplan

18 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

Sadly, what I also learned is that science and data do not always predict outcome. Politics, unfortunately, come into play. I’m afraid the pandemic is far from over and will be an issue for quite some time, which will continue to focus attention on the value of membership in our Association.

What do you see as the greatest challenges facing dentistry today and how should the profession respond?

We have many challenges, internal and external. Given the network of talent we possess, we will vet, collaborate, mediate and come to a unified decision, all in the best interest of the organization. Professionals need to respond with a clear message about the value of membership. We have a broad list of challenges within the profession, but membership and diversity have to be addressed as priority items. To that end, we need to embrace everyone involved in the profession, all of the diverse groups. I want all of the leaders within the dental profession, from all the diverse groups, to collaborate and, ultimately, become our leaders.

At our House of Delegates meeting in August, we adopted a resolution calling for the Association to commemorate Black History Month. Certainly, a wonderful move in the right direction, but not enough. We need to focus specifically on the diverse makeup of our profession and work toward including all disparate groups in the Association, especially in leadership positions.

It is necessary that we recognize that we are all dentists with the same responsibility to the profession and the patients we serve.

What convinced you that you needed to join organized dentistry?

Having many family members in organized dentistry was a start.

Certainly, my father and my brother and my father-in-law were a significant influence. However, I took my involvement to a new level. One of my introductions into organized dentistry came through the Suffolk County ethics and professional liability council. I joined and was immediately hooked! Thank you, Dr. Lester Beck and Dr. Al Sunshine. Who knew? I guess I always felt that I’d like to be at the table for the discussion of matters that influenced my entire professional life.

To our new dentist members and even our longer-serving members who have not engaged in the Association I say, there is a reason to sit at that table. I’m already there, but I would rather you be there, too, by my side. Power in numbers. It’s that simple!

Please understand that this is the rest of your professional life. I need you. We all need you, to protect the future of the profession and the future of the public we treat. We have an awesome responsibility, but we also have incredible ability to deliver our services and protect and treat our patients. Serving our membership in this manner only solidifies our reputation and our responsibility. p

Dr. Henner with staff, from left, Priscilla Arth, Andrey Salentino, Carlene Fasano, Office Manager Lina Smigiel, Michaela Engel.

Photo by Dana Kaplan

The New York State Dental Journal AUGUST/SEPTEMBER 2021 19 ●

online medical information

The Educational Quality of Aphthous Ulcer Content on YouTube Dorin Yakubov, D.D.S., M.B.S.; George F. Raymond, D.D.S.

ABSTRACT Background: YouTube is among the most popular internet entertainment sites, but it can function as well as an informational platform. There has never been a study of aphthous ulcer content on YouTube.

Methods: We obtained the top 10 videos by view count and relevance for the terms “Canker Sore” and “Aphthous Ulcer” and evaluated utilizing the DISCERN criteria.

Results: The videos received 9,830,678 combined views (396,211 average). The average DISCERN score was 2.17 overall and 2.83 for bias.

Conclusion: While videos may provide useful information, the limited evidence for much of the content on YouTube makes the content unreliable at best.

Aphthous ulcers, commonly known as canker sores, are common, round ulcerations of the oral mucosa that classically present as burning or stinging pain when eating or drinking. While aphthous ulcers may be attributed to a variety of etiologies, including trauma, hypersensitivity, vitamin deficiency, infection and auto-immune manifestations, the exact cause of the condition has never been defined.[1] Though the condition may be treated with topical anesthetics, vitamin supplementation, cautery, barrier protection, irritant avoidance, topical steroids, and in more severe cases, oral steroids,[1] treatment will most often depend upon the etiology of the ulcerations and, thus, patients should undergo formal evaluation for recurrent aphthous ulcers.

Aphthous ulcers are most often benign in nature; however, the pain associated with them can be intense and may lead pa-

20 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

tients to seek out any remedy that could alleviate their pain. In many cases, patients use online resources, including YouTube, to search for the cause of their aphthous ulcers and potential remedies. To date, there has never been a formal evaluation of the quality of content related to aphthous ulcers on YouTube. As such, we have evaluated the videos most likely to be viewed by patients searching YouTube to determine their utility, potential harm and common trends throughout the videos.

Methods The assessment is based on methods previously described by Ward et al.[2-4] A YouTube search was performed on April 24, 2020, for the terms “Canker Sore” and “Aphthous Ulcer” on Incognito Mode. Videos were filtered for relevance and view count to obtain the top 10 video results for each search parameter. Sorting by views and relevance is tabulated by internal YouTube algorithms.

Relevance is the default search parameter for users. Videos were categorized by author type: dentist, dental hygienist, medical physician, educational service, hospital, private practice group, company, advertiser, patient, pharmacist and unknown.

The DISCERN criteria for assessing consumer health information was used by the first author to evaluate each video.[5] The DISCERN criteria was created to be a reliable and reproducible method for evaluating the quality of health-related content and treatment options, which was meant to be distributed to the general public. Its original inception was for evaluation of written materials through a questionnaire with minimal subjectivity, to help patient and health providers with consumer health information.[5] The DISCERN criteria was chosen as many of the attributes that contribute to high-quality print publications should also be present in educational videos.

Each video is graded from 1 to 5, with 1 being the worst quality and 5 being the best quality. Bias is also graded from 1 to

5, with 1 being the most and 5 being the least biased. The average DISCERN score (DS) was compared for each author category using a two-sample t test. Duplicate videos that appeared in both search terms were included for individual search term analysis, but were removed for additional and overall analysis.

Results There were 30 unique and 10 duplicate videos. The videos received 9,830,678 combined views (396,211 average). The average video age was 1,463 days (range 268-3,880 days). The term “Canker Sore” received the more total views (8,250,934 vs 1,579,744). Canker sore had an average DS of 2.45 and bias score of 2.9, while aphthous ulcer had an average DS of 2.4 and bias score of 3.1 (Table 1). The overall DS was 2.17, and the bias score was 2.83. Only three videos included dentists—two by general dentists and one by an oral surgeon. There was no significant difference between DS for videos by dentists (CI: 2.01-3.32) and all other videos (CI: 1.77-2.45) (p=0.304). The most common authors were YouTube educational services (n=8), with an average DS of 2.38 and bias score of 3.5 (Table 2).

The most common video type was “patient education” (n=10), totaling 1,847,541 views, with a DS of 2.4 and bias score of 3.5 (Table 3). Twenty videos mentioned causes of aphthous ulcers, and 20 of the videos listed at least one therapy. The most commonly mentioned cause was trauma (n=16), followed by diet (n=13), stress (n=11) and vitamin/mineral deficiency (n=11) (Table 4).

The most commonly mentioned therapy was topical anesthetics, followed by antibacterial mouthrinses (Table 5). Homeopathic remedies, which were the only suggested therapy in three videos and mentioned in four, included raw onion, orange juice, coriander and rose petal preserve. The DS and the bias score for videos that only suggested homeopathic remedies were both 1.33. The bias scores for these videos (CI: 0.68-1.99) were significantly lower than other videos (CI: 2.54-3.46) (p=0.027). Nine videos explained the difference between canker sores and herpetic lesions.

Discussion While the last decade has seen significant increases in reliance on YouTube and social media for medical information, there has never been an evaluation of the quality of aphthous ulcer content on YouTube. Despite never being designed for utility in medical education, YouTube has rapidly become a major distributer of educational healthcare information in our time. Despite this, YouTube lacks any traditional peer-review process and, as such, this paper serves to evaluate the current content.

The average DISCERN score and bias score for all videos were 2.17 and 2.83 overall, indicating fairly low-quality videos with moderate bias. Compared to similar studies, there were noticeably fewer advertisements in this study, likely because the marketability and profitability of aphthous ulcers are minimal when compared to more profitable fields. Videos that focused entirely

The New York State Dental Journal AUGUST/SEPTEMBER 2021 21 ●

on homeopathic remedies garnered 2,228,394 views, almost a quarter of all views despite being a tenth of all videos; however, they had a significantly worse bias score then other videos and a noticeably worse DS that did not meet significance.

Interestingly, while these videos provided a wide variety of homeopathic remedies for cankers sores, none of them provided evidence or sources for their claims.

Despite performing the study on Incognito mode, to control for search history, the unclear nature of the YouTube algorithm is a limitation to this study. Additionally, when users perform searches off of Incognito mode, their results may differ significantly from this study.

Additionally, the DISCERN criteria was not initially developed for video materials, and unrecognized user error when utilizing the tool may have led to error in the study.

Conclusion YouTube was never meant as a primary source of medical information; however, the rising prominence of social media in spreading news and health information cannot be ignored. The bothersome and poorly understood nature of aphthous ulcers will likely lead a significant number of users to search for information regarding their cause and therapy. As such, we sought to evaluate the YouTube content related to aphthous ulcers and found that while there were few advertisements, a significant portion of views were garnered by videos touting unsupported homeopathic remedies. While many of the videos do provide useful information about the causes, clinical course and treatment of aphthous ulcers, users should be aware that the information presented in videos does not undergo any form of peer review process and, thus, should be discussed with the searcher’s dental provider. p Queries about this article can be sent to Dr. Yakubov at Dy975@nyu.edu.

REFERENCES 1.

2.

3.

4.

5.

Öztekin A, Öztekin C. Vitamin D levels in patients with recurrent aphthous stomatitis. BMC Oral Health 2018;18(1):186. Published 2018 Nov 9. doi:10.1186/s12903-018-0653-9.

Ward M, Ward B, Warren C, et al. The Quality of YouTube videos as an educational resource for attention-deficit/hyperactivity disorder. Pediatr Neurol 2020;103:84-85.

Ward M, Ward B, Abraham M, et al. The educational quality of neurosurgical resources on YouTube. World Neurosurg 2019;130:e660-e665.

Ward B, Ward M, Nicheporuck A, Alaeddin I, Paskhover B. Assessment of YouTube as an informative resource on facial plastic surgery procedures. JAMA Facial Plast Surg 2019;21(1):75-76.

Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 1999;53(2):105-111.

Dorin Yakubov, D.D.S., is a GPR resident at North Shore Hospital, Manhasset. She is a graduate of New York University College of Dentistry, New York, NY.

Dr. Yakubov

22 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

Dr. Raymond

George F. Raymond, D.D.S., is clinical assistant professor, Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, NY.

periodontology

Minimally Invasive Coronally Advanced Tunnel A Novel Surgical Technique for Treatment of Multiple Recession Defects: A Case Series Joann Pauline George, M.D.S.; Divya Khanna, B.D.S., M.D.S.

ABSTRACT Perio-plastic surgeries are a continuously evolving and expanding field of research. A multitude of options are available for root coverage. Connective tissue grafts are the gold standard but have limitations, including patient morbidity, invasiveness and scar formation.

The aim of this study is to evaluate the effectiveness of a novel minimally invasive coronally advanced tunnel (MI-CAT) technique for treatment of multiple recession-type defects (MRTD). The technique involves a muco-periosteal tunnel and stabilization of the advanced gingival margin by using orthodontic buttons as anchor units for two weeks postsurgery.

After six months, enhanced root coverage (92.28%), excellent esthetics and significant improvement in periodontal parameters were achieved. The results indicate that the MI-CAT technique proved to be effective, minimally invasive and a predictable option for treatment of MRTD.

Gingival recession is a frequent finding, with an average 1 mm of recession in approximately 80% of the adult population.[1] The term denotes the oral exposure of root surfaces due to displacement of the gingival margin apical to the cementoenamel junction.[2] The condition results in unfavorable esthetics, a roller-coaster of soft- and hard-tissue anatomy, gingival clefts and fissures, loss of keratinized attached gingiva, increased root caries susceptibility and dentin hypersensitivity.[3,4] Trauma from toothbrushing, malposition of teeth, periodontal disease, and ectopic insertion of freni and muscle attachment are the main etiological factors for Miller Class I and Class II recession defects.[5] Increasing age, periodontal disease and smoking are environmental factors that negatively influence gingival health, and recession is frequently seen in these individuals.[1] The affliction of multiple adjacent teeth with recession have been termed Multiple Adjacent Recession Type Defects (MARTD)[6] or Multiple Recession Type Defects (MRTD) interchangeably in scientific literature.[5] Currently there are a multitude of perio-plastic surgical techniques for soft-tissue coverage of the exposed root surfaces in MRTDs. These include the coronally advanced flap (CAF), the modified CAF,[7] modified CAF with an subepithelial connective tissue graft (CAF+SCTG),[8,9] CAF with connective tissue graft (CAF+CTG),[9,10] CAF with orthodontic buttons,[6] expanded

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mesh technique,[11] vestibular incision subperiosteal tunnel access technique (VISTA),[12] CAF with and without vertically releasing incisions[13] and the pinhole surgical technique.[14] This is a continuously evolving and expanding field of research, and these surgical techniques have achieved complete root coverage (CRC) in 35% to 90% of recession defects.[5,9] Among the various factors that influence the treatment outcome, the final position of the gingival margin (GM)[15] plays a critical role in achieving CRC.[16] Surgical anatomy and technique-related factors, such as flap thickness,[16] flap tension before suturing,[17] GM location at the end of surgery and the passivity with which it is displaced coronal to CEJ seem to dictate to a large extent the probability of achieving CRC.[18] The greater postoperative advancement of the GM under minimal tension favors a desirable outcome.[15,16] Chao, in 2012,[14] reported a pinhole surgical technique (PST) that employed a vestibular incision to elevate a sub-periosteal tunnel that was freely movable, coronally displaced and stabilized with either a malleable bio-resorbable membrane or a collagen matrix. The surgical follow-up at 18 months showed a positive outcome. However, the lack of suturing and connective tissue barrier at the recession site may negatively influence the long-term stability of the results achieved, as noted

by Marggraf et.al.[23] Prevention of tissue collapse after the surgical procedure can better stabilize the flap during the critical two weeks of initial wound healing. This can be achieved by composite stops at the contact point[19] and orthodontic buttons.[6] Therefore, we propose a mimimally invasive coronally advanced tunnel technique (MICAT) that is a modification of the PST, wherein the freely movable tunnel is coronally advanced and sutured. This suturing technique was combined with orthodontic buttons to prevent the collapse of the suspended sutures. In the case series presented here for the first time, we have discussed the clinical outcome of this modification for enhanced root coverage and aesthetic results.

Materials and Methods A total of 35 recession defects were selected in seven patients in the age group 25 to 55 years, with a mean age (46.12 ± 9.40 years).

Subject inclusion criteria were as follows: 1) Multiple (at least two or three) Millers Class I and II or combined Class I and II recession defects[14] affecting adjacent teeth of the maxillary arch; 2) Patients with thick gingival biotypes >0.8mm;16 3) Presence of adequate keratinized tissue apical to recession > 1mm;[5] 4) Systemically healthy (American Society of Anesthesiologists Physical Status I or II)[14,20]; 5) No contra-indications for periodontal surgery;[14] 6) Nonsmokers;[5,21] 7) Patients with esthetic concerns;[22] 8) Patients with history of compliance to oral hygiene instructions and a full-mouth plaque score of <10% (O Leary 1972).

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Patients with the following criteria were excluded from the study: 1) Recession defects associated with caries/demineralization and deep abrasions (step >2mm);[6] 2) occlusal interferences;[6] 3) Teeth with evidence of pulpal pathology;[6] 4) Patients who have undergone previous periodontal surgical procedures at the involved sites;[14] 5) Pregnant and lactating women; 6) Patients on medications known to interfere with periodontal tissue health or healing.[13] Detailed, thorough medical and dental histories were obtained, and each patient was subjected to comprehensive clinical and radiological examination. All patients were informed about the nature of the study, surgical procedure involved, potential benefits and risks associated with the surgical procedure; and a written informed consent was obtained from all patients.

The study was strictly conducted in accordance with the principles of World Medical Association, Declaration of Helsinki (version 2008), and the study protocol was reviewed and approved by the Institutional Ethical Committee and Review Board (REF:KCDS/168a/2013-2014) of Krishnadevaraya College of Dental Sciences and Hospital, Banglore, India, affiliated with Rajiv Gandhi University of Health Sciences (RGUHS).

The primary objective of this study was to evaluate the effectiveness and predictability of the MI-CAT surgical technique in the treatment of multiple adjacent recession defects. The secondary objective of the study was to assess the influence of these surgical procedures on the gingival and periodontal health.

The primary clinical outcomes assessed were: the difference in gingival recession depth (GRD); complete root coverage (CRC); root coverage esthetic score (RES); location of the gingival margin achieved immediately postsurgery; and gingival recession width (GRW). The secondary outcomes that were assessed were: difference in probing pocket depth (PD); clinical attachment level (CAL); and width of keratinized tissue (KTW).

Case Series All patients received scaling and thorough root planing and oral hygiene instructions. A coronally directed roll technique for brushing was prescribed. Surgical treatment of the recession defects was scheduled after the patient demonstrated an adequate standard of supragingival plaque control (plaque score <10% O Leary 1972). Clinical parameters were recorded to the nearest millimeter using a UNC-15-probe (University of North Carolina -15 periodontal probe – Hu Friedy, Chicago, IL) at baseline, six weeks, three months and six months.

Prior to starting the surgery, orthodontic buttons (Prime Orthodontics, Inc., Portland, OR) were bonded to the middle of the middle one-third of the crown of the tooth with dental cement.* (Figure 1A) to prevent the future collapse of the suspensory sutures. A modification of the original PST,[14] however, with a different elevator was carried out. Under local anaesthesia, 2%

A malleable bioresorbable collagen membrane§ was then tucked with curved tissue forceps under the CAT (Figure 1C). Sling sutures with 5-0 (non-absorbable surgical sutures)** were used to suspend the central area of the flaps on the buttons. The second sutures, with 6-0 (non-absorbable surgical sutures), were performed to accomplish a precise adaptation of the buccal flap on the convexity of the underlying crown surface and permitted the stabilization of every Figure 1. (A) Application of orthodontic buttons. (B) Intraoperative Figure 2. Digimizer evaluation of: (A) Location of gingival margin surgical papilla (Figures 1E, F).[6] view of minimally invasive incision and elevation of muco-periosteal before MI-CAT surgery; (B) Coronal advancement of gingival margin At the end of surgery, the flap martunnel with TKN2 instrument. (C) Tucking of bioresorbable achieved by 1.715 ± 0.830 mm (p< 0.001) beyond CEJ immediately gins were at least 2 mm coronal to membrane into minimially invasive tunnel. (D) Passive coronal after MI-CAT surgery.

CEJ of all teeth (Figure 2). Gentle advancement of tunnel achieved. (E) Modified sling suturing technique using orthodontic buttons as anchor units for coronally digital pressure was applied for approximately five minutes.[14] Periadvanced tunnel. (F) Suturing completed with interdental sutures odontal dressing† † was applied to avoid any mechanical trauma.[6] along with modified sling sutures.

Postoperative instructions recommended a 0.12% chlorhexidine gluconate mouthrinse and avoidance of brushing at surgical site for lignocaine hydrochloride,† using a No. 15 scalpel (Bard Parker), six weeks. Tab ibuprofen 400 mg thrice daily for three days and cap a minimum horizontal incision of 2 mm to 3 mm was made in amoxicillin 500 mg thrice daily for seven days were prescribed. the alveolar mucosa near the base of vestibule, apical to recipiThe sutures, orthodontic buttons and periodontal dressing ent sites. Papilla elevator‡ was inserted through the entry incision were removed 14 days after surgery. Clinical parameters were and sulcular incision, and a full thickness mucoperiosteal flap recorded at six weeks, three months and six months after surgiwas elevated and extended coronally and horizontally to allow for cal reconstruction. elevation of two adjacent papillae on each side of denuded roots (Figure 1B). The mucoperiosteal flap elevation was extended beyond the MGJ in the surgical area and under each papilla. Muscle and collagen fibers under the mucoperiosteal flap were dissected in order to facilitate a passive coronal positioning of the flap and papilla (Figure 1D). The interproximal extension of flap resulted in a freely movable flap, which was then positioned coronally to extend beyond cementoenamel junction (CEJ).

* † ‡ § ** † †

Dual Cure Glass Ionomer Cement 3M ESPE, USA. Lignox 2%, Indoco Remedies Ltd, Goa, India.

TKN2, Hu Friedy, Chicago, IL, USA. HealiguideTM, EnColl Corp. USA. Mersilk, Ethicon, Johnson & Johnson, Himachal Pradesh, India.

Coe Pack—Non-Eugenol Periodontal Dressing, GC America Inc. ALSIP, IL, USA.

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ferent visits (baseline to six months) was performed using Tukey post-hoc analysis and Wilcoxon signed-rank test. Student “t” test was done to evaluate advancement of gingival margin achieved postoperatively.

Difference associated with p value < 0.05 was considered statistically significant. Results were presented as mean ± SD. Results A total of seven patients with 35 multiple adFigure 3. Two different cases showing: (A) Preoperative view Figure 4. Third case. (A) Preoperative view of jacent recession-type defects (MARTD) were of recession defect; (B) Recession coverage achieved by MI-CAT recession defect. (B) Recession coverage achieved included in the study. All patients included surgery with stable results after six-month follow-up.

by MI-CAT surgery with stable results after six-month in the clinical trial completed the study. No follow-up. patient reported any postoperative complications or adverse effects, such as severe edema, pain or sensitivity.

Statistical Analysis Healing was noted to be uneventful in all cases. The results are A software package SPSS‡ ‡ was used for statistical analysis. All summarized in Tables 1-3. parameters were assessed at baseline, six weeks, three months A statistically significant (p< 0.001) reduction in the gingival and six months by ANOVA. Pairwise comparison between difrecession depth was noted from baseline to three months, after which the results were stable up to six months follow-up (Table 1). ‡ ‡ IBM SPSS Statistics 21.0; SPSS, Chicago, IL, USA. Similarly, the gingival recession width also showed a statistically significant reduction at six months (Table 1).

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The mean root coverage (MRC) achieved at six weeks follow-up was 87.42%; at three months it was 92.28%; and it remained the same, 92.28%, at six months follow-up. Out of the 35 teeth treated with MICAT, 29 teeth, 82.9%, showed complete root coverage (CRC) at six months follow-up postsurgery (Figures 3, 4; Table 3).

Even though there was a minimal gain in the keratinized tissue noted from baseline to six months, it was not statistically significant (p= 0.930). The root coverage esthetic score was 9.83/10, which was highly satisfactory (Figures 3, 4; Table 3).

There was a statistically significant (p< 0.001) difference achieved in probing depth from baseline: 1.66 mm to 1 mm at six months. The clinical attachment gain of 2.60 ± 0.617 was noted from baseline to six months, which was statistically significant p< 0.001 (Table 1).

There was a statistically significant (p< 0.001) improvement noted in all periodontal health indices (Table 1).

Discussion Coronally advanced flap techniques alone and with various modifications have been used widely and successfully for the treatment of MRTD. But these techniques have certain limitations, such as technique sensitivity, invasivity, long procedural time and high morbidity due to a second surgical site. These limitations have led to the need for a newer minimally invasive, practical, short-duration, single-site surgery and patient-centeed approach to the management of MRTD. Flap anchorage with sutures has always resulted in better outcomes[23-26] than techniques without sutures.[27] Ozcelik et al., in 2011, reported treating 155 recession defects, in which test sites were treated with CAF and button application for stabilization of sutures and coronal stabilization of advanced flap[6] and achieved RC of 96.2% and 66% CRC. Aroca et al., in 2010, reported a new technique that included composite stops placed at the contact points of teeth to prevent collapse of suspended sutures into interproximal spaces, with MRC of 82%

and CRC 38%.[28] The placement of orthodontic buttons in the current study helped stabilize the sutures.

In the current trial, GM advancement of 1.71±0.83mm was observed, which is statistically significant (Table 4) with a MRC of 92.28% and CRC of 82.9%. This was similar to the GM postoperative advancement achieved by Ozcelik et al., in 2011 of 1.7±1.3mm, who reported MRC of 96.2%. The rate of CRC outcomes of the present trial was in concordance with the results previously reported in root coverage of MRTDs by CAF+ buttons, VISTA, Zabaleugi et al. 1999, Ribero et al. 2008 and PST. [6,12,14,29,30] There was a 0.25 mm gain in the KTW, which is similar to that reported by Aroca et al. in 2010.[28] The gain in KTW was insignificant and may be attributed to altered blood supply (Baldi et al. 1999, Pini Prato et al. 2000).[16,17] Also, gain in KTW is a slow phenomenon due to the tendency of the MGJ to regain its genetically determined position.[13,31] A longer follow-up of more than 12 months might have shown more conclusive outcomes. A significant decrease in PPD (2.45mm) was noted as well. The increase in the connective tissue biotype and KTW, which can provide long-term stability, needs to be assessed over a longer time period, and six-month follow-up is insufficient.

The Root Coverage Esthetic Score (RES) was proposed by Cairo et al. in 2009 to evaluate the esthetic outcome following root coverage surgeries, and has been used widely.[32] In the present clinical trial, RES was very high, which denotes a good esthetic outcome achieved at the six-month follow-up (9.83/10).

This surgical technique is minimally invasive, effective and encourages patient compliance. The lack of a second surgical site and vertical releasing incisions leads to a highly predictable esthetic outcome and patient cooperation. Although CAF+ CTG is the gold standard for recession coverage, it may not always be a feasible option, due to the inability to harvest large amounts of CTG for MRTDs in such situations. The proposed surgical technique can cover 8 to 10 recession defects by a minimally invasive approach,

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where two or three horizontal slit incisions (2-3 mm each incision) for access in the alveolar mucosa is made, and use of collagen membrane will eliminate need for a second surgical site.

Chao had reported the use of specially designed papilla elevators in the PST technique, but in our clinical observation, the TKN2 papilla elevator was effective in raising the coronally advanced tunnel. The use of suspended sutures around the orthodontic buttons provided good coronal stabilization of the flap during the first two weeks of the crucial wound healing period.

The lack of vertical releasing incisions and papilla dissection will lead to a better healing and culminate in better esthetic outcome. The apical vestibular incision was quite effective in aiding flap elevation with the help of tunnelling instruments in areas where recession was deep (>5 mm). This additional incision prevents damage to the GM during sulcular access for tunnelling.

The incision was miminal (2 mm) and heals by primary intention uneventfully.

Limitations The current study reports only seven cases with mean 2.3 mm recession, which is less than ideal for interpretation of quantitative data. The short-term follow-up of six months is another limitation of this study.

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Conclusion Within the limitations of the present study, MI-CAT proved to be an effective, minimally invasive and predictable surgical option for treatment of MRTD in the esthetically compromised maxillary anterior region.

Such advanced, newer, minimally invasive perio-plastic surgical techniques are here to stay. However, more controlled clinical trials reporting the effectiveness and stability of this procedure and its comparison with a control group, that is, the original PST, and with other known techniques of recession coverage in MRTD is needed. Recession defects of >3 mm depth with longer follow-up (>12 months to 5 years) should be considered for future trials. p The authors report no potential conflict of interest relevant to this article nor source of support. Queries about this article can be sent to Dr. Khanna at drdivyakhanna31@gmail.com.

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Graziani F, Gennai S, Roldan S, Discepoli N, Buti J, Madianos P, et al. Efficacy of periodontal plastic procedures in the treatment of multiple gingival recessions. J Clin Periodontol 2014;41 Suppl 15:S63-76.

Periodontology A. Glossary of Periodontal Terms. American Academy of Periodontology 2001. 4th ed.

Carvalho PF, da Silva RC, Cury PR, Joly JC. Modified coronally advanced flap associated with a subepithelial connective tissue graft for the treatment of adjacent multiple gingival recessions. J Periodontol 2006;77(11):1901-6.

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Kerner S, Borghetti A, Katsahian S, Etienne D, Malet J, Mora F, et al. A retrospective study of root coverage procedures using an image analysis system. J Clin Periodontol 2008;35(4):346-55.

Chambrone L, Lima LA, Pustiglioni FE, Chambrone LA. Systematic review of periodontal plastic surgery in the treatment of multiple recession-type defects. J Can Dent Assoc 2009;75(3):203a-f.

Ozcelik O, Haytac MC, Seydaoglu G. Treatment of multiple gingival recessions using a coronally advanced flap procedure combined with button application. J Clin Periodontol 2011;38(6):572-80.

Zucchelli G, De Sanctis M. Treatment of multiple recession-type defects in patients with esthetic demands. J Periodontol 2000;71(9):1506-14.

Allen AL. Use of the supraperiosteal envelope in soft tissue grafting for root coverage. II. Clinical results. Int J Periodontics Restorative Dent 1994;14(4):302-15.

Pini-Prato GP, Cairo F, Nieri M, Franceschi D, Rotundo R, Cortellini P. Coronally advanced flap versus connective tissue graft in the treatment of multiple gingival recessions: a splitmouth study with a 5-year follow-up. J Clin Periodontol 2010;37(7):644-50.

Cortellini P, Pini-Prato G, Nieri M, Tonetti MS. Minimally invasive surgical technique and enamel matrix derivative in intrabony defects: 2. Factors associated with healing outcomes.

Int J Periodontics Restorative Dent 2009;29(3):257-65.

Cetiner D, Bodur A, Uraz A. Expanded mesh connective tissue graft for the treatment of multiple gingival recessions. J Periodontol 2004;75(8):1167-72.

Zadeh HH. Minimally invasive treatment of maxillary anterior gingival recession defects by vestibular incision subperiosteal tunnel access and platelet-derived growth factor BB. Int J Periodontics Restorative Dent 2011;31(6):653-60.

Zucchelli G, Mele M, Mazzotti C, Marzadori M, Montebugnoli L, De Sanctis M. Coronally advanced flap with and without vertical releasing incisions for the treatment of multiple gingival recessions: a comparative controlled randomized clinical trial. J Periodontol 2009;80(7):1083-94.

Chao JC. A novel approach to root coverage: the pinhole surgical technique. Int J Periodontics Restorative Dent 2012;32(5):521-31.

Albandar JM, Kingman A. Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994. J Periodontol 1999;70(1):30-43.

Baldi C, Pini-Prato G, Pagliaro U, Nieri M, Saletta D, Muzzi L, et al. Coronally advanced flap procedure for root coverage. Is flap thickness a relevant predictor to achieve root coverage?

A 19-case series. J Periodontol 1999;70(9):1077-84.

Pini Prato G, Pagliaro U, Baldi C, Nieri M, Saletta D, Cairo F, et al. Coronally advanced flap procedure for root coverage. Flap with tension versus flap without tension: a randomized controlled clinical study. J Periodontol 2000;71(2):188-201.

Cortellini P, Pini Prato G. Coronally advanced flap and combination therapy for root coverage. Clinical strategies based on scientific evidence and clinical experience. Periodontol 2000 2012;59(1):158-84.

Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D. Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study. J Periodontol 2009;80(2):244-52.

Maloney WJ, Weinberg MA. Implementation of the American Society of Anesthesiologists Physical Status classification system in periodontal practice. J Periodontol 2008;79(7):1124-6.

Trombelli L, Schincaglia GP, Scapoli C, Calura G. Healing response of human buccal gingival recessions treated with expanded polytetrafluoroethylene membranes. A retrospective report. J Periodontol 1995;66(1):14-22.

Zucchelli G, De Sanctis M. Long-term outcome following treatment of multiple Miller Class I and II recession defects in esthetic areas of the mouth. J Periodontol 2005;76(12):2286-92.

Marggraf E. A direct technique with a double lateral bridging flap for coverage of denuded root surface and gingiva extension. Clinical evaluation after 2 years. J Clin Periodontol 1985;12(1):69-76.

Romanos GE, Bernimoulin JP, Marggraf E. The double lateral bridging flap for coverage of denuded root surface: longitudinal study and clinical evaluation after 5 to 8 years. J Periodontol 1993;64(8):683-8.

Bittencourt S, Del Peloso Ribeiro E, Sallum EA, Sallum AW, Nociti FH, Jr., Casati MZ. Comparative 6-month clinical study of a semilunar coronally positioned flap and subepithelial connective tissue graft for the treatment of gingival recession. J Periodontol 2006;77(2):174-81.

Bittencourt S, Ribeiro Edel P, Sallum EA, Sallum AW, Nociti FH, Jr., Casati MZ. Root surface biomodification with EDTA for the treatment of gingival recession with a semilunar coronally repositioned flap. J Periodontol 2007;78(9):1695-701.

Tarnow DP. Semilunar coronally repositioned flap. J Clin Periodontol 1986;13(3):182-5.

Aroca S, Keglevich T, Nikolidakis D, Gera I, Nagy K, Azzi R, et al. Treatment of Class III multiple gingival recessions: a randomized-clinical trial. J Clin Periodontol 2010;37(1):88-97.

Zabalegui I, Sicilia A, Cambra J, Gil J, Sanz M. Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report. Int J Periodontics Restorative Dent 1999;19(2):199-206.

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Ribeiro FS, Zandim DL, Pontes AE, Mantovani RV, Sampaio JE, Marcantonio E. Tunnel technique with a surgical maneuver to increase the graft extension: case report with a 3-year follow-up. J Periodontol 2008;79(4):753-8.

Ainamo J, Asikainen S, Paloheimo L. Gingival bleeding after chlorhexidine mouthrinses. J Clin Periodontol 1982;9(4):337-45.

Cairo F, Rotundo R, Miller PD, Pini Prato GP. Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. J Periodontol 2009;80(4):705-10.

Dr. George

Dr. Khanna

Joann Pauline George, M.D.S., is professor, Department of Periodontology, Krishnadevaraya College of Dental Sciences & Hospital, Bangalore, Karnataka, India.

Divya Khanna, B.D.S., M.D.S., is a member of the Department of Periodontology, Krishnadevaraya College of Dental Sciences & Hospital, Bangalore, Karnataka, India.

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The New York State Dental Journal AUGUST/SEPTEMBER 2021 29 ●

oral pathology

Gingival Cyst of the Adult Case Report and Literature Review Samuel M. Fleisher, B.A.; Scott M. Peters, D.D.S.

ABSTRACT A gingival cyst of the adult (GCA) is a type of odontogenic cyst that is located on the free or attached gingiva, typically in the mandibular canine and premolar region. GCA usually affects people in their fifth and sixth decades of life, with a slight predilection for females. GCA is treated with simple excision, with a low chance of recurrence after surgery.

The gingival cyst of the adult (GCA) is an uncommon odontogenic cyst, representing less than 0.5% of all odontogenic cysts.[1] It is seen most frequently in adults in the fifth and sixth decades of life, with a slightly increased predilection for females.[2] The GCA often occurs on the gingiva of the mandibular canine and premolar region, where it presents as a firm-to-fluctuant, bluecolored nodule.[2,3,4] It is distinguished from the lateral periodontal cyst by a lack of findings radiographically.[3] GCA is most often treated by simple excision, with a low recurrence rate.[2,3,5] Herein, we present a case of a gingival cyst of the adult occurring in a 59-year-old female.

Case Report A 59-year-old female presented to the emergency clinic of Columbia University College of Dental Medicine with a chief complaint of a bump on her gums. The patient reported that the lesion had been present for approximately two weeks, and she complained of moderate pain at the site when brushing her teeth. The patient’s past medical and surgical history were unremarkable.

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Upon presentation, the patient was not in acute distress. The extraoral examination was within normal limits. Intraorally, a partially translucent, blue-tinged, firm nodule was identified on the facial aspect of the left mandibular attached gingiva in the canine region (Figure 1). A periapical radiograph of the site was taken and was unremarkable (Figure 2). The lesion was excised and submitted for histologic analysis. Microscopic examination revealed a cyst lined by a thin layer of epithelium (one to three cells in thickness) with focal areas of thickening (Figures 3a, 3b).

Based on these findings, a diagnosis of gingival cyst of the adult was rendered.

Discussion Small gingival cysts have been noted histologically as incidental findings on gingival biopsies; however, the term GCA was not coined until Bhaskar and Laskin described a series of cases in 1995.[6] GCAs are of odontogenic origin and comprise fewer than 0.5% of all odontogenic cysts. They typically occur in the fifth or sixth decade of life, with a slight predilection for females. Since many of the cysts are small and asymptomatic, they may, ultimately, go undetected or undiagnosed.[2,7] The epidemiology for GCA is not well-known. Although they are of developmental origin, a triggering event for cyst formation is still under investigation. Some evidence has led researchers to suspect an origin of GCA from junctional epithelium due to the frequent occurrence of lining epithelium of the cysts closely resembling reduced enamel epithelium. Therefore, GCA may be derived from remains of junctional epithelium after tooth eruption.[7]

Clinically, these lesions typically are found on the soft tissues of the free or attached gingiva or interdental papillae,[3] of the mandible in the canine and premolar regions.[1] GCAs can be mucosal-colored or bluish-tinged.[2] They are often small (often less than 6 mm in diameter),[4] asymptomatic[7] and slowgrowing.[5,6,8] The clinical differential for the GCA may include the lateral periodontal cyst (LPC), fibroma and parulis, among others.[1,4] Because of its blue-tinged appearance, the GCA is often mistaken for a mucocele; however, a mucocele should not originate from the gingiva, as this area lacks salivary gland lobules.

The gingival cyst of the adult and the lateral periodontal cyst are most commonly mistaken for each other due to their similarities in location of occurrence, age of onset and histological features.[4] The main distinguishing factor between the two is that GCA is extraosseous (not involving bone) and the LPC is intraosseous (involving bone). Therefore, GCA will not typically appear on a radiograph. But the LPC presents as a well-defined radiolucent lesion.[3] Histologically, the GCA appears as a cyst lined by a thin layer of squamous epithelium that forms focal plaque-like thickenings. These notches often contain glycogen-rich clear cells.[1,3] This microscopic appearance is the same as the LPC; again, the distinction between these two entities is made clinically and not histologically. GCAs are usually treated by simple excision with local anesthesia. Once removed, they have a low rate of recurrence.[3,5,8]p

Figure 1. Intraoral examination revealed partially translucent, blue-tinged, firm nodule on facial aspect of left mandibular attached gingiva in canine region.

Figure 2. Periapical radiograph taken of region showed no evidence of intraosseous pathology.

The authors report no conflicts of interest. Their study received no commercial funding. Queries about this article can be sent to Dr. Peters at smp2140@ cumc.columbia.edu.

Samuel M. Fleisher, B.A., is a D.D.S. candidate, Columbia University College of Dental Medicine, Class of 2022, New York, NY.

Dr. Peters

Scott M. Peters, D.D.S., is assistant professor, Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, New York, NY.

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Viveiros SK. A rare odontogenic cyst: gingival cyst of the adult. A Series of 20 New Cases from a Single Center. J Cranio-Maxillofacial Surg 2019;47: 647–650.

Giunta JL. Gingival cysts in the adult. J Perio 2002;73:827-831.

Chrcanovic BR. Gingival cyst of the adult, lateral periodontal cyst, and botryoid odontogenic cyst: an updated systematic review. Oral Diseases 2017;25.

Brod JM, et al. Gingival cyst of the adult: report of an inconspicuous lesion associated with multiple agenesis. Case Reports in Dentistry 2017;2017.

Brooks JK, Kleinman JW, Basile, JR. Emergent gingival cyst of the adult. Gen Dent.

2017;65:42–44.

Buchner A, Hansen LS. The histomorphologic spectrum of the gingival cyst in the adult. Oral Surg, Oral Med, Oral Pathol 1979;48:532-539.

Nxumalo TN, Shear M. Gingival cyst in adults. Journal Oral Pathol & Med 1991;21.

Kalmar JR, et al. Gingival cyst of the adult: regenerative therapy of associated root exposure. a case report and literature review. J Perio 2009; 80:2073–2081.

A Figure 3. (A) Low-power photomicrograph showing cyst beneath surface epithelium lined by thin layer of epithelium (H&E, x40). (B) On higher power magnification, focal thickenings can be observed within lining (H&E, x200).

B

The New York State Dental Journal AUGUST/SEPTEMBER 2021 31 ●

oral surgery

Nasopalatine Duct Cyst Jamie Larmie, B.S.; Louis Mandel, D.D.S.

ABSTRACT The nasopalatine duct cyst (NPC) develops in the incisive canal from embryologic remnants of the nasopalatine duct. Clinically, the NPC’s presence is usually confined within the limits of the incisive canal but, occasionally, it may extend posteriorly to involve significant portions of the anterior hard palate.

The nasopalatine duct cyst (NPC), first described by Meyer in 1914,[1,2] has been defined by the World Health Organization (WHO) as a developmental, epithelial, non-odontogenic cyst.[3] During the fetal period, an epithelial duct, the nasopalatine duct (NPD), exists as a communicator between the nasal and oral cavities. The duct probably served an olfactory function in primitive life.[4,5] Although present in the fetus, it is mostly obliterated by birth. Remnants of the duct may persist[5-8] and proliferate to form the NPC. The stimulus for the proliferation is believed to be trauma or infection, or it may even develop spontaneously. [2,7,9,10] Surprisingly, patency of the NPD may occasionally exist in adults, and its orifice is usually seen as small bilateral openings on either side of the papilla palatina.[5] The distinctive heart-shaped radiographic configuration of the NPC is best understood through an appreciation of the anatomy of the incisive canal. At the anterior aspect of the floor of the nasal cavity, on either side of the nasal septum, and in close relation to the septum, the foramina of Stensen are located. Stensen foramina open into the right and left incisive canals. These two canals course downward toward the oral cavity and join together to form the common incisive canal (Figures 1,2).

32 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

The common canal then exits on the anterior hard palate just lingual to the maxillary central incisors at the incisive foramen beneath the papilla palatina. Consequently, a funnel-shaped Y anatomy is created. The nasal-to-oral length of the canal is reported to be 10 mm.[4,11] Although there are variations, the right and left incisive canals usually join together in the middle third of the incisive canal’s length as it slants downward and forward from the nasal cavity into the oral cavity.[11] Anatomically, the nasopalatine canal transports the terminal branches of the nasopalatine nerve and sphenopalatine artery. These structures serve to supply sensory innervation and vascularity to the tissues of the anterior hard palate.

Although the NPC can occur in the young, it is seen most frequently in the 30- to 60-year age category,[1,8,10,12] with males slightly more susceptible than females.[2,8,10] Usually, the NPC is radiographically visualized as a heart-shaped radiolucency occupying the incisive foramen area (Figure 3). Its unique pattern results from the cyst’s growth conforming to the configuration of the Y anatomy of the incisive canal, plus the resistance offered superiorly by the anterior nasal spine.

Inferiorly, the NPC has a tapered contour, because lateral expansion is frustrated by the roots of the central incisors. The normal radiographic width of the incisive foramen has been reported to be 6 mm.[4,8,11,13] Lucencies > 6 mm should be viewed with suspicion. Pathologic involvement by an NPC is assumed if the width exceeds 10 mm.[11] If radiologic differentiation of a normal

From the Division of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, New York, NY.

Figure 1. The Y-shaped anatomy of incisive canal is outlined by wires placed in incisive canal of skeleton’s skull.

Figure 2. Surgical view following removal of another example of nasopalatine duct cyst that involved common incisive canal. Wires have been placed to identify right and left incisive canals.

foramen from an NPC becomes a problem, periodic observation will reveal an enlarging lucency when an NPC is present. Obviously, the lucency of an incisive foramen is static.

The NPC is asymptomatic unless secondarily infected. The cyst usually is diagnosed incidentally during a routine dental radiographic examination. Pain with a suppurative discharge may develop if the cyst becomes infected. Occasionally, the patient may notice a salty taste as cystic contents are discharged through any existing patent NPD orifice.[8] A tentative clinical diagnosis of an asymptomatic NPC can be made from its radiographic location, size, shape and its nondental involvement. However, substantiation must be obtained from a microscopic examination of the cystic wall. The type of epithelium that lines the cyst wall is determined mainly by the portion of the NPD from which the cyst originates. Proliferation of NPD remnants in the canal closer to the nasal cavity will produce a cyst lined by respiratory epithelium, while cysts arising from remnants closer to the oral cavity will be lined by stratified squamous epithelium. Cysts developing from NPD debris in the mid portion of the incisive canal will have a cuboidal or columnar epithelial lining.[7,8,12] However, mixed epithelial linings are always a possibility. Swanson’s review of 334 NPCs indicated that respiratory epithelium was present in only 28% of the cases.[9] Histologically, the cyst’s fibrous wall contains nerve tissue, blood vessels and mucous glands.[7] A significant inflammatory presence in the cyst’s wall also has been observed in many of the studied cases.[2,7] Although the vast majority of NPCs demonstrate the described standard signs and symptomatology, unusual manifesta-

Figure 3. Periapical radiograph illustrates heart-shaped lucency of another example of a nasopalatine duct cyst. (Courtesy Dr. Elizabeth Philipone)

tions may develop and present diagnostic problems. Occasionally, an NPC can enlarge to extend beyond the incisive foramen region and progress posteriorly to involve significant portions of the hard palate. Previously, these lesions were thought to represent midline fissural cysts that developed from ectoderm trapped during the embryonic fusion of the palatal processes.[14] However, the WHO now considers these cysts to be posterior extensions of an NPC.[15] The authors have treated such a large palatally located cyst and because of its relative rarity, wish to call the profession’s attention to its existence and character.

Case Report A 42-year-old male, in excellent health, was seen in the oral surgery clinic of the Columbia University College of Dental Medicine. His chief complaint concerned the presence of a painless swelling involving the anterior hard palate (Figure 4). He said he became aware of the swelling approximately one year ago, but sought no attention because it was asymptomatic. It was the insistence of his general dentist, during a routine dental examination, that initiated his decision to seek care.

The clinical examination revealed an asymptomatic midline swelling, measuring 2.5 cm in diameter, that involved the middle portion of the anterior half of the hard palate. The overlying mucosa was normal in appearance. No pain was elicited when the swelling was palpated, but some fluctuation was noted. No dental pathology was present. All maxillary anterior and premolar teeth were found to be vital when tested. The radiographic examination, periapical (Figure 5) and occlusal, demonstrated a large, well-defined midline radiolucency that involved the anterior hard

The New York State Dental Journal AUGUST/SEPTEMBER 2021 33 ●

Figure 4. Palatal swelling caused by nasopalatine duct cyst.

Figure 5. Periapical film demonstrating large lucent nasopalatine duct cyst with palatal involvement.

palate. Fine-needle aspiration of the swelling produced approximately .75 ml of cyst-like fluid.

A decision to surgically remove the lesion was made. Via local infiltration anesthesia, a palatal flap was mobilized extending from the left premolar area to the right premolar region. A cyst membrane was visualized in contact with the palatal mucoperiosteum. During the flap’s retraction, the cyst membrane ruptured and cystic fluid escaped. Curettage successfully removed the collapsed cystic sac from its bony palatal crypt. Invasion of the nasal cavity was not observed. Anteriorly, the cyst burrowed under a narrowed bridge of intact palatal bone lingual to the central incisors and involved the common incisive canal (Figure 6), but it did not involve the roots of the maxillary central incisors. Upon removal of the pathologic cyst membrane, the palatal flap was reflected and sutured back to its normal position. Healing was rapid and uneventful.

Histologically, stratified squamous epithelium was seen lining the wall of the cystic lesion (Figure 7). A diagnosis of a nasopalatine duct cyst was made.

Discussion The temptation to diagnose this case as a median palatine cyst was negated by the surgical observance of the anterior extension of the cyst membrane into the incisal canal. Again, it must be emphasized that the WHO considers these symmetrical midline palatal cysts to represent posterior extensions of an NPC. Our surgical intervention confirmed the cyst’s relation to the incisive canal from which it originated anatomically. It justified the WHO’s classification of these cystic entities as elaborations of an NPC. Surgery for the NPC, involving the narrow confining limits of the incisal canal, tends to compromise the nasopalatine nerve.

34 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

Figure 6. Surgical view of palatal bone destruction caused by nasopalatine duct cyst.

Because of the extensive involvement of the incisal canal, the surgical removal of this large cystic lesion inevitably implicated the closely approximated nasopalatine nerve. Sensory loss in the anterior hard palate can occur in about 10% of NPC patients.[3,16] However, the loss is ameliorated by the anterior extension of the greater palatine nerve, and the finding that the nasopalatine nerve only innervates a limited area of the anterior hard palate.[17,18] Our case varied from the NPC norm. The usual heart-shaped radiolucency in the midline of the anterior maxilla was not present because the NPC took the option to extend palatally rather than choose the more common incisal canal pathway of least resistance. Therefore, final diagnosis was only confirmed when the clinical and surgical observations were integrated with the microscopic study.

Treatment The NPC, like most cysts, lends itself to routine enucleation. Because of its location, well-defined wall and its non-invasive nature, the NPC can usually be treated successfully via a palatal approach. Recurrences are rare. Marsupialization has been suggested in those select cases that extensively destroy palatal bone and/or compromise the nasal mucosa.[2,3,8] p Queries about this article can be sent to Dr. Mandel at lm7@columbia.edu.

REFERENCES 1.

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3.

4.

Ely N, Sheehy EC, McDonald F. Nasopalatine duct cyst. Int J Paediatric Dent 2001; 11:135137.

Elliott KA, Franzese CB, Pitman KT. Diagnosis and surgical management of nasopalatine duct cysts. Laryngoscope 2004;114:1336-1340.

Francoli JE, Marques NA, Aytes LB, Escoda CG. Nasopalatine duct cyst: report of 22 cases and review of the literature. Med Oral Patol Oral Cir Bucal 2008 13:e 438-443.

Lake S, Iwanaga J. Kikuta S, Oskovian RJ, Loukas M, Tubbs RS. The incisive canal: a comprehensive review. Cureus 2018;10:e 3069.

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Figure 7. Microscopic view of nasopalatine duct cyst with stratified squamous epithelium lining (H and E stain, magnification X 100).

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6.

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von Arx T, Schaffner M, Bornstein MM. Patent nasopalatine ducts: an update of the literature and a series of new cases. Surg Radiol Anat 2018; 40:165-177.

Radlanski RJ, Emerich S, Renz H. Prenatal morphogenesis of the human incisive canal. Anat Embryol (Berl) 2004;208:256-271. da Silva Barros, de Pontes Santos HB, Cavalcante IL, Rolim LSA, Pinto LP, de Souza LB. Clinical and histopathological features of nasopalatine duct cyst: A 47-year retrospective study and review of current concepts. J Cranio-Maxillo-Facial Surg 2018;46:264-268.

Shylaja S, Balaji K, Krishna A. Nasopalatine duct cyst: report of a case with review of literature. Indian J Otolaryngol Head Neck Surg 2013; 65:385-388.

Swanson KS, Kaugars GE, Gunsolley JC. Nasopalatine duct cyst: an analysis of 334 cases. J Oral Maxillofac Surg 1991; 49:268-271.

Suter VGA, Sendi P, Reichart PA, Bornstein MM. The nasopalatine duct cyst: an analysis of the relation between clinical symptoms, cyst dimensions, and involvement of neighboring anatomical structures using cone beam computed tomography. J Oral Maxillofac Surg 2011; 69:2595-2603.

Thakur AR, Burde K, Guttal K, Naikmasur VG. Anatomy and morphology of the nasopalatine canal using cone-beam computed tomography. Imag Sci Dent 2013; 43:273-281.

Sankar D, Muthusubramanian V, Nathan JA, Nutalapati RS, Jose YM, Kumar YN. Aggressive nasopalatine duct cyst with complete destruction of palatine bone. J Pharm Bioallied Sci 2016; 8 (Suppl 1): S 185-188.

Nelson BL, Linfesty RL. Nasopalatine duct cyst. Head Neck Pathol 2010; 4:121-122.

Rangaswamy S, Singh M, Yomnun R. True median palatal cyst: a rare case report. J Oral Maxillofac Pathol 2018; 22:286-295.

Rapidis AD, Langdon JD. Median cysts of the jaw – Not a true clinical entity. Int J Oral Surg 1982;11:360-363.

Cecchetti F, Ottria L, Bartoli F, Bramanti NE, Arcuri C. Prevalence, distribution, and differential diagnosis of nasopalatine duct cysts. Oral Implantol 2012; 2-3:47-53.

Langford RJ. The contribution of the nasopalatine nerve to sensation of the hard palate. Br J Oral Maxillofac Surg 1989; 27:379-386.

Gharaibeh TM, Telha W, Al Khateeb T. Neurosensory status of the anterior palatal mucosa after separation of the nasopalatine nerve. Br J Oral Maxillofac Surg 2010; 48:1-4.

Jamie Larmie, B.S., is a research assistant and fourth-year student at Columbia University College of Dental Medicine, New York, NY.

Dr. Mandel

Louis Mandel, D.D.S., is director of the Salivary Gland Center and associate dean, clinical professor (OMFS), Columbia University lege of Dental Medicine, New York, NY.

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NEWS General

NYU Dentistry Names Leena Palomo Chair of Ashman Department of Periodontology and Implant Dentistry

LEENA PALOMO, D.D.S., M.S.D., an accomplished dental educator, clinician and researcher, has been named chair of the Ashman Department of Periodontology and Implant Dentistry at New York University College of Dentistry, effective Sept. 1.

Dr. Palomo joins NYU Dentistry from Case Western Reserve University School of Leena Palomo Dental Medicine (CWRU), where she was a tenured professor of periodontics. She brings over a decade of collaboration with the Cleveland Clinic and the Center for Specialized Women’s Health to her new position. Her research interests include women’s health, aesthetics and quality of life. She has mentored numerous dental and medical postgraduate students, who have received accolades and honors for the quality of their theses.

Through her collaborations, she played a key role in periodontal research and treatment for the rheumatoid spectrum dis-

eases, speaking at many national and international Sjögren’s and rheumatology meetings, and publishing her findings on wellness in multidisciplinary and interprofessional journals.

As department chair, she will integrate the knowledge gained through her extensive international collaborations to make the Ashman Department of Periodontology and Implant Dentistry the global leader in both predoctoral and postgraduate periodontology and implant dentistry education.

Dr. Palomo received her bachelor’s, dental and master’s in dentistry (periodontology) degrees from CWRU, and a certificate in periodontics, also from CWRU. She earned a certificate in general practice from the St. Elizabeth Health System.

A diplomate of the American Board of Periodontology (ABP) and longtime examiner for the ABP, Dr. Palomo was recently elected ABP Director. She continues to work with the ABP to define and test the ideal skillset of knowledge, skills, and abilities required of a diplomate-level periodontist.

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NEWS General

UB Research Lays Groundwork for Improving Success of Medical and Dental Implants

WHEN DENTAL IMPLANTS ARE INSERTED, saliva or blood plasma immediately coat them. The implants adsorb a thin layer of proteins from these fluids that help gum tissue attach, but also allow microorganisms— including potentially harmful bacteria—to grow on the implant surface.

The surface of implants, as well as other medical devices, plays a significant role in the adsorption of oral proteins and the colonization by unwanted microorganisms (a process known as biofouling), according to a new study led by the University at Buffalo and the University of Regensburg.

The research, published in the Journal of Dental Research, sought to increase scientists’ understanding of this complex biological process by examining the makeup of the oral protein layer and how it can be controlled by chemically modifying the biomaterial surface. The findings lay the groundwork for improving the success of medical and dental implants, says co-lead investigator Stefan Ruhl, D.D.S., Ph.D., professor of oral biology in the UB School of Dental Medicine.

“It is often this protein layer, rather than the biomaterial surface, that is encountered by colonizing bacteria or attaching tissue cells. These proteins help determine the biological or pathological consequences that result in either long-term survival of the implant or its failure, along with irreversible damage to the surrounding tissues from infection,” says Ruhl. “Therefore, it is important to determine how adsorption might be controlled through chemical modification of the biomaterial surface to achieve a desired outcome.”

The study was also co-led by Rainer Müller, Ph.D., professor at the Institute of Physical and Theoretical Chemistry at the University of Regensburg in Germany.

Using silica beads designed in Müller’s lab with various chemically modified surfaces, the researchers found that the adsorption of proteins from blood plasma is more influenced by the amount of protein adsorbed than by the composition of the protein layer.

However, the adsorption of proteins from saliva was directly impacted by the biomaterial’s surface. Adsorption was lower on surfaces that had a negative electric charge or that repelled water, countering the findings of previous studies.

When examining complex biofluids such as saliva and blood, adsorption became unpredictable for the majority of proteins, says Ruhl.

The model system of chemically modified silica surfaces developed by the researchers may serve as a platform to study the basic principles of protein adsorption from complex biofluids.

Additional UB School of Dental Medicine investigators include alumnus Yegor Dukashin, D.D.S.; alumna Janet Mark, D.D.S.; Gregory White, D.D.S., volunteer clinical assistant professor; and alumna Stephanie Wu, D.D.S.

Heart Association Revises Infection Guideline THE AMERICAN HEART ASSOCIATION (AHA) has updated its 2007 guideline “Prevention of Viridans Group Streptococcal Infective Endocarditis: A Scientific Statement from the American Heart Association.” The 2021 AHA scientific statement on prevention and infective endocarditis no longer recommends the use of clindamycin as an oral or parenteral alternative to amoxicillin or ampicillin in individuals with allergies to these drugs because clindamycin “may cause more frequent and severe reactions than other antibiotic used for [antibiotic prophylaxis]” (including C. difficile infection).

The AHA continues to recommend infective endocarditis prophylaxis only for categories of patients at highest risk for adverse outcome. The current medication regimes recommended (when indicated) are listed in Table 2 of the 2021 AHA scientific statement. To learn more, view prevention of infective endocarditis: ADA oral health topics- antibiotics-prophylaxis.

New York State to Train Public Health Responders APPLICATIONS ARE BEING ACCEPTED for the New York State Public Health Corps Fellowship Program, a first-in-the-nation program that will assist with immediate COVID-19 response and vaccination efforts and strengthen local and statewide workforce capacities required to respond to future public health emergencies. The program will provide up to 1,000 full-time, paid positions with placements at the New York State Department of Health, local health departments outside of New York City or other public health departments throughout the state. Among eligible applicants are dental professionals. For information and to apply, visit www.ny.gov/programs/ new-york-state-public-health-corps.

The New York State Dental Journal AUGUST/SEPTEMBER 2021 37 ●

Component

Members Meet and Learn

NASSAU COUNTY

Past Presidents in New Roles Congratulations to NCDS past president Fabiola Milord, who was installed as president of the Long Island Academy of Odontology during a ceremony June 15 at Verdi’s in Westbury. At the same event, NCDS past president Binod Verma was installed as the organization’s editor.

Members Recycle Unfortunately, our summer membership event scheduled for Aug. 25 had to be postponed due to low registration. However, on Sept. 13, we held our first in-person Board of Directors meeting in over 18 months, since the beginning of the pandemic. Then, on Sept. 18, we hosted our first recycling event at our headquarters. Dentists from Nassau and surrounding areas brought their paper charts to be shredded, their X-ray films to be recycled and their electronics to be destroyed and recycled. Also on hand was Garfield Refining, which purchased dental scrap metal to be recycled. This full-service event was sponsored by Garfield Refining and MLMIC.

Our General Membership meetings on Oct. 4 and Nov. 8 will be held in-person.

They will take place at the Jericho Terrace in Mineola.

And, finally, our women’s dental conference “Scrubs and Stilettos,” cosponsored by the Suffolk County Dental Society, will be a live event at a new venue, The Heritage Club at the Bethpage Golf Course. It should be bigger and better than ever!

All of our continuing education courses will remain virtual at least through the end of the year. Please check our website, www.nassaudental.org, to view, and register for, all upcoming events and courses.

NEW YORK COUNTY

New Dentists Get Social Mina C. Kim, D.D.S. Our New Dentist Committee held a successful (and much sought-after) in-person social just as COVID restrictions started to

lift at the end of June. The “welcome back” event on June 24 took place outdoors on a lovely terrace overlooking the Hudson on a perfect early summer night.

The venue, Classic Car Club of Manhattan, a large warehouse filled with some of the world’s finest cars, was part of the appeal. So many dentists felt the need to reconnect in real life after the stress of the past year, limited opportunities to meet up and so much time spent on Zoom meetings, they filled a waitlist. Many attendees stayed well past the end of the event to linger over drinks, happy to be connecting in person again.

The support of Corporate Friends MLMIC and Straumann, as well as Hands Online LIVE, Ignite DDS and Tend, was instrumental in the success of the event.

Gear Up for the GNYDM After participating in a virtual meeting in 2020, dentists, lecturers and exhibitors are eager to meet again in person at the Greater New York Dental Meeting, the largest dental meeting in the U.S., Nov. 26 to Dec. 1.

NYCDS is excited to have its former president James Doundoulakis serve as general chair of this year’s meeting.

Education has always been a hallmark of the GNYDM. There are over 350 seminars, hands-on workshops, essay and scientific poster sessions planned, featuring hundreds of the world’s most respected educators. As an added bonus, there are more

NASSAU COUNTY Fabiola Milord and Binod Verma celebrate installations as officers of Long Island Academy of Odontology with, from left, Aleyda Grullon, Lisa Sedotto, Gene Porcelli (in back), Howard Baylarian, Diana Geroy, Dr. Milord, Michael Shreck, Al Granger, Meena Verma, Dr. Verma, Charlie Hanna, Grace Korpi-Hanna.

NEW YORK COUNTY June social proved popular with new dentists, many of whom welcomed opportunity to meet in person with colleagues.

38 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

than six hours of free continuing education courses offered daily.

As in past years, there will be many exhibitors on hand, ready to demonstrate their products and services. The 2021 GNYDM is a fully vaccinated event—proof of vaccination is required. Visit www.gnydm. com to learn more and to register to attend—for free!

Continuing Education Responding to the popularity of the programs, NYCDS will continue offering continuing education webinars after Labor Day. The webinars are given without charge to ADA members. We welcomed the return to in-person continuing education on Sept.

29 with a Basic Life Support course taught

by Marc Reilly of Rescue Resuscitation.

The NYCDS CE program was enhanced in July and August with a series of popular webinars sponsored by Benco Dental. Topics included “Improving Indoor Air Quality Through Effective Aerosol Control,” “Respiratory Protection: Ensuring Your Safety in the Fight Against Covid-19” and “Intelligent Dentistry: Secrets of the Top 10%.” Join us on Sept. 30 for “Introduction to 3D Printing,” the final webinar of the series.

Upcoming webinars include an exciting opportunity to hear international practice management speaker Dr. Roger Levin, who will share “8 Powerful Strategies to Ensure a Thriving Practice.” Anyone who has attended Dr. Levin’s lectures in the past knows that this one-hour webinar is not to be missed.

The ACD Mentoring Lecture Program returned on Sept. 22 with another series of webinars on diverse topics for residents and new dentists.

Visit www.nycdentalsociety.org for the latest course and registration information.

BRONX COUNTY

Dr. Robert Yeshion Laurence Schimmel, D.D.S. The Bronx County Dental Society mourns the passing of Dr. Robert Yeshion. Bob served as president and executive director of the BCDS and was a lifelong proponent of organized dentistry. He was a friend and

mentor to many of us. In his eulogy to Dr. Yeshion, Gordon Gaynor said: “His encouragement and lack of self-interest led to many successful practices in the neighborhood. Bob was the CEO, our mentor and advisor. His philosophy was always to do what served the interests of his patients best, and he was dearly loved by them. After 20 years of establishing a highly successful practice, Bob expanded his vision of helping people when he became active in the BCDS. He quickly moved up the executive ladder to become president. Bob served on every committee and represented the society on the state and national levels….He was such a strong presence in our lives. I loved him like a brother, and I knew that he would always be there for me, as I would be for him.

I speak for his friends and colleagues here today when I say that our lives have been enriched by this exceptional man. “

Services (DDS) program in 2007 and its long-time support to help people with disabilities or who are elderly or medically fragile and have no other access to dental care. During these ever-challenging times, DDS is especially thankful to the dentists of New York State, who have donated over $11.6-million worth of comprehensive treatment for 1,848 people. It appreciates the dentists who continue to provide care to vulnerable patients who have no other resources for the treatment they desperately need. Anyone interested in helping a patient is asked to visit the site WillYouSeeOne.org.

NINTH DISTRICT

New Beginnings Olga Lombo-Sguerra, D.D.S.

The BCDS, will offer cardio-pulmonary resuscitation with defibrillator training Oct. 5. This continuing education course will take place at Maestros caterers in the Bronx. Please contact Joy at bronxdental@ optonline for more information. On Oct. 14, Dr. Richard Lipscomb Jr. will present the lecture “Better Preps, Less Stress: Creating Readable, Workable C+B Margins.” This will be part of the BCDS remote lecture series, offered via Zoom. To register, please contact Joy at bronxdental@optonline.net

Sometimes we’re tested not to show our weaknesses, but to discover our strengths!

As we near the one-and-a-half-year mark of the COVID-19 pandemic, which has disrupted our lives, we continue to strengthen our partnerships with our executives, our committee leaders and our members, creating avenues for sharing ideas and information to bolster the profession and our association.

The Ninth District is planning a full slate of CE courses for the fall—both inperson and virtually—to accommodate the wishes of our speakers and members.

CPR courses offered through the AHA will continue as an online education module, followed by an in-person, hands-on skillsassessment at district headquarters.

Our thanks to President Roberto Rodriguez and Renuka Bijoor, chair of the Membership & Communications Committee, who helped pave the way back to in-person events with a Ninth District Social June 24 at the St. Andrew’s Golf Club. The small size and outdoor venue created the perfect atmosphere to alleviate any anxiety about the gettogether, which was a resoundingly positive and welcome opportunity to once again be together with colleagues and friends.

Donated Dental Services

Annual Meeting Update

Dental Lifeline Network is grateful for the New York State Dental Association’s partnership in developing a Donated Dental

Our NYSDA Delegates, Alternate Delegates, Trustee and our executive director attended the NYSDA House of Delegates meeting

New Website We are thrilled to roll out our new website www.bronxcountydentalsociety.org/ The site is designed to be a resource for member dentists, as well as the public we serve. It features a “Member Center,” full of resources for BCDS members. All information is updated constantly by the ADA and NYSDA to keep you informed in real time. Other features include a “Public Resource Center” for the general public and “Find A Dentist” tool that enables patients to search for ADA member dentists by zip code and specialty.

Upcoming Lectures

The New York State Dental Journal AUGUST/SEPTEMBER 2021 39 ●

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Ninth District

cont.

Aug. 13-15 at the Westin Hotel in Jersey City, NJ. At this first in-person meeting for many attendees, the Ninth District submitted a resolution addressing virtual card payments as reimbursement for treatment by insurance companies. It was passed by the House. Also, our very own Anthony Cuomo, a past Ninth president, was installed as NYSDA Vice President. We all extend our congratulations to Dr. Cuomo!

Welcomed return to social outing, hosted by Membership and Communications Committee, enjoyed by, from left, Monica Barrera, Tina Cho, Paul Kim, Yan Chen.

General Meeting In-Person Our March General Meeting, held virtually, was well-attended. We were, however, be in-person again for our September General Meeting, Sept. 22 at the Crowne Plaza Hotel in Suffern. Dr. Paul Zhivago presented his highly anticipated lecture “How is Digital Technology Revolutionizing the Art and Science of Dentistry?” Attendees received 7 MCE credits in a forum through which members can interact with colleagues and vendors.

Member Resources The ADA, NYSDA, our executives and delegates continue to work tirelessly to provide guidance and resources for our members.

We hope that most of our members are vaccinated and that they continue to offer support to patients regarding an important community issue.

Our September Bulletin, containing relevant information for members, will be available soon. We are grateful to our advertisers and sponsors for their continuing support and welcome any comments and ideas for upcoming issues. In fact, we encourage you to reach out to headquarters with questions or concerns. We’re here for you!

Gathered on rooftop for cocktail party at Annual House Meeting are, from left, Gary Scharoff, Daniel Doyle, Paul Kim, Paul Albicocco (Second District), Michael Smith, Stephen Ossen, John Constantine, Duraid Sahawneh.

NINTH DISTRICT

Installation of new officers is highlight of House Meeting. Immediate Past President Craig Ratner, at lectern, introduces, from left, Speaker Steven Gounardes, Vice President Anthony Cuomo, President-Elect James Galati, President Kevin Henner.

40 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

EIGHTH DISTRICT

Good to See Everyone Kevin J Hanley, D.D.S. Things are finally getting back to normal here in the Eighth District. The Zoom meetings are occurring less frequently. In-person meetings are beginning to be held. In September, the district’s Executive Council will meet in person for the first time in over a year. It certainly has been a long, strange trip we have been on this past year and a half.

The first big event held this summer was the annual William Knauf Golf Tournament and CE Day, which took place June 14 at the Niagara Falls Country Club. About 100 golfers teed up in the yearly competition for golf supremacy in the Eighth.

The morning began with the traditional CE opportunity. This year, Raymond Miller, the district’s guru on forensic dentistry, gave a stimulating lecture on “21st Century Forensic Odontology.” Forensic odontology has historically been used in victim identification and bitemark analysis. Emerging dental technologies are changing the methods used in victim identification and solving cases which, in the past, would have been inconclusive. Bitemark analysis is undergoing increased scrutiny in courtrooms for its admissibility and reliability. Dr. Miller spoke concisely about these controversies. And he explored the history and science of forensic dentistry, as well as its future, including the changing role of dentistry.

Following the lecture, lunch was served and then a shotgun start to the golf tournament. It was a beautiful day to play golf, with sunny skies and low humidity. In the end, the overall champion was Carl Embury, who carded an 81 over the challenging layout. The Men’s Scramble was won by David Bourque, Matthew Bourque, Jim Mantzanis, and James Mantzanis. Catherine Gogan, Patricia Starring, Lauren Boyczuk and Alyssa Tzetzo won the Women’s Division.

The Mixed Team Division was captured by the team of David Croglio, Elizabeth Kapral, John Nasca and Robert Buhite. The Senior Division victors were Leon Kantor, Robert Reszel, Scott Seier and Greg George.

The team of Roger Anderson, Marshal Fagin, Mark Wendling and Michael Cassese

The New York State Dental Journal AUGUST/SEPTEMBER 2021 41 ●

Component

Eighth District

cious buffet dinner. It was a terrific day, and one long in coming. The 2020 tournament was cancelled due to the pandemic. It was terrific to see everyone out there, enjoying themselves after a tumultuous year.

cont.

Document Disposal

won the Super Senior Division.

Following golf, participants enjoyed a deli-

destroyed. Many members took advantage of this event to dispose of sensitive documents, including old patient charts. The district is looking into making this a yearly event, as Lincoln Archives, the shredders, said members filled their truck to capacity, at 8,060 pounds.

The district held a “Shred Event” in June at the district office. Members were invited to bring any documents they wanted shredded, including films needing to be

SUFFOLK COUNTY The Year So Far

Patricia Hanlon, D.M.D., for Howard Schneider, D.D.S. Our New Dentist Summer Social took place July 21, one of many fun and engaging new dentist events planned for 2021. Seen at the social, from left, Rehka Reddy, Noreen Doherty, Farnaz Hadaghian, New Dentist Chair Lauren Heisinger, Tony Makrides (purple shirt) of Neodent, Craig Smith, Parandis Nejati, Dhaval Shah, Devyn Fleishhacker.

SCDS President Patricia Hanlon and Claudia Mahon-Vazquez lunched with dental residents from St. Charles in June. They are, from left, Dr. Mahon-Vazquez, Ryan Davis, Travis Mackey, Dr. Hanlon, Nicole Trepeta.

Newly installed NYSDA President Kevin Henner of SCDS addresses the NYSDA House at its annual meeting in August in Jersey City.

SCDS’s Steven Snyder, recipient of the NYSDA Distinguished Service Award.

SCDS was prominent presence at NYSDA House of Delegates. Contingent included, from left, Paul Markowitz, Guenter Jonke, Dimitrios Kilimitzoglou, Nick Vittoria, Radha Munk, Steven Snyder, Kevin Henner, Patricia Hanlon, Craig Smith, Kerry Lane, Lauren Heisinger, Paul Leary, Ivan Vazquez, Claudia Mahon-Vazquez, John Guariglia, Scott Firestone, Martin Dominger, Bill Panzarino. Other members of delegation were Sharon Pollick, Chris Salerno, ASDA representative Diana Kim.

42 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

Guenter Jonke, SCDS, at far right, is sworn in as NYSDA Trustee for four years.

Past President Payam Goudarzi administers oath to Dr. Jonke and other new trustees Maurice Edwards of New York County and Theresa Casper-Klock of Seventh District.

SECOND DISTRICT

SDDS Hosts In-Person NYSDA House Alyson Buchalter, D.M.D. NYSDA held its first in-person House of Delegates meeting since the start of the COVID-19 pandemic Aug. 13-15 at the Westin Hotel in Jersey City, NJ. The Second District Dental Society was the proud host of this event. And a true event it was! The opportunity to see and interact face-to-face with our colleagues was like a breath of fresh air.

The traditional pre-meeting golf outing took place on Thursday at the Richmond County Golf Course. Participants were treated to amazing vistas of the New Jersey Highlands and Atlantic Ocean while enjoying the challenging course. At dinner, golfers enjoyed great food and outstanding gift bags.

The SDDS used the opportunity to showcase the Staten Island Greenbelt and the best of the borough. Despite the extreme heat, all appeared to be having a great time.

Speaker of the House, SDDS’s own Steven Gounardes, ran a superb meeting. The business of the House was dispatched in his usual efficient and orderly fashion. Honors and accolades were bestowed on many.

Paul Albicocco, chair of the SDDS Local Arrangements Committee, forgot he was not on Zoom and delivered an opening speech to the House in typical, for him, style—in his pajama bottoms!

Friday night, the SDDS hosted a cocktail party on the roof of the waterfront Hyatt Hotel. Attendees were blown away by the views. All of lower Manhattan, from the Javits Center and the Vessel to the Statue of Liberty and the Freedom Tower, were on display. Selfie was the word of the evening. We delighted in the opportunity to relax and socialize with each other in a COVID-safe environment, the first time in over two years.

Saturday night we celebrated the presidency of Craig Ratner. To say he led us through challenging times is a major understatement. He worked tirelessly to get our offices reopened sooner than many other businesses. He and the other leaders of NYSDA convinced Gov. Cuomo what we all know: dentistry is essential! Craig guided the Association though the pandemic in

many ways, including improving NYSDA’s ability to communicate with members through email blasts, online content and webinars. SDDS is very proud of his accomplishments. Thank you, Craig!

To honor Dr. Ratner, NYSDA hosted a banquet onboard “The Cornucopia,” a luxury, chartered yacht. Those who took the cruise were awed by breathtaking views as they sailed through lower Manhattan and around the Statue of Liberty. Per Dr. Albicocco’s promise, the weather was perfect.

Everyone there, including typically jaded New Yorkers, was beyond words, impressed.

The SDDS wants to take this opportunity to thank Dr. Albiccoco and his team,

consisting of Michael D’Anna, John Halikias, Phyllis Merlino, Mitchell Mindlin and Brian Peroni. We also owe many thanks to members of the SDDS staff—Christine Terrio, Stephanie Carter and Executive Director Bernard Hackett—as well as NYSDA staff, including Jenna Bell and her team, for making this amazing weekend happen without a hitch.

It cannot be said enough: A good time was had by all!

Second District Caucus gathers in Jersey City for NYSDA House of Delegates Annual Meeting.

SECOND DISTRICT Craig Ratner, at center of photo, is surrounded by SDDS members, friends, family at rooftop cocktail party, one of several events at House meeting honoring his presidency.

The New York State Dental Journal AUGUST/SEPTEMBER 2021 43 ●

continuing education

Read, Learn and Earn Readers of The New York State Dental Journal are invited to earn three (3) home study credits, approved by the New York State Dental Foundation, by properly answering the following 30 True or False questions, all of which are based on articles that appear in this issue.

When you have completed the questionnaire, return it to the New York State Dental Foundation, along with payment of $60.

All those who achieve a passing grade of at least 70% will receive verification of completion. Credits will automatically be added to the CE Registry for NYSDA members.

For a complete listing of online lectures and home study CE courses sponsored by the New York State Dental Foundation, visit www.nysdentalfoundation.org/course-catalog.html.

Minimally Invasive Coronally Advanced Tunnel—Page 23-29 1. Connective-tissue graphs have not been used for periodontal root coverage.

❑ T or ❑ F 2. The minimally invasive coronally advanced tunnel (MI-CAT) technique for the treatment of multiple recession-type defects (MRTD) has been the standard for years.

❑ T or ❑ F 3. The MI-CAT technique is used by involving orthodontic buttons as anchor units.

❑ T or ❑ F 4. Gingival recession is a frequent finding, with an average 1 mm of recession in approximately 80% of the adult population.

❑ T or ❑ F 5. Trauma from toothbrushing is not an etiological factor in recession defects.

❑ T or ❑ F

❑ Enclosed is a check for the full amount of $60. (Make

checks payable to the New York State Dental Foundation.) Mail to NYSDF, 20 Corporate Woods Boulevard, Suite 602, Albany, NY 12211. Questionnaires must be received within 90 days of Journal publication.

Please charge my: ❑ VISA ❑ MasterCard ❑ American Express

Telephone

Card #

E-mail

Expiration Date

ADA #

Name

License #

Address

NYSDA Member? ❑ yes or ❑ no

City

State

Zip

44 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

Local/State Dental Society

6. The orthodontic button was utilized to prevent the collapse of suspended sutures that were used.

❑ T or ❑ F 7. In the clinical case presented, the sutures, the orthodontic buttons and periodontal dressing were removed 14 days after surgery.

❑ T or ❑ F 8. Flap anchorage with sutures has always resulted in better outcomes than techniques without sutures.

❑ T or ❑ F 9. Better healing is not achieved by the lack of vertical-releasing incisions.

❑ T or ❑ F 10. The authors conclude, though their study was limited, that minimally invasive perio-plastic surgical techniques are here to stay.

❑ T or ❑ F Gingival Cyst of the Adult—Page 30-31 1. A gingival cyst of an adult (GCA) is a type of odontogenic cyst.

❑ T or ❑ F 2. GCA usually affects people in their second and third decades of life.

❑ T or ❑ F 3. GCAs are common cysts and have a high recurrence rate.

❑ T or ❑ F 4. A GCA is distinguished from the lateral periodontal cyst by lack of findings radiographically.

❑ T or ❑ F 5. GCAs are usually treated by simple excision.

❑ T or ❑ F 6. Some GCAs are small and asymptomatic and may go undetected.

❑ T or ❑ F 7. It is suspected that GCAs may be derived from remains of junctional epithelium after tooth eruption.

❑ T or ❑ F 8. GCAs are fast growing.

❑ T or ❑ F 9. Because of its blue-tinged appearance, the GCA is often mistaken for a mucocele.

❑ T or ❑ F 10. GCAs, once removed, have a slow rate of recurrence.

❑ T or ❑ F

Nasopalatine Duct Cyst—Page 32-35 1. The nasopalatine duct cyst (NPC) develops in the incisive canal from embryonic remnants of the nasopalatine duct.

❑ T or ❑ F 2. The anterior hard palate is never involved in the development of an NPC.

❑ T or ❑ F 3. Patency of the NPC may occasionally exist in adults, and its orifice is usually seen as small bilateral openings on either side of the papilla palatina.

❑ T or ❑ F 4. Anatomically, the nasopalatine canal transports the terminal branches of the nasopalatine nerve and sphenopalatine artery.

❑ T or ❑ F 5. NPCs only occur in the young.

❑ T or ❑ F 6. Radiographically, the NPC is usually visualized as heartshaped radiolucency.

❑ T or ❑ F 7. The NPC is asymptomatic unless secondarily infected.

❑ T or ❑ F 8. Microscopic examination of the cyst wall is used to verify the diagnosis of an NPC.

❑ T or ❑ F 9. Sensory loss in the anterior hard palate is not associated with NPC patients.

❑ T or ❑ F 10. NPCs, like most cysts, are usually treated by routine enucleation.

❑ T or ❑ F

The New York State Dental Journal AUGUST/SEPTEMBER 2021 45 ●

CLASSIFIED INFORMATION

Online Rates for 60-day posting of 150 words or less: Members: $100—can include photo/im-

FOR SALE

age online. Non-Members: $150 + $40 fee for

CENTRAL NEW YORK: New to market. Wellestablished implant-centric practice just outside downtown in one of region’s most desirable communities. Gorgeous freestanding building; real estate also for sale. Current doctor interested in buy-out or partnership. 3 fully equipped operatories. Collections nearly $900K, and seller’s discretionary earnings are $330K. 2,350 active patients and 10 new patients/month. To learn more about this longstanding prosthodontic practice, including exact location, please contact Sam Schoenecker with Professional Transition Strategies by email: sam@professionaltransition.com; or phone (719) 694-8320. We look forward to speaking with you.

CLASSIFIEDS

BRONX: Newly renovated, 31-year-old practice.

Running well; owner retiring. Three ops, digital X-rays, lab, sterilization room, Nitrous oxide. Very good set up; must see. No Medicaid, no HMO, no DMO. Only good insurance and private pay. Call for details (718) 862-9232.

CENTRAL NEW YORK: Soon-to-retire doctor looking to sell or rent second practice. 1,000-square-foot building with four fully functioning ops. Office gross $150K working 5 hours/day and one day/week.

Current clientele includes approximately 500 active patients with potential for expansion of up to 10 new patients per week. Includes second-floor one-bedroom apartment and adjacent 3-family rental property with $10K profit per year. Call for details (315) 794-0527; or email: ericrachadds@gmail.com.

CENTRAL PARK SOUTH: Oral Surgery practice for sale. Transition to ownership of premier Oral Surgery practice. 4 operatories with windows facing Central Park. Prime, exclusive, medical condominium building on Central Park South. Established dentoalveolar surgery practice since 2001 with large patient database, complete medical equipment and website. Long-term lease of professional space of approximately 900 square feet included. Current oral surgeon retiring. Office-based practice includes dentoalveolar surgery, bone grafting, ridge augmentation, sinus floor augmentation, dental implants, wisdom teeth and IV general anesthesia. Pristine office in prime location. Tremendous growth potential. Please inquire by email: nycentralparksouth@gmail.com.

BUFFALO: Periodontal practice. Ownership opportunity. If you’ve been searching for ideal partnership opportunity in Western NY, look no further. Busy periodontal practice has two locations with over 2,100 active patients. With 40-50 new patients per month, you’ll be busy from day one.

Current doctors seek 50/50 partner or to hire an associate to help with increase in patient load. 9 operatories across both locations and collections of $2.25M. Adjusted EBITDA $480K, with seller’s discretionary earnings of $980K. To learn more about this busy perio practice, please contact Sam Schoenecker with Professional Transition Strategies by email: sam@professionaltranstiion.com; or phone (719) 694-8320.

online photo. Corporate/Business Ads: $200 + $40 fee for photo/image/logo. Classifieds will also appear in print during months when Journal is mailed: Jan, March, July and Sept.

BROOME COUNTY: Beautiful, busy, wellestablished practice with very limited competition available for immediate purchase. Six well-equipped operatories, digital X-ray and pan, updated computer system, turnkey. Easy transition to new owner. Gross revenue $585K/net; $285K on 4-day work week.

Practice alone appraised at $411K. Will sell practice and building for $399K. Contact cncnl@aol.com; or text (607) 768-3810.

ROCKAWAY BEACH: Dental practice for sale. How would you like to make your own schedule as owner of profitable dental practice? Ground level, turnkey, newly renovated, 3-op office with ample parking and spectacular bay view. 700 active patients grossing $350K on 2.5 days/week. Bustling hygiene schedule. Files completely electronic and fully networked with Open Dental software. Carestream digital X-rays and intraoral cameras, 3 Aegis aerosol evacuators, Global microscope, air abrasion/plasma arc curing, Nitrous oxide, electric handpieces, Velscope, Diagnodent, hard- and soft-tissue laser training. Will mentor in transfer if desired. Price negotiable. You may never need to buy another hand instrument. Contact: mybeachdentist@gmail.com.

SYRACUSE: Very nice 4-op dental practice for sale by owner. Newly renovated; equipment older but kept in great condition. Ideal for satellite office or first office. Practice was 2-3/day office Tues, Wed and Thurs. Currently open just Thursday and booked out 2-3 months. Great production and collections. Seller will stay on as long as need for surgical procedures, i.e., implants, oral surgery and perio surgery. Contact: syrdentaire@gmail.com; or text to: (607) 752-4376.

GLENS FALLS: General dental practice. Outstanding, long-established, quality family practice. Fully digital with CEREC. Owner will train during transition. Sale includes building with office, equipment and apartment. Self-sufficient. Three ops and room for fourth.

Excellent reputation and ever-expanding patient base and loyal staff. Golden, walk-in opportunity for right person. $550K on 4.5-day week. For details call (518) 791-7457.

CONNECTICUT: Beautiful CT practice just over state line, along Housatonic river. Looking for an idyllic location to raise family and do great dentistry? This is it.

Six equipped operatories, with room for expansion in stunning freestanding building. 3,500 square feet. All digital, including CBCT. Collections over $1.1M. Must see. Please call Ed Ferraro at (603) 493-1316; or email: eferrero@ddsmatch.com.

46 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

LONG ISLAND: Multi-location orthodontic practice for sale; owner seeks affiliation with a group. Thriving orthodontic practice with two locations in Brooklyn and Long Island. Current doc interested in staying on and continuing to grow practice and in exploring group affiliation options. Each practice has over 1,200 square feet with four and five operatories, respectively. Great growth potential as practice open only four days/week.

Practice experienced great rebound in last 12 months and has even better 2021 projected. Collections nearly $1M and EBITDA $155K. 250 starts per year and 20 new patients per month. To learn more, contact Sam Schoenecker with Professional Transition Strategies: by email: sam@professionaltransition.com; or call (719) 694-8320. We look forward to speaking with you!

QUEENS: Douglaston/Little Neck area general dental practice for sale. 3 ops; FFS/PPO. $2,100/ month rent with very favorable lease available.

Doctor retiring. Referring out all specialties. Average gross past 3 years $275K on 2 days/week. Contact: es1011sm118@gmail.com.

FINGER LAKES REGION: Dental practice with three locations across region for sale. Practice sees great number of patients with little competition.

Current doctor also interested in bringing on associate and exploring path to partnership. Either route would be considered, as seller would like to continue to practice long term. Each location approximately an hour apart, located in freestanding or office buildings. Real estate for two locations for sale. Each location has at least four operatories, while one practice has 7 ops for total of 15 plumbed operatories. Collections of $1.4M & EBITDA $140K. To learn more, contact Sam Schoenecker with Professional Transition Strategies by email: Sam@professionaltransition.com; or give us a call: (719) 694-8320. We look forward to speaking with you.

GREATER ALBANY AREA: Practice for sale.

Nine ops and 3,000 square feet. Active patient count exceeds 1,500. Net revenue for June 2020 – May 2021 at $650K, with almost $200K in owner profit.

Great opportunity and room to grow. Lots of potential; priced to sell fast. Please call (703) 439-4019; or email: jmikailonis@midwest-dental.com.

NEW HAVEN, CT: Practice for sale with 4 ops and 2,200 square feet. Active patient count exceeds 2,000. Net revenue for June 2020-May 2021 at $420K. Practice is 100% fee-for-service, with tons of potential. Please call (703) 439-4019; or email: jmikailonis@midwest-dental.com.

SYRACUSE: Long-established general practice for sale. Modern facility with 5 ops, digital radiography, Panorex and Picasso laser. Profitable, with room for growth. Easy access along well-traveled route. Seller will retire after short transition period. Please contact Dave Kasper by email: dave@jimkasper.com; or call (603) 381-4392.

UPSTATE NY: General practice for sale. Charming, long-established, quality, busy practice. Turnkey opportunity has revenue near $1M, with low overhead. Brand new equipment, steady stream of new patients, robust hygiene department, NV laser, Dentrix/Dexis technology throughout and prime location on busy main street.

Standalone, 2,170-square-foot facility feels extra spacious, with high ceiling and large windows. Four ops, with room to expand to one more if desired. Additional 1,120 square feet of space has separate entrance and could be turned into dental lab, space for dental specialist or anything else. Plenty of onsite parking.

Seller refers out oral surgery, perio and ortho, providing additional revenue potential for any buyer keeping those services in house. Real estate available for sale or lease. For details, contact Catherine Etters at Legacy Practice Transitions by phone: (610) 520-9677; or email: catherine@legacypracticetransitions.com.

ROCHESTER: New to market. Incredibly well-established periodontal practice for sale. Current doctor has practiced in community and cared for patients for 40 years. Ready to retire. Open to staying on and mentoring incoming dentist if desired. Pristine new office with 4 operatories and brand new equipment replaced within last two years. Enjoy benefits of new practice with added bonus of existing patient base. Collections of $865K and $250K. 1,000 active patients. To learn more, please contact Sam Schoenecker with Professional Transition Strategies by email: sam@professionaltransition.com; or call (719) 694-8320.

We look forward to speaking with you.

WEST ESSEX, NJ: Well-established general practice for sale in desirable West Essex, NJ. Current doctor practiced in community for 35 years and seeks transition that leads to retirement. Four operatories, with significant expansion opportunity into adjacent space of retail condo. Collections $880K and EBTIDA (TTM) $270K. Retail condo real estate for sale. 100% FFS practice. To learn more about this gorgeous and longstanding practice, please contact Sam Schoenecker with Professional Transition Strategies: sam@professionaltransition.com; or give us a call: (719) 694-8320. We look forward to speaking with you.

OGDENSBURG: Fully equipped and operational dental office with 2,400-square-foot building located on St. Lawrence river. Three operating rooms, lab and X-ray room with panoramic X-ray machine. Lot size is 3.0 acres; plenty of parking. Retired due to sudden illness and left office as is. Priced to sell at $160K or best offer. Call Dr. Qudsi at (315) 528-5512; or email: navedqudsi@hotmail.com.

LONG ISLAND: North Shore. Ready for terrific opportunity in highly desirable area? Step right up. PPO and FFS private practice with updated equipment features 3 ops in 900 square feet utilizing Dentrix, digital X-rays, Dexis and laser. Clinical procedures referred. 41 patient hours per week and strong support staff. Met all postCOVID challenges and now uses electrostatic disinfection. Seller available to stay as needed. Contact Henry Schein Professional Practice Transition Sales Consultant Mike Apalucci by phone: (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY2403.

OSWEGO: 6 ops in north central part of NYS. Town located on beautiful lake housing popular state college. Revenue $868K; sale price $550K. All digital, quality equipment; 3,000-square-foot office in professional standalone building. Includes rental space earning $25K/year also for sale. Loyal staff, large patient base of PPO patients. Accepting all insurances; no Medicaid.

Contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick at (315) 430-0643; email: donna.bambrick@henryschein.com. #NY1751.

BRONX: Great family neighborhood in highly desirable area. Strong PPO/FFS private practice, features 3 ops in 900-square-foot condo. Real estate also available. Seller refers Endo, Pedo, Oral Surgery, Perio and implant placement. Room to grow adding days and procedures. Strong hygiene program. Contact Henry Schein Professional Practice Transition Sales Consultant Michael Apalucci at (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY1874.

WATERTOWN: Class act office in best location near Fort Drum, off main highway with high visibility in active small strip mall. Doctor moving out of state. Gross revenue $445K working 3.5 days.

Three ops; Eaglesoft, Planmeca digital pan, all A-Dec chairs and cabinetry, including sterilization center.

Only 9 years old. Contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick by email: donna.bambrick@henryschein.com; or call (315) 430-0643. #NY2484.

CICERO: Well-established general practice in community’s fastest growing suburb. Located in busy plaza with 1,460 square feet. Walking distance to area’s largest high school, creating potential for significant growth. Four A-Dec ops, sterilization center, new digital Pan, Dentrix software and Dexis sensors.

Doctor refers out most specialty procedures. Healthy new patient flow and patient base; accepting mix of insurances, plus FFS. Gross just under $700K. Contact Transition Sales Consultant Donna Bambrick by email: donna.bambrick@henryschein.com; or call (315) 430-0643. #NY1677.

WATERTOWN AREA: General practice with $500K revenue. Digital, walk-in ready with nice equipment, located in standalone building which is for sale with two (2) apartments with private entry. Contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick by email: donna.bambrick@henryschein.com; or call (315) 430-0643. #NY1421.

STATEN ISLAND: Home/office for sale with real estate. Established 35 years and still going strong.

High-quality, caring, family cosmetic practice in super visible location. Plenty of parking and easy to get to.

Two ops can be expanded to 4 or more. Gross can easily be doubled. Perfect for 2 dentists. Don’t miss this opportunity and location. Contact: drgoody@aol.com; or text (917) 494-8882.

WOLCOTT: Great rural lifestyle with fully modernized, up-to-date, high-tech general practice. Revenue $850K on 3 days/week. One hour from Rochester and Syracuse. Standalone converted 2,500-square-foot residence has real estate for sale. Two full-time hygienists; four ops, mostly all A-Dec; new Sirona CBCT, Eaglesoft, Schick sensors, CEREC scanner and milling machine.

50% FFS and 50% indemnity plans, with 8-10 new patients/month. Consideration for Associate, with buy-in agreement. Contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick by email: donna.bambrick@henryschein.com; or call (315) 430-0643. #NY2692.

SOUTH BUFFALO: Very reasonably priced practice for sale. Excellent option especially if considering expansion of current practice or recent graduate not desiring to incur sizeable debt. Two large, bright, ops, with great Pelton Crane chairs/delivery units. Utilizes Sirona Orthophos XG5 pan with bitewing feature.

Clinical production highly focused on quality restorative, with most specialty services referred to local specialists.

In-network with larger insurance providers. No Medicaid.

Contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick at (315) 430-0643; or email: donna.bambrick@henryschein.com. #NY273.

NASSAU COUNTY: North Shore. Productive, wellestablished practice located in very desirable community. 5 operatories, plus 1 additional not equipped, in 1,700 square feet. Utilizing Eaglesoft, Schick, Biolase, Sirona CBCT and Itero. 60% PPO; 20% FFS; 20% Delta Premier. Seller willing to work post-sale for agreed timeframe. Great opportunity to acquire strong, solid practice running 39 hours/week, with unlimited growth potential. Location, location, location. Contact Henry Schein Professional Practice Transition Sales Consultant Linda Zalkin at (631) 357-1003; or email: linda.zalkin@henryschein.com. #NY313.

NASSAU COUNTY: General practice with 3 equipped ops; digital, high tech. Updated using EagleSoft. Located in desirable, diverse financial community. Gross $387K. Contact Henry Schein Professional Practice Transition Sales Consultant Mike Apalucci at (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY316.

The New York State Dental Journal AUGUST/SEPTEMBER 2021 47 ●

CLASSIFIEDS

GREATER ALBANY AREA: Established practice, growing for past 40 years with only 1 doctor. Very efficiently run and highly profitable, with $1.4M revenue and extremely low overhead of less than 40%. Four fully equipped ops; loyal customer base and highly experienced staff. Office manager has been part of practice for over 35 years. Solely focused on PPO/FFS, with no Medicaid. High potential for growth as doctor works only 4 days/week with no marketing. Contact for details: albpracticeforsale@gmail.com.

WESTERN NY: Practice for sale. Well-established, modern general practice located in eastern suburb of Buffalo. Five fully equipped ops, Eaglesoft, digital, Sirona Pan/Ceph. Last full-year gross receipts $835K. For details, contact: karealuv@icloud.com.

SYRACUSE: Immaculate general practice, fully equipped with latest technology: Dentrix, Dexis, Waterlase, CAD/CAM, digital Pan. Three ops and 2,300 active patients. Strong FFS and some PPO. Revenue $481K. Refers out specialties. Standalone, converted residence with income apartment featuring 3 bedrooms, 1.2 baths. Building for sale. Near hospital and college. Contact HSPPT Consultant Donna Bambrick at (315) 430-0643; or email: donna.bambrick@henryschein.com. #NY317.

CLASSIFIEDS

SUFFOLK COUNTY: South Shore. Begin practicing immediately in beautifully treated facility located in growing and popular community. 1,500 square feet. 3 ops, plus additional room for expansion. Digital X-rays, intraoral camera with Dexis and Dentrix software.

Insurance and FFS driving $528K in gross receipts, with strong profit margins. Seller owns condo, available for lease or purchase. Strong hygiene program; all specialties referred out. 22- to 24-hour workweek.

Lovely office; amazing upside for continued growth.

Contact Mike Apalucci at (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY1587.

AMHERST: General/Prosthodontic practice situated in growing community. 4 fully equipped operatories and one unequipped for expansion. 1,875 square feet of leased space in handicapped-accessible, beautiful office park. Dentrix, Digidoc cameras, Gendex sensors, Planscan with milling unit and glazing machine, Sirona pan, digital X-rays and Ivoclar laser. Great staff. All endo and oral surgery referred out; no state insurance. Doctor willing to stay for transition. Gross revenue $439K. Contact Donna Bambrick at (315) 430-0643; or email: donna.bambrick@henryschein.com. #NY1594.

ERIE COUNTY: Located on busy road surrounded by established residential population and beautiful town.

3-op digital practice; well-positioned for future growth. $307K gross revenue. Crown and bridge, restorative and preventative focus. Some specialties referred out.

Strong patient base and mixed PPO. Real estate next to practice owned by seller and for sale with practice.

Contact Brian Whalen at (716) 913-2632; or email: brian.whalen@henryschein.com. #NY1648.

SUFFOLK COUNTY: Seller ready to retire from 40 years of practicing in small professional building in lovely community. 1,350 square feet. 4 ops, plus 1. Nicely appointed, extremely neat, with welcoming, warm feel.

2019 gross receipts $330,951; 2018 gross receipts $373,230. Specialties referred out. 70% PPO and 30% FFS. 1,250 active patients. Rent: $2,705, including water. Functional office needs updating. Seller highly motivated. Contact Henry Schein Professional Practice Transition Consultant Linda Zalkin at (631) 357-1003; or email: linda.zalkin@henryschein.com. #NY1704.

ERIE COUNTY: Well-established general practice in heart of south Buffalo. Highly visible practice located on busy street with on-street and off-street parking.

Five ops with excellent workflow. Dentrix, digital pan and sensors. Mix of FFS and PPO, with some

Medicaid. Real estate for sale, with apartment for rental or to live. Great opportunity to acquire strong net income practice and grow. Gross revenue $410K. Contact Brian Whalen at (716) 913-2632; or email: brian.whalen@henryschein.com. #NY1796.

HUDSON COUNTY, NJ: Beautiful, well-established and nicely equipped general practice in high-visibility corner location. Four (4) operatories, all digital with Dentrix, CBCT and Ceph, intraoral cameras, Zoom and laser. Over 1,100 active patients; leased 2,000-squarefoot. space. Some ortho and implant placement being done. Revenue $780K. For details contact Henry Schein Professional Practice Transition Sales Consultant Donna Costa by phone: (609) 304-0652; or email: donna.costa@henryschein.com. #NJ1478.

NASSAU COUNTY: North Shore. Well-established practice in desirable community with 4 ops. Digital X-ray and Easy Dental in 1,200 square feet. Open 39 hours/ week; referring out most specialty procedures. 85% PPO and 15% FFS. Well-trained, experienced staff of 6 available for transition. Fourteen new patients per month, with no outside marketing, and 1,800 loyal patients. 2020 showed nice post-Covid production rebound. Seller will remain available for smooth transition. Contact Linda Zalkin at (631) 357-1003; or email: linda.zalkin@henryschein.com. #NY1854.

DUTCHESS COUNTY: Well-established GP in desirable growth community. Established 47 years, practice has loyal patient base. Located in professional building, with ample free parking and main street visibility.

1,000-square-foot office. Seller owns real estate and willing to continue long-term lease. Four treatment rooms; digital X-ray, intraoral cameras, laser unit and Eaglesoft. Most specialty procedures referred. $613K revenue can quickly grow by adding days and procedures.

Contact Henry Schein Professional Practice Transition Sales Consultant Mike Apalucci at (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY2390.

LIVERPOOL: North Syracuse. Six ops, with Pelton Crane and X-ray room with pan, Dexis and ScanX. Insurance practice. Professional building with parking; working 4 days/week. Contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick at (315) 430-0643; or email: donna.bambrick@henryschein.com. #NY250.

NORTHEAST BRONX: Established since 1980, private and insurance-based GP located in busy, desirable Bronx community. Loyal patient base, with active new patients per month. Street corner, street-front location, with bus stop right at office and directly across from Montefiore Medical Center. Selling practice and real estate together. 1,700-square-foot office. 3 equipped treatment rooms, with 2 additional plumbed. Seller willing to stay as needed. Contact Henry Schein Professional Practice Transition Sales Consultant Mike Apalucci at (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY2404.

48 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

KINGSTON: Biological/Holistic, high-producing FFS practice that is mercury safe. About 2 hours from NYC and minutes from Woodstock. Revenue of $1.5M. Five ops, standalone building also for sale.

Great systems keep A/R low; open 5 days/week.

Equipment 6 years old, includes Ozone generators, lQ air operatory filtration, Dentrix and Dexis. Paperless office. 1,600 patients. Perio associate one day/week.

Doctor will stay if needed. 15 new patients/month; dedicated staff. Contact Transition Sales Consultant Donna Bambrick at (315) 430-0643; or email: Donna.bambrick@henryschein.com. #NY2560.

SUFFOLK COUNTY: North Shore. Well-established practice in desirable community, located in storefront building with lots of visibility. The 1,000-square-foot office, using Dexis digital X-ray, Panoramic digital pan and Easy Dental software, provides 2 treatment rooms, plus 1 additional plumbed. Open 4.5 days/week, with stable patient base and strong hygiene program.

Specialty procedures referred out. Gross receipts over $450K. Well-trained staff available for transition. Seller open to transition options. This will not last. For details contact Linda Zalkin by phone: (631) 357-1003; or email: linda.zalkin@henryschein.com. #NY1815.

STATEN ISLAND: Well-established orthodontic practice for sale in desirable area. Approximately 2,000 square feet. Six operatories, fully equipped with OrthoTrac, Carestream digital. Averaging 15 new patients monthly. Only 20 hours/week, but 5 days of work available. Nice mix of FFS and insurance. Real estate available for purchase. Excellent opportunity for firsttime buyer or someone looking for additional location.

Turnkey option. Owner motivated to sell. For details, contact Henry Schein Professional Practice Transition Sales Consultant Linda Zalkin by phone: (631) 357-1003; or email: linda.zalkin@henryschein.com. #NY2579.

SCHENECTADY: Three-op general practice in Historic District, with Dentrix, digital and 5 days of hygiene/ week. Gross $543K. Shared waiting room, lab and leased space. 5,645-square-foot building, with rental apartments, for sale at $300K. For details contact Henry Schein Professional Practice Transitions Consultant Donna Bambrick by phone: (315) 430-0643; or email: Donna.bambrick@henryschein.com. #NY294.

GATEWAY TO FINGER LAKES: Open for offers.

GP practice in an amazing community. The world has changed. Why not practice safely in Chemung County?

We test all dental patients at nearby hospital before procedures. Long-standing, original owner, three years average collection—$255K. Open 4 mornings/ week for 10 months/year. Excellent growth potential. 4 ops, low overhead and cost of living. Area is gateway to Finger Lakes region, only five hours from New York City. Great family living, hunting, fishing, hiking, and skiing. For details contact Donna Bambrick by phone: (315) 430-0643; or email: donna.bambrick@henryschein.com. #NY220.

WEST ISLIP: Rare opportunity to purchase well-established general practice in highly desirable area of Suffolk County, Long Island. Freestanding, home-style office on town’s main street, very close to major hospital and medical offices. Equipped with five treatment rooms and one additional plumbed, along with intraoral camera and digital X-rays. Seller willing to sell real estate.

Averages 36 hours/week and utilizes fee-for-service and insurance plans. Specialties referred out. Contact Mike Apalucci by phone: (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY2483.

AUBURN: Productive, growing practice in quaint CNY community. Outright sale or available for Associate leading to buy in. Located in village proper; $700K revenue. Dental office occupies 3,200 square feet of 5,530 square feet, with four ops and one plumbed, not equipped. Large patient base and referring out many specialty procedures. Real estate also for sale with rental apartment that brings additional revenue. For details contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick by email: donna.bambrick@henryschein.com; or call (315) 430-0643. #NY2624.

BRONX: 7-year new facility with 1,400 square feet of office space and 4 fully equipped operatories.

Turnkey, ground-floor opportunity. Completely digital and constructed in accordance with newest technologies. Starting January 2020, office open 5 days/ week, with steady flow of new and existing patients.

Closed March through May 2020 due to pandemic, but recovered beautifully. Rent very reasonable for area at $2,025/month. Office has 3 digital Gendex X-ray machines and digital Vatech panorex unit. Contact Mike Apalucci by phone: (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY2678.

NASSAU COUNTY: Well-established practice in small house with 950-square-foot dental office, plus legal residential rental. Practice has three operatories. Seller’s income based on 4 days and 35 hours weekly. Located on main road, with nice traffic flow that draws an average of 14 new patients/month. 2019 gross receipts of $500K and strong post-COVID recovery in 2020. Office utilizes Dentrix Software. Own real estate with incomeproducing apartment along with practice. For details contact Linda Zalkin by phone: (631) 357-1003; or email: linda.zalkin@henryschein.com. # NY2684.

CAPITAL DISTRICT: Growing community close to downtown Albany, on bus line, near major highways leading to NYC. Modern-feel office with four ops; Dentrix Ascend, Dexis, Pan, Diode laser and more. Two full-time hygienists, along with valued team, working 4-day work week, with systems in place and excellent collection policies. No HMOs or state insurance. Excellent opportunity for any dental entrepreneur. For details contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick by email: donna.bambrick@henryschein.com or call: (315) 430-0643. #NY2712.

FOR RENT TRIBECA: 10-foot ceiling dental operatory in brand new dental office located in Tribeca. State-of-the-art dental chair with curing light, Cavitron, camera and monitor. X-ray machine and TV in room. Please contact for information. Phone: (917) 392-0506; or email: Patmoez@gmail.com.

MANHATTAN: Murray Hill. Space available in established, friendly dental practice off Park Avenue. One op with shared reception area, WiFi and utilities. First floor of luxury doorman building in desirable location, at 35 East 35th Street. Call (212) 532- 0690; or email: parkavedentistny@gmail.com.

NASSAU COUNTY: Excellent opportunity for specialists seeking space sharing at new, modern digital office. Easy access to highway. Please contact to discuss options. Phone: (516) 592-1555; or email: parul-dua@yahoo.com.

NORTH FORK: 1,300-square-foot office for rent.

Three ops fully plumbed and equipped with fourth plumbed and ready to go on booming North Fork in Southold. Large lab, private office with bath. Main road frontage; high-traffic area. Specialist ONLY due to covenants. Dire need for Endos, Oral Surgeons and Pediatrics.

Flexible for use as multi-specialty. For more information, please contact: amcdds44655@optimum.net.

CAMDEN, NY: 4 + 4-op general practice. Associate buyin opportunity. Digital, high tech, paperless, modern; utilizes EagleSoft and has strong hygiene program. For details contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick by phone: (315) 430-0643; or email: donna.bambrick@henryschein.com. #NY285.

MIDTOWN MANHATTAN: Beautiful, new, largewindowed dental operatories for rent. Pelton Crane equipment, massage chairs, private office and front desk space. Doorman; warm environment. Best location – 46th Street and Madison Avenue. Please call (212) 371-1999; or email: karenjtj@aol.com.

BROOKLYN: General practice in desirable location with 5 equipped ops. Digital, high-tech modern office that has been updated and uses Dentrix software. Strong hygiene program exists in this turnkey opportunity. For details contact Henry Schein Professional Practice Transition Sales Consultant Linda Zalkin by phone: (631) 357-1003; or email: linda.zalkin@henryschein.com. #NY288.

MANHATTAN: Murray Hill. 4-op office available for rent 1-3 days/week. Accessible all weekends and holidays. Established dental practice in luxury doorman building. Convenient to public transportation. Perfect for start-up or established general practice that needs room to grow or maintain existing practice. Owner reducing days. Opportunity to transition into buy out. Contact: murrayhilldentist@gmail.com.

SYRACUSE SUBURB: 4 equipped ops in desirable location. Fully digital, paperless, with strong hygiene program and Eaglesoft. Refers out specialties. Gross revenue $773K For details contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick, by phone: (315) 430-0643; or email: donna.bambrick@henryschein.com. #NY291.

WHITE PLAINS: Modern, state-of-the-art operatories available in large office with reception. Available FT/PT; turnkey.

Rent includes digital radiology with Panorex, equipment, Nitrous, all disposables. Start-up or phase down. Need a satellite or more space? Upgrade or downsize. Please call (914) 290-6545; or email: broadwayda@gmail.com.

BAY RIDGE: 63-year multi-generational practice on Doctors’ Row. Entire office newly renovated with 2 modern ops. Digital, Easy Dental software. Excellent staff, willing to stay, $500K last 4 years. PPO, Cap and private. Professionally appraised at $350K. Practice and rent negotiable. Option to buy building (limestone), 4-bedroom duplex + practice, 2,400 square-feet, appropriately zoned. $1.2M. Owner retiring. Call or email for details: pjsciortinodds@aol.com; (646) 404-2279.

CENTRAL NEW YORK: Soon-to-retire doctor looking to sell or rent second practice. 1,000-square-foot building with four fully functioning ops. Office gross $150K working 5 hours/day one day/week. Current clientele includes approximately 500 active patients, with potential for expansion of up to 10 new patients per week. Includes second-floor one-bedroom apartment and adjacent 3-family rental property with $10K profit per year. Call for details (315) 794-0527; or email: ericrachadds@gmail.com.

The New York State Dental Journal AUGUST/SEPTEMBER 2021 49 ●

CLASSIFIEDS

QUEENS: Well-established private and insurancebased GP practice in desirable, busy Queens community. Now is your chance. Located in beautiful storefront location with main street visibility and easy subway access. Seller owns 1,800-square-foot building, which allows 900 square feet for office, with additional backyard space for growth construction. Seller willing to sell both practice and real estate together as package. Equipped with three treatment rooms and one additional plumbed room for expansion. Contact Mike Apalucci by phone: (718) 213-9386; or email: michael.apalucci@henryschein.com. #NY2677.

MADISON COUNTY: Absolutely stunning general practice with modern six-operatory practice, plumbed for future 7th op. Gross revenue ranges from $1.2 to $1.5M for last 3 years. Equipped with 3D Pan, nitrous oxide, lasers, intraoral cameras, computers and smart TVs in each op.

Reception has movie theater room and video game room for entertainment. 90% fee-for-service. Located on high-visibility main street across from busy shopping plaza. Located in highly desirable lake community that boasts fishing, swimming, boating and sailing. Winter ski hill also operates in this quaint town. School system top rated in state. Practice situated in 3,500-square-foot freestanding building, with large parking lot, and available for purchase or lease. Truly rare, one-of-a-kind opportunity. For details contact Henry Schein Professional Practice Transition Sales Consultant Donna Bambrick by email: donna.bambrick@henryschein.com; or call (315) 430-0643. #NY2711.

MIDTOWN MANHATTAN: Facing Central Park South. Fully digital dental office, including i-Cat, for lease. Great opportunity to be on your own.

State-of-the-art décor; newly renovated, modern office and equipment; handicap access. Near all public transportation. Available immediately, full time or part time. To schedule appointment, please email: perioimplantbythepark@gmail.com; or call: (917) 679-6013.

CLASSIFIEDS

MIDTOWN MANHATTAN: Dental ops for rent on Madison Avenue. FFS practice has 1-2 ops available full time or part time. Beautiful, new, large-windowed dental ops with Pelton Crane equipment, massage chairs and two TVs at 12 o’clock and overhead. Pano/CT/ Ceph available. Shared front desk space and private office. Will consider sharing staff if needed. Located at 53rd Street and Madison Ave. Please inquire at: nycmidtownoffice@gmail.com.

SUFFERN: Dental space for lease. Prominent building located across from Crown Plaza Suffern, which sits directly off NYS Thruway Exit 14B. Airmont is highly desirable area not far from NJ border. Easy access to Route 59, Route 17 and NYS Thruway. Building offers visibility on Airmont Road and contains elevator, large parking lot in rear of building and well-maintained.

Space fully fitted for dental office, with 4 ops, large waiting room and reception area, private office, 2 bathrooms, X-ray room and lab/lunchroom. Call broker for more information. Lynn Teger, Licensed Real Estate Broker, eRealty Advisors, Inc. Phone: (845) 709-0929; email: lynnteger@hotmail.com. Visit online at: www. lynnteger.com.

WHITE PLAINS: Dental operatory for rent in modern and beautiful 4-chair office with Pan and ceph units.

Free parking in center of White Plains. Very accessible to public transportation (Metro North and buses). Open to rental by specialist or GP. Rent negotiable. Email inquiries to: 21eh1997@gmail.com.

BRONX: Co-op City. Beautiful, running dental office for rent. Two fully equipped ops, digital X-ray, computer, labs and sterilization room. Option to purchase. Call (718) 862-9232.

BROOKLYN: Sheepshead Bay/Avenue V. Modern dental office for rent. Approximately 1,800 square feet of prime storefront location. Large reception/front desk area, 5 plumbed operatories, private doctor’s office, large staff lounge and laboratory space. Can be expanded to 3,600 square feet. Long lease with comfortable terms available. Call landlord directly at (516) 593-0962; or email: fordcoyle@optonline.net.

MANHATTAN: Fully equipped operatory available full time or part time in newly built, multi-specialty private practice located on 58th Street between Lexington and 3rd Ave. For more information, please contact us at (212) 838-0840; or email: manager@zarabidental.com.

SERVICES TAXES: Your office, business or personal. Specialty dentists. Personable CPA. Call Stuart A. Sinclair, CPA, at (516) 935-2086. Visit our website: www.dentaxsolutions.com. Offices located at 1120 Old Country Rd., Plainview, NY 11803.

DENTAL LEGAL SERVICES: Whether it be a dentist purchasing or selling dental practice, buying, selling or leasing office space, employment matters, partnership agreements or litigation, the Law Office of Alan C. Stein, PC, will zealously advocate for your rights. With over 25 years of legal experience in dental transactions, the Law Office of Alan C. Stein can handle the most complex of dental transactions to the most basic. “I’m not just married to a dentist……I live dentistry!” Zoom and in-person appointments available. Offices in Woodbury & Southampton, NY. Call the most trusted law firm for dentists today for your free consultation: (516) 932-1800 Find us online at: www.dentalattorney.net.

OPPORTUNITIES AVAILABLE WHITE PLAINS: Well established, busy and growing practice in White Plains is looking for enthusiastic, skilled and experienced general dentist with excellent communication skills and affable personality to join our dental team with potential for partnership. Senior dentist retiring and we are acquiring his patients. One to two days to start. Candidate must be proficient in comprehensive treatment planning, operative dentistry, endodontics and routine crown & bridge dentistry and implant restorations. Inquiries to: 21eh1997@gmail.com.

NYU COLLEGE OF DENTISTRY: Brooklyn Practice Directors. NYU College of Dentistry seeks qualified applicants for full-time clinical track faculty positions to inaugurate our new patient care facility in Brooklyn.

Responsibilities include but will not be limited to providing direct patient care and providing instruction under new mentor-protégé model designed to increase efficiency and improve student learning. Under mentor-protégé model, instructor-practitioner will mentor very small group of student protégés or associates, who will also provide patient care alongside faculty-mentor. This will increase student clinical experience by increasing patient volume, while allowing care to be delivered more efficiently than traditional dental school clinics. New model will further extend oral healthcare to community and offer important role-modeling opportunity for students by faculty. Qualifications: Ideal candidate will have 3-5 years practice experience in General Dentistry and be able to demonstrate proficiency in Operative Dentistry, Endodontics, Digital Dentistry, Fixed and Removable Prosthodontics, Periodontics and Esthetic Dentistry.

Candidate must also demonstrate passion for patient care and strong desire to mentor students in demanding, fast-paced academic environment. Candidate must

50 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●

be comfortable working and interacting with students, faculty and staff from diverse backgrounds and have commitment to inclusion and equity. Candidates must possess DDS/DMD degree and be eligible for licensure in New York State. Application Instructions: NYU offers competitive compensation, including excellent benefits. Salary and academic rank commensurate with credentials and experience. Practice Director position would also include entry (if desired) into new certificate program called “TOP,” “Transition to Ownership Program,” aimed to give Practice Director high level experience in running practice with guidance in managing finances, human resources and everything else attached to running your own dental practice. Applicants should submit letter of interest and curriculum vitae to Dr. Andrew Schenkel, Clinical Professor, via Interfolio: https://apply.interfolio.com/70356. NYU is Equal Opportunity/Affirmative Action Employer.

SARATOGA COUNTY: Fantastic and rare opportunity to join high-quality and rapidly growing dental group.

Modern, state-of-the-art facilities with new equipment, digital X-rays and paperless charting. Seeking right dentists to join team as we expand and grow. First- and second-year salary minimum guaranteed, with opportunity for earnings well above average. Flexible terms can be tailored to fit individual desires if determined to be right fit. Very competitive compensation methodology.

Training available for precision-guided dental implant surgery. Very strong mentorship program for new and recent graduates. Contact John O’Brien, DDS, by email: jobrien1218@gmail.com; or call (518) 703-5321.

FINGER LAKES REGION: Dental practice with three locations across region. Practice sees great number of patients with little competition. Current doctor interested in bringing on associate and exploring path to partnership. Either route would be considered, as seller would like to continue practicing long term. Each location approximately an hour apart, located in freestanding or office buildings. Real estate for two locations for sale.

Each location has at least four operatories, while one practice has 7 ops, for total of 15 plumbed operatories.

Collections of $1.4M & EBITDA $140K. To learn more, contact Sam Schoenecker with Professional Transition Strategies by email: Sam@professionaltransition.com; or give us a call: (719) 694.8320. We look forward to speaking with you!

ORLEANS COUNTY: Silsby Dental is extraordinary, comprehensive and growing general dentistry practice in search of associate to join our team. Looking for team member to provide the highest level of quality dentistry to each of our valued patients. Ideal candidate is highly motivated, shares our values for quality care, engages in honest dialogue with our patients, is committed to continued education and embraces our friendly, team-oriented atmosphere. Our office has fully remodeled operatories and state-of-the-art technology, including CBCT, fully digital imaging and scheduling, online patient tools and more. At Silsby Dental, you would start off as associate, with partnership oppor-

tunity as you grow within practice. Please reply with resume and cover letter via email to Heidi Silsby at: silsbyfamilydental@gmail.com.

ASTORIA, BAYSIDE AND BRONX: Dentists and specialists needed. Multi-specialty offices looking for General Dentist (must provide treatment for crowns, bridges and root canals); Oral Surgeon, Pedodontist & Endodontist. Positions available in 3 locations. Must examine, diagnose and provide treatment counseling to patients in comprehensive manner; solicit patient feedback to improve service; and direct assistants and other auxiliary personnel. Specialists must provide certificate of residency. Please email CV for consideration: belldentalcare@gmail.com.

STAMFORD, CT: General dentist opportunity. What are you looking for in practice? Is it working alongside great staff? Having clinical autonomy? What about location? Lucky for you, Midwest Dental is hiring in Stamford, CT, and we can check all those boxes.

Seeking full-time general dentist ready to jump in and bring their experience to the team. Not only do we offer full benefits package, but you will also have access to our booming CE program. If interested in learning more about this exciting opportunity, contact Morgan Keating by phone: (715) 797-4649; or email: mkeating@midwest-dental.com.

YORKTOWN HEIGHTS, NY: Looking to make your dental dreams come true? Midwest Dental in Yorktown Heights, NY, may be exactly what you are looking for.

Practice has close to 2,000 patients of record and is very cosmetic driven. Not only does Midwest Dental offer great benefits, such as health insurance and 401k, but you can choose from robust list of CE to keep learning and growing. To learn more about this great opportunity, contact Morgan Keating by phone: (715) 797-4649; or email: mkeating@midwest-dental.com. Let’s add your name to our list of successful general dentists at Midwest Dental.

PITTSFORD NY: Genera dentist opportunity. Midwest Dental is looking for general dentist ready to grow and

KINDERHOOK NY: What are you looking for in practice? Working alongside great staff? Having clinical autonomy? What about location? Lucky for you, Midwest Dental is hiring in Kinderhook, NY, and we can check all those boxes. Seeking full-time general dentist ready to jump in and bring their experience to the team.

Not only do we offer full benefits package but you will also have access to our booming CE program. If you are interested in learning more about this exciting opportunity, contact Morgan Keating by phone: (715) 797-4649; or email: mkeating@midwest-dental.com.

NASSAU COUNTY: Looking for general dentist for growing, well-established, private FFS office in Nassau County, Long Island. Must have 5 years experience.

Please contact by phone: (917) 589-4775; or email: adriannekoster@gmail.com.

ROCKEFELLER CENTER: Three-operatory FFS general/perio/prostho practice in prestigious Rockefeller Center. On 18th floor, with unobstructed views of skating rink and Christmas tree, 630 Fifth Avenue is center of New York City and known throughout the world.

Long-established office with loyal patient base and constant stream of new patients due to five-star web presence. Seeking experienced Associate dentist who will join this very special practice and assume ownership and care of patients after short introductory period.

Owner leaving New York and motivated to transition practice to right individual. General office could also easily transition to specialty office for perio/prostho or implant dentistry. Modern and fully digital office with A-Dec chairs, digital X-ray, piezo surgery, implant surgery, Nd:YAG laser and paperless front desk. Favorable long-term lease. Seller highly motivated. For details, please contact: spe3@mac.com.

MIDWESTERN UNIVERSITY: Downers Grove, Illinois, seeks FT Faculty Member. Responsible for teaching one-to-one, small group and plenary settings; demonstration and facilitation related to clinical situations; and use of electronic media as needed.

Candidates must possess DDS/DMD degree and be eligible for licensure in Illinois. Successful candidate will possess enthusiasm for dentistry; excellent clinical, communication and interpersonal skills; and ability to embrace new technology. Previous teaching experience not required, but candidate must have history of clinical experience. Also hiring for the following specialties: • Oral and Maxillofacial Surgeon • Discipline-Focused • Pediatric Dentist • Orthodontist. Apply online at:

https://recruiting.ultipro.com/MID1016/ JobBoard/14e53f57/a561-4a17-e6ef-fbd 661b8b6c1/?q=&o=postedDateDesc. For questions, contact Rebecca Siscel, Associate Dean, by email: rsisce@midwestern.edu.

Midwestern University is Equal Opportunity/Affirmative Action employer that does not discriminate against an employee or applicant based upon race; color; religion; creed; national origin or ancestry; ethnicity; sex (including pregnancy); gender (including gender expressions, gender identity and sexual orientation); marital status; age; disability; citizenship; past, current, or prospective service in the uniformed services; genetic information; or any other protected class, in accord with all federal, state and local laws, including 41 C.F.R. 60-1.4(a), 250.5(a), 300.5(a) and 741.5(a). Midwestern University complies with the Smoke-Free Arizona Act (A.R.S. 36-601.01) and the Smoke-Free Illinois Act (410 ILCS 82/). Midwestern University complies with the Illinois Equal Pay Act of 2003 and Arizona Equal Pay Acts.

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Choice Transitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Dental Post . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Epstein Practice Brokers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

First Republic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Jacobson Goldberg & Kulb . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Law Office of Alan Stein . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

MLMIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cover IV

NSS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 & 36

NYSSOMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

The Smilist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cover III

UB Continuing Education . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Wexler Healthcare Properties . . . . . . . . . . . . . . . . . . Cover II

The New York State Dental Journal AUGUST/SEPTEMBER 2021 51 ●

CLASSIFIEDS

SARATOGA COUNTY: Seeking associate dentist.

Great benefits and bonuses. Fast growing, privately owned dental office seeks talented and enthusiastic associate to join us in great deal of fun. Huge opportunities for advancement for everyone on our team and because of our unique bonus system and promotion policy, your potential is essentially limitless. Managerial potential. Enjoyable, respectful and professional environment; newest, most advanced instruments/procedures.

Full educational support and in-practice training and CE allowances. Two days per week, with outstanding morning and evening positions available. Role will be vitally important to keeping our practice running smoothly and maintaining our valued patients at highest level of dental health. Please contact Dr. Richard Dunham by email: abettersmile@yahoo.com.

expand their knowledge within great organization. Our Pittsford, NY, practice is excited to offer full-time general dentist position to someone ready to work with great patient base, continue their education with robust CE program and practice with full clinical autonomy.

Full-time position also includes health insurance, 401k and malpractice coverage. If you are interested in learning more about this exciting opportunity, contact Morgan Keating by phone (715) 797-4649; or email: mkeating@midwest-dental.com. We look forward to speaking with you.

Addendum

NYSDA and Foundation Salute CE Achievers And the results are in! Continuing education (CE) hours accumulated

46 years and always found CE courses to be a great way to interact

by NYSDA members have been counted and, based on credits submit-

with colleagues and exchange information.”

ted to the NYSDA CE Registry for 2020, the top achievers are Richard

Dr. Blauzvern said: “Over 3,500 continuing education hours lat-

Faber of Suffolk County (4,000 hours), followed by Peter Blauzvern of

er and I have gained a great wealth of knowledge, wonderful new and

Nassau County (3,500) and Frederick Marra of Third District (3,500).

old friends, all of which have given me the wherewithal to perform

Each year, NYSDA recognizes its members who earn 100, 300,

challenging dental cases and provided me with years of experience

500, 1,000 and every 500 hours of CE after that as recorded within

and growth. The time has flown quickly. Enjoy your journey!”

the CE Registry. This year, the breakdown by numbers of members

Rounding out our top three CE earners, Dr. Marra added: “My four

at each level is as follows: 100 (59); 300 (58); 500 (82); 1,000

years of dental school, followed by my year of general practice residency

(46); 1,500 (12); 2,000 (7); 2,500 (4); 3,500 (2); and 4,000 (1).

at the University of Pennsylvania, provided an arduous yet stimulating

All awardees receive certificates from NYSDA, which are presented

learning environment that forged my passion for my profession. Early

by the awardee’s component.

in my career it became apparent that lifetime learning was the means

NYSDA was the first professional organization within New

for recreating that environment in my solo general practice in the small

York State to mandate that its members amass a certain amount

town that I grew up in. Continuing education brought me knowledge,

of continuing education as a prerequisite for relicensure in accor-

confidence, understanding, improved communication skills and, most

dance with its belief that lifelong learning is related to practicing

of all, camaraderie among likeminded peers seeking the same values.”

dentistry in the best possible way.

CE credits are entered year-round for members. Dentists can

Dr. Faber, this year’s highest CE earner, put it this way: “CE is

submit credits that are up to a year old by mailing certificates of

one of the best ways to keep current with what is going on in den-

course completion to NYSDA: Continuing Education, 20 Corpo-

tistry. Attending CE courses gives you the most up-to-date infor-

rate Woods Blvd., Suite 602, Albany NY 12211; by faxing them to

mation when it’s relevant. Eventually, information gets published

(518) 465-3219; or by sending them electronically via the NYSDA

in journals, but it’s not really current, since it takes time to reach

website, www.nysdental.org.

publication. I have been in practice and dental education for over

Congratulations to this year’s top achievers, listed below:

4,000

1,500

Louis Rubins . . . . . . . New York County

Richard Faber . . . . . . . . Suffolk County.

Lauro Medrano-Saldana Second District

Sheldon Small . . . . . . New York County

Howard Baskin . . . . . . . . . Ninth District

Elaine Wong . . . . . . . . Second District

Robert Sorin . . . . . . . New York County

Luis Blanco . . . . . . . . . . . . Ninth District

3,500

John Whiteman . . . . . . . . Eighth District

Henry Wong . . . . . . New York County

Steven Feinstein . . . . . . . . Ninth District

Frederick Marra . . . . . . . . Third District

Ira Halper . . . . . . . . . . . . Ninth District

Alyson Buchalter . . . . . . Second District

M. Isabel Lyra-Leeds . . . . . Ninth District

Peter Blauzvern . . . . . . . Nassau County

Bart Silverman . . . . . . . . . Ninth District

Alfred Joseph . . . . . . . . Second District

Frederick Melone . . . . . . . Ninth District

Michael Smith . . . . . . . . . . Ninth District

Alan Pernikoff . . . . . . . . Second District

Warren Rosenzweig . . . . . Ninth District

2,500

Jeffrey Giller . . . . . . . . . Nassau County

Ewa Smyk-Fidel . . . . . . . Second District

Marshall Rubin . . . . . . . . . Ninth District

Nathan Hershkowitz . New York County

Francine Raxenberg . . . Nassau County

Vincent DiMento . . . . . . . . . Fifth District

Henry Russo . . . . . . . . . . . Ninth District

David Levine . . . . . . . . . . . Third District

Howard Weiner . . . . . . Nassau County

Bruce Dines . . . . . . . . . . . . Fifth District

Frank Vigliotti . . . . . . . . . . Ninth District

Suresh Goel . . . . . . . . . Seventh District

Frank Egan . . . . . . . . . . . Suffolk County

Gregory French . . . . . . . . . Fifth District

Nina Patel . . . . . . . . . . Nassau County

Henry Sachs . . . . . . . . . Nassau County

Meredith Jaffe . . . . . . . . . Suffolk County

Joan Laura . . . . . . . . . . . . . Fifth District

Rosanne Puoplo-Carter . Nassau County

John Rathbauer . . . . . . . . Suffolk County

Thomas Gadziala . . . . . . . Sixth District

Mark Rosenkranz . . . . . Nassau County

Daniel Barletta . . . . . . . Seventh District

Kamrooz Korori . . . . . . Queens County

2,000

Stanley Zak . . . . . . . . . . Eighth District

John Young . . . . . . . . New York County

1,000

Robert Buhite . . . . . . . . Seventh District

Frank Pappas . . . . . . . . Queens County

Mark Barone . . . . . . . . . Eighth District

Sara Babich . . . . . . . New York County

Thomas DeStefano . . . . Seventh District

Juan Pesantes . . . . . . . . Queens County

William Maloney . . . . . . . Ninth District

Debra Cohn . . . . . . . New York County

Gerard Gizzi . . . . . . . . Seventh District

Mitchell Stein . . . . . . . . Queens County

Roberto Rodriguez Gutierrez . . Ninth District

Steven Edelson . . . . . New York County

Vernon Loveless . . . . . . Seventh District

Jacqueline Fries . . . . . . . Suffolk County

Bradley Fischman . . . . . Nassau County

E. Mitchell Greenstone New York County

David Skeels . . . . . . . . .Seventh District

Jeffrey Seiver . . . . . . . . . Suffolk County

Brian Raskin . . . . . . . . . Nassau County

Steven Moss . . . . . . . New York County

Mary Zebracki . . . . . . . Seventh District

Patricia Regan . . . . . . . Nassau County

Theresa Mueller . . . . New York County

Pamela Pellerite . . . . . . . Eighth District

52

AUGUST/SEPTEMBER 2021 • The New York State Dental Journal

We Love New York!

The Smilist Dental started in Rockville Centre, NY. Now we have over 25 locations across New York!

Help us grow in our hometown.

We'd love to speak with you. Give us a call today!

Raj Mangalick Vice President of Business Development (516) 405-6825 | raj@thesmilist.com

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