NYSDJ January 2026 Vol. 92 No. 1

Drilling Down on Plastics in the Office the new york state dental journal

Volume92 Number 1

January 2026

Inside: Finding Fault with Medicaid Oversight

A Viable Alternative When Conventional Implants Won’t Do

the new york state dental journal

Volume 92 Number 1

January 2026 12 No Need to Travel the Road to Licensure Renewal Alone Brenda Turner NYSDA has the tool to support dentists every step of the way.

It’s called CE Navigator.

16 IPS Subperiosteal Implant for the Maxilla and Mandible Tal Sastow, D.M.D.; Ian Mark, D.M.D.; Edward Woodbine, D.D.S.; Jared Miller, D.D.S.; Erik D. Gilroy, D.D.S.; Harry Dym, D.D.S. Authors present two distinct and difficult scenarios where both traditional endosseous and zygomatic implants were not feasible.

Their remedy was a custom-designed Individual Patient Solutions Implants Preprosthetic system, an innovative approach that effectively addressed the challenges faced.

Cover: The Individual Patient Solutions Implants Preprosthetic system offers novel and effective solution for patients with significant bone loss where traditional endosseous and zygomatic implants are not viable.

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Editorial How green is your office?

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Attorney on Law NYSDOH fails Medicaid audit

10 Association Activities 37 Component News 48 Read, Learn, Earn 50 Classifieds 50 Index to Advertisers 52 Addendum Sjögren’s sleuths

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 at commons.ada.org and can be downloaded to mobile devices.

28 Amyloidoma of the Palate Philip Bacigalupo, D.D.S.; Nora Odingo, B.D.S., D.M.D., M.P.H. A so-far-unreported case of isolated amyloid deposition of hard palate is described by authors, along with review of literature and acknowledgment that localized amyloidoma of palate is rare.

32 Titanium Hypersensitivity as Possible Cause of Dental Implant Failures William J. Maloney, D.D.S., PG CertMedEd; George Raymond, D.D.S.; Maura Maloney, D.D.S. A look back at the history of development and use of titanium implants helps lead to suspicion that they may factor into unexpected failures in patients who are allergic to the material.

editorial

Going Green

Y

Can We Save Teeth and the Planet?

ou might not think you have a role to play in combatting climate change, but dentists can make a difference by reducing plastics in their offices.

Plastics are polluting the world. The streets of New York City are littered with plastic bottles, plastic bags, plastic packaging and all sorts of plastic refuse. According to news reports, over a billion tons of plastic are predicted to be dumped into our oceans in the next 20 years. In 25 years, plastic waste may outnumber the fish in the sea.[1-3] Plastic can take 10 years to hundreds of years to degrade. And while it’s decomposing, it fragmentizes into micro- and nanoplastics, 2

JANUARY 2026 . The New York State Dental Journal

entering the environment and, ultimately, our bodies. There is high concern about the effects these plastics have on our health and that of marine life.[4] Even dental materials fabricated from plastic, such as orthodontic aligners, may be contributors.[5] Fossil fuel used in the manufacturing of plastic is responsible for over 3% of the world’s greenhouse gas emissions. Today, burning fossil fuels in general is accountable for producing the most (75%, according to the United Nations) greenhouse gas emissions.

These gases cover the world, trapping in heat and causing climate change.[6] Climate change increases the temperature on our planet. With higher temperatures

THE NEW YORK STATE DENTAL JOUR­NAL

come wildfires, droughts, severe storms, melting polar ice caps, rising sea levels and flooding. According to the World Health Organization (WHO), “These weather and climate hazards affect health both directly and indirectly, increasing the risk of deaths, noncommunicable diseases, the emergence and spread of infectious diseases, and health emergencies.”[7] It’s interesting to note that 90% of New York City’s power, as opposed to upstate New York, is still derived from fossil fuels.[8] However, thanks to the embrace of AI and its requisite demand for more energy, nuclear reactor plants are being developed, which may be the only solution to this environmentally challenging modern technology and spur the need to eliminate our dependence on fossil fuels.

Our Future Depends Upon It It is becoming increasingly clear to me that reducing single-use plastic waste and attempting to reverse climate change are of utmost importance to our future survival. Nations of the world need to unite to prevent these problems.

A similar threat to our world occurred with the depletion of ozone in the stratosphere over Antarctica in the 1980s.

Thinking back to this time, as a young adult, I was struck by the fact that a hole in the ozone layer appeared due in no small part to my mother’s can of hairspray. Back then, chlorofluorocarbons (CFC) were used as propellants in all kinds of spray cans. CFC, when broken down into chlorine atoms, interacted with the ozone layer, depleting it, allowing increased UV radiation to reach the earth and causing all kinds of health issues, from skin cancer to immune system suppression.

Freon, also a CFC, was used in air-conditioning units. I still remember having freon loaded into my car when the air conditioner started blowing warm air. Thanks to the discovery of the harmful effects of CFC, confirmed in the 1980s,[9] the world came together with the Montreal Protocol (1987), which “is the first treaty to achieve universal ratification by all countries in the world” and phased “out the production and consumption of ozone-depleting substances,”[10] leading to the healing of the ozone perforation.[11] Doing Our Part One way dentists can help is by decreasing their reliance on single-use plastics (SUPs). Going around my own dental office, I had my staff list the SUPs we use: saliva ejectors, high-speed suctions, air-water syringe tips, prophy angles, needle covers, dental implant irrigation tubing, sterile water IV bags, headrest covers, laptop and keyboard covers, barrier film, X-ray sensor protectors,

EDITOR Stuart L. Segelnick, D.D.S., M.S.

MANAGING EDITOR Mary Grates Stoll

ADVERTISING/SPONSORSHIP MANAGER Jeanne DeGuire

ART DIRECTOR Ed Stevens

EDITORIAL REVIEW BOARD Frank C. Barnashuk, DDS. Past Clinical Assistant Professor, Department of Restorative Dentistry, University at Buffalo School of Dental Medicine, 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. David Croglio, DDS. Clinical Assistant Professor, University at Buffalo School of Dental Medicine, Buffalo, NY. Private Practice (retired), Amherst, 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, University at Buffalo School of Dental Medicine, Buffalo, NY. Private Practice, Hamburg, NY. G. Kirk Gleason, DDS. General Dental Practice (retired), Clifton Park, NY. Kevin Hanley, DDS. Orthodontic Private Practice, Buffalo, NY. Stanley M. Kerpel, DDS. Diplomate, American Board Oral and Maxillofacial Pathology, Associate Director, Oral Pathology Laboratory, Inc. Attending, Section of Oral Pathology, New York-Presbyterian, Queens, NY. Mohini Ratakonda, DDS, Clinical Assistant Professor, University at Buffalo School of Dental Medicine, Buffalo, NY. Endodontics.

Joseph Rumfola, DDS. Clinical Assistant Professor, AEGD Program Director, University at Buffalo School of Dental Medicine, Buffalo, NY. Private Practice, Springville, NY. Jay Skolnick, DMD. Board-certified Pediatric Dentist. Attending dentist, Rochester General Hospital. Private Practice, Webster, NY. Lisa Marie Yerke, DDS, MS. Diplomate, American Board Peiodontology, Clinical Associate Professor, Director Advanced Education Program in Periodontics, University at Buffalo School of Dental Medicine Department Periodontics & Endodontics, Buffalo, NY. Private Practice, East Amherst, NY.

PRINTER Fort Orange Press, Albany NYSDJ (ISSN 0028-7571) appears two times a year in print: January and June/July.

The March, April, August/September 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. Subscription rates for nonmembers: $75 per year or $12 per issue, U.S. and Canada; $135 per year foreign or $22 per issue. Editorial and advertising offices are at Suite 602, 20 Corporate Woods Boulevard, Albany, NY 12211. Telephone (518) 465-0044. Email info@nysdental.org. Website www.nysdental.org.

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sterilization pouches, face shields, protective eyewear, toothbrushes, pens, highlighters, utensils, straws, cups and trash bags. We are still evaluating the list for further items. I was astonished at how much plastic waste my office creates and wondered whether it could be replaced by more ecofriendly items?

Many of the SUPs on my dental practice list are important, effective infection-control barriers, which must not be compromised. The ADA has a great resource, “80 Ways to Make Your Dental Practice Green,” which was very useful. I tasked my office with finding compatible single-use materials that would replace these plastics or alternative multiuse materials, like our new metal autoclavable air-water syringe tips and autoclavable high-speed surgical suctions, which can be metal (or autoclavable plastic multi-use). Barrier film was found on a tattoo online store website that was triple the size of what we use, which would be too timeconsuming to cut.

Bamboo handle toothbrushes were located to give to our patients. We unearthed durable garbage bags that were biodegradable and compostable. We even started using alternative utensils and straws made of bamboo and plant-based material. These multi-use disposable and biodegradable products worked well, though they took some getting used to. The straws didn’t bend but were much better than the paper straws that tasted terrible and dissolved in certain drinks. Paper straws were, thankfully, all but trashed by an executive order signed by the President in February 2025.[12] Some of my staff didn’t like the texture of the wooden utensils on their tongues. This seemed a small inconvenience on the way to saving the world; however, like any new endeavor, there is a time commitment to implementing these changes—ordering from new vendors and most onerous to small businesses like ours, increased cost. Single-use, similar quality, biodegradable products turned out to be more expensive. For dental practices that are insurance-based or unable to easily raise their fees, going green may turn into going red, as well as impractical.

Government subsidies may be needed or passing these extra charges through to our patients.

This editorial hasn’t even touched upon nitrile gloves, which are not biodegradable and have been shown to negatively impact the environment, along with the controversial question of whether a completely biodegradable nitrile glove truly exists.[13] My addiction to SUPs was not easy to overcome and has been a battle. Lucky for me, my office staff were very supportive; however, you may experience pushback. We didn’t go all or nothing; we paced ourselves, replacing one SUP at a time, and are still in the process.

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Yes, We Can Hopefully, awareness of the dentist’s potential role in eliminating SUPs while balancing sustainability, as the United Nations addresses, speaks to our responsibility of “meeting the needs of the present without compromising the ability of future generations to meet their own needs.” [14] And, as related by a very helpful group called the Plastic Pollution Coalition on its website: “By adopting greener practices, choosing eco-friendly materials, and minimizing waste, dental professionals can have a significant positive impact when it comes to plastic pollution.” [15] We can help our patients continue to live in a world with happy healthy smiles. Let’s go green!

REFERENCES

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2.

3.

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5.

6.

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8.

9.

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11.

12.

13.

14.

15.

https://www.cbc.ca/news/politics/ocean-plastic-liberals-fact-check-1.5212632. https://www.cnbc.com/2020/07/23/enormous-amount-of-plastic-will-fill-oceans-and-landby-2040-report.html. https://www.iaea.org/newscenter/news/more-plastic-than-fish-by-2050-iaea-event-gathersexperts-working-together-to-save-marine-environments-from-plastic-pollution. https://www.epa.gov/plastics/impacts-plastic-pollution.

Saha U, Jena S, Simnani FZ, et. al. The unseen perils of oral-care products generated micro/ nanoplastics on human health. Ecotoxicol Environ Saf. 2025 Jan 15;290:117526. https://www.un.org/en/climatechange/science/causes-effects-climate-change. https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health. https://www.nyserda.ny.gov/All-Programs/Large-Scale-Renewables/Tier-Four. https://ozonewatch.gsfc.nasa.gov/facts/history_SH.html. https://www.state.gov/the-montreal-protocol-on-substances-that-deplete-the-ozonelayer#:~:text=The%20Montreal%20Protocol%2C%20finalized%20in,%2C%20fire%20extinguishers%2C%20and%20aerosols. https://earthobservatory.nasa.gov/images/153523/ozone-hole-continues-healing-in-2024.

Ending Procurement and Forced Use of Paper Straws – The White House.

Mészáros E, Bodor A, Kovács K, et.al. Plastic contamination from latex and nitrile disposable gloves has the potential to influence plant productivity and soil health, Journal of Hazardous Materials Advances, Volume 17,2025,100605, ISSN 2772-4166. https://www.un.org/en/academic-impact/sustainability. https://www.plasticpollutioncoalition.org/blog/2025/5/7/plastics-in-dentistry-the-currentreality-and-plastic-free-solutions.

“80 Ways to Make Your Dental Practice Green” (https://www.ada.org/resources/practice/ practice-management/office-design/80-ways-to-make-your-dental-practice-green).

Addendum In the November Journal, I thanked my colleagues who offered their expertise and time reviewing manuscripts submitted for publication in The Journal. I inadvertently left off one name. That is, Gary A. Nord, DMD, FACP. Dr. Nord of Prosthodontic Associates in New York City, is Northeast Regional Director, American College of Prosthodontists Board of Directors, immediate past president, ACP New York State Board of Directors, and sits on the ACP Council for the American Board of Prosthodontics. Thank you, Dr. Nord and all our reviewers.

D.D.S., M.S.

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ATTORNEY ON LAW

Could Have Seen That Coming New York State Department of Health taken to task for failing to provide proper oversight of Medicaid managed care provider networks.

A

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

recent audit conducted by the Office of the New York State Comptroller (OSC) found that the New York State Department of Health (NYSDOH) oversight of Medicaid managed care healthcare provider networks was largely illusory and a paperwork sham. This raises the much larger question of whether Medicaid managed care is really serving the population of Medicaid patients. It is already almost a given that it is not serving healthcare providers well.

OSC conducted the audit to determine if NYSDOH had provided adequate oversight of Medicaid managed care provider networks to ensure cost efficiency and access to adequate in-network care. OSC explained that most of New York State’s Medicaid members receive their services through managed care and that NYSDOH is responsible for ensuring that managed care organizations (MCOs) maintain and monitor a network of providers, supported by written agreements, that is sufficient to provide timely and adequate access to all services covered under the contract. If the provider network cannot provide services, the member can go out of network.

MCOs are required to submit their provider networks to NYSDOH quarterly, using the Provider Network Data System (PNDS) for assessment of network adequacy. This 6

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information is used to generate a deficiency report identifying areas where the MCO lacks enough providers in certain counties. MCOs are given an opportunity to dispute deficiencies and provide supporting information to have the deficiency removed. NYSDOH reviews the MCOs’ responses and updates the status of the deficiency. At the conclusion of this process, the remaining deficiencies are compiled into a quarterly Statement of Agreement (SOA) for each MCO.

Setting the Stage

At the end of the recent state fiscal year on March 31, 2025, the New York State Medicaid program had 8.4 million members and Medicaid claim costs amounted to $93 billion ($49.2 billion from fee-for-service healthcare payments and $43.8 billion in managed care premium payments). The federal government funded 55.7% of New York’s Medicaid claim costs, and the state and local governments funded the remaining 44.3%.

A little basic background on Medicaid in New York State will help set the stage for the OSC audit conclusions. NYSDOH, in administering the Medicaid program, uses two methodologies to pay for Medicaid services: 1) fee-for-service; and 2) managed care. Under the fee-for-service methodology, NYSDOH, through its Medicaid claims

NYSDA

Directory

OFFICERS

processing and claims payment center—eMedNY— pays enrolled Medicaid providers directly for services delivered to Medicaid members. Under the managed care methodology, NYSDOH makes monthly premium payments to managed care organizations (MCOs) for each enrolled Medicaid member and, in turn, the MCOs arrange for the provision of healthcare services and reimburse healthcare providers for those services.

Pursuant to federal regulations and the New York State Model MCO Contract, NYSDOH is responsible for ensuring that MCOs maintain and monitor a network of healthcare providers, through written agreements, that is sufficient to provide timely and adequate access to all services covered under the MCO Model Contract.

If the MCO provider network cannot provide services, the Medicaid member is allowed to go outside the network for services for as long as the MCO network is unavailable to provide the services. NYSDOH has developed guidelines for MCOs that define the minimum requirements for network adequacy by county, county surrounding areas and by healthcare provider type, such as dentists.

NYSDOH uses PNDS, a software product provided

by Quest Analytics, to collect data needed to evaluate healthcare provider networks. Each quarter of the year, MCOs are required to self-report their healthcare provider networks to NYSDOH to determine their adequacy. The information reported by each MCO is used

by PNDS to identify available healthcare providers in each county. Quest Analytics uses this information to generate a deficiency report identifying areas where the MCO lacks sufficient healthcare providers to meet network requirements. NYSDOH then reviews this report to ensure it contains valid deficiencies and shares the report with the MCO. The MCOs are given an opportunity to dispute deficiencies and submit supporting information to have the deficiencies removed. NYSDOH reviews the MCOs’ responses and updates the status of the deficiency to one of nine possible statuses, ranging from “deficiency resolved” to “deficiency removed” to “deficiency retained.” At the conclusion of this process, the remaining deficiencies are compiled into a quarterly Statement of Agreement (SOA) for each MCO. The SOAs specify deficiencies by county and type of healthcare provider. MCOs have 10 days to sign the SOAs, agreeing to allow Medicaid members to access out-of-network healthcare providers for the specified services in the specified counties until the network requirements are satisfied.

Maurice Edwards, President Amarilis Jacobo, President-Elect Lynn Stacy, Vice President Paul Leary, Secretary-Treasurer William Karp, Speaker of the House

30 East 60th St., #1401, New York, NY 10022 824 East 181st St., Bronx, NY 10460 7504 East State St., Lowville, NY 13367 80 Maple Ave., Ste 206, Smithtown, NY 11787 4500 Pewter Ln., Bldg 6, Manlius, NY 13104

BOARD OF TRUSTEES

Prabha Krishnan, Immediate Past President Brendan Dowd, ADA Trustee NY – James E. Jacobs 2 – John P. Demas 3 – Geoffrey Gamache 4 – Adrienne L. Korkosz 5 – Steven Stacey 6 – Louis Giordano 7 – David Ramjattansingh 8 – Raymond G. Miller 9 – Gary M. Scharoff N – Donald R. Hills Q – Mitchell S. Greenberg S – Martin Dominger B – Jacqueline J. Samuels

11045 Queens Blvd., Ste 108, Forest Hills, NY 11375 3435 Main St., Squire Hall, Room 235G, Buffalo, NY 14214 10 East 53rd St., Ste 2500, New York, NY 10022 8814 Fort Hamilton Pkwy, Brooklyn, NY 11209 24 Eastview Rd., Averill Park, NY 12018 1309 Union St., Schenectady, NY 12308 6702 Buckley Rd., Ste 120, Syracuse, NY 13212 864 Hooper Rd., Endwell, NY 13760 71 King Arthurs Ct., Rochester, NY 14626 122 Covington Rd., Buffalo, NY 14216 1255 North Ave., Ste A1H, New Rochelle, NY 10804 5 Willow Rd., Old Bethpage, NY 11804 11966 80th Rd., #1A, Kew Gardens, NY 11415 5225 Nesconset Hwy., Suite 57, Port Jefferson Station, NY 11776 120 Alcott Place, Bronx, NY 10475

COUNCIL CHAIRPERSONS Dental Benefit Programs Dental Education

Joseph A. Craddock 3325 East Main St., Attica, NY 14011 Robert M. Peskin 601 Franklin Ave. #225, Garden City, NY 11530

Dental Health Planning Dental Practice

Maria Maranga 8 Rolling Meadow Ln., Northport, NY 11768 Mina Kim 2 West 46th Street, #501, Bryant Park Dental Assoc., New York, NY 10036

Ethics

Julie A. Connolly 115 East 61st Street, Fl. 8, New York, NY 10065

Governmental Affairs

Radha Sachdeva-Munk 203 Smithtown Blvd., Nesconset, NY 11767

Membership & Communications

Christopher W. Calnon 3220 Chili Ave., Rochester, NY 14624

Nominations

Prabha Krishnan 11045 Queens Blvd., Ste 108, Forest Hills, NY 11375

Peer Review

Lawrence J. Lehman 7303 197th St., Fresh Meadows, NY 11366

OFFICE Suite 602, 20 Corporate Woods Blvd., Albany, NY 12211 (518) 465-0044 | (800) 255-2100 Michael Herrmann Lance R. Plunkett Mary Grates Stoll Jenna Bell Jacquie Donnelly Heather Relation Stacy McIlduff

Executive Director General Counsel/Director Governmental Affairs Managing Editor Director Meeting Planning Director Dental Practice Support Director Outreach Membership & Engagement Executive Director NYS Dental Foundation

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Faulty Process

The OSC audit found that NYSDOH lacked sufficient oversight of managed care provider networks. There were problems identified with all the following areas: • Collection of accurate self-reported MCO data.

• Unjustified exclusion of certain services from review.

• Inaccurate deficiencies being identified.

• Broad failure to adhere to SOA timeliness deadlines.

• Inadequate communication about the entire network adequacy review process.

• Lack of consistency with providing out-of-network payments in network adequacy deficiency situations.

OSC even determined that, in many instances, NYSDOH did not follow its own internal PNDS Review Guidance. The SOAs contained inaccurate deficiencies, and deficiency statuses were not always updated, which made it unclear whether NYSDOH took the additional steps needed to complete its quarterly network adequacy review.

In addition, OSC found records that appeared to have been incorrectly labeled as “excluded” from the network adequacy process, which could result in incomplete SOAs. OSC also found that NYSDOH did not provide MCOs with

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adequate guidance regarding the deficiency review process or out-of-network provider payments, which may have exposed the Medicaid program to increased expenses. Furthermore, despite having access to the SOA data, NYSDOH officials did not use this information to identify patterns or areas for improvement or to provide any other oversight of the network adequacy process.

Basically, the entire Medicaid managed care network adequacy review process, which looks wonderful on paper, approaches being farcical. NYSDOH responded that while some of the OSC conclusions were overly harsh and based on flawed sampling, improvements were already being made. OSC responded to that by stating NYSDOH was making misleading statements and that the sampling methods used were scientifically reliable and routinely used. NYSDOH is seemingly hoisted by OSC on the same sampling petard used by the Office of the Medicaid Inspector General (OMIG) that NYSDOH adores.

The adequacy of dental networks in Medicaid has been a hot button issue for years. NYSDA has constantly berated NYSDOH over the inaccuracy of dental network information and the inattention by NYSDOH to the overall problem

of policing dental networks. OSC has now confirmed that the system is broken. OSC almost regularly issues audits finding that NYSDOH wastes hundreds of millions of dollars on improper Medicaid payments through a wide variety of blunders. The OSC network adequacy audit concluded that it was difficult to quantify how much money NYSDOH had wasted through its feeble enforcement efforts.

Marching Orders

OSC made three specific recommendations in its audit.

First, OSC made the commonsense recommendation that NYSDOH improve monitoring and controls over the provider network adequacy process to ensure network deficiencies are reported timely and accurately, including issuing guidance detailing MCO responsibilities within the deficiency review process. Second, OSC recommended that NYSDOH evaluate the provider network deficiencies identified in SOAs and take steps to improve MCO provider networks. Third, OSC recommended that NYSDOH develop a complete and accurate list of healthcare provider categories that are excluded from the quarterly network adequacy review process to ensure that all services are appropriately

reviewed for network adequacy.

The OSC recommendations basically amount to directives to make the network adequacy review program function as it was intended to and for NYSDOH to perform its required regulatory duties. Put another way, it is like saying wake up and do something.

The audit speaks directly only to Medicaid network adequacy issues, but it also speaks indirectly to much larger issues with Medicaid. The bright promise of the program when first created in 1965 has consistently dimmed over 60 years. Despite adding layers and layers of regulations meant to improve the program, the reality is that it has subsumed itself with unhelpful bureaucracy. What is really needed is a moment like 1965 where the program can be completely reinvented so that it works sensibly again in getting services to the public. It has been suggested that artificial agentic intelligence might be useful in such a reform process, since NYSDOH intelligence appears to be absent. 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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Association Activities Santa’s Helpers NYSDA staff gave Santa a helping hand in 2025 by “adopting” a needy family of seven (two adults and five children, recent arrivals from Thailand) through Albany County Department for Children, Youth and Families Adopt-a-Family Program. Staff purchased items from gift lists provided by the department, then wrapped each item for delivery in time for Christmas.

Rekha Gehani to Continue on State Board QUEENS COUNTY orthodontist Rekha Gehani has been reappointed to a five-year term as an extended member of the New York State Board for Dentistry by the New York State Education Department Board of Regents. Dr. Gehani will serve through October 2030 on licensure disciplinary and/or licensure restoration and moral character panels. She received a B.D.S. (dentistry) from the University of India, Bombay, and D.D.S. from Columbia University College of Dental Medicine.

NYSDA Instrumental in Adoption of Updated Workers’ Compensation Dental Fees After years of sustained advocacy by the New York State Dental Association, the New York State Workers’ Compensation Board has adopted a new dental fee schedule. It went into effect on Nov. 13.

This long-awaited update marks the first adjustment to dental fees since 2009, representing a significant victory for fairness and modernized reimbursement across New York State. NYSDA has long championed the need for this revision, working closely with the Workers’ Compensation Board and other stakeholders to ensure equitable compensation for dental providers treating injured workers.

“This is a tremendous achievement for New York’s dental community,” said NYSDA President Maurice Edwards. “NYSDA’s advocacy made a real difference in helping to secure long-overdue updates that recognize the true value of dental care in the Workers’ Compensation system.”

The revised fee schedule has also been adopted by the New York State Department of Financial Services for dental treatment provided to victims of motor vehicle accidents through its no-fault program. No-fault cases are subject to different policy interpretations.

For further information regarding no-fault insurance, contact the Department of Financial Services directly: www.dfs.ny.gov/.

In addition, as of Aug. 1, 2025, the Workers’ Compensation Board has required that all claims be submitted electronically us-

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ing the CMS-1500 universal billing form. Electronic claims submission must be done through a Board-approved submission partner. Further information can be found on the Board’s website: www.wcb.ny.gov/CMS-1500/.

With the new fees in place, NYSDA encourages providers to consider treating patients who have been injured at work or in a motor vehicle accident. Although dental providers are now required to register for access to the Board’s medical portal in order to submit claims and prior authorization requests, it does not mean that they are “enrolled,” “in-network,” or are required to treat every patient seeking treatment. Unlike with physicians, Workers’ Compensation Law does not require that dental providers be authorized by the Board, only that they hold a valid New York State dental license.

A copy of the new fee schedule can be found here: www.wcb. ny.gov/content/main/regulations/adopted/dental-fee-2025-10/ dental-fee-schedule.pdf.

Providers with additional questions about the Workers’ Compensation System may contact Ms. Jacqueline Donnelly at NYSDA at jdonnelly@nysdental.org, or (518) 689-2750. They may also contact the Workers’ Compensation Board directly at OnBoard@wcb. ny.gov, or (877) 632-4966.

Association Activities In Memoriam SECOND DISTRICT Ronald Rosa New Jersey University of Medicine and Dentistry ‘67 1457 Bay Street Staten Island, NY 10305 November 13, 2025

FOURTH DISTRICT Ernest Winslow University at Buffalo ‘54 80 Willey Hill Road Norwich, VT 05055 October 29, 2025

FOURTH DISTRICT Matthew Kearney New York University ‘81 1 Commerce Plaza Albany, NY 12210 November 15, 2025

SEVENTH DISTRICT Marvin Wolff University at Buffalo ‘54 214 Ferris Hills Canandaigua, NY 14424 November 12, 2025

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No Need to Travel the Road to Licensure Renewal Alone NYSDA has the Tool to Support Dentists Every Step of the Way Brenda Turner

NYSDA staff recently assisted a well-established New York dentist—more than two decades into practice—who was confident his CE requirements were in order. He regularly attended educational programs and assumed that exceeding the required hours meant he was fully compliant.

That assumption was challenged during an audit. As he gathered records, gaps emerged: some certificates lacked required elements or were missing; a mandated course had been completed outside the appropriate registration period; and another mandated requirement had changed without his knowledge.

The matter was ultimately resolved, but the experience was eye-opening. Good intentions alone don’t guarantee compliance, and even the most careful dentists must stay vigilant to ensure safe, trusted care for every patient.

Maintaining an active dental license in New York State is more than a regulatory obligation. It is part of a dentist’s commitment to professional excellence and patient safety.

Yet navigating licensure renewal requirements, continuing education (CE) documentation and mandated coursework can be time-consuming and, at times, confusing—particularly as regulations evolve.

Most dentists believe they are compliant. They attend courses regularly, exceed the minimum number of CE hours and act in good faith. But experience has shown that compliance is not defined by intention; it is defined by documentation and verification.

Why Compliance Matters New York State Education Department (NYSED) regulations require that dentists complete 60 hours of continuing education every three-year registration period from approved sponsors with coursework that falls under the scope of 12

JANUARY 2026 . The New York State Dental Journal

practice. Certain courses are mandated based on a dentist’s stage of practice: • All practicing dentists must maintain current CPR certification; and infection control is required every four years.

• Newly licensed dentists must complete courses in ethics and oral cancer/smoking cessation, while dentists holding specific certificates or permits must complete opioid prescribing education or approved sedation coursework.

• All dentists must complete a child abuse identification and reporting course—although previously considered “once-in-a-lifetime,” regulatory updates may require additional training.

NYSED expects not only that these requirements are met, but that every hour is verifiable and readily retrievable. Incomplete or disorganized records can place dentists at risk during audits, license renewals, credentialing reviews or malpractice insurance inquiries.

Compliance protects more than a license. It protects professional reputation, practice continuity and peace of mind.

Dentists Encounter Challenges Responding to routine member inquiries, NYSDA staff has been able to compile a list of the most frequently heard concerns. They are: • Lost or incomplete CE documentation.

• Uncertainty about approved sponsors or qualifying activities.

• Difficulty tracking progress within the three-year renewal cycle.

• Confusion surrounding mandated coursework and deadlines.

Many dentists rely on paper files, email folders, spreadsheets or memory. These systems may work, until they are

CE Navigator: Turning Lessons into Prevention tested. As the dentist described at the beginning of this article discovered, even conscientious practitioners can find themselves vulnerable when documentation is fragmented or requirements change.

The Solution More than 3,000 NYSDA members currently use CE Navigator, with enrollment continuing to grow.

Dentists consistently cite reduced stress, improved organization and greater confidence as key benefits of using the system. The CE transcript generated through CE Navigator provides a standardized, NYSDA-issued record of continuing education that is recognized by the New York State Education Department (NYSED) for verification purposes, helping members prepare for audits and license renewal. CE Navigator is available at no cost to all current NYSDA members. To enroll or request support, visit www.nysdentalnavigator.com; or email CE@nysdental.org.

Compliance does not have to be complicated.

With the right tools and proactive planning, it becomes manageable—and empowering.

Brenda Turner is NYSDA Director of Continuing Education. She can be reached at bturner@ nysdental.org.

CE Navigator was developed by NYSDA in direct response to the challenges dentists face in fulfilling continuing education requirements. It provides a centralized, secure and intuitive platform to track CE activity and enhances understanding of licensure requirements—before issues arise.

Key benefits include the following: •

Centralized CE Recordkeeping—Members can upload certificates, track completed coursework and view CE totals for the current registration cycle in one secure location.

•

Requirement Tracking with Guidance—CE Navigator distinguishes between general CE and mandated coursework and helps clarify which credits count toward compliance.

•

Audit-Ready Documentation—Organized, accessible transcripts allow members to respond quickly and confidently to NYSED verification requests.

•

Personalized Member Support—CE Navigator users receive direct support from NYSDA’s CE Department for questions related to requirements, anesthesia permits, mandated coursework, sponsor eligibility and data entry. Members are encouraged to seek a compliance review at least three months before license renewal.

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Endorsed Vendor Updates

Exclusive Discounts from Trusted Vendors As a valued NYSDA member, you have access to something the broader dental community doesn’t— exclusive, member-only pricing from our carefully vetted, endorsed vendors. These special rates are negotiated specifically for you and are unavailable anywhere else, making this a powerful opportunity to maximize value while working with firms you can trust.

Every NYSDA-endorsed vendor has been thoroughly reviewed for quality, reliability and integrity, so you can move forward with confidence knowing you’re doing business with reputable partners who understand your needs.

Take advantage of this rare combination of savings and assurance—benefits reserved exclusively for NYSDA members.

Introducing the new ADA Credit Cards The new ADA® Rewards World Elite Mastercards® are the only cards exclusively endorsed for ADA and NYSDA members!

ADA® Rewards World Elite Mastercard® • 5x points on ADA, State Dental Society, and select ADA Member Advantage-endorsed product purchases (previously 2x points) 3x points on travel purchases 2x points on gas & groceries 1.5 points on all other purchases

ADA® Rewards World Elite Business Mastercard® • 5x points on ADA, State Dental Society, and select ADA Member Advantage-endorsed product purchases • 2x points on dental supply purchases • 1.5 points on all other purchases Enhanced Benefits Available on Both Cards • Access to Mastercard World Elite benefits and perks (Benefits like Priority Pass coming soon!)

• $0 annual fee • No foreign transaction fees • Flexible point redemption on travel, gift cards, cash back in the form of a statement credit, and more • Best-in-class fraud protection and card security Applications for the new ADA® Rewards World Elite Mastercard® are now open.

Experience a world of exclusive benefits in travel, entertainment, dining, and beyond.

Contact ADA Mastercard, 888.293.1595 or 888.487.0206 or visit us online at: www. adamastercard.com/ The ADA Rewards World Elite Mastercard is issued by FinWise Bank d/b/a Cottonwood Payments pursuant to a license from Mastercard International Incorporated. Mastercard is a registered trademark, and the circles design is a trademark of Mastercard International Incorporated. Use of cards in the Card Programs is subject to the terms and conditions of the cardholder agreements. *Cardholder Terms, Limits, and Conditions Apply. See adamastercard.com for details. This card is issued by Cottonwood Payments pursuant to a license from Mastercard. **Activation bonus points apply to upgraded customers. Rewards bonus varies for new customers.

For more information about these and other Endorsed Programs call Jeanne Deguire at: 800-255-2100

Endorsed Vendor Updates Take Advantage of Quality, Discounted services through NYSDA Endorsed Services

Dentrix ePrescribe simplifies prescription management with speed, safety, and ease.

Send prescriptions—including controlled substances—directly to a patient’s preferred pharmacy in just a few clicks. No phone calls. No paper. Just streamlined care.

Built-in safety checks catch allergies, interactions, and duplicates before sending.

Plus, automatic integration with New York’s Prescription Drug Monitoring Program keeps you compliant—without extra effort.

Fewer delays for patients. Smoother workflows for staff. Greater trust in your practice. Dentrix ePrescribe makes modern prescription management effortless.

For more information about these and other Endorsed Programs call Jeanne Deguire at: 800-255-2100

implantology

IPS Subperiosteal Implant for the Maxilla and Mandible Tal Sastow, D.M.D., M.S.; Ian Mark, D.M.D.; Edward Woodbine, D.D.S.; Jared Miller, D.D.S.; Erik D. Gilroy, D.D.S.; Harry Dym, D.D.S.

ABSTRACT

This two-case report presents the use of the Individual Patient Solutions (IPS) Implants® Preprosthetic system in two patients with distinct clinical needs.

Case #1 involves a 69-year-old male with significant unilateral maxillary bone loss and a residual oroantral communication (OAC) following the failure of both conventional implants and sinus lift procedures. Case #2 involves a patient with a severely atrophic, edentulous mandible. These cases present two distinct and challenging clinical scenarios where both traditional endosseous and zygomatic implants were not feasible. Both cases were successfully managed with a custom-designed IPS subperiosteal implant. This innovative approach involves a rigidly fixated, stable metal framework that is compatible with screw-retained temporary and final prostheses, effectively addressing the challenges of restoring severe vertical bony defects and the severely atrophic maxilla or mandible.

The Individual Patient Solutions (IPS) Implants® Preprosthetic system offers an innovative approach for restoring edentulous sites that have significant underlying bony defects or atrophy. This novel solution significantly enhances and, thereby, fundamentally differs from the underlying concept of the subperiosteal implant first introduced in 16

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1943.[1] It is designed for the prosthetic rehabilitation of the fully or partially edentulous maxilla and mandible. This innovative treatment modality utilizes CAD/CAM technology for the digital engineering of patient-specific solutions. The IPS implant is a multi-vector skeletal anchorage system that is fastened to the skeleton via rigid, screw-retained fixation to either the alveolar ridge or the facial skeleton.[3] The IPS Preprosthetic system was developed by the Hannover Medical School in conjunction with the KLS Martin Group and has been employed for use since 2015 in Europe. It was approved by the FDA in 2022 for use in the U.S. The IPS subperiosteal implant builds upon the principles first introduced and described by Dahl in 1943, with the significant innovations of adding rigid fixation and digitally guided CAD/CAM fabrication to Dahl’s passive-fit, non-stabilized model. Until the advent of IPS, subperiosteal implants were not recommended for use due to their high complication and failure rates. However, at present, enough literature exists to suggest the use of the IPS system. This is based on sound biomechanical and biomedical principles that demonstrate significant improvements over the historical subperiosteal implant design.[5] IPS implants are designed for patients with significant bone loss where traditional endosseous or zygomatic implants are not feasible. For the maxilla, IPS implants provide a solution for fully edentulous or partially edentulous spans with deficient bone. For the mandible, IPS provides an alternative to endosseous implants when they are not feasible due to mandibular atrophy.

For the placement of a conventional endosseous implant to be successful, optimal hard- and soft-tissue conditions are recommended, such as adequate dimensions

Figure 1. Preoperative panoramic radiograph.

Figure 2. IPS Preprosthetic virtual surgical model.

of bone in the vertical, sagittal and transverse dimensions, high-quality bone, paired with healthy and stable soft tissues around the implant. Zygomatic implants are one exception, exclusively available for restoration of the maxilla, as an alternative to both endosseous implants and the IPS system. However, in circumstances where both zygomatic implants and conventional endosseous implants are not feasible, the IPS system may be viewed as another available option.[1] The workflow involves two planning steps: prosthodontic-driven backward planning for the implant posts and designing a wireframe-style framework on the recipient site’s bone surface. These components are digitally fused and manufactured as a single-piece implant from a titaniumaluminum-vanadium alloy.[2] With regards to the prosthetic restoration of the IPS Preprosthetic system, KLS outlines a stepwise process for dental providers to follow after the surgical stage. The first prosthetic step, in fact, takes place in the operating room with the insertion of the temporary prosthesis that will arrive prefabricated by the KLS Group based on preoperative digital scanning and/or CT or CBCT image data.

Upon resolution of the expected postoperative edema, patients then present to their dental provider for final restoration of the IPS system. The steps that follow are similar to the standard procedure for dental implants, with the exception that the implant abutments are already incorporated into the implant pillars of the IPS system. As such, scanbodies are not required, simplifying the restorative process. Impressions are then taken via either digital scanning or traditional impressions, and the final prosthesis is fabricated by a dental lab.

At six weeks postop, adequate soft-tissue healing and adaptation were observed to proceed to final prosthetic impressions. DESS Multi-Unit closed-tray impression copings were hand-tightened directly to the IPS framework. Final impressions were taken with VPS and sent to the laboratory for an otherwise standard three-unit, screw-down, abutment-supported zirconia bridge. The IPS dental implant system has been in situ for about six months without any dehiscence, periimplantitis or any other complications.

This article presents two cases of IPS implementation with subsequent prosthetic restoration conducted at The Brooklyn Hospital Center in 2024. The first case presents a 69-year-old male with a significant maxillary bony defect after failure of both conventional implants and sinus lift procedures that resulted in an OAC, which was then repaired with soft-tissue closure. The second case presents a 52-yearold patient with a severely atrophic, edentulous mandible.

Case #1 A 69-year-old male with medical history of diabetes and hypertension presented for consultation to The Brooklyn Hospital Center oral surgery clinic. The patient had a history of sinus lifts and implants in the left posterior maxilla performed approximately 20 years prior. The patient’s implants failed and were removed, and a residual OAC (~2 cm) was present. The patient underwent left maxillary oroantral fistulectomy and OAC closure with buccal fat rotational flap and buccal mucosal advancement. Four months later, the patient healed well with no complications and no residual OAC symptoms. Though the OAC was repaired successfully via soft-tissue closure, as expected, a severe vertical bony defect remained (Figure 1).

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Figure 3. 3D-printed prosthesis.

Figure 4. Perioperative clinical picture of placement of IPS metal framework.

Figure 5. Postoperative clinical picture with insertion of temporary prosthesis.

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Clinical and radiographic exam revealed a posterior edentulous severe maxillary defect involving tooth extraction sites #13 through #15. To reconstruct this defect, a decision was made to utilize a custom computer-designed and 3Dgenerated titanium IPS prosthesis (Figure 2). Virtual surgical planning session was completed designing an implant fixated to the pyriform rim, zygomaticomaxillary buttress, and the palate with two pillar emergences (sites #13 and #15) (Figure 3).

Incision was made in the edentulous area buccal to the crest continuing with a sulcular incision around teeth #9 through #12 with a midline vertical release. A periosteal elevator was used to reflect a full-thickness mucoperiosteal flap and expose the infraorbital foramen, zygomaticomaxillary buttress and pyriform area. Custom IPS implant was fit and secured with bicortical screws, as per the virtual surgical plan (VSP) (Figure 4). The implant was stable with good adaptation to the bone and was immobile. Two slit incisions were made in the crest for the pillars, and another incision was made in the palate near tooth #12 for access to the palatal screw. Platelet-rich fibrin (PRF) membranes were formed and placed over the implant at the site of the incision. The surgical site was closed with 3-0 Vicryl sutures (Figure 5). A custom temporary prosthesis was screwed on, and occlusion was adjusted to ensure temporary prosthesis was not in occlusion (Figure 6).

At the time of this writing, the patient’s IPS dental implant system has been successfully restored with a temporary prosthetic restoration, which has been in situ for six months without any dehiscence, periimplantitis or any other complications.

Case #2 A 52-year-old male with past medical history of diabetes and hypertension presented for consultation to the oral surgery clinic at the Brooklyn Hospital Center. Due to the patient’s severely atrophic mandible, his denture had minimal-to-no retention despite multiple adjustment attempts.

The patient was examined clinically and radiographically, and it was determined that the optimal option for fixed restoration for this patient’s mandible would be best satisfied with the IPS implant.

The procedure was performed in the operating room under general anesthesia. After adequate local anesthesia, a #15 blade was used to make a full-arch crestal incision with bilateral small distal vertical releases. A periosteal elevator was then used to reflect a bilateral full-thickness mucoperiosteal flap on the buccal and lingual. Dissection was carried down to the inferior border, and the mental nerve was identified and protected. A custom-cutting guide

Figure 6. Postoperative panoramic radiograph with insertion of IPS framework.

Figure 7. Models, guides, plates.

Figure 8. 3D rendering of framework insertion.

Figure 9. Intraoperative photo of framework fixation.

was seated, and pre-planned alveolar bone reduction was completed on both sides to enable ideal adaptation of the implant (Figure 7).

The IPS implant was then fitted and secured to the jaw with bicortical screws as planned in the VSP (Figure 8). A right-angle screwdriver was used for the posterior screws.

The implant was immobile with good adaptation to the bone (Figure 9). Closure was completed with 3-0 Vicryl sutures. A temporary prosthesis was then secured onto the abutments (Figure 10). The temporary prosthesis was nonmobile and out of occlusion (Figure 11).

At the time of this writing, the patient’s IPS dental implant system has been successfully restored with a temporary prosthetic restoration that has been in situ for five months without any dehiscence, periimplantitis or any other complications.

Discussion and Literature Review The IPS Implants® Preprosthetic system suggests a promising alternative for cases where endosseous and zygomatic implants are not viable treatment options for a patient.[2] The scope of the utility of IPS is not limited to simple cases of pneumatized sinuses or simple cases of atrophy. IPS also has the potential for utilization of post-ablation for head and neck cancer patients or for patients with other varying craniofacial defects.

Historically, the most frequently employed methods for reconstructing the maxilla after ablation are autologous bone grafting and prosthodontic restoration with obturators.

However, each of these treatments has its own drawbacks: Autologous bone grafts can lead to donor-site morbidity and the potential for graft failure, while obturators may cause nasal leakage and discomfort due to instability. Consequently, The New York State Dental Journal . JANUARY 2026

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there are no definitive recommendations regarding optimal therapy, particularly in terms of improving quality of life.

The IPS system appears to have the potential to serve as a reasonable treatment modality in such cases. It allows for a one-step, palate-free, implant-borne prosthodontic restoration that eliminates the need for a donor-site and, thus, donor-site morbidity.[5] Additionally, it bypasses time-consuming and more invasive augmentation procedures, which often not only require hospital admission, but also carry a risk of graft failure and are frequently declined by patients.[8] In its inception, the concept of IPS originated from the need to treat oral cancer patients with extensive jaw defects, whether resulting from ablation or unsuccessful previous bone reconstruction attempts, where patients were unwilling to undergo an additional microvascular graft.

This method has also been applied to patients with trauma

Figure 10. 3D custom-printed model, framework and provisional prosthesis.

Figure 11. Postoperative panoramic radiograph.

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or severe atrophy. Additionally, the IPS system has been employed in cases of cleft-lip and palate patients. In 2022, Rahlf et al. reported to have successfully reconstructed “all defects” using this approach.[7] Not only has the IPS system been successfully applied to an array of clinical scenarios, ranging from simple atrophy of the maxilla, to the restoration of a post-ablative, microvascular, free-flap-reconstructed mandible, but the system has also been shown to have higher patient satisfaction scores. This satisfaction was mirrored by the positive sentiments expressed by the two patients presented in the cases reported here. In 2020, Jehn et al. were the first to evaluate oral health-related quality of life (OHRQoL) following dental rehabilitation using the novel IPS implant system with prosthetic restoration in patients with surgically acquired bony defects related to tumor resection.

Their findings demonstrated an improvement in OHRQoL, particularly when a fixed dental prosthesis was the definitive restorative treatment modality.[9] Due to the relative novelty of this treatment, patient follow-up is crucial and of significant interest. Of the literature reviewed that presented follow-up results, the outcomes were overwhelmingly positive. In 2017, Gellrich et al. published a three-patient case series. All the patients received the IPS implant and subsequent prosthetic restoration for varying clinical reasons. The follow-up period for the patients ranged from 14 to 21 months, with no reported failures of the implanted IPS hardware.[3] In 2021, Korn et al. published a case series consisting of 19 patients, all of whom received the IPS implant and subsequent prosthetic restoration after ablative tumor resection surgery. In this study, the mean follow-up period was 26 months, at which time, the authors reported that all the patient-specific implants placed displayed primary stability throughout the observation period.[5] Another study, published by Rahlf et al. in 2022, examined 63 patients, all of whom underwent placement of IPS implants from March 2015 to July 2021 also with subsequent prosthetic restoration. Patients received either IPS implants for the mandible or maxilla due to post-traumatic, atrophic, post-ablative or congenital defects. During the follow-up period, the authors reported no implant failures, and there were no instances of screw loosening or changes in the stability of the implant at the recipient site.[7] Another case series published in 2022 by Korn et al. presented 10 patients who underwent placement of IPS implants to treat and restore the severely atrophic maxilla. The authors reported that all implants maintained clinical stability throughout the follow-up period, which averaged 8.2 months

Additionally, this novel technique further diverges from traditional subperiosteal implants by employing CAD/CAM digital planning and machine milling, thereby minimizing distortion and achieving a more precise fit, with minimal anatomical distortion.

(range: 1 to 29 months). Additionally, all patients with a followup period exceeding two months received prosthetic restorations.[6] Most recently, Gellrich et al. published a case series involving five patients who received patient-specific subperiosteal implants with prosthetic restoration. In this series, there were no instances of implant failure or screw loosening, with the longest follow-up period reaching 68 months.[1] Conclusion The Individual Patient Solutions (IPS) Implants® Preprosthetic system offers a novel and effective solution for patients with significant bone loss where traditional endosseous and zygomatic implants are not viable. Presented here are two cases of varying clinical complexity and scope highlighting the potential utility and range of the IPS system. The rigid, screw-retained fixation of the IPS system provides stability and long-term viability, making it a valuable alternative option for cases with severe vertical bony defects or atrophy.

Additionally, this novel technique further diverges from traditional subperiosteal implants by employing CAD/CAM digital planning and machine milling, thereby minimizing distortion and achieving a more precise fit, with minimal anatomical distortion. Previous methods relied on alginate or rubber base impressions and stone models, all of which are highly vulnerable to imperfections and distortions. In contrast, the IPS system offers far greater stability and accuracy of its titanium framework, significantly reducing the risk of implant failure.

Although this approach is in its early stages, it is grounded in sound biomechanical principles and addresses a critiThe New York State Dental Journal . JANUARY 2026

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cal need in patients with significant bony atrophy or defect where conventional methods are not feasible. Despite the absence of long-term clinical data, preliminary outcomes suggest a very promising and substantial improvement in success rates, paired with high patient satisfaction scores.

We propose that this technique, with its innovative approach and early positive results, warrants publication to inform and potentially advance practice within the oral and maxillofacial surgical community. As patient-specific, rigidly fixated subperiosteal implants continue to be explored in various clinical settings, it may well establish itself as a staple alternative treatment modality for challenging maxillofacial reconstructions. Further studies and longitudinal follow-ups are recommended to fully understand the longterm outcomes and patient satisfaction associated with this innovative approach.

With regards to the prosthetic restoration of the IPS Preprosthetic system, KLS outlines a stepwise process for dental providers to follow after the surgical stage. The first prosthetic step, in fact, takes place in the operating room with the insertion of the temporary prosthesis that will arrive prefabricated by the KLS Group based on preoperative digital scanning and/or CT or CBCT image data. Upon resolution of the expected postoperative edema, patients then present to their dental provider for final restoration of the IPS system.

The steps that follow are similar to the standard procedure for dental implants, with the exception that the implant abutments are already incorporated into the implant pillars of the IPS system. As such, scanbodies are not required, simplifying the restorative process. Impressions are then taken via either digital scanning or traditional impressions, and the final prosthesis is fabricated by a dental lab.

Queries about this article can be sent to Dr. Sastow at talsastow@gmail.com.

REFERENCES 1.

2.

3.

4.

5.

6.

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Gellrich N-C, Korn P, Jehn P, Neuhaus M, Lentge F, Rahlf B. Exceptional cases demand exceptional personalized solutions: the next level in dental rehabilitation. Journal Personalized Medicine 2024;14(3):294. https://doi.orß/10.3390/jpm14030294 .

Gellrich N-C, Rahlf B, Zimmerer R, Pott P-C, Rana M. A new concept for implant-borne dental rehabilitation; how to overcome the biological weak-spot of conventional dental implants? Head & Face Medicine 2017;13(1):17-17. https://doi.org/10.1186/s13005-017-0151-3.

Gellrich N-C, Zimmerer RM, Spatthoff S, Jehn P, Pott P-C, Rana M, Rahlf B. A customised digitally engineered solution for fixed dental rehabilitation in severe bone deficiency: a new innovative line extension in implant dentistry. Journal Cranio-Maxillo-Facial Surgery 2017;45(10):1632-1638. https://doi.org/10.1016(i.icms.2017.07.022.

Jehn P, Spalthoff S, Korn P, Stoetzer M, Gercken M, Gellrich N-C, Rahlf B. Oral health-related quality of life in tumour patients treated with patient-specific dental implants. International Journal Oral and Maxillofacial Surgery 2020;49(8):1067-1072. https:((doi.org/10.1016(i. iiom.2020.01.011.

Korn P, Gellrich N-C, Jehn P, Spalthoff S, Rahlf B. A new strategy for patient-specific implantborne dental rehabilitation in patients with extended maxillary defects. Frontiers in Oncology 2021;11:718872-718872. https:Udoi.org/10.3389/fonc.2021.718872 .

Korn P, Gellrich N-C, Spalthoff S, Jehn P, Eckstein F, Lentge F, Zeller A-N, Rahlf B. Managing the severely atrophic maxilla: farewell to zygomatic implants and extensive augmentations?

Journal Stomatology, Oral and Maxillofacial Surgery 2022;123(5):562-565.

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7.

8.

9.

Rahlf B, Korn P, Zeller A-N, Spalthoff S, Jehn P, Lentge F, Gellrich N-C. Novel approach for treating challenging implant-borne maxillary dental rehabilitation cases of cleft lip and palate: a retrospective study. International journal Implant Dentistry 2022;8(1):6-6. https://doi. org/10.11861s40729Q2-00401-x.

Rencber Kizilkaya A, Sagsöz A, Dündar S, Bozoélan A, Düger N, Özcan EC. Mandibular fixed prosthesis with a 3D-printed subperiosteal implant: a case report. J Oral Implantol 2024;50(4):391-396. https://doi.org/10.1563/aaid-i0i-D-24-00045.

Spalthoff S, Borrmann M, Jehn P, Rahlf B, Gellrich N-C, Korn P. Comparison of conventional and digital workflow for dental rehabilitation with a novel patient-specific framework implant system: an experimental dataset evaluation. International Journal Implant Dentistry 2022;8(1):4-4. https://doi.org/10.1186/s40729-022-00405-7.

Dr. Sastow

Dr. Mark

Tal Sastow, D.M.D., is chief resident, Department Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, Brooklyn, NY. Ian Mark, D.M.D., is resident, Department Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, Brooklyn, NY. Edward Woodbine, D.D.S., is attending physician, The Brooklyn Hospital Center, Brooklyn, NY. Jared Miller, D.D.S., is attending physician, The Brooklyn Hospital Center, Brooklyn, NY. Erik D. Gilroy, D.D.S., is a general practitioner, Park North Dentistry, Brooklyn, NY. Harry Dym, D.D.S., is program director and department chair, The Brooklyn Hospital Center, Brooklyn, NY.

New ‘Dental Download’ Scheme Targets Dental Practices Approach all emails with skepticism.

Gary Salman

Dentists across New York State need to be on guard against a sophisticated new cybersecurity scheme—often dubbed a “dental download” attack—that is specifically targeting dental practices. This dangerous tactic exploits human trust through social engineering. And it possesses the ability to compromise your entire practice network with a single, unsuspecting click.

This emerging threat is highly deceptive because the cybercriminals behind it masquerade as trusted partners: referring providers. The attack begins with an email that appears to originate from a real email address belonging to one of your referring doctors or clinics.

The critical danger lies within the link or attachment itself. While the entire communication is crafted to appear legitimate, clicking the link or downloading the file silently installs malicious software. Often, this software is a sophisticated screen-sharing application designed specifically to bypass standard defense mechanisms. Crucially, this type of malware is engineered to avoid detection by traditional anti-virus programs or firewalls, instantly providing the cybercriminals with remote access to your entire network.

Once inside, they can steal protected health information (PHI), financial data, and potentially lock you out of your systems using ransomware.

How the ‘Dental Download’ Scheme Works The fraudulent email typically requests that the dental practice download patient forms, records, diagnostic images or other “dental files” by clicking a link or accessing a shared drive. The excuse is always plausible—such as the files being “too large to send” or the sender “having trouble with the online form.”

Critical Recommendations Dentists and their staff need to adopt an immediate and heightened level of skepticism and vigilance to defend against this growing threat.

• Be Suspicious of Unsolicited Links and Downloads: Never, under any circumstances, open unexpected attachments or click links sent via email. This rule ap-

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•

•

•

plies even if the sender’s name looks familiar. If the email is unexpected or the request is unusual, treat it as highly suspect.

Verify Before You Download: If a colleague or referring office requests that you download files, access a new link or use a new file-sharing method, independently verify their identity and the request. The safest way is to call the referring office using a known, trusted phone number—do not reply to the suspicious email.

Use Secure Workflows Only: Demand that patients and referring providers use your established, secure portals and processes for all sensitive data sharing, including patient forms and diagnostic images. Consistency is key to security.

Involve Your IT/Cybersecurity Vendor: Immediately notify your vendor about this specific “dental download” threat. Ask them to review and update your email filters, ensure robust backups are being performed, verify that multi-factor authentication (MFA) is fully enabled, see if new screen sharing apps were installed, and confirm that staff training is up-to-date and effective.

Take a proactive approach. Watch any available threat briefings (such as the one developed by Black Talon Security), and share this critical information with every member of your team. p Gary Salman is CEO and cofounder of Black Talon Security (www.blacktalonsecurity.com). A leader in the cybersecurity field, Mr. Salman has a 30-plus-year background in law enforcement and healthcare technology.

His firm monitors and secures approximately 65K computers and networks worldwide and has trained tens of thousands of healthcare professionals.

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IMPACT REPORT

January 1, 2025 - December 31, 2025

20 25

NEW LEADERSHIP FOR THE NEW YORK STATE DENTAL FOUNDATION The New York State Dental Foundation enters 2026 with renewed energy, experienced leadership, and a continued commitment to advancing oral health equity across New York State. This year marks a significant transition for the Foundation, as we welcome several new officers to the Executive Committee.

Ronald Bellohusen, DMD, MS, has been elected to serve as Chair of the Board of Trustees. A retired orthodontist and advocate for expanding access to care, Dr. Bellohusen brings a collaborative spirit and a clear vision for strengthening the Foundation’s role in supporting vulnerable populations.

“The work of the Foundation is more essential than ever,” said Dr. Bellohusen. “As oral health needs rise across New York, our profession has a responsibility—and a profound opportunity— to lead with compassion on behalf of those who are too often left behind. I’m honored to serve alongside an exceptionally dedicated Board of Trustees and a tirelessly committed Executive Director to help guide this next chapter.”

Joining him in Foundation leadership are Dr. Robert Peskin, elected Vice Chair, and Dr. Donald Tucker, elected Secretary. Dr. Larry Volland will continue in the role of Treasurer. Together, the new Executive Committee will guide a Board composed of accomplished and passionate leaders from across the state.

As we welcome new leadership, the Foundation also expresses heartfelt appreciation to Dr. Maria Maranga, who concluded her twelve years of service on the Board on December 31, 2025— including the last three years as Chair.

BOARD OF TRUSTEES

Ronald Bellohusen, DMD, MS ​Chairperson Robert M. Peskin, DDS Vice Chair Donald Tucker, DDS Secretary ​ awrence Volland, DDS L Treasurer Stacy McIlduff, CFRE Executive Director Loren Baim, DDS Renuka Bijoor, DDS Joseph Brofsky, DMD Helen E. Chiao, DMD, MMSc Egidio A. Farone, DMD James E. Galati, DDS Michael Herrmann Lois A. Jackson, DDS ​Elizabeth B. Kapral, DDS, MS Paul Kim, DDS Mary Ellen Lukaswitz, DDS David J. Miller, DDS Rory A. Ogden, DDS Alexander Pilavsky, DDS, FICD, FICOI ​Michael Shreck, DMD Jay Skolnick, DMD Christian Stohler, DMD ​Yun-Po Zhang, PhD, DDS, MBA

With the leadership of Drs. Bellohusen, Peskin, Tucker and Volland—and the collective expertise of the full Board—the Foundation is poised to advance its mission with even greater impact. Together, we will continue to champion oral health as an integral part of overall health, expand access to care, and ensure that every New Yorker has the opportunity to achieve a healthy smile.

THANKS TO YOU Donor contributions fueled our mission to improve oral health care for all New Yorkers through a variety of programs in 2025, including: oral health screening booths at 5 sporting events, presentation of the Stevenson Award to 9 graduating dental hygiene students, oral cancer prevention education through our 9 to Thrive: HPV Vaccination for Cancer Prevention course, hosting our first-ever Discovering Dentistry Symposium in partnership with Planet Smilez, connecting 76 veteran cases to pro bono dental care through Salute Vets with a Smile, reimbursing dental students for travel to the Special Olympics State Summer Games to screen 124 athletes, and rollout of the Early Head Start Oral Health Prevention Project in Otsego and Norwich.

oms

Amyloidoma of the Palate Philip Bacigalupo, D.D.S.; Nora Odingo, B.D.S., D.M.D., M.P.H.

ABSTRACT

There have been 17 reported cases of isolated amyloid deposition (amyloidoma) of the hard palate (Table 1). We present an 18th case, with a review of the literature on amyloidosis. Systemic conditions, such as multiple myeloma, must be ruled out when amyloid deposition is present. However, localized amyloidoma of the palate is rare, and there are few cases reported in the literature.

The term “amyloid” was first used by Virchow in the mid19th century to refer to abnormal hepatic extracellular material found at necropsy.[1] Amyloidosis is a rare condition in which abnormal proteins are deposited in tissues. The deposits aggregate into insoluble fibrils and cause progressive organ damage. Currently, 36 of these proteins have been identified in humans. Approximately 2,200 new cases of the most common form of amyloidosis, AL-amyloidosis, are diagnosed each year in the United States. The prevalence between 2007 and 2015 has increased 2.6-fold, from 15.5 cases per million to 40.5 per million.[2] Case Presentation An 82-year-old male with a maxillary complete denture presented with a swelling of the left palate of several years’ duration (Figure 1). The patient claimed that the mass had been examined previously, and he was reluctant to have it re-evaluated.

His medical history was significant for myocardial infarction, hypertension, hypercholesterolemia, psoriasis, 28

JANUARY 2026 . The New York State Dental Journal

benign prostatic hyperplasia, cataracts and hepatitis A decades ago. His medications included simvastatin, amlodipine besylate, valsartan, metoprolol succinate, pantoprazole, acitretin and finasteride. He had no known allergy to medications or dental materials and denied a history of smoking.

On physical examination, the patient was afebrile with slight bradycardia, consistent with findings at previous examinations. Intraoral examination revealed a fluctuant, smooth-surfaced, soft-tissue mass of the left hard palate measuring 25 mm x 20 mm x 3 mm (Figure 2). The overlying mucosa was pinkish-red, interspersed with yellow areas. The mass was slightly exophytic and sessile, with no tenderness on palpation. Mucosal-colored papules were present at the junction of the hard palate and soft palate in the midline, posterior to the mass.

The clinical impression for the papular lesions was inflammatory papillary hyperplasia, and the patient was informed it should resolve with proper home care and denture hygiene. The clinical presentation of the palatal swelling was strongly suggestive of a salivary gland tumor. Since the lesion displayed benign characteristics, we favored pleomorphic adenoma as the clinical diagnosis.[3] The mass of the left palate was biopsied for definitive diagnosis.

Investigations The specimen from the incisional biopsy of the left palatal soft-tissue mass was sent to the laboratory. The histopathologic diagnosis was oral mucosa with underlying diffuse amyloid deposits (Figure 3). Staining with Congo red was positive in the corresponding areas of amyloid deposition

The patient was informed that he had a rare presentation of amyloidosis and that his laboratory values would be monitored for the long-term.

Figure 1. Fluctuant, smooth-surfaced, soft-tissue mass of left posterior palate. (Courtesy Devin Klein, D.D.S.)

(Figure 4). Medical evaluation to exclude primary or secondary amyloidosis was recommended. The paraffin block was sent to a specialty laboratory for further characterization of the amyloid deposits. These investigations concluded that the specimen was likely a form of rare, localized AL-amyloidosis, with a recommendation for close monitoring for possible progression to systemic amyloidosis.

Treatment No treatment was rendered as there was no evidence of systemic amyloidosis and the palatal mass did not interfere with the stability of the patient’s maxillary prosthesis.

Outcome and Follow-up Our patient underwent comprehensive medical examination following the amyloid characterization. Medical workup did not reveal any pertinent, significant findings in the laboratory or other tests and was, therefore, negative for features of systemic amyloidosis. The patient was informed that he had a rare presentation of amyloidosis and that his laboratory values would be monitored for the long-term.

Discussion Amyloid nomenclature has been subject to multiple changes and inconsistencies in terminology, making classification difficult. The nomenclature was clarified at the Nov. 6 and 7, 2006, meeting of the Committee of the International Society of Amyloidosis. Classification is now based on the main protein that constitutes the main fibril protein followed by a suffix, which classifies the precursor protein.

The criteria for a deposit to be characterized as amyloid in-

Figure 2. Soft-tissue mass of left posterior palate with separate papular lesion at midline.

(Courtesy Devin Klein, D.D.S.)

Figure 3. Hematoxylin and eosin staining showing intact epithelium overlying connective tissue containing eosinophilic amorphous amyloid material. (Courtesy Sarah Kande, D.M.D.) The New York State Dental Journal . JANUARY 2026

29

clude: in vivo deposition, fibrillar appearance on electron microscopy, specific X-ray diffraction pattern, histologic Congo red staining and apple-green birefringence on polarization.

Additionally, reports of the deposits in question need to be published in peer-reviewed journals prior to acceptance

Figure 4. Congo red stain demonstrating amyloid material within connective tissue.

(Courtesy Sarah Kande, D.M.D.)

and recognition in the official nomenclature.[4] However, recent studies show that Congo red may bind to non-amyloid substances. Furthermore, green is not the only color observed in birefringence assay. As such, Congo red staining alone is insufficient evidence of amyloid.[5] Amyloid deposition can be both localized and systemic. Localized amyloidosis is characterized by its appearance at one site or type of tissue and is derived from proteins expressed by cells at the deposition site. Systemic forms are characterized by a precursor protein being expressed in at least one site prior to being released into plasma and deposited from the bloodstream at another location.[4] Although the exact etiology for amyloid is unclear, deposition has been thought to be associated with either the etiology or progression of certain diseases. Aβ-amyloid deposition in brain tissue has been correlated with Alzheimer’s disease, and AIAPP-amyloid (islet amyloid polypeptide) in the islets of Langerhans has been associated with Type 2 diabetes mellitus.[4] AL-amyloidosis is a plasma cell disorder associated with multiple myeloma. In AL-amyloidosis, plasma cells in bone marrow produce immunoglobulins that form amyloid. Free monoclonal light chains of the kappa or lambda variety, known as Bence-Jones proteins, are also produced

TABLE 1.

Seventeen cases of isolated palatal amyloidoma reported in the literature (F=female, M=male).

Age (years)/ Sex

Biopsy Specimen Site

Amyloid Confirmed Histopathologically

Localized or Systemic

[1]

F

Sub-epithelial connective tissue of palate

Yes

Unknown

[1]

F

Sub-epithelial connective tissue of palate

Yes

Unknown

[1]

Patient

Study

1

Stoopler et al.

2 3

Stoopler et al.

F

Sub-epithelial connective tissue of palate

Yes

Unknown

4

[8]

Aono et al.

74F

Hard palate

Yes

Localized

5

[9]

65M

Soft palate

Yes

Localized

6 7

Alvi et al.

Stoor et al.

[10]

80M

Hard palate

Yes

Localized

[11]

68F

Hard palate

Yes

Localized

[12]

Pentenero et al.

8

Balatsouras et al.

45F

Soft Palate

Yes

Localized

9

[13]

70F

Palate

Unknown

Unknown

[14]

Chaari et al.

10

David et al.

11

Timosca et al.

12

Yoshida et al.

13 14 15 16 17

30

Stoopler et al.

45F

Right posterior palate to right tonsillar fossa

Yes

Localized

[15]

10F

Palate

Yes

Localized

[16]

63M

Hard palate

Unknown

Localized

[17]

13F

Nasopharynx & left soft palate

Yes

Localized

[18]

Unknown

Palatal region

Unknown

Unknown

[19]

63F

Vault of hard palate

Yes

Localized

Rennie et al.

[20]

52F

Palate & maxilla

Yes

Localized

Rennie et al.

[20]

59F

Palate & maxilla

Yes

Localized

Domínguez et al.

Habelak et al.

Henley et al.

JANUARY 2026 . The New York State Dental Journal

with a kappa-to-lambda ratio of 1:3. Bence-Jones proteinuria also occurs in multiple myeloma, but with the kappa variety seen more frequently.[1] Renal with or without cardiac involvement frequently may be seen, as well as hepatomegaly. Macroglossia is a common intraoral finding.[4] The current basis of treatment is directed towards the precursor-product concept. The goal is to decrease levels of precursor proteins in serum to either normal or undetectable levels. Future research is needed to examine blocking amyloid deposition and increasing amyloid clearance.[6] The long-term outcome is dependent on the degree of organ involvement. When no treatment is rendered, the median survival is one to two years.[1] The significance of amyloid deposits of the oral cavity is debatable. Oral tissues have been advocated for use in biopsy to confirm amyloid deposition in cases where there is an absence of clinical symptoms. Selikoff and Robitzek were the first to present evidence that gingival biopsy was valuable in confirming the diagnosis of generalized secondary amyloidosis.[7] However, other sites in the oral cavity have been utilized for diagnostic purposes.

In the case of our patient, once the diagnosis of amyloid deposition had been made on routine histopathology, it was important to characterize the nature of the deposits and rule out systemic disease. Liquid chromatographymass spectrometry identified the specific protein to be AL-amyloid. Renal, cardiac and hepatic involvement were ruled out following extensive testing, including electrocardiography, echocardiography, imaging and laboratory testing, all of which yielded no significant abnormalities. The patient will be monitored indefinitely to rule out progression from isolated amyloidoma to systemic amyloidosis.

Conclusions • Localized amyloidosis of the palate is uncommon in the literature.

• Congo red staining and apple-green birefringence have been used to demonstrate the presence of amyloid.

However, recent studies have shown that other substances may bind to Congo red and that other colors may be seen in birefringence assay. Therefore, Congo red staining alone is not sufficient for the diagnosis of amyloid.

• Systemic conditions such as multiple myeloma must be ruled out when amyloid deposition is present in intraoral tissues. p

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Stoopler ET, Sollecito TP, Chen SY. Amyloid deposition in the oral cavity: a retrospective study and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003 Jun 1;95(6):674-80.

Picken MM. The pathology of amyloidosis in classification: a review. Acta Haematol 2020;143(4):322-34.

Neville BW, Damm DD, Allen CM, Chi AC. Oral and Maxillofacial Pathology. St. Louis, MO: Saunders/Elsevier (2024).

Westermark P, Benson MD, Buxbaum JN, Cohen AS, Frangione B, Ikeda SI, Masters CL, Merlini G, Saraiva MJ, Sipe JD. A primer of amyloid nomenclature. Amyloid 2007 Jan 1;14(3):17983.

Yakupova EI, Bobyleva LG, Vikhlyantsev IM, Bobylev AG. Congo red and amyloids: history and relationship. Bioscience reports 2019 Jan 31;39(1).

Hazenberg BP. Amyloidosis: a clinical overview. Rheum Dis Clin North Am 2013 May 1;39(2):323-45.

Selikoff IJ, Robitzek EH. Gingival biopsy for the diagnosis of generalized amyloidosis. Am J Pathol 1947 Nov;23(6):1099-111.

Aono J, Yamagata K, Yoshida H. Local amyloidosis in the hard palate: a case report. Oral Maxillofac Surg 2009 Jun;13(2):119-22.

Alvi A, Goldstein MN. Amyloidosis of the palate. Otolaryngol Head Neck Surg 1999 Feb;120(2):287.

Stoor P, Suuronen R, Lindqvist C, Hietanen J, Laine P. Local primary (AL) amyloidosis in the palate: a case report. Int J Oral Maxillofac Surg 2004 Jun 1;33(4):402-3.

Pentenero M, Davico Bonino L, Tomasini C, Conrojo D, Gandolfo S. Localized oral amyloidosis of the palate. Amyloid 2006 Jan 1;13(1):42-6.

Balatsouras DG, Eliopoulos P, Assimakopoulos D, Korres S. Primary local amyloidosis of the palate. Otolaryngol Head Neck Surg 2007 Aug;137(2):348-9.

Chaari C, Ellouze S, Chamli H, Makni SK, Karray F, Boudawara TS. Squamous cell carcinoma on a pleomorphic adenoma with amyloid stroma of the palate. Rev Stomatol Chir Maxillofac Chir Orale 2010 Feb;111(1):53-5.

David R, Buchner A. Amyloid stroma in a tubular carcinoma of palatal salivary gland. A histochemical and ultrastructural study. Cancer 1978 May;41(5):1836-44.

Timoşca G, Gavrilisǎ L. Primary localized amyloidosis of the palate. Oral Surg Oral Med Oral Pathol 1977 Jul 1;44(1):76-83.

Yoshida T, Yazaki M, Gono T, Tazawa KI, Morita H, Matsuda M, Funakoshi K, Yuki N, Ikeda SI. Severe cranial nerve involvement in a patient with monoclonal anti-MAG/SGPG IgM antibody and localized hard palate amyloidosis. J Neurol Sci 2006 May 15;244(1-2):167-71.

Dominguez S, Wienberg P, Claros P, Claros A, Vila J. Primary localized nasopharyngeal amyloidosis. A case report. Int J Pediatr Otorhinolaryngol 1996 Jun 1;36(1):61-7.

Habelak M, Cieślik T, Lipiarz L, Zajecki W. Rare case of palatal amyloidosis. Wiad Lek 2006 Jan;59(1-2):113-6.

Henley E, Houghton N, Bucknall R, Triantafyllou A, Field EA. Localized amyloidosis of the palate. Clin Exp Dermatol 2008 Jan;33(1):100-1.

Rennie JS, Critchlow HA. Solitary oral amyloid: a report of two cases. Int J Oral Maxillofac Surg 1982 Feb 1;11(1):73-6.

Dr. Bacigalupo

Dr. Odingo

Philip Bacigalupo, D.D.S., is a graduate of the Class of 2022, Stony Brook University School of Dental Medicine, Stony Brook, NY. He is in private practice in Bloomfield, NJ. Nora Odingo, B.D.S., D.M.D., M.P.H., is clinical assistant professor, Division of Oral & Maxillofacial Pathology, Department of Oral & Maxillofacial Surgery, Stony Brook University School of Dental Medicine, Stony Brook, NY.

The authors have no financial, economic or professional interests influencing positions presented in this article. Queries about this article can be sent to Dr. Bacigalupo at Drdifrontdesk@gmail.com.

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31

implant failure

Titanium Hypersensitivity as Possible Cause of Dental Implant Failures William J. Maloney, D.D.S., PG CertMedEd; George Raymond D.D.S.; Maura Maloney, D.D.S.

ABSTRACT

For many decades, titanium implants have achieved

chenoid reactions.

light on why dental implants occasionally fail. One such cause is that titanium can be an allergen, which can lead to an inflammatory response and, eventually, implant failure.

In 1952, Swedish orthopedic surgeon, anatomy professor and researcher Dr. Per-Ingvar Branemark was studying blood flow in relation to the healing of bones in rabbits.

Optical devices were placed in the legs of the rabbits. Branemark unexpectedly was unable to remove these devices after he had collected the requisite data. The titanium casings of the devices had fused to the bones of the rabbits.[1] Using his research of the previous decade, Branemark put the first osseointegrated dental implant in the mandible of Gosta Larsson in 1965.[2] He placed four mandibular implants for a complete arch-fixed, implant-supported, metal-resin prosthesis. When Mr. Larsson died, in 2006, the implants were still in place and fully functioning.[3] Branemark became known as the “Father of the Modern Dental Implant.”

Dentistry has provided a reprieve from edentulism—either partial or full—for millions of people worldwide. The material of choice for dental implants has been titanium. Although titanium dental implants have been very successful, there have also been failures. Dental researchers and clinicians have conducted many remarkable studies that have shed

Born in Greek Mythology Titanium was discovered in 1791 by the Rev. William Gregor. Pure titanium metal was later manufactured by M.A. Hunter at General Electric in 1910.[4] Rev. Gregor was an amateur English mineralogist. He found black sand next to a creek and determined the sand contained iron ox-

a remarkably high success rate. However, there are cases in which osseointegration does not occur as predicted or desired. In these cases, an analysis of the factors that led to the implant failure must be conducted. There are multiple, widely accepted potential causes of such implant failures. Today, one must also consider titanium hypersensitivity as a potential reason for failure. Symptoms of a titanium allergic reaction may include mucosal erythema, swelling of lips, purpuric patches on hard and soft palate, ulcers in the oral cavity, hyperplastic gingivitis, cheilitis, eczematous eruptions on face and li-

32

JANUARY 2026 . The New York State Dental Journal

ide and another unidentifiable metal oxide, later identified titanium is the metal used for biological purposes that is as powdered titanium dioxide. The newly discovered eleleast likely to cause an allergic reaction. [9,22-24] However, allergic reactions to titanium in dentistry do occur. Sympment was named after the Titans, the pre-Olympian gods toms of a titanium allergic reaction include mucosal in Greek mythology.[5] Titanium possesses multiple beneficial erythema, swelling of lips, purpuric patches on characteristics, which have resulted in its hard and soft palate, ulcers in the oral cavfrequent use in medicine and dentistry. ity, hyperplastic gingivitis, tongue depaTitanium alloys have superior corropillation, angular cheilitis, eczematous [6] sion resistance and strength, as well eruptions on face and lichenoid reacas a modulus of elasticity similar to tions.[17,25] [6,7] Unlike Type I hypersensitivity, bone and equivalent to approximately 50% of stainless steel.[8] The which occurs within minutes, and modulus of elasticity measures the Type II and Type III hypersensiresistance of a material to elastic tivity, which occur within hours, deformation under stress.

Type IV hypersensitivity has a Titanium implants have delayed onset. Allergic responses achieved a remarkable success rate, to titanium would most regularly but there are cases in which osseobe classified as a Type IV delayed integration does not occur in a desirhypersensitivity.[26] The local exable manner. Osseointegration failure istence of T lymphocytes and conof titanium implants may result due to siderable amounts of macrophages titanium and titanium alloy particles beshowing Type IV hypersensitivity lead ing deposited into the tissues surrounding to the characterization of sensitivity to the implant. This is a result of corrosion and titanium.[27,28] A Type IV hypersensitivity is essential for wear of the implant, thus leading to inflammaRev. William Gregor tory reactions and, ultimately, bone loss.[9] the body’s defense against intracellular pathogens The placement of titanium dental implants in allerand plays a role in the immune response against various gic patients has been shown to result in skin rashes, noninfections. However, it can also contribute to autoimmune [10] specific immune suppression, hives, eczema, itching of diseases and allergic reactions when the immune response the skin or mucosa, edema and reddening.[11] The scientific is misdirected or excessive. literature refers to a process called tribocorrosion,[12] durType IV hypersensitivity can lead to the formation of ing which titanium ions are released into the surrounding granulomas, which are aggregates of immune cells that entissues, triggering a cascade of reactions, which can be eicapsulate and attempt to contain the antigen. Symptoms of ther localized, distant or systemic.[13] a titanium allergy can include redness, itching, rash, swellThe friction and wear of the implant components ing and discomfort at the site of contact with titaniumcaused by mechanical movement facilitates the release of containing materials.[29] In the case of dental or medical implants, symptoms can be more severe and may involve metal ions. The metabolic products produced by micropain and inflammation at the implant site. organisms in an individual’s biofilm are responsible for Allergies are typically triggered by exposure to commicrobial corrosion.[14] They secrete organic acids and extracellular polymeric substances, which degrade the metal mon allergens, like certain foods (e.g., peanuts, shellfish), surface.[15] The micro gaps on the interfaces of the dental pollen, pet dander, dust mites and insect stings.[28] These [15] implant are a desirable environment for biofilms. The reactions can manifest as skin rashes, hives, nasal conresulting pathogens accumulate and induce pitting corrogestion, sneezing, itchy or watery eyes, asthma, gastrosion, which deteriorates the implant material.[16] In animal intestinal symptoms or, in severe cases, anaphylaxis, a studies, titanium ions have been detected in regional lymph life-threatening systemic reaction. The prevalence of comnodes and the lungs following implant placement.[17-20] mon allergies is widespread, and many individuals are affected by them to varying degrees.

Trigger Reaction Mombelli et al. have detected in oral tissues products In 2008, Ergusa et al. published the first case of an allergic of titanium particles associated with the degradation of tireaction to dental implants.[21] Most researchers agree that tanium. Titanium products that are released from the surThe New York State Dental Journal . JANUARY 2026

33

face of dental implants most notably involve the contact to chemical agents and substances produced by biofilm and inflammatory cells, thus promoting inflammation.[29] However, there has been speculation that the presence of biofilms and inflammation in peri-implantitis lesions could cause higher concentrations of titanium rather than the titanium itself being the trigger of disease.[29]

Dr. Per-Ingvar Branemark.

A widely applied concept throughout healthcare is the use of ultraviolet (UV) radiation in conjunction with devices such as UV germicidal lamps, water purification, and air and surface sterilization equipment.[30] A common use of UV light familiar to all dental practitioners is the photopolymerization of dental materials. A variation of UV light treatment can be applied to support the titanium implant’s more inert surface area. Ultraviolet light treatment improves titanium’s physicochemical properties, induces hydrophilicity and, eventually, increases osteoconductivity.[31] Organic contaminants can significantly limit the bioactivity of titanium implants, resulting in the degradation known as aging of the titanium.[32] Utilizing UV light treatment of titanium implants immediately before placement, called photofunctionalization, has been shown to improve the physicochemical properties of titanium, [31,33-36] that the expression of inflammatory cytokines was consistently lower in osteoblasts cultured on UV-treated titanium.[31] Since it has been established that soft-tissue adhesion and seal at the transmucosal and transcutaneous surface of implants 34

JANUARY 2026 . The New York State Dental Journal

are imperative to prevent infection and ensure the longterm stability of implants, the addition of UV light therapy enhances the interaction with epithelial cells.[36] UV-Light Treatment Shows Promise While titanium is known for its biocompatibility, some individuals can still have allergic reactions or inflammatory responses. UV-light treatment has been shown to reduce the presence of inflammatory mediators on the surface of titanium, potentially decreasing the risk of allergic reactions or inflammatory responses in patients with sensitivities to titanium implants or devices. The effects of UV-light-treated titanium may be a viable method to decrease the risk of allergy due to the reduction in inflammatory mediators present. Overall, UV-light-treated titanium holds promise for improving the biocompatibility, longevity and performance of titanium dental implants, potentially leading to better patient outcomes and reduced risks of complications.

It is recommended that prior to the placement of titanium implants, patients with a history of multiple or severe allergies (especially to artificial jewelry, nickel, cobalt and penicillin) be tested for titanium allergies.[37] The in vitro lymphocyte transformation test (LTT-MELISA) is superior to other testing modalities, such as patch testing, for testing titanium, probably because of the reduced immunologic reactivity of titanium.[38] The lymphocyte transformation test detects metal hypersensitivity by measuring lymphocytes in peripheral blood that has been produced in the seven days following allergen exposure.[39,40] Memory Lymphocyte Immunostimulation Assay (MELISA) is one test that can be used to determine titanium sensitivity.

A blood test, it detects the proliferation of memory lymphocytes after exposure to metals in vitro.[41-43,45] These memory lymphocytes have had contact with a sensitivity allergen.[44] A recent study by Podzimek et al.[46] using MELISA demonstrated the lowest hypersensitivity for all tested metals to be zirconia, which is a component of zirconium ceramics. As it is well-known in scientific literature that ceramic-based implants do not exhibit corrosion or degradation in biological environments, ceramic implants should be considered an alternative to those with metallic materials.[47] Irradiation with C-range ultraviolet (UVC) light has been shown to be useful in the reactivation of titanium surfaces,[48] and it has successfully removed hydrocarbons from the surfaces of commercially available dental implants.[49] Also, UV photofunctionalization has a positive effect on the early inflammatory human response, with a resultant positive enhancement of osseointegration.[48,50] Surface modifications of zirconia implants have enhanced cell response with a resultant improvement in osseointegration.[51]

Conclusions The biocompatability of titanium has been a major factor in its successful use in dental implants for decades. Titanium implants have played a large role in providing a predictable solution to either partial or full edentulism. Titanium implants have a very high success rate. However, titanium dental implant failures do occur, and the scientific community has provided much stellar research investigating the causes of these failures. Among the causes are poor surgical techniques, tobacco use, bruxism, low-bone quality and peri-implantitis. We must now consider the possibility that an allergic reaction to titanium may play a role in the failure of titanium dental implants in, at least, some cases.

To achieve success in more implant cases, we must consider if titanium should continue to be the material of choice for dental implants. Also, the protocols for the maintenance and care of titanium implants should be revisited, as well as if allergic testing should be performed for patients with a known history of allergies prior to the placement of titanium implants. p Queries about this article can be sent to Dr. William Maloney at wjm10@nyu.edu.

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Janeway CA Jr, Travers P, Walport M, et al. Immunobiology: The Immune System in Health and Disease. 5th edition. New York: Garland Science; 2001. Available from: https://www. ncbi.nlm.nih.gov/books/NBK10757/.

Mombelli, et al. What is the impact of titanium particles and biocorrosion on implant survival and complications? A critical review. Clin Oral Implants Res 2018 Oct; 29 (S18):37-53.

Razali M, Ngeow WC, Omar RA, Chai WL. An integrated overview of ultraviolet technology for reversing titanium dental implant degradation: mechanism of reaction and effectivity. Applied Sciences 2020;10(5):165.

Ueno T, Ikeda T, Tsukimura N, Ishijima M, Minamikawa H, Sugita Y, Yamada M, Wakabayashi N, Ogawa T. Novel antioxidant capability of titanium induced by UV light treatment. Biomaterials 2016 Nov;108:177-86. doi: 10.1016/j.biomaterials.2016.08.050. Epub 2016 Aug 31.

PMID: 27639113.

Arroyo-Lamas N, Arteagoitia I, Ugalde U. Surface activation of titanium dental implants by using UVC-LED Irradiation. Int J Mol Sci 2021 Mar 5;22(5):2597. doi: 10.3390/ijms22052597.

PMID: 33807532; PMCID: PMC7961349.

Aita H, et al. Ultraviolet light-mediated photofunctionalization of titanium to promote human mesenchymal stem cell migration, attachment, proliferation and differentiation. Acta Biomaterialia 2009 Oct.5:3247-3257.

Kasai H, et al. Analysis of a form of oxidative DNA damage, 8-hydroxy-2-deoxyguanosine, as a marker of cellular oxidative stress during carcinogenesis. Mutation Research/Rev in Mutations 1997 December;287(3):146-163.

Shi M, et al. Oxidative damages in chronic inflammation of a mouse autoimmune disease model. Immunology Letters 2004 September;95(2):233-236.

Nakhaei K, Ishijima M, Ikeda T, Ghassemi A, Saruta J, Ogawa T. Ultraviolet light treatment of titanium enhances attachment: adhesion and retention of human oral epithelial cells via decarbonization. Materials (Basel) 2020 Dec 31;14(1):151. doi: 10.3390/ma14010151. PMID: 33396339; PMCID: PMC7796045.

Singh R, Lehl G, Bin Hussain H, Abhang T, Kulkarni N, Flagib M, Tiara RVC. Prevalence of titanium hypersensitivity in patients with titanium implants. A systematic review and metaanalysis. J Pharm Bioallied Sci 2021 Nov; 13 (Suppl 2):S345-S1349.

AAAAI.org. Titanium allergy and lymphocyte transformation test. 2/21/21. Accessed on 10/31/23. Available at: https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2021/titanium.

Richards LJ, Streife A, Rodrigues JM. Utility of patch testing and lymphocyte transformation testing in the evaluation of metal allergy in patients with orthopedic implants Schalock PC, Crawford G, Nedorost S, et al. Patch testing for evaluation of hypersensitivity

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Dermatitis 2016;27:241-247.

Stejskal VD, Olin RG, Forbeck M. The lymphocyte transformation test for diagnosis of druginduced occupational allergy. J Allergy Clin Immunol 1986; 77:411-426.

Stejskal VD. Allergy to drugs and other chemicals diagnosed by the presence of specific memory cells in human blood. In: Ivan P, editor. Realm of Tolerance. Springer: 1989. Pp 213-225.

Stejskal VD, Forsbeck M, Nilsson R. Lymphocyte transformation test for diagnosis of isothiazolinon allergy in man. J Inest Dermatol 1990; 94:798-802.

Vadala M, Laurino C, Palmieri B. The memory lymphocyte immunostimulation assay in immune system disorders: is useful or useless. J Lab Physicians 2017 Oct- Dec; 9(4):233-226.

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Podzimek S, Himmloua L, Roubickova A, Janovska M, Janatova T, Bartos M, Vinsu A. Titanium and other metal hypersensitivity diagnosed by MELISA test. Follow-up study. Biomed Research International Volume 2021. Article ID: 5512091.

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Arroyo-Lamos N, Arteagoitia I, Ugalde U. Surface activation of titanium dental implants by using UVC-LD irradiation. Int J Mol Sci 2021 Mar; 22(5):2597.

Roy M, Pompella A, Kubacki J, Szade J, Roy RA, HGedzelek W. Photofunctionalization of titanium: an alternative exploration of a chemical-physical mechanism. PLoSONE 2016;11e0157481.

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Qu Y. Zirconia materials for dental implants: a literature review. Front Dent Med 13 Aug 2021. Sec. Dental Materials Volume 2- 2021.

Dr. Maloney

Dr. Raymond

William J. Maloney, D.D.S., PG CertMedED, FACD, is attending at BronxCare Health System, Bronx, NY. George Raymond, D.D.S., FACD, is clinical associate professor, New York University College of Dentistry, New York, NY. Maura Maloney, D.D.S., is in private practice in Scarsdale, NY.

Component formation, or go right to the GLIDM website: www.GLIDM.org.

Component Second District cont.

NASSAU COUNTY

Another Trip Around the Sun Eugene Porcelli, D.D.S., Executive Director

Here we are, after another trip around the sun, at the beginning of a new year.

It’s hard to believe we’re already a quarter of the way through this century— anyone remember the anxiety of Y2K? Nonetheless, as we march forward, I’d like to highlight some of our accomplishments in 2025.

When all was said and done, we provided 40 courses, totaling 113 hours of continuing education, for our members, including our first hands-on course devoted to “Advanced Adhesion Injection Molded Direct Composites.” This course and five others were so popular, they sold out. We also installed a new system that will allow us to livestream some of our courses beginning in the spring.

Speaking of CE, in 2026, GLIDM will be back to a two-day event. It will take place Sunday and Monday, April 2627, at the Huntington Hilton. Meeting hosts, NCDS and SCDS, received such positive feedback on the new format in 2025, that we’re keeping it for 2026, and expanding the meeting back to two days. Some great courses are scheduled, including hands-on courses in lasers, implants and direct bonding, as well as lectures in anesthesia, oncology, minimally invasive dentistry and ethics. We have a series of three courses geared for hygienists and the dental team, just about every mandatory course you need for licensure, right there in one spot.

Finally, for the first time in its 15-year history, our women’s dental symposium, “Scrubs & Stilettos,” will be held on Sunday during GLIDM. There’s something for everyone, so watch your email for registration in-

NASSAU COUNTY Dr. Richard Young delivers advance adhesion advice at sold-out course in 2025.

Favorable Forecast Mother nature was kind to us for our two fall outdoor events, delivering absolutely gorgeous weather. On Saturday, Sept. 13, we shredded over three tons of charts and files and collected over 1,400 pounds of electronics and X-ray film for recycling. In addition, Garfield Refining was on hand to purchase dental scrap. It was a successful event and since it’s free to Nassau County Dental Society members, it’s another example of the benefits of membership.

Then on Sunday, Oct. 5, we had our third annual Walk for Oral Cancer Awareness. This year we walked at Eisenhower Park and had a wonderful turnout of over 140 participants. Everyone had a great time, and several of our attendees walked away with terrific raffle prizes!

A big thank you to all our volunteers and to everyone who came out to support us. Special thanks to our sponsors: The New York State Dental Foundation, Leading Edge Oral Surgery, Premier Endodontics of Long Island, Benco Dental, Long Island Oral Surgeons, dasarc Architecture and Design, Dr. Jane Arena, East Hills Endodontics, PDM Family Dental, Island Endodontics, Dr. Maureen Tredwell, South Shore Long Island Periodontics and Implantology, and Drs. Katayoon & Delilah Leibowitz. We raised enough money to donate $5,000 to Memorial Sloan Kettering for oral cancer research and $2,500 to fund our many free public oral cancer screenings.

Achievements Another wonderful event that occurred in 2025 involved Executive Assistant Larissa Irving. She gave birth to a beautiful baby boy, Shane Luca. Born on Dec. 1, he weighed in at 7 lbs. 3oz. Both mother and son are doing fine, and Larissa plans to return to us in March.

We also want to congratulate our past president, former NYSDA Trustee

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Nassau County cont. and current NYSDA ADPAC representative Dr. Michael Shreck. He was chosen to be our nominee for NYSDA Vice President in 2026 by the members present at our November General Membership Meeting.

Strictly Personal Finally, on a personal note, I am honored and humbled to be the 2026 re-

cipient of the Nassau County Dental Society’s Herbert L. Taub Distinguished Service Award. The Taub Award is named after one of our founding members, who served as president and as our first executive director for 21 years.

The award recognizes a member’s unique contribution to the growth and well-being of the Nassau County Dental Society. I sincerely appreciate this recognition, and I’m reminded of a quote from Mahatma Gandhi: “The best way to find yourself is to lose yourself in the service of others.” I think that sentiment not only applies to me as the NCDS Executive Director, but to every one of you who serves the profession in your leadership roles and the public every day in your practice, making their lives better.

NINTH DISTRICT The Year that Was

Monica Barrera, D.D.S.

Dr. Michael Shreck, NYSDA Vice President nominee, addresses November General Membership Meeting.

NASSAU COUNTY Dr. Maureen Tredwell hands goodie bag to Walk for Oral Cancer Awareness participant.

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2025 marked some new initiatives in the Ninth District. These included establishing a WhatsApp chat community for members and using the tripartite’s Salesforce/Fonteva more effectively.

The ADA Annual Meeting took place in October in Washington, DC, and the Ninth was there on all fronts.

Seen on the House floor and around town were our NYSDA Trustee Dr. Gary Scharoff, along with Drs. Renuka Bijoor, Anthony Cuomo, Bharat Joshi, B.J. Mistry and Michael Smith.

CE Courses The 9th wrapped up its fall CE program with a two-part CPR course that included an online module provided to registrants by the American Heart Association, followed by a hands-on session at the Blythedale Children’s Hospital. Members continue to tout the process, including the presence of onsite instructors for the hands-on work.

We also provided a couple of the newest updates to the mandated Child Abuse/Neglect Reporter Training in

JANUARY 2026 . The New York State Dental Journal

the form of the state-sanctioned “Addendum,” for those who have already taken the Part I Update through the same provider. The 9th is planning at least one more Addendum in February, and we’re discussing the possibility of a second spring Addendum and a fully updated course for anyone who’s yet to take it. The due date for completing this course is Nov. 17, 2026.

General Meetings This year’s Annual Meeting took place Nov. 12 at the Westchester Country Club in Rye. It included the installation of our 2026 officers (Executive Committee). They are: President Bharat C. Joshi, D.D.S., Westchester County; President-Elect Michael R. Smith, D.M.D., Dutchess County; Vice President Monica A. Barrera, D.D.S., Rockland County; Secretary-Treasurer Alexander J. Pilavsky, D.D.S., Orange County; and Immediate Past President Renuka R. Bijoor, D.D.S., M.D., Westchester County.

Dr. Vigliotti’s choice of Dr. Eduardo Rodriguez, who presented “Face Transplant Program: Culture of Excellence

NINTH DISTRICT New dentists enjoyed several special events in 2025, including reception in November at Vida in Thornwood.

and High-Performance Case Study,” was extremely well-received by members.

Events The 9th hosted a number of events this year. A new dentist bowling outing at Bowlero in White Plains was a big success, as was the reception at the new Vida in Thornwood in November.

Our Celebration of Dentists at the St. Andrew Golf Club in Hastings in June was, as always, a big hit. The gathering in a beautiful venue was a great start to the warm-weather months and provided the perfect atmosphere for camaraderie and support.

Our now annual Shredding Day in June was met with pleasure and thankfulness. Members feel this is a helpful event, one that saves them time, space and money, and they are beginning to look forward to it each year.

On the wellness front, the incomparable Dr. Bhagwati Mistry, a 9th past president and chairman of the Substance Use Disorder and Well-Being Committee, who continues to support her colleagues post-retirement from the profession, provided yoga/meditation instruction to attendees at the 9th’s Health and Wealth event at Hudson River Park in July. Dr. Mistry is a certified yoga teacher, a restorative yoga & rise resiliency facilitator with the Kripalu School of Yoga in Massachusetts, and certified in medicine and yoga meditation for anxiety, depression, addiction and recovery.

Our Give-Kids-A-Smile events at Head Start locations in Brewster and Peekskill were big hits, as was our joint effort with NYSDA at Signing Day and Lunch & Learn at Touro.

Thanks to all the volunteers who make these events educational and worthwhile.

Looking Ahead The 2026 Executive Committee and our Board of Governors will be getting right back to work after the holidays—both have meetings scheduled in January.

We also look forward to our March General Meeting, which will be held this year at the Westchester Country Club in Rye, a new March venue but a favorite of 9th members. It’s sure to be a big hit, with Dr. Vincent Celenza presenting on “Long-Term Effects—Realistic Expectations with Implant Restorations” and “The Dental Restorative Battlefield.”

For information on these and other programs, visit our website at: www. ninthdistrict.org; or call Ninth District headquarters at (914) 747-1199.

SUFFOLK COUNTY

Stony Brook Presentation Devin J. Klein, D.D.S., M.S.

On Oct. 22, we had the honor of engaging Dr. Jeff Seiver’s third-year class

at the Stony Brook School of Dental Medicine on organized dentistry. The class had lots of good questions, and two hours flew by. We were fortunate to have NYSDA Secretary-Treasurer Paul Leary with us to help field questions and share his personal dental journey.

We look forward to seeing these students as they continue their careers in dentistry.

House Meets in Washington Your fellow ADA members met Oct. 2528 in Washington, DC, for the Annual Meeting of the ADA House. They came together to work toward the benefit of the public’s health and to move the dental profession forward.

We are very proud of participants from Suffolk County Dental Society, New York State Dental Association and

Members take steps to protect their license by attending one of several compliance courses in December.

SUFFOLK COUNTY Turnout was impressive for end-of-year General Membership Meeting in November.

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Take advantage of Quality, Discounted Services through

NYSDA Endorsed Services BANKING Bank of America 800-932-2775 800-497-6076

Practice Loans

FINANCIAL SERVICES CareCredit 800-300-3046 (#5)

Patient Financing

Altfest Personal Wealth Management 888-525-8337

Financial Planning

Best Card 877-739-3952

Credit Card Acceptance

Laurel Road 855-245-0989

Student Loan Refinancing

INSURANCE SERVICES MLMIC 800-683-7769

Professional Liability Insurance

Bronx, Manhattan, Staten Island & Westchester Brooklyn, Queens, Nassau & Suffolk Other Counties

888-263-2729 888-744-6729 Arthur Gallagher 888-869-3535

Other Business Insurance

Long-term Care 844-355-2596

Long-term Care Insurance

OTHER Henry Schein 800-734-5561

Electronic Prescribing

ProSites 888-932-3644 www.prosites.com/nysda

Digital Marketing Solutions

Mercedes 866-628-7232

Luxury Vehicles

Lands’ End 800-490-6402

Apparel for Staff

UPS 800-636-2377

Delivery Services

The Dentists Supply Company 888-253-1223

Dental Supplies

Volvo 800-550-5658 ada.org/volvo

Sustainable Vehicles

OnDiem hub.ondiem.com

Office Staffing

Practice Mojo 888-932-3644 practicemojo.com

Patient Communications

For further information about NYSDA Endorsed Programs, call Jeanne DeGuire at 800.255.2100

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JANUARY 2026 . The New York State Dental Journal

Suffolk County cont. all the ADA Delegates and Alternate Delegates, who put forth extraordinary effort to work through what seemed like a record number of resolutions. A special shoutout to the ADA and state leaders and staff who facilitated the sessions.

Delegates and alternate delegates from SCDS and colleagues dined together and discussed various resolutions before House meetings. The speeches and ribbing tradition continued, to make it a joyful and memorable experience.

Tacos and Teeth A big thank you to our new dentist sponsors—Bank of America Practice Solutions, TargetRock Wealth Management, MLMIC and Straumann—who made our Nov. 5 “Tacos and Teeth” event possible. This was our last new dentist program for the year, and it was a huge success as we extended an invite to all Suffolk County members.

Sixty-three dentists, representing several generations, attended the soldout event. They mixed, chatted and enjoyed each other’s company. Dr. Alex Sanchez’s lecture “Endodontic Management of the Pediatric Patient” was wellreceived, as were the tacos and other Mexican fare. Rave reviews continue to come in. Thank you, Dr. Sanchez, New Dentist Committee Chair Devin Klein and other committee members for putting this together.

Closing Out the Year We held our last General Membership Meeting of the year on Nov. 19. It was both wonderful and impactful. We shared a meal, had engaging sponsors, elected a new Board member, adopted Bylaws revisions, honored our veteran dentists, heard from the New York State

Dental Association’s President-Elect and had what many attendees called an outstanding and engaging lecture.

We thank President-Elect Amarylis Jacobo for joining us, and our motivating lecturer Dr. Robert Bacigalupo for sharing his knowledge, expertise and passion. All of this was made possible by our sponsors, Straumann, MLMIC, Long Island Speech, Rivkin Radler, Dentaquest, Stony Brook School of Dental Medicine, Ivoclar and Pearl.

Adhering to the Rules Compliance Day, Dec. 3, was amazing! More than 100 members joined us, spending some or all of their day attending various license compliance courses, including HIPAA, OSHA, Opioid, CPR, Risk Management and Infection Control. As always, ADA members saved 50% on the cost of these courses, demonstrating real value for their membership dollars.

We are grateful to have had the sponsorship of MLMIC, Straumann, Pearl, DDSMatch, HR for Health, Nobel Biocare, Implant Direct, Synergy Dental Partners and HealthFirst. We thank

our lecturers and instructors for sharing their knowledge, skill and craft. They included Dr. Michael Rubinstein, Dr. Peter Mychajliw, Dr. Marc Gottlieb, Have Dummy Will Travel (Erik, Kaitlin and Billy), Dr. Kevin Henner, Seth Kirschbaum and Dr. David Scharf. Survey results for the event were very positive.

We hope you can join us for courses in 2026!

Don’t Miss a Thing We continue to make a significant push to better communicate and connect with our members in methods that more easily integrate with their lifestyle. You can find us on Facebook, X, Instagram, LinkedIn and Spotify, in addition to our traditional www.SuffolkDental.Org presence.

BRONX COUNTY Coming Attractions Don Safferstein, D.D.S.

The Bronx County Dental Society has exciting events coming up. They are listed below.

• A dinner lecture on Jan. 27 will feature presenters Dr. Alla Gizerskaya and Ecodent Laboratory. The program is entitled “Can Digital Dentistry Lower Cost and Increase Productivity in an Insurance-Based Practice?” The program gets underway at 6 p.m. at Maestro’s Caterers.

It’s open free to all members and local hospital residents.

• The BCDS annual Job Fair will take place beginning at 6:30 p.m. March 19 at Maestro’s Caterers. The fair,

New dentists enjoy Mexican fare while learning about Endodontic Management of Pediatric Patient at Tacos and Teeth.

SUFFOLK COUNTY Delegates to ADA Annual House Meeting on meal break from session.

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Bronx County cont.

•

sponsored by MLMIC, is open to all young dentists looking for career opportunities and all dentists thinking about practice growth and/or transitions. It’s free and includes food, beverage and raffle prizes.

On April 21, members will return to Maestro’s for a presentation by Dr. Megan Cloidt entitled “Safe, Effective, Essential: Evidence-based Dental Care in Pregnancy.” It begins at 6 p.m.

For the Good of the Community BCDS is proud to announce it has received a $10,000 grant from Healthfirst Foundation to support its ongoing efforts to promote community oral health and wellness. Healthfirst is a not-for-profit foundation that works to improve health equity in the New York City area.

EIGHTH DISTRICT Dental Meeting

Kevin J. Hanley, D.D.S. The University at Buffalo Dental Alumni Association held its annual Buffalo Niagara Dental Meeting from Nov. 5-7 at the Convention Center in downtown Buffalo. The meeting brought together nationally known speakers covering all aspects of dentistry, along with a trade show featuring exhibitors from national dental companies.

Five-year reunion classes were recognized at the annual Alumni Dinner Dance. Also at the dance, Dr. Raymond Miller, Class of 1985, received the Alumni’s Honor Award for his outstanding work in the field of dentistry, particularly as a forensic dentist, as well as his positive promotion of the 42

UB Dental School throughout his career and his contributions to the community at large. Dr. Paul DiBenedetto, Class of 1979, received the Distinguished Service Award for his dedication to the Alumni Association over his extensive career and for his contributions to the dental community and the public.

Those who attended the Dental Meeting were able to earn a maximum of 15 MCE credits if they were present for all two and a half days of the meeting.

Memorial Lecture The Buffalo Marriot Hotel in Amherst was the venue for the 2025 Dr. Rick Fink Memorial Lecture on Dec. 5. Dr. Peter Auster presented “AI and More—Growing Trends in Dentistry” and “Be Your Own Prosthodontist: Keep Big Cases in House.”

His AI presentation focused on how AI can assist in elevating dentistry to the highest levels. He discussed the best retraction pastes, the best pulpcapping agents, the newest lasers and other technological advances in dentistry.

In “Be Your Own Prosthodontist,” he discussed the difficult cases presenting in everyone’s offices. He provided guidance for deciding where you want to go and how to reach those goals. And he shared tips and pathways to becoming the dentist you desire.

His presentation lived up to expectations and awarded attendees with 7 hours of MCE. That Holiday Feeling The Eighth District held its annual Children’s Holiday Party at Transit Valley Country Club in East Amherst on Dec. 6. A popular event, it attracted more than 50 families. The morning began with the serving of a delicious buffet brunch and moved on to entertainment provided by a magician, who wowed the crowd with his feats of prestidigitation and illusion.

A visit from Santa Claus added to the morning’s excitement as much to the joy of partygoers, he distributed a stock-

JANUARY 2026 . The New York State Dental Journal

EIGHTH DISTRICT Members and their families revved up their holiday spirit at annual party in early December that included visit from Santa Claus and toys for all children.

ing of toys to all the children present.

After enjoying the morning together, families departed at noon, no doubt looking forward to the coming holiday season.

Presidents’ Reception The Orchard Park Country Club will provide the backdrop for the Eighth District and Erie County Dental societies’ Presidents’ Reception on Saturday, Jan. 31. Being sworn in that evening for the Eighth District are: Dr. Michael Ehlers, president; Dr. Jennifer Frustino, president elect; Dr. Elizabeth Kapral, vice president; Dr. Nicole Hinchy, secretary; and Dr. Joseph Modica, treasurer.

For Erie County: Dr. Katherine Pauly, president; Dr. Amanda Torsney, vice president; Dr. Kaitlyn Taylor, secretary; Dr. Onalee Sortino, assistant secretary; and Dr. Karl Neuhaus, treasurer.

Music will be provided by the Eighth District’s Central Groove, all members of the society. It promises to be another wonderful night of fellowship.

February CE The Erie County Dental Society will hold its first quarterly “Basic Life Support for Health Care Providers” course at the district office on Monday, Feb. 2. This course fulfills the New York State requirements for CPR retraining. All participants will be asked to complete a skills test and a written exam to achieve recertification. Attendees will receive 4 MCE credits for attending and a two-year certification in CPR. Erie County’s annual Ski Day is set for Friday, Feb. 13, at the Holimont Ski Club in Ellicottville. It includes a CE presentation, “Perio on the Slopes: What’s New and What Matters,” by Dr. Renato Casarin. Dr. Casarin contends that just like skiing down the slopes, periodontology and implant dentistry go through constant highs and lows.

Concepts rise quickly to fame and sometimes disappear just as fast. This course will take a refreshing and critical look at what is truly new, what really matters and what may simply be a passing trend in clinical practice.

SEVENTH DISTRICT MCDS Hosts Scholarship Luncheon

Becky Herman, Executive Director The Monroe County Dental Society held its annual scholarship luncheon with dental students from the University at Buffalo, University of Maryland, University of Pittsburgh and Case Western.

Each year, MCDS provides financial grants to second-, third- and fourthyear dental students who had been legal residents of Monroe County prior to entering dental school.

An in-person lunch provides students with an opportunity to meet with our member dentists, who answer questions about transitioning from dental school to residency, provide early career tips and explain the benefits of organized dentistry.

Society Donates to Local Charities Each year, the Seventh District donates to local charities in counties where our members work. Our county representatives hand-deliver checks and presents to organizations and families in need.

We are proud to have supported Matthew House in Cayuga County; Bridges for Brain Injury, Inc., and Happy Tails Animal Shelter in Ontario County; the Geneseo/Groveland Emergency Food Pantry and Sent by Ravens Food Pantry in Livingston County; the Boys & Girls Club of Rochester and the YWCA in Monroe County; Keuka Comfort Care Home in Yates County; and the Seneca County Office for the Aging.

New dentists properly attired as teeth at Brews, Boos & New Dentists Halloween party in October.

New Dentists Celebrate Halloween New dentists and residents from the Eastman Institute for Oral Health and Rochester Regional Health had a fangtastic time at the district’s Brews, Boos & New Dentists Party at the Irondequoit Beer Company on Oct. 30.

Thank you to our sponsors, who supported this event and dressed up for the occasion: Bryan Gray, CPA; Empire Dental Administrators; Genesee Regional Bank; Morgenstern DeVoesick; Straumann; and Walsh Insurance.

Mentorship & Leadership Development Program Pints & Perspectives Mentorship & Leadership Development Program was held on Nov. 3 at Rohrbach Brewing.

The panel discussion was titled “Humbled by Experience: My Biggest Mistakes in Dentistry.” Member dentists from private practice, a DSO, academia and at varied stages in their careers shared stories about things they’ve learned along the way in an open, humorous format. Candid lessons, big laughs and real-world wisdom made it a night to remember.

Dr. Dudney Presents to the Monroe County MCDS hosted its annual business meeting prior to Dr. Thomas Dudney presenting “Be Aware of Wear” and “MACdentistry” during a full-day of

Dr. David Ramjattansingh following his induction into American College of Dentists.

SEVENTH DISTRICT Dr. Xiomara Restrepo-Jaramillo, right, presents check to food pantry representative, one of many checks given out during year to local organizations and families in need.

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were joined by Drs. Christopher Calnon and William Zugner, who served as alternate delegates.

Seventh District cont. continuing education at Brook-Lea Country Club. At that meeting, Dr. Taylor Squires received a gift certificate and plaque in recognition of his two years as president of the Monroe County Dental Society.

Thank you to our sponsors: Bisco, Empire Dental Administrators, GCA, Kettenbach, Pearl, RTG, Shofu, Urgent Dental and Walsh Insurance.

ACD Inducts Dr. David Ramjattansingh Congratulations to Dr. David Ramjattansingh, who was inducted into the American College of Dentists (ACD) during its Annual Meeting and Convocation in Washington, DC. Fellowship in the ACD is a prestigious honor, recognizing leadership, integrity and outstanding contributions to the profession of dentistry.

Dr. Ramjattansingh is currently serving as our NYSDA Trustee, and he was one of our ADA delegates, alongside Dr. Michael Keating, at the American Dental Association House of Delegates meeting in late October. They

SECOND DISTRICT

Greater New York Dental Meeting Christine Terrio, Executive Director

The Second District Dental Society, in conjunction with the New York County Dental Society, hosted a successful Greater New York Dental Meeting. We extend sincere congratulations and gratitude to the following SDDS members, who serve on the organization committee: Drs. Saad A. Butt, Steven Gounardes, Charles J. Mistretta and Lawrence Flaum. Congratulations also to our general chair, Dr. John Young, for the dedication and effort he put into staging this premier dental conference, and to Dr. Lorna Flamer-Caldera, the incoming and first female GNYDM General Chair. This event would not be possible without you all!

As always, the GNYDM provided access to more than 1,000 exhibit booths, hands-on workshops, seminars, poster sessions and other educational programs, and put dental professionals in touch with each other. A highlight of this year’s meeting was the first New Dentist Reception, an opportunity for new dentists to enjoy the venue and

SEVENTH DISTRICT Monroe County hosts scholarship recipients, all dental students with ties to county, at annual scholarship luncheon.

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connect with each other. Many new dentists, residents and SDDS members were in attendance, which sparked conversation aimed at getting younger dentists excited about participating in organized dentistry. The reception was a perfect addition to GNYDM’s new dentist track, which caters to younger professionals.

GNYDM attendees also had the opportunity to experience Broadway while attending the meeting, with an exciting performance from “Michael Jackson the Musical.”

Loan Forgiveness Program On Jan. 1, The Second District Dental Society (SDDS) launched its 9th Dental School Loan Forgiveness Program. The program, which was established by the SDDS Board in 2016, aims to help lighten the load for young dentists just starting out in practice who have chosen to call Brooklyn or Staten Island their professional home. Since its inception, the program has awarded grants totaling over $1.5 million.

The program is open to all newly licensed dentists who have had their licenses for five years or less, are fully active members of the SDDS and have more than $50,000 in documented dental school loan debt. The award is a onetime grant, which is paid directly to the loan provider on the awardee’s behalf.

Awardees may reapply in subsequent years and are eligible to receive up to three awards if they meet current program criteria.

In addition to completing an online application, applicants who meet the eligibility requirements must submit dental school transcripts, complete three essays distinguishing them to the program committee and have their current Brooklyn/Staten Island employer submit a directed recommendation form illustrating the candidate’s character and leadership skills. This year’s application cycle ends on March 31.

2025 SDDS Dental Student Loan recipients are Drs. Benjamin Babaev, Weng Si Chan, Christina Eskew, Mark

Goodenough (RCDS officer), Magda Jeznach, Alan Meskin, Paulina Micek, Kasey Muchnicki, Maxine Navi, Mariah Pewarski, Mariam Pincus, Sejndi Rusi (SDDS BOT member), Nathaniel Saed, Arman Ghafarian, Danielle Grushkovskiy, Thema Hepburn, Rebecca Solomon and Jessica Vitale.

Past Presidents’ Night Members of the Richmond County Dental Society (RCDS), a branch society of the Second District, convened on Nov. 18 for the society’s regular monthly meeting at Max’s EsCa restaurant. It included a lecture by past president Dr. Louis DeSantis.

The occasion was Past Presidents’ Night, an evening organized to celebrate and thank those who have served the society at the highest level. Several RCDS past presidents were there, including Drs. Paul Albicocco, Phyllis Merlino, Edward Jastremski, Christen Carute, Michael Costa, Raymond Flagiello, Louis DeSantis, Phillip Buccisgrossi, Michael D’Anna, Charles Mistretta and Valerie Venterina.

Leadership Transition at Second District After 34 years of distinguished service, Bernard Hackett retired as executive director of the Second District Dental Society. Throughout his tenure, Bernard became known for his leadership, integrity and institutional knowledge.

He guided and encouraged volunteers to step into leadership roles at all levels of the tripartite. He helped the society through major shifts in organized dentistry, such as co-founding the SDDS Dental Student Loan Forgiveness program, creating the NYSDA Medicaid Committee and so much more, all while maintaining an unwavering commitment to supporting dentists and elevating the profession in Brooklyn and Staten Island. His leadership guided SDDS through challenging times, like Superstorm Sandy, when parts of Brooklyn were flooded, and during the pandemic, when he helped get supplies to dentists.

Richmond County past presidents gather for group photo during monthly meeting, held in part to thank them for service.

Second District volunteers meet up on floor at Greater New York Dental Meeting.

SECOND DISTRICT 2025 SDDS Dental Student Loan recipients.

The New York State Dental Journal . JANUARY 2026

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Component

NEW YORK COUNTY

Celebrating Those Who Move the Profession Forward Egidio Farone, D.M.D.

Second District cont.

His steady leadership and deep respect for the organization’s mission have left a lasting impression that will continue to shape SDDS for years to come.

As SDDS looks to the future, Christine Terrio will step into the role of executive director, following a six-month succession period as associate director.

This transition provided Christine with the opportunity to work closely with Bernard and the Board to ensure continuity and a smooth handoff of responsibilities. While any leadership change naturally brings a period of adjustment, Christine enters the role with a collaborative, transparent and member-focused approach, committed to honoring the foundation Bernard established while guiding SDDS forward in a rapidly evolving professional landscape.

As this new era begins, SDDS looks forward to building on its strong foundation while embracing new opportunities to serve its members with excellence.

The New York County Dental Society met Nov. 3 for its General Membership Meeting. The evening lecture was delivered by Dr. Charles N. Bertolami, dean of New York University College of Dentistry and recipient of the prestigious Henry Spenadel Award, which honors individuals or organizations for significant contributions to advancing the dental profession. The award was presented by New York County Dental Society President Vera Tang. Dr. Bertolami’s lecture, “The Medium is the Message— How Dentists Avoid Brand Suicide,” emphasized that every communication channel conveys a message, whether intended or not, and showed members how to use media thoughtfully to strengthen their brand and prevent

common reputation-harming mistakes.

President Tang also presented NYCDS Past President James Doundoulakis with the Mark Mintzer Award for Service, recognizing his outstanding dedication to the society and the dental community through leadership and volunteerism. In his remarks, Dr. Doundoulakis reflected on the importance of service and the enduring value of supporting organized dentistry.

At the meeting, Dr. Suchie Chawla and Dr. Yakir Arteaga were thanked for their service on the NYCDS Executive Committee and Board of Directors, respectively. And members approved the 2026 slate of officers, who will serve alongside President Andrew S. Deutch. They are President-Elect Egidio A. Farone, Vice President Jaskaren Randhawa, Secretary Ada S. Cooper and Treasurer Barry Sporer. Michelle Lee, Nojan Bakhtiari and Margaret Romao will serve on the Board of Directors.

New dentists gained valuable insights into practice management at Legal and Lending event.

SECOND DISTRICT Bernard Hackett and Christine Terrio.

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NEW YORK COUNTY NYCDS members, NYU alumni and residents gather at NYU Fall Networking Night at society headquarters.

JANUARY 2026 . The New York State Dental Journal

New Dentists Get Legal & Lending Advice On Nov. 5, new dentists gathered for “Legal and Lending Insights for New Dentists,” receiving valuable guidance to help build a strong foundation for their careers. Legal experts from Mandelbaum Barrett, PC, and a lending specialist from Bank of America Practice Solutions shared key strategies to help attendees navigate the challenges of practice ownership and financial planning.

Our newest Corporate Friend, Philips Sonicare, showcased several of their products at the event and raffled off a Sonicare toothbrush to one lucky attendee. The event also gave new dental professionals the chance to connect with peers, expand their professional networks and gain insights from trusted advisors who work with dentists every day.

NYCDS President Vera Tang and Henry Spenadel Award recipient Dr. Charles Bertolami.

NEW YORK COUNTY Steven Moss with Mark Mintzer Award recipient and past president James Doundoulakis, his wife and daughter.

NYU Fall Networking Night The New York County Dental Society paired with NYUCD Alumni Affairs on Nov. 6 to host the annual networking event for dental students. This event is designed to connect NYU College of Dentistry students with experienced dentists from various specialties and NYU alumni members. NYCDS members, NYU alumni and residents enjoyed an evening of speed networking sessions and career-focused conversations.

Greater New York Dental Meeting The 2025 Greater New York Dental Meeting (GNYDM) once again brought the dental community together for a memorable week of education, innovation and making connections. With thousands of dental professionals in attendance, the meeting delivered a dynamic program of world-class speakers, cutting-edge clinical and business courses, and hands-on learning opportunities designed to support dentists at every stage of their career.

The exhibit hall buzzed with energy, as leading manufacturers and service providers showcased products and solutions shaping the future of dentistry.

GNYDM 2025 fostered meaningful networking through special events, receptions and dedicated programs for students, residents and new dentists.

Special Olympics Special Smiles On Dec. 6, several NYCDS members and dental student volunteers from Columbia, NYU and Touro participated in the Special Olympics Special Smiles event. A total of 82 athletes received dental screenings, with 13 identified as having urgent dental needs.

Thank you to all our dedicated volunteers for their compassion, teamwork and commitment to making this event a success.

and oral hygiene education to children in need. If you’ve never taken part in this event, this is the perfect time to do so. It is truly an unforgettable experience that reminds us why we do what we do.

We would also like to acknowledge our premier sponsor, Healthfirst, for their support of GKAS 2026, which empowers our mission to improve oral health in underserved communities in Manhattan.

Learn more by visiting www.nycdentalsociety.org Continuing Education Schedule & Special Events • Jan. 27 6 p.m.: Installation of Officers.

• Jan. 28 9:30 a.m.-4:30 p.m.: Innovations in Aesthetic Dentistry: Everything You Need to Know About Veneers.

• Feb. 5 6-8 p.m.: How to Build 5 Star Team. (Zoom) • Feb. 6 9:30 a.m.-12:30 p.m.: Mandated Infection Control.

• Feb. 11 6-8 p.m.: From HIPAA to Hackers: A Dentists Guide to Cybersecurity That Actually Works.

(Zoom) • Feb. 20 9:30 a.m.-1:30 p.m.: BasicLife Support/CPR Certification Course.

• Feb. 27 9:30 a.m.-3:30 p.m.: A Hands-On Workshop in Composite Injection Moulding Utilizing Digital Workflows.

• March 18 9:30 a.m.-12:30 p.m.: Local Anesthesia: Myths and Truths Explained.

• March 27 9:30 a.m.-4 p.m.: EasyPedo for the GP Workshop.

Give Kids A Smile We’ll gather Feb. 6 as a community of caring dentists, team members and volunteers for Give Kids A Smile NYCDS 2026, a special day dedicated to providing dental exams, fluoride treatments The New York State Dental Journal . JANUARY 2026

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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 Association, by properly answering the following 20 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 the appropriate fees: $35/dentists; $25/hygienists. Nonmember fees are: $65/dentists; $45/hygienists. All those who achieve a passing grade of at least 70% will receive verification of completion. Credits will automatically be added to your CE Navigator account.

For a complete listing of online lectures and home study CE courses sponsored by the New York State Dental Association, visit www.nysdentalfoundation.org.

q

IPS Subperiosteal Implant for the Maxilla and Mandible— Page 16-22

1.

2.

3.

4.

5.

The purpose of the article is to present a method to treat challenging clinical scenarios where both endosseous and zygomatic implants are not feasible. q T or q F Individual Patient Solutions (IPS) does not utilize CAD/ CAM technology. q T or q F IPS implants are designed for patients with significant bone loss. q T or q F IPS has the potential for utilization of post-ablation for head and neck cancer patients. q T or q F The IPS system has not been employed for cases of cleft-lip. q T or q F

Enclosed is a check for the full amount. Members’ fees are $35/dentists; $25/hygienists. Nonmember fees are $65/dentists; $45 hygienists. (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: q VISA q MasterCard q American Express

Telephone

Card #

Email

Expiration Date

ADA #

Name

License #

Address

NYSDA Member? q yes or q no

City

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State

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JANUARY 2026 . The New York State Dental Journal

Local/State Dental Society

6.

Due to the relative novelty of IPS treatment, patient follow-up is crucial. q T or q F 7. The IPS system offers far greater stability and accuracy than systems relying on alginate and rubber base impressions. q T or q F 8. The IPS system has long-term clinical data. q T or q FF 9. The restoration of the IPS system provides a stepwise process for clinical providers to follow after the surgical phase. q T or q F 10. Implant abutments are already incorporated into the implant pillars for the IPS system. q T or q F Amyloidoma of the Palate—Page 28-31

1.

Amyloidoma of the palate is a common disease of the hard palate. q T or q F 2. Amyloidoma must be differentiated from multiple myeloma. q T or q F 3. Amyloidosis is a condition in which abnormal proteins are deposited in the tissues. q T or q F 4. The clinical presentation of the case described here was strongly suggestive of a salivary gland tumor. q T or q F 5. The clinical case presented with malignant characteristics. q T or q FF 6. It was recommended that the patient be closely monitored for possible progression to systemic amyloidosis. q T or q F 7. The clinical patient required extensive surgery to treat the palate. q T or q F 8. The clinical patient proved to be negative for features of systemic amyloidosis. q T or q F 9. The etiology for amyloid is well understood. q T or q F 10. When there is no treatment for amyloidosis, the medical survival rate is one to two years. q T or q F

Titanium Hypersensitivity as Possible Cause of Dental Implant Failures—Page 32-36

1.

Titanium allergic reaction will not produce ulcers in the oral cavity. q T or q F 2. Dr. Per-Ingvar Branemark became known as the “Father of the Modern Dental Implant.” q T or q F 3. Titanium has a modulus of elasticity similar to bone. q T or q F 4. Titanium reactions are never systemic. q T or q F 5. In animal studies, titanium ions have been detected in regional lymph nodes and the lungs following implant placement. q T or q F 6. Allergic responses to titanium would regularly be classified as a Type IV-delayed hypersensitivity q T or q F 7. A Type IV hypersensitivity will not contribute to autoimmune diseases. q T or q F 8. UV-light-treated titanium holds no promise for improving the longevity and performance of titanium dental implants. q T or q F 9. Surface modification of zirconia implants has enhanced cell response with a resultant improvement of osteointegration. q T or q F 10. Dentists must consider the possibility that an allergic response to titanium may in some cases lead to implant failure. q T or q F

To complete the questionnaire online, scan QR code above

The New York State Dental Journal . JANUARY 2026

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CLASSIFIED INFORMATION

Online Rates for 60-day posting of 150 words or less — can include photos/images online:

FOR SALE HAMPTONS: General practice for sale. Established feefor-service practice on Long Island’s South Fork. $1.685M collections and $340K EBITDA. Recently remodeled, freestanding building featuring four operatories and space available to add fifth. Real estate also available for purchase, offering strong long-term investment opportunity.

915 active patients; 15 to 20 new patients each month.

Practice benefits from strong patient loyalty, high household incomes and consistent demand for quality dental care.

Area attracts families and professionals seeking balanced lifestyle, with access to beaches, parks, outdoor recreation and top local amenities. Both owner doctors ready to transition and will support smooth handoff. Rare opportunity to acquire modern, profitable FFS practice in highly desirable South Fork community. Contact PTS: bailey@ professionaltransition.com for more information. Reference #NY112025.

CLASSIFIEDS

LONG ISLAND CITY: Rare opportunity to own thriving dental practice in Long Island City, one of New York City’s fastest-growing neighborhoods. Modern, fully equipped office produces over $1M annual revenue with strong patient retention and steady new-patient flow. State-ofthe-art operatories, digital technology and efficient layout designed for both comfort and productivity. High-traffic, rapidly developing area surrounded by new residential and commercial projects. Practice perfectly positioned for continued growth. Excellent lease terms and well-established brand make this ideal turnkey opportunity for solo practitioner or group looking to expand. Don’t miss this chance to acquire profitable, well-managed dental office in one of NYC’s most dynamic communities. Serious inquiries only.

Confidential information available upon request. Email: ianmapes@gmail.com.

ALBANY: Thriving, well-established practice in Capital Region. Located in Albany, practice boasts 1,560 active patients and six fully equipped operatories, supporting both owner doctor and associate. With $1.9M in collections and $530K in EBITDA, practice offers strong profitability and growth potential. Currently open only four days per week, creating significant opportunity to increase revenue by extending hours. Freestanding building available for purchase making compelling investment opportunity. Contact Bailey Jones, Professional Transition Strategies, by phone: (719) 694-8320; or email: bailey@professionaltransition. com. Reference #NY83023.

LONG ISLAND: Established, multi-generational practice in Greater Long Island with strong community ties. With almost no advertising, practice attracts 15-20 new patients per month and maintains 1,120 active patients, creating solid foundation for growth through marketing or expanded services. Freestanding building includes three operatories and consult room. Real estate available. Owner doctor open to staying for up to three years to mentor incoming dentist, ensuring smooth transition. With collections of $600K and true take-home of $145K, rare opportunity for buyer or group seeking established presence in Long Island market.

Contact Bailey Jones, Professional Transition Strategies, by phone: (719) 694-8320; or email: bailey@professionaltransition.com. Reference #NY91025.

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Members: $200. Nonmembers: $300. Corporate/Business Ads: $400. Classifieds will also

INDEX TO ADVERTISERS

appear in print during months when Journal is mailed: Jan and July.

GLENS FALLS, QUEENSBURY: Beautiful 5,800-squarefoot, 8-chair office for sale or lease. Large lab, library, conference room, 2 private offices, staff lounge, surgery suite, X-ray and sterilization rooms. Office liquidation, including office furniture and equipment, CBCT/PAN, 8 chairs/units, extensive instruments and supplies, including Periodontal surgery and preventive maintenance, Oral Surgery, Endodontics, Implant Surgery, Crown and Bridge and Restorative. Dual motor air compressor and suction pump.

Very nicely decorated; immaculate. Call (518) 793-5908 to leave message or email: robertsharpdds@adirondackdental implantcenter.com.

BRONXVILLE: Dental/professional office for sale at 915 Palmer Road. Located 3 blocks from New York Presbyterian-Westchester Hospital. Great space for dental practice. Near train station, and bus stop in front of building. 3,500 square feet includes 3-5 exam rooms, office, 2 storage rooms, 3-5 bedrooms, 3.5 bathrooms, kitchen/dining room/conference room. Parking lot in back holds 6 cars, ample on-street parking. Asking: $1.295M. Contact Realtor Camelia Pena-Rivera, RE/MAX Distinguished Homes & Properties, by phone: (914) 441-1393 or email: camiesproperties@gmail.com.

WATERTOWN/THOUSAND ISLANDS: Dental practice for sale in beautiful Northern NY. Desirable location, approximately 1 hour north of Syracuse, in close proximity to Thousand Islands and Canadian border. Modern, well-designed, attractive, standalone building with ample parking. 3,395 square feet. Main floor offers 9 ops with digital X-ray, CBCT, Eaglesoft, Schick Sensors, 3D printing and CEREC. Finished 1,500-square-foot basement includes conference room, laundry/locker room, kitchen and 2 additional offices. Building available for sale or lease. Reputable practice can run 1-2 dentists, with gross revenue in excess of $1M annually on 4-day week. Experienced, highly motivated team of 8 willing to remain after sale. Owner retiring and willing to help with transition. Contact Robert Schonfield, DDS, by phone: (315) 771-4012; or email: rob@docschonfield.com.

Choice Transitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

DDSMatch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Endorsed Vendor Feature . . . . . . . . . . . . . . . . . . . . . 14 & 15

Epstein Practice Brokers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Henry Schein . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

NYDSA Member Benefit Guide . . . . . . . . . . . . . . . . Cover III

NYSDA Renewal Ad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

NYSDF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

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

FOR RENT DOWNTOWN BROOKLYN HEIGHTS: Modern, turnkey dental office available for rent. Walk in and start practicing. Downtown Brooklyn Heights with views of lower Manhattan. Available now. Fully furnished with 3 ops, A-Dec chairs, Nitrous. New server and computers included. Near all trains. Call or text for more information: (347) 712-0778.

JANUARY 2026 . The New York State Dental Journal

NYSSOMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Raisin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cover II

GLENS FALLS, QUEENSBURY: Beautiful 5,800-squarefoot, 8-chair office for sale or lease. Large lab, library, conference room, 2 private offices, staff lounge, surgery suite, X-ray and sterilization rooms. Office liquidation, including office furniture and equipment, CBCT/PAN, 8 chairs/units, extensive instruments and supplies, including Periodontal surgery and preventive maintenance, Oral Surgery, Endodontics, Implant Surgery, Crown and Bridge and Restorative. Dual motor air compressor and suction pump.

Very nicely decorated; immaculate. Call (518) 793-5908 to leave message or email: robertsharpdds@adirondackdental implantcenter.com.

SERVICES

UTICA: Upstate NY practice seeks general dentist. Dentist needed for long-established, private, fee-for-service practice. Full- or part-time associateship or associateship leading to partnership. Associate compensation range 38%40% of collections, with sign-on bonus. DDS/DMD from accredited dental school and active NY license required.

Contact Mark Slavin, DDS, or Brian Jackson, DDS, by phone: (315) 724-5141; or email: slavin094@gmail.com.

SULLIVAN COUNTY: Part-time dentist needed for children’s dental health program. Provide preventive and restorative care in fully equipped clinic. Hours: 9 am-4 pm. Experience treating children required. Rewarding work with competitive pay. Should you be interested in learning more or would like to apply, please call or email: (845) 434-0376 ext. 210; prasad@prasad.org.

MALONE NY: Seeking Dentist for position at Alice Hyde Medical Center to provide high-quality care to patients in Dental Clinic. Requirements: Active NYS license (or ability to obtain post hire); graduation from accredited dental school with DDS or DMD degree with school accredited

by American Association of Dental Education; current DEA registration; as applicable, training/competency in attend-

ing to special needs and/or behaviors appropriate to age of patients. Responsibilities: Provides high-quality care to Dental Clinic patients as set forth in scope of services consistent with JCAHO, NYSDOH standards and Alice Hyde Medical Center guidelines; accurate and timely documentation to ensure corporate compliance and timely claims billing; understanding of unique physiological, emotional and cognitive characteristics of each patient’s different developmental stages; thorough knowledge of principles and practices of modern dentistry and prevention; familiar with reporting risk management issues to Director; maintain continuing medical education requirements according to bylaws; participates in quality assurance and performance improvement initiatives; assists Director with comprehensive review on all patient/family complaints and appropriate employee follow-up; professional knowledge base through participation of continuing education; commitment toward improving patient care, customer satisfaction and exceeding customer expectations; flexible and creative in dealing with challenges and changes for patients, coworkers and healthcare delivery. Compensation Ranges: $230K - $255K (subject to change). Alice Hyde Medical Center | Dental Center. For more information, please contact: Matt Canasi, Network Recruiter by email: Matt.Canasi@uvmhealth.org.

The New York State Dental Journal . JANUARY 2026

CLASSIFIEDS

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ADDENDUM

UB Dental Professor Studying Immune System’s Role in Sjögren’s Disease SJÖGREN’S DISEASE affects about 4 million people in the United States, predominately women. Characterized by severely reduced tears and saliva, the autoimmune disease makes the sufferers’ mouths feel like they’re filled with cotton and often results in tooth decay and difficulty swallowing.

Jill M. Kramer, D.D.S., Ph.D., associate professor in the Department of Oral Biology at the University at Buffalo School of Dental Medicine, is looking at how targeting a key molecule in the immune system could lead to better therapies for this debilitating condition.

“There are no FDA-approved drugs for Sjögren’s other than those that reduce eye inflammation,” she said. “Unfortunately, we don’t have anything that prevents the loss of salivary flow or reverses it. As dentists, we just advise patients to drink lots of water, avoid sugary, sticky foods, brush their teeth often, and use high-fluoride products to manage the symptoms and try to prevent decay.”’

Dr. Kramer, who has studied Sjögren’s disease for several years, last year received a $2.1-million, five-year renewal grant from the National Institute of Dental and Craniofacial Research to study the molecule MyD88 and how it is activated by various receptors. This study continues research that Kramer and her team began in 2017.

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JANUARY 2026 • The New York State Dental Journal

“We know that MyD88 plays a key role in the immune system by helping cells respond to the signals that trigger inflammation,” she said. “If you don’t have this molecule, you’re very susceptible to disease.”

In their initial study, MyD88 was genetically removed from mice that were prone to Sjögren’s, and they didn’t exhibit the typical dry mouth or inflamed organs.

“We knew that MyD88 was really important because if it was gone, a lot of the disease manifestations were completely abrogated,” Kramer said.

There is a huge caveat: the mice typically became very sick by six months of age. Thus, blocking MyD88 may not work as a therapeutic approach to combatting Sjögren’s because humans could become severely ill with other diseases.

Understanding exactly how MyD88 causes Sjögren’s, however, could lead to the development of new drugs that block these harmful pathways. And insights gained from studying Sjögren’s could potentially benefit patients with other autoimmune diseases, such as lupus and rheumatoid arthritis, Dr. Kramer said. p