Thomas T. Nguyen, DMD, MSc, MBA, FRCD(C)

During the COVID‐19 pandemic, the dental education community faced unprecedented challenges. In this commentary, we share the perspectives of faculty clinicians, residents and students in academic dental institutions in the United States and Canada. We discuss COVID‐19’s impact on various aspects of academic dentistry including patient care, education, research and raise key concerns regarding the future of dental education post‐pandemic.

The COVID‐19 pandemic is a major public health crisis for countries around the world. In response to this global outbreak, the World Health Organization declared a public health emergency of international concern. Dental professionals are especially at high risk of contracting the COVID‐19 virus due to the unique nature of dentistry, more specifically, exposure to aerosols and droplets. When it comes to dental emergencies, it was crucial to maintain urgent dental care services operational to… Show more

The COVID‐19 pandemic is a major public health crisis for countries around the world. In response to this global outbreak, the World Health Organization declared a public health emergency of international concern. Dental professionals are especially at high risk of contracting the COVID‐19 virus due to the unique nature of dentistry, more specifically, exposure to aerosols and droplets. When it comes to dental emergencies, it was crucial to maintain urgent dental care services operational to help reduce the burden on our healthcare system and hospitals already under pressure. The COVID‐19 pandemic has significantly impacted how dentistry is practiced in North America in both the private practice and academic settings. This article shares the perspectives of dentists practicing in private practice and clinician‐researchers in academic dental institutions. More specifically, we discuss about measures implemented to minimize risks of disease transmission, challenges in emergency dental care, impact on patients, as well as impact on the professional and personal lives of the dental team during the COVID‐19 crisis. Show less

Introduction: Historically, the treatment of palatal recession was thought to be extremely challenging if not impossible due to the anatomy of the palate. A novel technique is presented for treating gingival recession on maxillary molars utilizing a rotated subepithelial connective tissue pedicle graft. The technique is designed to maximize perfusion to the graft as compared to a free graft
Case Presentations: The authors present two cases in which the technique was utilized to achieve… Show more

Introduction: Historically, the treatment of palatal recession was thought to be extremely challenging if not impossible due to the anatomy of the palate. A novel technique is presented for treating gingival recession on maxillary molars utilizing a rotated subepithelial connective tissue pedicle graft. The technique is designed to maximize perfusion to the graft as compared to a free graft
Case Presentations: The authors present two cases in which the technique was utilized to achieve attachment gain and root coverage. The cases were followed for at least 2 months.
Conclusions: More than 5 mm of attachment was gained and 55% to 60% root coverage achieved over recession defects on maxillary first molars. The following case reports demonstrate that the Reverse Palatal Pedicle Graft (RPPG) technique was successful in improving root coverage over maxillary palatal recession defects. Show less

Introduction: Bone remodeling after tooth extraction and immediate implant placement will occur nonetheless and as a result, additional hard and soft tissue augmentations are often necessary to compensate for the loss of alveolar ridge dimension. The socket shield (SS) technique has shown encouraging clinical results in maintaining original ridge morphology, and thus, may be used as an alternative protocol for the conventional immediate implant placement in the esthetic zone.
Case… Show more

Introduction: Bone remodeling after tooth extraction and immediate implant placement will occur nonetheless and as a result, additional hard and soft tissue augmentations are often necessary to compensate for the loss of alveolar ridge dimension. The socket shield (SS) technique has shown encouraging clinical results in maintaining original ridge morphology, and thus, may be used as an alternative protocol for the conventional immediate implant placement in the esthetic zone.
Case series: The authors report three cases of SS technique used in conjunction with immediate implant placement in an anterior maxilla. The patients were followed for a period of 2 to 6 years, and the evolution of the soft and hard tissue surrounding the implants was documented.
Conclusions: The SS technique produces virtually no change in the hard and soft tissue dimensions with relatively minimal invasive surgical interventions and shorter treatment time. Show less

Background: Gingival thickness, keratinized tissue width, and bone morphotype are three important parameters used to categorize periodontal phenotypes. These ele- ments all play an important role in the maintenance of periodontal health. The aim of this review is to explore the importance of converting thin phenotype into a thick phenotype for periodontal health maintenance.
Methods: Three clinically relevant focus questions were defined to understand the role of gingival phenotype around… Show more

Background: Gingival thickness, keratinized tissue width, and bone morphotype are three important parameters used to categorize periodontal phenotypes. These ele- ments all play an important role in the maintenance of periodontal health. The aim of this review is to explore the importance of converting thin phenotype into a thick phenotype for periodontal health maintenance.
Methods: Three clinically relevant focus questions were defined to understand the role of gingival phenotype around teeth. 1) What are the factors affecting gingival phenotype (e.g., age, sex, dental arch, race, crown forms, etc.)? 2) Is there a difference between thin versus thick gingival phenotype in terms of gingival health? 3) Does the conversion of gingivae from a thin to thick gingival phenotype in sites without mucogingival defects help with periodontal health maintenance?
Results: Extensive electronic and manual literature search identified a total of 1,129 citations. After title, abstract, and full-text screenings, 30 articles were included in the present review. Twenty-five studies met the inclusion criteria and provided data for focus question 1. It was found that periodontal phenotype varies among different individuals and different areas of the mouth within the same individual. Asian indi- viduals tend to have thinner gingival phenotype compared with white subjects. Eleven studies met the inclusion criteria for the focus question 2. Prevalence and severity of gingival recession was higher at the sites with thin gingiva compared with the sites with thicker gingiva. No studies provided data for focus question 3.
Conclusions: Available evidence indicates that subjects with thin and narrow gingiva tend to have more gingival recession compared with those with thick and wide gin- giva. Currently, there is no published evidence to support conversion of thin to thick gingival phenotype in sites without gingival recession or mucogingival deformity. Show less

Purpose of Review: Periodontitis and cardiovascular diseases are both inflammatory conditions. Recent epidemiological studies have associated the effects of periodontitis on cardiovascular disease (CVD) progression. This review aims to summarize the relationship between those two conditions.
Recent Findings: Although there is no evidence of a causal relationship, an association between the two conditions is apparent. The potential factors include bacterial pathway, inflammation, and… Show more

Purpose of Review: Periodontitis and cardiovascular diseases are both inflammatory conditions. Recent epidemiological studies have associated the effects of periodontitis on cardiovascular disease (CVD) progression. This review aims to summarize the relationship between those two conditions.
Recent Findings: Although there is no evidence of a causal relationship, an association between the two conditions is apparent. The potential factors include bacterial pathway, inflammation, and genetics. Periodontal bacteria affect endothelial cells through interactions that aggravate the atherogenic process. Ulcerated periodontium produces cytokines which increase the production of acute-phase proteins that have been associated with cardiovascular events. Genetic studies have demonstrated the presence of risk alleles in the genes ANRIL and CAMTA1/VAMP3 that are shared between these two diseases.
Summary: This review discusses the current understanding of CVD pathogenesis, underlying mechanisms of periodontitis in CVD, and effects of periodontal therapy on CVD, and provides guidelines for treating patients with CVD risks in respect to periodontal disease. Show less

Regenerative therapy in oral health care is limited by both the body’s natural capacity for regeneration and the materials and methods currently available. Research on various aspects of regenerative therapy, such as tissue engineering and stem-cell and gene therapy, has produced promising results. Compelling advances, ranging from the discovery and characterization of stem-cell populations in oral tissue to the engineering and transplantation of whole tooth structures, could result in exciting… Show more

Regenerative therapy in oral health care is limited by both the body’s natural capacity for regeneration and the materials and methods currently available. Research on various aspects of regenerative therapy, such as tissue engineering and stem-cell and gene therapy, has produced promising results. Compelling advances, ranging from the discovery and characterization of stem-cell populations in oral tissue to the engineering and transplantation of whole tooth structures, could result in exciting new treatment methods for clinicians in the near future. In this review, we discuss the limitations of natural healing and regeneration of various tissues of the oral complex, including teeth, periodontium and salivary glands, and summarize current treatment methods for tissue damage as well as research advances in oral tissue regeneration. Show less

L’ostéonécrose des maxillaires associée aux bisphosphonates (ONAB) est définie comme
étant « une exposition osseuse des mâchoires chez un patient ayant reçu ou ayant été
exposé aux bisphosphonates, et n’ayant pas été exposé à la radiothérapie dans cette même
région. L’os exposé doit être présent depuis huit semaines après avoir été identifié par un
professionnel de la santé. » Puisque des millions de gens reçoivent des bisphosphonates
pour diverses raisons, il est important que… Show more

L’ostéonécrose des maxillaires associée aux bisphosphonates (ONAB) est définie comme
étant « une exposition osseuse des mâchoires chez un patient ayant reçu ou ayant été
exposé aux bisphosphonates, et n’ayant pas été exposé à la radiothérapie dans cette même
région. L’os exposé doit être présent depuis huit semaines après avoir été identifié par un
professionnel de la santé. » Puisque des millions de gens reçoivent des bisphosphonates
pour diverses raisons, il est important que les dentistes généralistes puissent identifier les
patients présentant des risques de développer une ONAB . L’objectif du présent texte est de résumer les recommandations quant à la prise en charge dentaire des patients traités aux bisphosphonates sous la forme d’un article et de tableaux qui pourront être utilisés dans les cabinets dentaires. Show less