Poor Oral Health in the Etiology and Prevention of Aspiration Pneumonia
This article reviews the epidemiology, microbiology, pathogenesis, and prevention of AP, focusing on the role of poor oral health as a risk factor for, and on dental care for the prevention and management of, this important infection. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - January 5, 2021 Category: Dentistry Authors: Frank A. Scannapieco Source Type: research

Interdisciplinary Education and Health Care in Geriatric Dental Medicine
Geriatric patients are more likely to have multiple medical comorbidities, physical limitations, and mental impairments that warrant careful consideration while providing patient care. Dentistry, along with other health care professional programs, incorporate interprofessional education (IPE) experiences to provide students with skills they need to deliver collaborative care in their future practice. Health professional programs should consider geriatric training in simulated learning environments, adult day programs, nursing homes, long-term care facilities, and home care experiences to provide students valuable IPE exper...
Source: Dental Clinics of North America - January 2, 2021 Category: Dentistry Authors: Matthew Mara Source Type: research

Consideration in Planning Dental Treatment of Older Adults
This article discusses a variety of treatment planning techniques and illustrates the problem with a longitudinal case history. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - December 30, 2020 Category: Dentistry Authors: Ronald Ettinger, Leonardo Marchini, Jennifer Hartshorn Source Type: research

How to Avoid Life-Threatening Complications Associated with Implant Surgery
Life-threatening complications of dental implant surgery are rare, but include hematoma/hemorrhage of the floor of the mouth, aspiration, and ingestion. Prevention of lethal hemorrhagic complications stem from knowledge of anatomic structures and precise surgical planning. Prevention of aspiration and ingestion can be improved by simple techniques while understanding clinical settings and factors that put patients at higher risk. In the event of these potential lethal situations, early recognition of signs and symptoms along with immediate action followed by transfer to an emergency department is often necessary. (Source: ...
Source: Dental Clinics of North America - November 17, 2020 Category: Dentistry Authors: Earl Clarkson, Eunsu Jung, Spencer Lin Source Type: research

Implant Material Sciences
In the past, the only way to replace missing teeth was to have a removable appliance. However, these days, dental implants are commonly being used to replace missing teeth. The dental implants are improving as a result of new technological and scientific advances. Different materials have been used in the past for dental implants such as lead, stainless steel, and gold. Currently, the focus is on using Roxolid, surface-modified titanium implants, and zirconia. These materials have superior esthetic and functional characteristics for dental implants. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 17, 2020 Category: Dentistry Authors: Allen Glied, Junaid Mundiya Source Type: research

Maxillofacial Bone Grafting Materials
This article summarize the grafting materials and growth factors that are now in use to provide an improved understanding of the properties of each material and indications for subsequent use. The article gives an overview of the fundamentals of bone healing, including the physiology of regeneration. It is hoped that clinicians can make improved decisions that are based in literature when considering treatment options for restoring patients ’ functional dentition. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 17, 2020 Category: Dentistry Authors: Nabil Moussa, Yijiao Fan, Harry Dym Source Type: research

Implant Surgery
DENTAL CLINICS OF NORTH AMERICA (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 17, 2020 Category: Dentistry Authors: Harry Dym Source Type: research

Copyright
ELSEVIER (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 17, 2020 Category: Dentistry Source Type: research

Contributors
HARRY DYM, DDS, FACS (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 17, 2020 Category: Dentistry Source Type: research

Contents
Harry Dym (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 17, 2020 Category: Dentistry Source Type: research

Forthcoming Issues
Geriatric Dental Medicine (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 17, 2020 Category: Dentistry Source Type: research

Prosthodontic Principles in Dental Implantology
More patients are requesting fixed prosthesis to replace missing teeth. More than 5 million dental implants are placed annually in the United States. This number will decrease in 2020 owing to the coronavirus disease-19 pandemic. The edentulous patient has a decreased quality of life. Prosthodontic rehabilitation/reconstruction of edentulism improves overall quality of life. Patient-reported outcome measures are subjective reports of patients ’ perceptions of their oral health status and the impact that it has on their quality of life. This chapter contains a variety of prosthodontic principles for the reader to help...
Source: Dental Clinics of North America - November 5, 2020 Category: Dentistry Authors: Ricardo A. Boyce Source Type: research

An Update on the Treatment of Periimplantitis
As implant placement increases within all dental specialties, it is expected that the number of suboptimal results will increase, as well. The goal of this article is to provide clinicians with an outline of the management of periimplantitis cases, ranging from simple to complex. It will review signs and symptoms, diagnosis, case selection, and armamentarium. In addition, this chapter will discuss basic techniques which can be utilized at various stages to salvage the compromised implant. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Raza A. Hussain, Michael Miloro, Jennifer B. Cohen Source Type: research

Soft Tissue Injury in Preparation for Implants
Diagnosis and treatment planning are critical in preparation for implant placement. Adequate evaluation, preoperative imaging, and surgical planning minimize early and late-stage soft tissue injuries. Correct placement of dental implants can be challenging with several contributing factors such as lack of proper preoperative soft tissue evaluation and surgical experience in dealing with soft tissue incisions and flap reflection, resulting in injury and complications involving the soft tissues. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Earl Clarkson, Monica Hanna, Guillermo Puig Source Type: research

Guided Implant Surgery
Guides used in dental implant surgery add accuracy and an overall predictability. Successful guided implant workflow depends on 3-dimensional image acquisition and precise medical model fabrication. The contemporary process blends acquired images to existing dentition to create implant-specific precise guides. We discuss the overall process, types of guides, and complications to expect during surgery. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Peter Chen, Levon Nikoyan Source Type: research

Immediate Implants
This article describes the surgical and restorative considerations involved in the planning and placement of an immediate implant. Immediate implants require appropriate hard and soft tissue assessment. Virtual planning can help assist in planning of immediate implants. Radiographic and computed tomographic guidance can help in establishing the relationship between the planned implant to the hard tissue and anatomic structures. This article discusses a technique in fabrication of the immediate provisional and final restoration. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Raymond Fan, Harvey A. Quinton, Marvin B. Golberg, Jason E. Portnof Source Type: research

Vertical and Horizontal Augmentation of Deficient Maxilla and Mandible for Implant Placement
This article presents the indications, techniques, and complications of the various procedures for alveolar ridge augmentation. This information will educate the general dental practitioner of the techniques available and provide information on the surgical procedures that could be used to discuss with patients when they are being referred to a specialist. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Amanda Andre, Orrett E. Ogle Source Type: research

Implant Surgery Update for the General Practitioner
This article discusses these complications, incidence rates, tips to avoid common complications, and management options when a patient returns with a complication. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Rinil Patel, Earl Clarkson Source Type: research

Update on Maxillary Sinus Augmentation
Implant stability is critical to implant success, and the amount of available bone is vital to achieving that end. Because of low-lying maxillary sinuses, adequate alveolar height on the posterior maxilla is often lacking in many patients in need of implant replacement. This chapter reviews both the traditional lateral sinus lift maxillary approach to achieve vertical augmentation as well as the transcrestal osteotome intraoral approach. A discussion of osseodensification will also be mentioned as an alternative approach. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Natasha Bhalla, Harry Dym Source Type: research

All-on-4 Concept Update
This article highlights clinically relevant data compiled by numerous All-on-4 investigators including complications and their remedies, occlusion and cantilever trends, implant size utilization, and controversial topics. We provide insights for navigating the complexities of medically diverse populations, faced by our daily practice, with a focus on patient avoidance, risk factors for implant and prosthetic failures, in hopes to minimize complications so clinicians would choose this treatment with confidence. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Michael H. Chan, Yoav A. Nudell Source Type: research

Zygomatic Implants
Restoring the dentition of an edentulous patient is often challenging. Endosseous dental implants have allowed for far more versatility in this area but still require adequate maxillary and mandibular alveolar bone. Often, unless significant bone grafting techniques are used, true restoration of the dentition can be impossible with traditional endosseous implants. The advent of zygomatic implants, however, may provide a viable, predictable, and stable alternative for the restoration of the dentition in patients with severe maxillary alveolar bone loss. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 31, 2020 Category: Dentistry Authors: Jonathan Rosenstein, Harry Dym Source Type: research

Implant Surgery
I have once again been honored with editing another issue of the Dental Clinics of North America. However, this preface will not follow the template of my previous ones, as I find myself writing it in extraordinary times. I sit squarely in the epicenter of the COVID-19 novel coronavirus pandemic of the world, New York City. My hospital, The Brooklyn Hospital Center, where I have spent the totality of my career of 35 years and am currently the Chairman of Dentistry/Oral and Maxillofacial Surgery, literally stands at the frontlines and has already been featured multiple times (front page) in the New York Times, as well as on...
Source: Dental Clinics of North America - October 29, 2020 Category: Dentistry Authors: Harry Dym Tags: Preface Source Type: research

Placement of Short Implants
The placement of short implants, which measure less than 10  mm in length, requires the practitioner to have a thorough comprehension of implant dentistry to achieve acceptable results. Innovation of the rough-surface implant and the progression of the implant-abutment interface from an external hex to an internal connection have considerably influenced the longevity of short implants. Dentists are better equipped to serve their patients because the utilization of short implants may preclude the need for advanced surgical bone-grafting procedures. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 13, 2020 Category: Dentistry Authors: David Sheen, Levon Nikoyan Source Type: research

Medically Complex Dental Implant Patients
This article applies the hierarchy of scientific evidence ranging from case reports, retrospective, prospective cohort investigations, systematic reviews, and meta-analyses criteria in order to determine whether dental implant placement in medically compromised patients yields any detrimental sequelae. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 9, 2020 Category: Dentistry Authors: Leslie R. Halpern, David R. Adams Source Type: research

A Communication Guide for Orthodontic-Restorative Collaborations
This article discusses the importance and steps utilizing digital outline tool to provide quick and effective communication on treatment progress and recommendations. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Authors: Yair Y. Whiteman Source Type: research

Branding Dynamics for the Esthetic Dentist
The objective of this article is to introduce the concept of branding to dentists interested in implementing elective esthetic treatment into their practice. For many, this will serve as an introduction to begin; for others, it can provide a road map for revising and reinforcing a branding program already in place. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Authors: David J. Wagner, Julie Logan Source Type: research

A Beginning Guide for Dental Photography
This article provides readers with a simplified and attainable approach to begin the dental photography journey, as well as increase skill level, depending on practice style and desired investment. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Authors: David J. Wagner Source Type: research

The Journey to Excellence in Esthetic Dentistry
Our ability to provide patients with the most up-to-date treatment options, materials, treatment modalities, and evidence-based decision making requires a culture of continuous learning, collaborative teamwork, and exceptional focus. In his influential work, Outliers, Malcolm Gladwell claims that an average of 10,000 hours is required for a person to become an expert in a certain field. In dentistry, a considerable amount of time outside of “normal work hours” is necessary in order to develop skills to become an expert. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Authors: Yair Y. Whiteman, David J. Wagner Tags: Preface Source Type: research

The Journey to Excellence in Esthetic Dentistry
DENTAL CLINICS OF NORTH AMERICA (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Authors: YAIR Y. WHITEMAN, DAVID J. WAGNER Source Type: research

Copyright
ELSEVIER (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Source Type: research

Contributors
YAIR Y. WHITEMAN, DMD (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Source Type: research

Contents
Yair Y. Whiteman and David J. Wagner (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Source Type: research

Forthcoming Issues
Implant Surgery Update for the General Practitioner (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - September 2, 2020 Category: Dentistry Source Type: research

Science in the Practice of Clinical Dentistry
This article informs dental clinicians on the essential workings of scientific research and statistical analyses. It provides clinicians with the essential knowledge necessary to understand and review scientific work. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - August 11, 2020 Category: Dentistry Authors: Todd R. Schoenbaum Source Type: research

Dentist-Ceramist Communication
This article highlights some of the authors ’ philosophies, as well as an overview of the key communication protocols that have proved effective for this team. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - August 11, 2020 Category: Dentistry Authors: Sivan Finkel, Peter Pizzi Source Type: research

Implementing Digital Dentistry into Your Esthetic Dental Practice
The use of digital dentistry is on the increase as costs to acquire digital technology have gone down dramatically and allowed for more practitioners to integrate digital equipment with reduced investment. One of the most significant benefits of digital technology in dentistry is the ability to streamline processes that can be cumbersome via the analog way. In digital dentistry, it is important to understand the advantages and disadvantages of each device or system available. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - August 11, 2020 Category: Dentistry Authors: Lawrence Fung, Phil Brisebois Source Type: research

A Communication Guide for Orthodontic-Restorative Collaborations
As both restorative dentists and specialists have their respective realms of expertise, it is important to develop a team of qualified providers to improve treatment outcomes for patients. In many cases, this involves collaboration between a restorative dentist and orthodontist. Effective communication is critical, with the dentist ’s understanding of basic orthodontic terminology and case planning considerations. Recognizing the context in which to apply normative occlusal and cephalometric values often necessitates comprehensive specialty-level experience. All providers should recognize when to involve the indicate...
Source: Dental Clinics of North America - August 4, 2020 Category: Dentistry Authors: Kathryn Preston Source Type: research

Review of the Modern Dental Ceramic Restorative Materials for Esthetic Dentistry in the Minimally Invasive Age
This article is designed to provide the practitioner with up-to-date practical information on ceramic restorative materials and techniques in a clear, evidence-based, and unbiased manner. It also provides decision-making guides to help the practitioner determine the best ceramic material for various clinical scenarios. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - July 29, 2020 Category: Dentistry Authors: Alireza Moshaverinia Source Type: research

The Use of Botulinum Toxin and Dermal Fillers to Enhance Patients ’ Perceived Attractiveness
Physical appearance and attractiveness consciously and subconsciously, affect patients ’ quality of life. Traditionally, dentists were tasked with improving a patient’s smile, a central aspect of facial aesthetics and physical appearance. More recently, as the scope of practice of the aesthetic dentist has broadened to potentially include other components of facial cosmesis that g o hand-in-hand with a patient’s smile, new options have emerged with which modern aesthetic dentists should familiarize themselves. As laws surrounding their use in dental offices continue to evolve, Botox and dermal fillers rep...
Source: Dental Clinics of North America - July 29, 2020 Category: Dentistry Authors: Phong Tran Cao Source Type: research

Adhesive Dentistry
Successful adhesive dentistry begins with correct placement and polymerization of the bonding agent. Although numerous agents exist, all abide by certain key principles, including the newest group, the universal adhesives. Fundamental steps also exist in the application process that require the operator to understand the chemistry of the adhesive being used. Modalities exist that can help preserve the durability of the bond achieved, thus slowing down the degradation process. However, no material or agent can overcome poor technique. Thus, it is of the utmost importance that the practitioner respects the technique sensitiv...
Source: Dental Clinics of North America - July 14, 2020 Category: Dentistry Authors: Marc Hayashi Source Type: research

Preface
Dentists have been on the forefront of pain management for well over 4000 years.1 In fact, it was a dentist, William Morton, who pioneered the first public demonstration of anesthesia at Massachusetts General Hospital in 1843, an event that made possible the development of Surgery as we know it today. In the years that followed, a range of oral analgesics also was developed as a mainstay of acute pain management in dental care. With all of these efforts, the late nineteenth century brought a recognition that prescribed opioids for pain could pose addiction-related risks. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Authors: Ronald J. Kulich, David A. Keith, Michael E. Schatman Source Type: research

Introduction
Dental pain is real, and most dentists in practice were taught that the most effective way to alleviate severe pain was with opioid painkillers. That ’s what I was taught during my dental school experience and my residency in pediatric dentistry. During the early part of my career in dental education, I served as Dean for Clinical Affairs at the dental schools at Harvard University and the University of Connecticut. Students and residents faced with patients who presented complaining of pain were eager to address their symptoms, and opioids were often prescribed for them. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Authors: Richard W. Valachovic Source Type: research

Controlled Substance Risk Mitigation in the Dental Setting
DENTAL CLINICS OF NORTH AMERICA (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Authors: Ronald J. Kulich, David A. Keith, Michael E. Schatman Source Type: research

Copyright
ELSEVIER (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Source Type: research

Contributors
RONALD J. KULICH, PhD (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Source Type: research

Contents
Ronald J. Kulich, David A. Keith, and Michael E. Schatman (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Source Type: research

Dental Clinics of North America
The Journey to Excellence in Esthetic Dentistry (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Source Type: research

Dentistry ’s Role in Assessing and Managing Controlled Substance Risk
Dentistry is in a unique position among the health care professions to assess and manage the patient with controlled substance risk. The concern over opioid risk is not new, and historically dentists have had to balance the critical need for adequate pain care with the importance of recognizing the consequences of using controlled substances for their patients. Barriers for providing adequate patient assessment and management may be greater in dentistry than other health care fields, although these barriers can be recognized and overcome. Collaboration with cotreating providers will improve patient outcomes and reduce pati...
Source: Dental Clinics of North America - April 28, 2020 Category: Dentistry Authors: Shuchi Dhadwal, Ronald J. Kulich, Priyanka Monga, Michael E. Schatman Source Type: research

Special Screening Resources
The prescription drug crisis has affected all sectors of the population, and so it is inevitable that dentists will increasingly see at-risk patients or those with substance use disorders in the course of their professional activities. Recognizing these patients and the special needs that they may have is now part of the standard of care for the profession. Screening for substance misuse involves a thorough history and review of the patient ’s medical record and, as appropriate, reviewing prior records and use of available screening tools. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 27, 2020 Category: Dentistry Authors: David A. Keith, Mar ía F. Hernández-Nuño de la Rosa Source Type: research

Opioid Prescribing in Dental Practice
Dentistry should be proud of its history of providing responsible pain relief, as well as becoming more cautious in prescribing opioid medications when other safer pharmacologic options exist. Our training directs us to first eliminate the source of dental pain and prescribe analgesics only as adjunctive relief. Prescriptions must be written for a legitimate dental purpose and for a patient of record. Through self-regulation, the dental profession must continue to establish pain management guidelines based on scientific evidence and clinical experience to avoid further regulatory action restricting our prescribing privileg...
Source: Dental Clinics of North America - April 27, 2020 Category: Dentistry Authors: David A. Keith, Ronald J. Kulich, Alexis A. Vasciannie, Richard S. Harold Source Type: research