2022

Great news… This past May 2022, my daughter Mary Nell graduated with honors from The State University of New York at Buffalo School of Dental Medicine. Her interest is in Pediatric Dentistry, and she has been accepted to a post graduate program in Pediatric Dentistry at Boston University Goldman School of Dentistry. She will begin the two year program this July. In the meantime and during school breaks, she will be working in my office. We are very pleased to have her working along side us. I look forward to working with her and playing weekend golf at the CC of P with her and her boyfriend “Kian”.
My office continues to run at Dentistry’s leading edge. Recently, I purchased a CAD-CAM ( computer aided design and computer aided manufacturing) machine that utilizes digital technology to make “same visit” crowns and other dental restorations (inlays, onlays, provisional restorations and more). It works like this… Our digital i-Tero intraoral scanner generates a STL file (standard tessilation language) or digital impression that replaces the old impression material we used for years. These STL files are exported to a computer that uses cloud based design software. Utilizing AI (artificial intelligence) and a few mouse clicks, I design a restoration on a monitor. The restoration design is then sent to a milling machine and again with a few simple mouse clicks, the restoration is “milled” or made in roughly 35 minutes using subtractive manufacturing principles. The restorations are “tried in” and cemented with zero or minimal adjustments. We and our patients are truly impressed with the results. We are confident that this technology is here to stay and the old methods of impressioning, waxing restorations, investing wax ups, burn outs using the lost wax investment casting techiques and porcelain build ups and firing ovens will go the way of the horse and buggy.
At YDC Yankee Dental Congress 2022 this past January in Boston, I met representatives of a company called 3-D Predict that manufactures clear aligners – think Invisalign. The difference between 3-D predict and other clear aligner companies is that 3-D Predict utilizes three dimensional X-Ray data from cone beam computerized tomography machines to analyze the patient’s tooth root bony architecture to treatment plan the patient’s treatment results. In theory, outcomes should be more predictable and more stable long term. We are excited about this new partnership. My assistant Amanda Desautels RDA is invaluable in this technologically driven process. We are trying this new process. Not sure if it will overtake Invisalign in my office, a company we have gotten very good to excellent results with.
Still enjoy serving as Secretary of the Berkshire District Dental Society working with Chairman Dr. Frederic Hyman, Past Chairman Dr. Joshua Kleederman, Chair Elect Dr. Dennis Dermody, Treasurer Dr. Jolene Krol, Continuing Education Chairman Dr. Erich Schmidt, Regional Trustee Dr. Paul Gamache, At Large Trustee Dr. Neha Das, and Dental Practice and Benefits Chairman Dr. Edwin Helitzer.
Earned fellowship status in the International Congress of Oral Implantologists (ICOI)* – April 2018
Received Invisalign certification – March 2019
Elected Secretary of the Berkshire District Dental Society – January 2019
PRP/PRF is here… Pioneered by Dr. Arun Garg and Robert Marx and later modified by Dr. Joseph Chokroun, Platelete Rich Fibrin is a formulation produced by drawing a small volume of the patient’s own blood, spinning it in a centrifuge thus concentrating platelets that contain growth factors that expedite healing. Not used routinely, reserved for challenging cases.
Densah Burs developed by Dr. Salah Huwais and promoted by noted implantologist Ziv Mazor are now being used in my office to perform “crestal sinus lifts” for areas in the posterior maxilla where bone bone volume has been lost.
Recent Purchases: VaTech cone beam CT, X-Nav dynamic surgical guidance and iTero element intra-oral scanner.
My team and I have reached the summit of digital dental implant planning. By merging our STL (3D) files from our intra oral scanner, with our DICOM (X-Ray) files from our cone beam CT into our X-Nav dynamic surgical guidance software, we are able to achieve absolute state-of-the-art (2019) dental implant surgical placement planning.
February 2019 – Volunteer dentist at Give Kids A Smile Day at Suny Buffalo School of Dental Medicine under the leadership of Dr. Stephen N. Abel Associate Dean for Student, Community, and Professional Initiatives and Dr. Joseph J. Zambon Phd. Dean, School of Dental Medicine
April 2019 – Served as screening dentist at the Pitsfield Family YMCA for Healthy Kids Day.
Professional Photographer Mark Swirsky setup our new Canon DSLR camera with 100mm Macro Lens and ring flash (best industry practices) for intra-oral photography, replacing our previous camera.
Using Noble Biocare type implants replacing previously used Zimmer Tapered Screw Vent implant.**
Invisalign done with i-Tero scanner has experienced significant growth, and success, with many patients benefiting from introductory pricing.
The socket preservation bone graft is a commonly used procedure in implant dentistry. Borrowing from a technique initially developed in periodontology, the minor oral surgical procedure utilizes Guided Bone Regeneration using Barrier Membranes. Following tooth removal the extraction site often shrinks or resorbs to varying degrees making implant placement more challenging. The “bone graft” procedure fills the extraction site with a bone substitute and then covers the site with a membrane designed to prevent faster growing soft tissue cells (epithelium and connective tissue) from populating the “socket”. This allows the patient’s own bone cells to grow and replace the graft material with the patient’s own bone. Healing time varies according to the magnitude of the site, but typically is 3-4 months. The procedure preserves hard and soft tissues thus facilitating implant placement and improving patient outcomes. Grafting materials continue to evolve and excellent results can now be realized from synthetic “scaffolds” and autogenous blood products. I have included a few of my own slides to demonstrate the procedure.

*The awarding of Fellowship status is an honor which a professional society such as the ICOI bestows on a dental professional involved in dental implant treatment. The ICOI has a Fellowship program in which active members are encouraged to achieve Fellowship status through their efforts in education, research, and actual clinical experience. All Fellows of the ICOI may choose to list the designation “FICOI” after their names. This is a fairly rigorous test, where a minimum of 25 cases are sent to the ICOI faculty for approval. Minimum requirements are pre-op and post-op photos and x-rays of implant cases.

**In an effort to preserve crestal bone and combat implantitis, the trend in implant dentistry is to use slightly narrower implants, with platform switching, conical connections, concave abutments, and screw retained crowns. In the event a crown must be cemented, a custom milled abutment is always used. Additionally, the crown is cemented using the Wadwhani (copy abutment) technique to minimize cement extrusion.