Comparative Analysis of User-Generated Online Yelp Reviews for Periodontal Practices in Multiple Metropolitan Markets.

BACKGROUND: Previously published research for a single metropolitan market (Austin, Texas) found that periodontists fare poorly on the Yelp website for nearly all measured metrics, including average star ratings, number of reviews, review removal rate, and evaluations by "elite" Yelp users. The purpose of the current study is to confirm or refute these findings by expanding datasets to additional metropolitan markets of various sizes and geographic locations. METHODS: A total of 6,559 Yelp reviews were examined for general dentists, endodontists, pediatric dentists, oral surgeons, orthodontists, and periodontists in small (Austin, Texas), medium (Seattle, Washington), and large (New York City, New York) metropolitan markets. Numerous review characteristics were evaluated, including: 1) total number of reviews; 2) average star rating; 3) review filtering rate; and 4) number of reviews by Yelp members with elite status. Results were compared in multiple ways to determine whether statistically significant differences existed. RESULTS: In all metropolitan markets, periodontists were outperformed by all other dental specialties for all measured Yelp metrics in this study. Intermetropolitan comparisons of periodontal practices showed no statistically significant differences. CONCLUSIONS: Periodontists were outperformed consistently by all other dental specialties in every measured metric on the Yelp website. These results were consistent and repeated in all three metropolitan markets evaluated in this study. Poor performance of periodontists on Yelp may be related to the age profile of patients in the typical periodontal practice. This may result in inadvertently biased filtering of periodontal reviews and subsequently poor performance in multiple other categories.

Reconstruction of posterior mandibular alveolar ridge deficiencies with the piezoelectric hinge-assisted ridge split technique: a retrospective observational report.

BACKGROUND: Reconstruction of alveolar defects in the posterior edentulous mandible can be a difficult task. In addition to complicating anatomic features, such as the inferior alveolar nerve, mental foramen, oblique ridge, and lingual undercut of the mylohyoid ridge, edentulous ridges in the posterior mandible have thicker cortices and decreased volumes of vascular trabecular bone than their maxillary counterparts. Traditionally, these areas have been treated with autogenous block grafts. Significant resorption of these grafts, in combination with patient morbidity at secondary donor sites, has led clinicians to seek alternatives for augmenting the edentulous posterior mandible. The aim of this retrospective consecutive case series is to report on both the technique of the piezoelectric hinge-assisted ridge split procedure for augmenting these sites and the results that were achieved. METHODS: Thirteen patients with 17 horizontal alveolar ridge deficiencies of the posterior mandible were treated with the piezoelectric hinge-assisted ridge split procedure. After an average healing period of 14 weeks, dental implants were placed into the augmented sites. Intrasurgical alveolar ridge measurements taken at the initial surgery and subsequently at the time of implant placement documented the horizontal gains achieved by this procedure. RESULTS: Overall mean gain in horizontal width was 4.03 mm (± 0.67). For single implant-site augmentations, the mean gain was 3.38 mm (± 0.25). For multiple adjacent implant-site augmentations, mean gain was 4.25 mm (± 0.62). A total of 31 dental implants were successfully placed in all sites and none required additional augmentation procedures. There were no instances of adverse outcomes, such as neurosensory deficits or sequestration of mobilized buccal plates. After a minimum of 6 months of loading, all dental implants have been successful. CONCLUSIONS: This retrospective observational report demonstrates that the piezoelectric hinge-assisted ridge split procedure can achieve substantial gains in horizontal ridge width of the edentulous posterior mandible without associated morbidity. Further prospective and larger observational studies are warranted to see if this is true over a larger patient population and to compare this technique to other more traditionally used approaches.

Surgical considerations and management of patients with mucocutaneous disorders.

Surgeons may be confronted with providing periodontal plastic or implant therapy for patients with gingival manifestations of systemic conditions. These conditions (often referred to as mucocutaneous disorders) commonly present with features of desquamative gingivitis, which was once believed to represent a disease entity. However, today, the term desquamative gingivitis is used to describe clinical features of various local or systemic diseases or disorders that result in chronic gingival lesions characterized by epithelial desquamation, erythema, ulceration, and/or vesiculobullous lesions of the gingiva. Often, other oral tissues also are involved. Mucocutaneous disorders include such disease entities as lichen planus, graft-versus-host disease, pemphigoid, pemphigus vulgaris, lupus erythematosus, erythema multiforme, and linear IgA disease. Surgeons should be able to recognize these disorders and have the tools necessary to treat these conditions so that they can render the appropriate surgical care. This article describes the diagnosis, etiology, and clinical manifestation of these disease entities, as well as the surgical considerations and management in providing care to these patients.

Periodontal and periimplant maintenance: a critical factor in long-term treatment success.

Periodontal maintenance (PM) is a critical factor in the long-term success of both periodontal and dental implant therapy. Studies have shown both modern periodontal and dental implant therapies are effective in maintaining natural teeth and replacing lost teeth, respectively. However, without a regular program of clinical reevaluation, plaque control, oral hygiene instruction, and reassessment of biomechanical factors, the benefits of treatment often are lost and inflammatory disease in the form of recurrent periodontitis or periimplantitis may result. This article reviews the goals, types, and appropriate frequency of PM in periodontal and dental implant therapy, as well as the incidence and etiology of periimplant disease and strategies for management when recurrent disease develops during the maintenance phase of treatment.