Master Clinician Editorial

How did I reach the level to be the recipient of the 2014 Master Clinician (MC) Award? The answer is mentorship. Early on I had an older cousin that I looked up to. He became an Eagle Scout and I became an Eagle Scout. He was going to become an engineer and that is what I wanted to be early on. That of course changed and I turned to dentistry for my future profession. After 3 years of college, I was accepted into the University of Pennsylvania School of Dental Medicine. There I was exposed to many teachers and clinicians whom I looked up to and desired to be just like them. These included Herman Corn (MC 1987 and the first), Manny Marks (ortho-perio), Arnold Weisgold, Morton Amsterdam (MC 2003), and Robert Summers. I visited them in their offices, sat in on additional seminars they gave and picked their brains whenever I could. Dr. Summers was the person most responsible for my setting my sights on becoming a periodontist. I spent many Saturdays watching him work and realized that this is what I wanted to do. One of my mentors (probably Amsterdam) gave me a quote which I have attempted to live with: “Those that strive for perfection may never achieve it but those that don't even try won't ever come close.” After graduating from Penn (3 years) I attained a full-time teaching position in treatment planning and fixed prosthetics. During that time, I was allowed to sit in on Morton Amsterdam's graduate program Perio-Pros treatment planning seminars – 6.5 hours per week for the year—in the evenings! This helped shape my thought process for a lifetime. After a year of teaching, I started the Graduate Program in Periodontics at Columbia. There I inherited another group of Mentors; Burt Langer (Clinical Chair and MC 1997), Robert Gottsegen, Leonard Hirschfeld and Bernard Wasserman (introduced me to Vicryl), Steven Stein, Steve Silston, and many others. Collaterally, I was introduced to Myron Nevins (MC 2001) and Gerald Kramer (MC 1989). I again visited them all in their offices and drew out what knowledge I could. It was infectious. Still trying to duplicate what my mentors gave to me (and there were others I have not mentioned). I have been introducing through education via lectures and publications. Perhaps my greatest commitment has been to train general dentists through a GPR program at Beth Israel Hospital, Newark since 1976. I chaired the Periodontal Department when Ed Bressman retired. I have been Director of Dental Education in the Department of Dentistry for 28 years. The dental department at Beth Israel has been in existence since 1901. The GPR started in 1932. Dr. Abraham Chasens was in our second-year class! We have now trained over 500 dentists with all of the specialties represented on faculty. We perform over 500 medical consults each year. The course I have given each year involves 38 hours of lectures. It details procedures that periodontists perform that can aid in salvaging the natural dentition. It demonstrates how to save teeth and stabilize them for the future. The only factor is that implants cannot be considered in the treatment planning process. Toward the end the residents are given 7 cases that they have to treatment plan: periodontal therapy as well as restorative. Then they need to write a letter to the restorative dentist as to how to proceed. I gave the same course from 2001 to 2016 to the NYU graduate students. In approximately 1985, dentistry was introduced to a tooth replacement system of implant therapy by Dr. P-I Brånemark. Training started and again I was lucky enough to have the first two periodontists trained on the system as mentors: Dr. Burton Langer (MC 1997) an Dr. Oded Bahat (MC 2018). Again, I visited offices and picked brains. Obviously, I have incorporated implants into the GPR training system and multiple attendings (presently about 67 active teaching) discuss their role in tooth replacement. Where were we and where are we going? Initially, periodontists became the dental professionals to go to in order to set up a plan integrating periodontics and prosthetics into a coordinated effort to save and maintain natural dentition. We were the gatekeepers of the treatment plan. There were multiple ways to accomplish this; bone regeneration, orthodontics, root resections, mucogingival surgery (Pat Allen—another friend MC 2002), stabilization—intracoronal and extracoronal, surgical crown lengthening. All of these procedures have aided us in maintaining the natural dentition for multiple years (many times over 30–40). It worked and it still does. Brånemark gave us an implant system that worked. It was designed to replace missing teeth—those we could not save. From 1985 to 2001 this system provided long term bone stability. Since the original design was altered (in approximately 2001) in order to decrease the interval of healing in the mandible from 3 months to 2 months and in the maxilla from 6 to 4 months by having a roughed implant surface. A great savings? Worth it? Today two of our major meetings, AAP and AAO, host multiple courses on “peri-implantitis treatment in each of their sessions. It should alert us that something is different. Perhaps we have altered something that was working on a high level”. In my practice and with others I have spoken with, those implants that were placed prior to the alteration of the implant surface come in with bone near the most coronal threads most of the time. Not so with the altered surfaces (again note the number of courses available on peri-implantitis). Dennis Tarnow (MC 2005) developed an implant that had the original machined implant surface towards the top of the implant and then went to a roughened surface. I recently published a paper on that implant. After a mean of 8 years loading, bone loss on the distal was 0.3 mm and the mesial 0.2 mm. We also need to challenge the clinicians to demonstrate to us what percentage of the cases actually showed regenerated bone around the disease surfaces; how many demonstrated bone regeneration at 90%, 60%, 40%, or less. Also, we usually never see cases with long term results: 5–10 years. How much of the bone that was “regenerated” remains. For this we have given up procedures that work long term—surgical crown lengthening, bone regeneration, root resections, etc. We need to save the natural dentition for as long as possible and then use implants when this can no longer be accomplished. That would again place the periodontist as the gatekeeper of the treatment plan. Implants are a great tool when used as an answer to a failed natural dentition. Finally, everyone wants to place implants. Unfortunately, this is without regard to the amount and quality of their training. Sometimes a weekend course. We should encourage the ADA to initiate minimal requirements for those wanting to place implants. This is necessary to protect our patients. As Dr. Schallhorn (MC 1995) has said, “At the end of the day, we must feel that we would have wanted to receive the treatment that we have given.” Before I even become a dentist, I have the rare privilege of meeting Dr. Barry Wagenberg. At the time, I am a student searching for direction, unsure of where my path will lead, but certain of one thing: I want to become a periodontist. What I do not yet know is how deeply mentorship and professional membership will shape that journey. Now, nearly a decade into private practice, I recognize that every step of my clinical and professional growth is shaped by Dr. Wagenberg's ongoing mentorship. His passion, precision, and insistence on doing things the right way, even in the smallest details, guide me daily in the pursuit of excellence. Dr. Wagenberg's influence begins long before I wear a white coat. I observe him in the operatory as he manages complex procedures with calm focus. Whether placing implants, performing sinus grafts, or handling soft tissue deficiencies, his hands reflect experience and purpose. What stands out is not just his surgical expertise, but his integrity. From the tone of referral letters to the timing of follow-ups, everything is deliberate. He tells me that everything matters, and it is clear he lives by those words. He knows of my goal to specialize in periodontics, but instead of urging me forward, he tells me to become a great general dentist first. On his advice, I pursue a general practice residency before entering a periodontal program. That decision gives me a stronger foundation and a deeper understanding of restorative principles, occlusion, and diagnosis. Today, those skills influence how I approach every procedure, whether it is a ridge preservation, esthetic tissue graft, or full arch reconstruction. One of the most valuable aspects of his mentorship comes not just from what he teaches, but how he teaches it. He shows me what works in his hands, how he approaches flap design, how he sequences implant cases, and how he handles complications. Just as importantly, he shares techniques he used to do differently and explains why his approach has changed. He is transparent about trial and refinement, and in doing so, he gives me permission to think critically about my own methods. That combination of tradition and adaptability is one of the most meaningful gifts he offers as a mentor. He often says that if you do the right thing and focus on quality, everything else will follow. I carry that principle into every treatment plan and every surgical decision. When the clinical road is unclear, I find myself asking what Dr. Wagenberg would do. That compass continues to guide me. He also often quotes Dr. Mort Amsterdam, long before I even know who Dr. Amsterdam is. He says, “Those who strive for excellence will never achieve it, but those who do not try will not even come close.” I do not fully understand it at first, but over time, the meaning becomes clear. It is about the pursuit, not perfection. That mindset drives how I approach my surgeries, treatment plans, and relationships with patients and colleagues. Striving, reflecting, and refining is the rhythm he teaches, and it becomes the framework for how I grow. Recently, I was honored to receive the Ten Under 10 Award, a distinction presented by the Massachusetts Dental Society that recognizes dentists who have made a meaningful impact within their first decade of practice. While I am proud of the recognition, I know it reflects the support and mentorship that shape me. That award belongs as much to Dr. Wagenberg as it does to me. His values shape how I lead, how I teach, and how I manage complex conversations in and out of the operatory. What continues to define Dr. Wagenberg's mentorship is his unwavering presence. During residency and early in practice, I call him often, sometimes late at night. On more than one occasion, he answers while traveling abroad with his family, always making time to listen thoughtfully and walk me through a case or clinical dilemma. Whether I have questions about tissue management or sinus elevation, he helps me think through the details. These conversations give me clarity and, more importantly, confidence. He is never too busy to be a mentor. Many lessons come from time spent in his office. As he dictates notes or prepares for surgery, he shares quiet pearls about clinical strategy, patient psychology, and leadership. Behind his chair stands a wall lined with textbooks, framed articles, and years of academic accomplishment. But between his seat and that wall are picture upon picture of his family. His children, his grandchildren, family gatherings, vacations, and celebrations fill the space. The contrast is striking yet seamless. His professional identity is surrounded by evidence of what matters most to him. His influence extends into every corner of my practice. When I plan a full arch case, prepare for a connective tissue graft, or communicate with referring doctors, I apply what I have learned from his example. My decision making is more thoughtful. My clinical outcomes are more consistent. My communication is more intentional. My professional identity is stronger because of him. Through the American Academy of Periodontology, I find a community that supports and amplifies those same values. Clinical excellence, mentorship, and shared advancement define the Academy's culture. Membership is not just a credential. It is an active connection to purpose and progress. Dr. Wagenberg exemplifies that connection. He remains deeply involved in organized dentistry, and his mentorship continues to shape the field in ways both seen and unseen. His impact lives in the decisions we make, the standards we uphold, and the clinicians we become. Today, I mentor students, lecture at study clubs, and contribute knowledge and experience wherever it is most valuable. I speak at the Yankee Dental Congress, collaborate with implant companies, and present on advanced surgical techniques, including dual arch hybrid restorations using remote anchorage. In every one of these settings, I feel Dr. Wagenberg's influence. His voice is still present, reminding me to elevate the profession, to keep learning, and to always do the right thing. In honoring Dr. Wagenberg, I am reminded that mentorship and membership are not separate. They are intertwined forces that shape not only capable surgeons but complete professionals. His legacy lives on in the implants I place, the grafts I manage, the colleagues I support, and the letters I write, always reviewed with care, down to the very last period. The Master Clinician Editorial is not a peer-reviewed article.