You’re a partnership that has endured in excessof 30 years in the case of Drs. Ronald Goldsteinand David Garber, 23 years since Dr. MauriceSalama joined you, and 18 years since Dr.Henry Salama joined the team in Atlanta.That’s an amazing record in any field, and cer-tainly reason enough to talk to you about yourpractice, your teaching, and also what you seeas the future for dentistry. Let’s start with thebeginning of your practice, and then how yourpartnership and “Team Atlanta” developed. Dr. Goldstein: The predecessor to Goldstein,Garber, and Salama (GG&S) was initiallyfounded in 1929 on the rather progressivevision of my father, Dr. Irving Goldstein. Ijoined the office in 1959, and while workingwith different specialists individually inAtlanta, as well as being exposed to theperio dontal-prosthetic philosophies of Dr.Morton Amsterdam, I came to recognizehow effective and beneficial it would be toincorporate virtually all these dental special-ties under one roof. I initiated the process ofimplementing this vision by recruiting Dr.David Garber from the faculty of the Uni -versity of Pennsylvania, who had postdoc-toral expertise in both periodontics andfixed prosthodontics.

How did your practice then develop into thecomprehensive team that you have today?Dr. Garber: In 1992, we specifically soughtout Dr. Maurice Salama for his dual-specialtytraining in orthodontics as well as periodon-tics, which along with his implant residencysecured our vision of having a “one-stop,”cross-disciplinary, interactive practice.

As the practice continued to grow, werealized the need for someone with more sig-nificance and expertise in the burgeoningrealm of dental implants. Dr. Henry Salama,who was the director of the Im plant ResearchCenter at the University of Pennsylvania, wasthe optimal candidate, as well as also having

dual prosthetic and periodontal postdoctoralspecialty training. In 1996, Henry joined thepractice and, along with Maurice, subse-quently became partners. In addition, as ahigh-level interdisciplinary practice, we al -ways incorporated an in-house dental labora-tory team to better ensure quality control andefficiency, especially in cases involving aceramist. Throughout the years, we haveworked hand in hand with some of the mosttalented international ceramists such as Drs.

Gui Cabral, Christian Coachman, MuriloCalgaro, as well as Pinhas Adar; all of whomjoined Mark Hamilton with his 36 years ofproviding outstanding technical laboratoryexpertise in our facility. Throughout time, wewere often asked to lecture together on thesame podium at various symposiums andconferences emphasizing multidisciplinarydentistry, and, therefore, eventually becameknown as Team Atlanta.

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Goldstein, Garber, and Salama: A Legacy Lives

A written interview requested and directed by our editor-in-chief, Dr. Damon Adams, with Ronald E. Goldstein, DDS; David A. Garber, DMD; Maurice Salama, DMD; and

Henry Salama, DMD; on the unique history of one of the most successful and iconic practices in North America as well as the future of dentistry.

“Team Atlanta” (left to right: Drs. Maurice Salama, David Garber, and Ronald Goldstein) reviewing a complex case utilizing modern 3-D technologies.

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Dr. Goldstein, explain to our readers howyour primary concern, which is patientcare, benefits from the teaching endeav-ors in which all the team members areactively involved.Dr. Goldstein: Teaching requires oneto constantly stay up to date with thelatest science and technology, whichhas accelerated dramatically duringthe last 30 years. The team’s teaching,as well as research initiatives, havemade them leaders in the field andconstantly on the cutting edge ofcomprehensive therapy. This promi-nent profile has generated profes-sional and patient inquiries; and in -terest from all over the world, includ-ing industry. Our combined compre-hensive experience and acumen inthe fields of periodontics, prostho-dontics, orthodontics, and oral sur-gery gives us the ability to effectivelytreat most of our patients’ oral healthneeds as well as those especially com-plex challenges that are likely toelude many individual practitioners;specifically those complex clinicalcases that normally require multiplepatient consultations at multiplelocations. We have tried to patternGG&S as the dental equivalent of theMayo Clinic and, especially, as a den-tal resource center. A case to makethe point follows in Figures 1 to 6.

Dr. Goldstein, you are often recognizedby many as the “father” of aesthetic den-tistry. The initial realm of dental aesthet-ics in volved only restorative modalitiesthat were at first limited to crowns, thencomposite bonding, and eventually to

veneers. How has the “team” conceptchanged your perspective(s)?Dr. Goldstein: Dr. Adams, it was evi-dent that “complete” aesthetics reallyinvolved much more than therestorative procedures alone. Therewas a need to satisfy the newly devel-oping subjective cosmetic needs ofpatients, and to mold together thecollective knowledge of differentaspects of dentistry. I think that,while we were initially focused pri-marily on the restoration of teeth,this “team approach” allowed us to bethe first to go beyond, and to plan therestorations within the context of thelip framework and the smile, and

relating them to the patient’s faceand persona.

Drs. Maurice and Henry Salama, intoday’s evolving dental arena, what do yousee as the developing trends in dentistry?Dr. Maurice Salama: During the last25 years, it’s clear that the trends inclinical dentistry have been propelledby aesthetic and implant dentistry. Ibelieve that the ever-increasing publicawareness of our profession’s capabili-ties to enhance smiles and functioncontinues to propel the present trendsin dentistry; in part, this may be due toall the media and social exposure ad -dressing everything from “all-on-4” to

the single-unit implant replacement.The public is also requiring that thesmile enhancement and implantprocesses be done more rapidly, sim-ply, less expensively and, at the sametime, with greater predictability.

Dr. Henry Salama: This is exempli-fied by the trend for minimally invasiveand biomimetic dentistry. The expo-nential technological advancementsin bioengineering, adhesive, ceramic,and digital dentistry has empoweredclinicians to more predictably meettheir patients’ expectations.

Digital dentistry allows dentists tobetter document, diagnose, and designpatient specific treatment to obtaindigitally pre-visualized restor ative out-comes through 3-D printing andCAD/CAM technologies that are oftenaccessed through digitally em poweredlaboratories. In effect, it is creating amore level playing field in dentistry. Itis allowing a higher level of aestheticand implant dentistry to be deliveredto more patients by more clinicians.

Dr. Goldstein, you’re from an older genera-tion—isn’t there a huge cost factor as wellas learning curve that seemingly makesthis digital practice vision prohibitive? Dr. Goldstein: The short answer isyes, it is challenging at this stage inone’s career to incorporate new meth-ods. However, I don’t believe cliniciansof any age group can afford to avoidthis digital revolution in dentistry andmaintain their practice’s competitiverelevance in the marketplace. We’veseen the costs of CBCT scanning and

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Goldstein, Garber, and Salama...

Figure 1. A young female patient with asevere defect resulting from a failedimplant in the area of No. 10 and havingcaused severe damage and eventual lossof tooth No. 9.

Figure 2. A bone graft was performed toreconstruct the defect.

Figure 4. Additive autogeneous connectivetissue grafts on the upper left anteriorregion were combined with respectivecrown-lengthening surgery on the upperright anterior region to recreate a harmonious balance to the our smiledesign efforts.

Figure 5. Post-op radiograph showing acantilevered 2-unit bridge (Nos. 9 and 10)on an implant placed in the area of No. 10to avoid the aesthetic soft-tissue limita-tions often associated with adjacentimplants in the anterior region.

Figure 6. Final smile: A result of surgical,orthodontic, restorative, and dental laboratory team intervention and creativity.

Figure 3. Orthodontics was utilized toextrude the upper left canine, to verticallymobilize the bone and soft tissue, and positively modify/eliminate the zero-walldefect on the mesial tooth No. 11.

Dr. Maha El-Sayed using the TRIOS intraoral scan (3Shape) to scan an implant for immediate loading.

Drs. Garber and Maurice Salama examining a Carestream 9300 (Carestream)CBCT scan. continued on page 86

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other digital technologies and thera-pies rapidly decreasing into moremanageable price ranges. I believe thistrend will continue as it has in manyother areas of technology. In addition,the software is becoming progressive-ly more user friendly. As opposed toproprietary architecture, the opensource paradigm in software is permit-ting the efficient sharing of informa-tion and data across the board.

Today, digital technology in all itsdifferent forms is essential to makingdentistry, in general, and implants, inparticular, safer and more accessible fora higher percentage of the population.Similarly, most dental laboratories arealso on aboard, with about 80% nowusing in-house scanners and, just re -cently, metal-free crown and bridgerestorations have exceeded metal-basedrestorations for the first time ever.

You’ve all been lecturing for years, writ-ing textbooks and articles. So, how did theDentalXP educational concept evolve?Dr. Garber: Just as we suggested ear-lier that clinical practice today mustembrace the digital revolution toremain relevant and competitive, soit is with continuing dental educa-tion. The Web site dentalxp.com ini-tially began from a philosophy to cre-ate access to new, timely, and relevantinformation; to and from the globaldental community by sharing cases,opinions, and feedback on a Web-based forum. Throughout time,videos and lectures on cutting-edgesurgical and restorative modalitiesfrom Team Atlanta were featured. Itprogressively evolved with leadingclinicians and educators from aroundthe globe being invited to also sharetheir knowledge and expertise withthe fast-growing DentalXP communi-

ty. From the beginning, what mem-bers particularly appreciated is thatthe site was totally inclusive andnever exclusive to any one type ofphilosophy of therapy or brand. Thesubscriber base and demand quicklyoutstripped our resources, forcing usto make DentalXP into a more robustentity. Most of all, we realized it couldno longer be a hobby. It eventuallyrequired someone with the vision,expertise, and combined business/ -den tal acumen to develop and man-age it on a day-to-day basis. We werefortunate in being able to convinceEddie Salama, brother of Henry andMaurice Salama, to assume thisresponsibility as chief executive offi-cer. This made a significant differencein the further progress of Dental XP towhere it is now: the number one den-

tal continuing education provider onGoogle search with multinationalservers and a sophisticated and cus-tomized software that handles theneeds of about 128,000 doctors in 168different countries. Globalization indentistry is no longer just a vision; itis here, and it is now.

Dr. Maurice Salama, as the youngestrepresentative of 4 generations of educa-tors, do you believe that this is the futurefor dental education?Dr. Maurice Salama: There is nodoubt that Web-based continuingdental education is going to play acritical role in future access toknowledge and expertise. However,we also believe Web-based learningis most effective when supplement-ed with hands-on courses and timelyaccess to the educators themselves inlive courses. Therefore, we havedeveloped customized hands-oncourses that deliberately enhancethe didactic experience accessedonline. To further achieve this goal,DentalXP also organizes GlobalSymposiums as well as partnering inan online implant externship(implantextern ship.den talxp.com)to provide clinicians with a multi-tude of options to access continuingdental education in a way thataddresses their unique requirements.

I noticed when visiting dentalxp.com thatyou have nearly 300 different speakersfrom all over the world. How did thiscome about? Dr. Garber: As previously mentioned,our team has always felt very fortunateto lecture all over the world and evenmore fortunate to discover the incredi-bly creative and talented clinicianswhom we have met along the way. Notonly have we been able to impart someknowledge to our audience in theprocess, but we, in turn, also havelearned and gained even more. Most ofall, this exposure as well as the rela-tionships developed allowed us to iden-tify rising talents in dentistry, younglocal speakers with incredible abilityand remarkable results, whom wereopen and gracious enough to generous-ly share their knowledge with theirpeers and the DentalXP community. Ineffect, DentalXP embraces the role ofbeing a vehicle to expose these diversenew talents and their techniques to therest of the world. So, throughout theyears, Team Atlanta grew to incorpo-rate other speakers who, in turn,became their own “World Teams,”often brought together by differentacademy’s meetings and publications.“Team New York,” “Team Brazil,”“Team Japan,” “Team Israel,” “TeamUkraine,” “Team Italy,” “Team United

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Goldstein, Garber, and Salama...

Dr. Wendy Clark studies Dr. Salama’s virtual implant placement prior to surgery.

More eyes, more ideas: Drs. MauriceSalama, Henry Salama, and David Garberreview a surgical plan using SimPlant software (Materialise Dental).

Dr. Nadia Esfandiarinia uses a GG&S wallart decoration to explain proportion to apatient.

Thirty-seven-year GG&S laboratory technician Mark Hamilton completing aNobel Biocare scan.

Dr. Goldstein uses DenMat’s NV Microlaser, the world's smallest cordless laser.

Using laser therapy is Dr. Maurice Salama and dental assistant, Lori Gettinger. continued on page 88

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Kingdom,” and “Team South Africa”are a few that come to mind and havebeen featured on the site as well as aspecial issue of the The AmericanAcademy of Cosmetic Den tistry Journalthat was in partnership with DentalXP,and, had Maurice as the editor.

In February 2013, DentalXP had their first“brick and mortar” Global Sympo sium inLas Vegas. As someone who has attendedmany meetings throughout the years,what made this one stand out for you? Dr. Henry Salama: Combining thedifferent forms of education—“see-ing,” “hearing,” and then “superviseddoing,” followed by long-term inter-actions on the forum has resulted inan online community that demandsto periodically get together and shareinformation and experiences in anopen annual symposium. In my opin-ion, this meeting was a game changerin dental education. For the first time,the numbers that are all too oftenhighlighted by online educationalsites were translated into attendanceby real clinicians who took the nextstep from viewing videos and lecturesonline to coming and choosing fromalmost 30 hands-on workshops whileexamining and accessing productsdirectly from vendors.

Dr. Garber: Many of these attendeeswould encounter peers at the meetingand then recognize each other fromtheir virtual world, particularly theonline forum. We would then see themat the meeting, sharing a drink and rec-ollecting one another’s questions andcase reports, and then reflecting ontheir different solutions to a problempreviously posted on the online forum.

These previous “virtual connec-tions” facilitated an enormous amount

of enthusiasm, excitement, and devel-oping relationships not usually en -countered in the typical one-time oreven annual symposium. So, we wereinitially physically bringing togethertheir “dental lives” from an interactiveonline community who were now alsosharing personal philosophies.

Dr. Maurice Salama: It’s strange,Dr. Adams, but when we think tradi-tionally about being online, we imag-ine this world where we never reallymeet. However, the first DentalXPsymposium has shown us that there isa very definite need for the additionalpersonal contact, not only betweenthe speaker and the attendees, but alsowith industry and vendors.

What are your long-term hopes andvisions for DentalXP?Dr. Maurice Salama: It appears thatDentalXP serves a very diverse panop-tic role in the ever-growing demandfor quality continuing dental educa-tion. Dentistry is rapidly changingand DentalXP makes all the necessary

information readily available, almostas it’s evolving across the world. Onthe DentalXP Web site, you cansource out most any topic, frombleaching, to veneers, to crown andbridge and direct composite restora-tions, to different surgical techniquesfor sinus lifts, regenerative proce-dures, and all aspects of “digital den-tistry”—and it’s constantly available,24 hours a day, 7 days a week, frommost anywhere in the world and alsoin different languages such as Jap -anese, Spanish, and Portuguese. Weeven had Russian translation at therecent Global Miami Symposium.

On a different topic, you recently affiliat-ed with Heartland Dental Care, a largedental service organization. I believe thatour readers would be curious to knowwhy you made the decision to do this. Dr. Maurice Salama: It was an inter-esting decision, Dr. Adams, indeed!

Throughout the years, we oftenreviewed the options for the continuityof our practice, the commitments wefelt to our patients, our staff (some whohave been there 20 to 35 years), thecommunity at large, as well as to ourongoing teaching endeavors. We foundin Heartland Dental Care not only acompany but also a group of individu-als with the same strong commitmentsto dentistry, education, and people.What makes this affiliation a uniquefit is the commitment to education byHeartland Dental Care, GG&S, TeamAtlanta, and DentalXP. Heartland’spress release states, “Like HeartlandDental Care, Goldstein, Garber andSalama and team also understand andvalue the importance of continuingeducation and leadership, combinedwith clinical expertise.”

This has allowed us the ability toconcentrate on the practice of den-

tistry, and then education beyond thebusiness. The transition has beenremarkably smooth and we continueto operate in the same way, with oursame staff and products. They havealso been a remarkable resource forus in many different areas such astechnology, human resources, insur-ance, financial management, anddental practice acumen.

What do you see as the future for TeamAtlanta and DentalXP?Dr. Maurice Salama:We see securityfor the practice to continue to moveforward with us, Team Atlanta, allbeing able to continue providinghigh-level, quality dentistry in thesame environment while maintain-ing our role as educators and as aresource for other educators viaDentalXP. In response to our mem-bers and dentistry at large, we arelooking at our next global sympo-sium in February 2015 in Las Vegas. Abig focus of the 2015 symposium willbe to make sure we also address theneeds of young dentists entering theprofession and desiring to expandtheir knowledge base as well as theirtechnical capabilities. Therefore, wewill have new selections of hands-oncourses as well as speakers coveringthe most requested and relevant top-ics in dentistry today. In addition, asstated previously, we are excitedabout the new online implant extern-ship, a 300-hour program directed bya board of leading educators and cli-nicians in the field. This program willlead to certification and access to spe-cially designed advanced hands-ontraining in DentalXP affiliated teach-ing institutes located around theglobe for easy and efficient access tosubscribers. We have also startedorganizing smaller regional or local

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Goldstein, Garber, and Salama...

GG&S ceramist Nigel Letren places a porcelain crown in the oven (Programat P510 [IvoclarVivadent]) for final bake.

GG&S lab technician Jennifer Preston confers with Dr. Garber on the newest patient scanusing the Zimmer Zfx lab scanner.

Dr. Goldstein using the iTero (AlignTechnology) scanner to take a digital impression for a porcelain veneer.

INTERVIEW

ClubXP meetings in collaborationwith DentalXP’s leading educators,designed to fit the individual club’sspecific needs in any topic using aplatform that combines both livespeakers as well as online follow-up.It is also exciting to see so many effec-tive teachers using dentalxp.com toconstantly add ideas, tips, or newtechniques daily. We hope even moreclinicians will utilize this mode ofsharing, teaching, and learningtogether, and enjoy being part of aglobal community with personalrelationships that can be started sim-ply with a click on any computer,tablet, or smartphone.

Dr. Garber: Dentistry is evolvingfar more rapidly than we anticipated,and to remain a part of it, you cannotmanage on your own. We, GG&S, arefortunate to be part of Team Atlantaand now part of DentalXP globally—which allows us to be in constantcontact, sharing information andfriendships 24/7. We feel that eventhough we are an older partnership,built on traditional values, we arecontinuing as an active part of thecommunity, probably to an evengreater extent in the most contempo-rary way by virtue of DentalXP, andthe strength of Digital Technologies.We are very excited about the futureof dentistry and dental education!�

Dr. Goldstein is currently a clinical professorof oral rehabilitation at the Georgia RegentsUni versity, Augusta, Ga; an adjunct clinicalprofessor of prosthodontics at BostonUniversity Henry M. Goldman School of Den -tal Medicine; and an adjunct professor ofrestorative dentistry at the University of TexasHealth Science Center at San Antonio. He isco-founder and past president of the Amer -ican Academy of Esthetic Dentistry and pastpresident of the International Federation ofEsthetic Dentistry. In 2008, He founded theTomorrow’s Smiles program under the Na -tional Children’s Oral Health Foundation tohelp deserving adolescents receive cosmeticdental treatment and enjoy the benefits ofhealthy smiles. He is a contributor to 10 pub-lished texts and author of the 2-volume textEsthetics in Dentistry. PMPH-USA will be pub-lishing the third edition of Esthetics inDentistry this year. He is co-author ofBleaching Teeth, Porcelain Laminate Veneers,Porcelain and Composite Inlays and Onlays,Complete Dental Bleaching, and Imaging inEsthetic Dentistry (Quintes sence Publishing).His best-selling consumer book, Change YourSmile, now in its fourth edition, has had morethan one million readers and has been trans-lated into 10 languages. He can be reachedat (404) 261-4941 or via e-mail at the follow-ing address: rgoldstein@goldsteingarber.com.

Disclosure: Dr. Goldstein has a financial inter-est in DentalXP; however, he has received nocompensation for this article.

Dr. Garber is one of the internationally recog-nized multidisciplinary educators well knownas “Team Atlanta.” He is a dual-trained clini-cian and professor in the department of peri-odontics as well as in the department of oral

rehabilitation at Georgia Regents University.He is a clinical professor in the department ofprosthodontics at Louisiana State Universityand in the department of restorative dentistryat the University of Texas in San Antonio. Heis a past president of the American Academyof Esthetic Dentistry(AAED), and has servedon the boards of both theAAED and the AmericanAcademy of Fixed Pros -thodontics. He is a pastco-editor of the Journal ofEsthetic Den tistry and co-author of Porcelain Lam -inate Ve neers, Bleach ingTeeth, Porcelain and Com -posite Inlays and Onlays,and Complete DentalBleach ing, and he haspublished more than 60articles and textbookchapters. He can bereached at (404) 261-4941 or via e-mail atdgarber@goldsteingar-ber.com.

Disclosure: Dr. Garber hasa financial interest in Den -talXP; however, he hasreceived no compensationfor this article.

Dr. Maurice Salama re -ceived his BS in biology atthe State University ofNew York (Binghamton)and his DMD degree fromthe University of Pennsyl -vania (U Penn) School ofDental Medicine, where helater also received hisdual-specialty certificationin orthodontics and peri-odontics, as well asimplant training at theBrånemark Center at UPenn. He has completedan ADA-accredited hospi-tal-based general practiceresidency at MaimonidesMedical Center in NewYork City, along withexternships at HadassahHospital, Hebrew Univer -sity in Jerusalem, andBeth Israel Hospital inNew York City. He is cur-rently on the faculty of theU Penn and Georgia Re -gents University as clinicalassistant professor ofperiodontics, and is visit-ing professor of periodon-tics at Nova SoutheasternUniversity (Fla). He is apartner in the Atlanta aes-thetic dental practiceknown as “Team At lanta.”He can be reached at(404) 261-4941 or gold-steingarber@goldsteingar-ber.com.

Disclosure: Dr. MauriceSalama has a financialinterest in DentalXP; howev-er, he has received no com-pensation for this article.

Dr. Henry Salama re -ceived his postdoctoralspecialty certificates inboth periodontics andperiodontal-prosthesis,fixed prosthodontics fromthe University of Pennsyl -vania. He is the former

director of the Implant Research Center, atthe University of Pennsyl vania, where he con-tinues to be a clinical assistant professor inthe department of periodontics. He is cur-rently in private practice in Atlanta, limited toadvanced restorative and implant therapy. He

can be reached at (678) 872-7719 or via e-mail at hsalama@aol.com.

Disclosure: Dr. Henry Salama has a financialinterest in DentalXP; however, he has receivedno compensation for this article.

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