The Hidden Architects

May 13, 2026

·S. Thaddeus Connelly, DDS, MD, PhD, FACS

Modern dentistry often focuses on what is visible: plaque, inflammation, recession, lesions, ulceration. We inspect the surface, diagnose the surface, and treat the surface. But every biological surface is an output, not an origin. What you see clinically is the final expression of a deeper conversation occurring between cell layers that continuously build, repair, and regulate the tissue above. In the oral cavity, that conversation is driven largely by two cell populations: fibroblasts in the connective tissue below, and keratinocytes in the epithelial layer above.

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The complete article — figures, references, and clinical commentary — is published in The Oral Health Bulletin on LinkedIn.

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