Dr. Alvaro Gracia won the Table Clinic Award at the recent spring symposium of the International Congress of Oral Implantologists, Implant Prosthetic Society, and Association of Dental Implant Auxiliaries. Dentists are carefully selected to demonstrate the advanced or new clinical techniques used in their offices. The competition is strong, and the winning doctor is recognized at the next Symposium Awards Banquet. ADIA fellow and communications manager Teresa Duncan interviewed Dr. Gracia on his winning table clinic.
Teresa Duncan: How did you pick the case for your table clinic?
Dr. Gracia: There are very few cases for immediate loading with 5 mm height between the crest and the sinus floor. I was looking for an implant that could offer me surface and aggressive threads. Once I found the implant system, I looked for a patient who met the criteria.
Teresa Duncan: Your case was titled “Localized Management of the Sinus Floor With Immediate Placement and Simultaneous Loading.” What was the most challenging aspect of this case?
Dr. Gracia: Finding the patient was difficult, and then getting her to accept the treatment was another feat.
Teresa Duncan: Did the patient’s home care factor in to the success of this case?
Dr. Gracia: When I first saw the patient, she had only seven teeth remaining, and her home care was poor. After oral hygiene instructions and education regarding the procedure and prosthetic appliance, the patient agreed to improve her home care. Since the procedure was performed, her home care has greatly improved.
Teresa Duncan: Are there factors that would have prevented you from proceeding with treatment?
Dr. Gracia: This is not a procedure that should be performed on patients who are smokers, have serious systemic diseases, are bruxers, have less than 4 mm of bone, have TMD, or have serious dental or skeletal malocclusions. These are the exclusions for this specific topic.
Teresa Duncan: How much time did you and your implant coordinator spend with the patient answering questions and addressing concerns? What was the patient’s biggest concern?
Dr. Gracia: My implant coordinator spent quite a bit of time with the patient, who came in several times to go over treatment and finances. Affordability was a big issue with her, and the implant coordinator worked closely with Chase Health Advance to make the procedure affordable.
Teresa Duncan: What was the patient’s initial reaction to her new smile?
Dr. Gracia: She was absolutely thrilled. She wrote a letter to my practice that said, “I feel like I am beginning a new life because now I can smile at the world and I know they will smile back.”
Teresa Duncan: What is the interval in which you will see this patient for the next year? The next three years?
Dr. Gracia: The patient will be on a three-month recall indefinitely.
Teresa Duncan: Do you think it makes a difference to work with a trained implant coordinator on your cases? How so?
Dr. Gracia: When an implant coordinator knows as much about a case as the doctor and is present during the initial visit, it makes selling the cases much easier. My implant coordinator sometimes knows what I want for the patient before I do.
Teresa Duncan: Do you have any advice you would like to share with doctors who may be preparing their own case presentations?
Dr. Gracia: Select the case carefully, work closely with your technicians, design and project the case virtually, and once you do all that, the case basically sells itself.
Teresa Duncan: How did it feel to win the ICOI Table Clinic Award?
Dr. Gracia: It was an honor for me to win the ICOI Table Clinic Award. I am very grateful to be part of such a prestigious organization. I would like to thank my implant coordinator, surgical assistants, lab technicians, and patient for the time and effort put into this case. I truly couldn’t have done it without all of them.
Dr. Alvaro Gracia practices in Norton, Mass., and owns Advanced Dental Care of Norton. He has achieved the status of Diplomate in the International Congress of Oral Implantologists.
Teresa Duncan, MS, is the author of The Dental Implant Blog and owns Odyssey Management, Inc. She is recognized as an expert in the field of auxiliary implant training and insurance coding.
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