Through the Keyhole- Dr. Gary O'Brien

Dr. Gary O’Brien talks about his experience providing his general practice patients with comprehensive care

What can you tell us about your background?

I was accepted into dental school in my junior year at University of Southern California. In 1977, I started as a freshmen in dental school at the University of Southern California School of Dentistry. I was fortunate to get a job in the dental materials department at the dental school where I worked as a histological technician.  The study was a Vitreous Carbon Implant study on Rhesus monkeys under the direction of Dr. Paul Grenoble. He was a brilliant professor who shared his thoughts on the state of dental implants in 1977. The implant study was a disaster; however, I was fortunate to be allowed to attend a lecture given by Dr. P.I. Brånemark on the new concept of osseointegration.   I was fascinated and inspired to get involved with this new development when I became a doctor.

Who has inspired you?

I finished my clinical requirements a year early, so the administration assigned me to a grad student in the School of Prosthetics, Dr. Chris Travis. He was and is a brilliant man, and an incredible athlete. He was very hard on me as I took on advanced reconstruction cases with his guidance. He was equally hard on me as my ski instructor. During this last year of clinical training, I also received advanced time and training in the oral surgery department under the direction of Dr. Marsh Robinson. I love both prosthodontics and oral surgery a great deal. As I approached the winter months, I was preparing to apply to the School of Oral Surgery, as I felt that my training in prosthetics was complete. In March of 1981, I found out that my wife was pregnant, so graduate school was out of the question. I graduated with many honors and went to work.

I met Dr. Gerald Niznick in the winter of 1982 at a Century Club Meeting. My desire to place and restore implants was crushed, as Brånemark and IMZ, at that time, would not train general dentists. Dr. Niznick talked to me for almost an hour. At the end of our conversation, I purchased my first dental implant from him for $82. It was a 16-mm, 4.5-diameter Core-Vent® implant (Implant Direct/Sybron Dental Specialties). I was so excited because I had a patient who needed an implant in the position of tooth No. 30 as a distal abutment for a three-unit bridge. I set the patient up and sterilized the Core-Vent® Drill that Dr. Niznick sold me and plugged in my bead sterilizer because I was going to have to modify my implant to a MOD 3 based on the amount of space I had over the mandibular nerve from the acrylic overlay. The day of the surgery, I told the patient that this was crazy and that we should have Dr. Niznick put this implant in his jaw, and I would learn from him, as I had never placed an implant before. I called Dr. Niznick and asked when his next course was, and he waved my tuition as a guest because I was bringing a patient. During the class, Dr. Niznick asked me how many implants I had placed. I told him none. He looked at the attending dentists and said, “I’ll show you how easy this system is. Today, you’re putting your first implant in, kid.” I was scared to death, but the implant was successful.

In 1986, Dr. Niznick was going to launch his new implant, the Screw- Vent® (Zimmer Dental), at a lecture in San Francisco. I attended that lecture. In the middle of the lecture, Dr. Niznick recognized me and asked me to stand and tell the attendees how many implants I had placed. I said, “About a hundred Core-Vent® Implants.” Dr. Niznick laughed a bit and corrected me, as he knew how many I had purchased. He joked with the other attendees and said, “That is amazing that you have placed about 100 implants, as we have only sold you 80!” We became instant friends, and I still have the reputation of exaggerating. He invited my wife and me to have dinner with him and his wife, Ressa. At dinner, he asked me if I would be interested in lecturing for his company. That was the beginning of the most exciting ride of my professional career. He took me to every meeting there was all around the world. He taught me the lecture circuit, and exposed me to the world of implants. Then, I was fortunate enough to travel with Dr. Carl Misch for a year and lecture with him on the Core-Vent® System. He taught the science, and I introduced the system.

I was designing implants with some of the best biomechanical engineers in business. I filed for a patent on a concept of Stress Diversion Implants in the fall of 1987. I had seen and placed so many different implant configurations that I saw a pattern that was related to the sauserization of bone loss that occurred around dental implants. I developed the first tapered implant with threads that changed in surface area, pitch, and diameter. This varying pitch concept combined with a tapered design gave birth to today’s tapered implants that contain mini-threads and varying thread configurations. When Dr. Niznick sold his business to Dentsply, I became their lecturer. They contracted with me to take my implant to market, but instead bought the Fritec Implant System. ACE Surgical attempted to take my implant to market; we sold quite a few implants in a 4-year period. I eventually published an article entitled, “A 5 Year Prospective Study on 650 SDS Dental Implants.” In this study, I compared the 5-year radiographic data with the 3D Finite Element Analysis in the mathematical model developed by Martha Bidez at the University of Alabama Dental Material Department. In this study, I correlated the amount of bone loss over 5 years, in different qualities of bone, with the prediction made from the model. In 2004, while I was analyzing the data, I received a phone call from Dr Niznick. He asked me what I was doing with my implant. He told me that he was going to start a new company in a couple of years called Implant Direct and sell the top implants, the abutment, and the cover screw for less than I could manufacture my implant. After he explained the direct sale strategy over the Internet and the cost he would incur to come to market, I stopped making my implant and started buying implants from Implant Direct because they were better than anything I had seen to date on the market, and available for less money than I could make my own implant. Short lived as it was, it was very exciting and we did make some money while we were having fun.

What is the future of implant dentistry?

I have watched the implant industry evolve over the last 30 years, and now I am part of a revolution that is happening in dental implants. Implant Direct Sybron International is going to dominate the industry over the next 15 years by producing the highest quality of advanced implants, at an affordable price. This is going to change everything about the implant industry. We will see the average cost of dental implants to the patient drop considerably. Doctors will be able to stock their offices with quality product for a much-reduced fee. As the fee to the patient is reduced, it will broaden the population of patients who can afford the service. The entire industry will see an increase in usage, and there will be increased business in the field of dentistry in general.

Professionally, what are you most proud of?

Today, I am honored to be the educator for Implant Direct Sybron International. Working together with Dr. Niznick at this point in my career is a dream come true. This is my 30th year as a general dentist. I have always done my own periodontal treatment as well as endodontic therapy. I am using the endodontic system provided by Sybron Endodontic and love treating all the teeth, even third molars. When the TF™ files came out, I was the first to jump on the beta study and try the new system. It has made root canal therapy a breeze.

What do you think is unique about your practice?

I love meeting all the needs of my patients. Perio-surgery is fun for me because the results are immediate. Taking a difficult full-mouth rehab from the very beginning and watching the patient transform as we save teeth, add implants, and reverse their periodontal disease is the greatest thrill of my career. I watch the reclusive young man with periodontal disease and very few teeth left, transform into a nightclub-hopping playboy with three girlfriends that he can barely handle! That is the miracle of good solid dental care in the year 2011.

I have put together the greatest group of personnel to work with on a daily basis. They are truly amazing. I love each one of them like they were my own kid. Every day, I wake up and can’t wait to get back to the office and see what we are going to do together. Some of the staff has been with me now for more than 25 years and that just makes for cohesiveness and efficiency. A day doesn’t go by when I don’t hear from a patient or two that my office is so much fun. Patients really love to come into the dental office. I attribute that to an amazing office manager who has created a family-like work environment where all the employees genuinely care for each other.

My practice of 30 years in one location is made up of four generations of people that I have grown to love. Most of my patients have come to the office through inside referrals. Most recently, I have been getting calls in response to our website. Seven years ago, Juan Carreno and I started putting together a new website concept, and it is working well. I felt when the Internet increased in efficiency to greater speeds so that people were not annoyed to look online for a dentist, that it would be the best tool for marketing. I was right in my assumptions. Now, it is our best source of patients. We are now updating the site for the practice’s 30-year anniversary.



What are your hobbies, and what do you do in your spare time?

I am the husband of the most loving and beautiful wife. We love to go to movies. Sometimes we will do a movie marathon and see three in one day. I have three wonderful kids. My two granddaughters make me smile when I just think of them. I can’t run anymore, so I ride a road bike like the other old retired runners, so that I am able to keep up with the pace of a multimillion-dollar general practice that is run by one GP and a wonder staff of six. I would say that all my dreams have come true professionally and personally. I think that I am the happiest guy I know.

Top Ten List
1. Gendex CB-500 CBCT Machine
2. Anatomage Software to Tx planning Implants
3. Sybron Obturator Unit (Sybron Endo)
4. Root ZX (Apex Locator) J. Morita
5. M4 Safety Handpiece-Contraangle Attachment (Sybron Endo)
6. Real Seal Elements (Sybron Endo)
7. TF - Twisted Files-Rotary Nickel Titanium Files (Sybron Endo)
8. VersaWave Eurbium YAG Laser Hoia Con-Bio
9. miniEndo Ultrasonic Surgical instrument (Sybron Endo)
10. Dexis X-ray System

Bio

Gary O’Brien, DDS, graduated from the University of Southern California School of Dentistry and also served as a clinical instructor there, teaching Fixed Prosthetics and Restorative Dentistry. He has had surgical Training with Dr. Gerald Niznick, developer of the Core-Vent® Implant system, has lectured and written extensively on the subject of implants, and received patents on his own dental implant system.