1. ezlase™ Soft-Tissue, Whitening, and Pain Therapy System
May 2009

2. Why compromise on your soft-tissue laser?
4/19/2017
Why compromise on your soft-tissue laser?

3. Why Buy a Soft-Tissue Laser???
To make your patients even happier with minimally invasive dentistry, faster healing, less bleeding, and decreased post-op pain
To get rid of packing cord
Does not destroy healthy tissue like an electrosurge does
To provide your practice with extra sources of revenue
Why buy a soft-tissue laser now?
To attract and retain patients with expanded service that differentiates your practice
Every day without a diode laser is a day of money lost
Surveys show patients expect you to have a laser

4. Why Buy an ezlase™ ???
Unmatched Combination of Power & Portability plus choice of traditional 810 nm and optimized, proprietary 940 nm.
Up to 7 Watts of power
Battery pack (sold separately) for optimal positioning and easy transport between operatories
Unmatched Versatility
Various tips sizes, all bendable, for different applications
Surgical procedures, whitening, and pain therapy all in one system
Pain Therapy & Relief The only dental laser with FDA clearance ( Healing?)
The Best In-Office Whitening Solution, in less than 20 minutes of treatment time
The Comfort Patients Want
ComfortPulse™ feature can provide greater patient comfort
Minimal bleeding, swelling, or post-op pain
Reduced need for injections, sutures, hemostatic agents, and astringents
Added Revenue, Excellent Affordability
Less referring out – your patients want YOU to treat them
New procedures for additional practice revenue
No more packing cord
Training & Certification Included with Purchase

5. Soft-tissue procedures

6. The Best Soft-Tissue Solution
940 nm wavelength developed specifically for dental applications
Tissue does not have to be inflamed or vascular to cut well (compared to 810 nm)
Great hemostasis due to position on the absorption peaks of Hb and HbO2
ComfortPulse™ provides efficient cutting and greater patient comfort
Short, high-power cutting pulses with longer intervals are used for tissue thermal relaxation
Hundreds of pulse combinations
ezTips™ reduces chair time
Optically perfect every time
Single-use, disposable tips can be changed in seconds
No more stripping and cleaving of tips
Diameters from µm, lengths from 4-14 mm
Bendable for various procedures

7. From Good to Great
Challenges of the Good Dental Practice
ezlase™ Path to a Great Dental Practice
Access and Field of Vision
Minimally Invasive Gingival Recontouring
Better access and field of vision
Minimal/no bleeding without packing cord
Decreased post-op sensitivity
Running out of Solutions to Persistent Perio Problems
Minimally Invasive Periodontal Surgery
Sulcular debridement, laser curettage
Less recurrence of perio disease
Faster healing and decreased post-op pain
No Good Solution for Patients with “Emergency” Sores
Destruction of Lesions
Instant pain relief with faster healing
Simple, 5-minute solution keeps emergencies from disrupting schedule
Treats aphthous ulcers and herpetic lesions
These are just a few of the many new soft-tissue solutions that you will be able to provide to your patients!

8. Ezlase Procedures for Added Practice Revenue
continued

9. Ezlase Procedures for Added Practice Revenue

10. whitening

11. Full-Mouth Whitening in Less than 20 Minutes!
New LaserWhite20 gel and whitening handpiece (each sold separately) provide full-mouth whitening in less than 20 minutes of in-office treatment time1
Best whitening improvement compared to other solutions, in similar tests
Excellent results right away, and even more dramatic improvement after 24 hours
Desensitizer gel included to help reduce sensitivity if necessary
Only required training is for ezlase™ laser system
1 Does not include prep and post treatment preparation

12. How many have performed whitening with the ezlase?

13. Comparison of TreatmentTimes
Product
Light Source
Treatment Cycle*
35% H2O2 Gel
[none]
60 min
BriteSmile
LED
90 min
NUPRO White Gold
Opalescence Xtra Boost
Sapphire
Plasma Arc
40 min
Zoom2**
Mercury Metal
45 min
LaserSmile
Diode Laser
ezlase 940 nm
20 min
* Source: ADA Professional Product Review, Vol. 3, Issue 2, Spring 2008
** Used with the Zoom Advanced Power Light
ezlase™ and LaserSmile are the only laser based whitening systems
Other systems utilize light, but they do not use a laser
No sun block, etc. to protect face and lips

14. Comparison of Efficacy
Source of Charts: “LaserSmile Tooth-Whitening System: A Study by Two Independent Clinical Sites” from The Journal of Cosmetic Dentistry, Volume 19, Number 2, Summer 2003
As the above charts show, LaserSmile provides approximately 9 shades of improvement, versus less than 8 shades of improvement from non-laser systems
Biolase expects the ezlase Whitening System will deliver even better whitening results compared to the LaserSmile (see next slide)
Nevertheless, dentists are encouraged to discuss predictability and efficacy with the patient prior to the start of the whitening process:
Results may vary depending on type of stain, enamel thickness, tooth structure, and age
Teeth with deep, intrinsic staining in the grayer tones generally will not respond as well as yellow shaded teeth
Some teeth are a natural yellow shade because enamel transparency allows the color of dentin to be visualized

15. Laboratory Results on Hydroxyapatite Discs
Gel
Total Gel Contact Time
Laser Exposure Time
Approximate Improvement in Shade*
LaserWhite10
16.5 min
3 min 9
LaserWhite20
5 min
1 min 13
* Improvement in shade derived from "ΔE" measure, defined as a mathematical calculation of the "distance" between two colors on the CIE color space.
LaserWhite20 is approximately 44% more effective than LaserWhite10
LaserWhite20 takes approximately 1/3 of the time compared to LaserWhite10 on hydroxyapatite discs
[Note: Protocol recommends 9 min of gel contact time on teeth, but laser exposure time remains 1 min]
Less laser exposure time reduces heating effects
Note: Although these tests were not performed on teeth, enamel’s primary material is hydroxyapatite (~95%)

16. Clinical Results
Typical results range from 6 to 12 shades of improvement on the Vita Shade Guide Brightness Scale
BEFORE LASER WHITENING
AFTER LASER WHITENING
Results may vary depending on type of stain,
enamel thickness, tooth structure, and age

17. Another reason for ezlase over all other whitening modalities?

18. Another reason for ezlase over all other whitening modalities?

19. SEM of Take-Home Before and After
Pola Office
SEM of Take-Home Before and After
35%; je (8 x 30 sec. light + 5 min. exposure time)
reference: 500x reference: 8.000x
treated: 500x treated: 8.000x
very strong chemical attack

20. SEM of Diode + Gel Before and After
Diode Laser + Gel
SEM of Diode + Gel Before and After
1,5W cw; H2O2 (30%); 2x (60 sec.; +120s exposure time + 30s rinsing)
reference: 500x reference: 8.000x
treated: 500x treated: 8.000x
No visible damage

21. Exposure Time
A long exposure time increases the risk of damage to the dental hard substance
V. Cavalli, C. A. G. Arrais, M. Giannini & G. M. B. Ambrosano: High-concentrated carbamide peroxide bleaching agents effects on enamel surface
Journal of Oral Rehabilitation
Volume 31 Issue 2 Page February 2004

22. Pain therapy

23. Bill Brown VP, International
4/19/2017
Bill Brown
VP, International

24. Background
LLLT (Low Level Laser Therapy) has been utilized in medical fields in Europe and Asia for more than 30 years with several thousand published clinical papers
After resisting for many years, the FDA finally recognized the efficacy of LLLT in 2000
The American Society of Lasers in Medicine and Surgery established a section devoted to LLT and there are now a national ( NAALT) and a global ( WAALT) organization with a journal (Photomedicine and Laser Surgery) devoted to this important area of medicine.
LLLT in dentistry has been found to accelerate wound healing and reduce pain, possibly by stimulating oxidative phosphorylation in mitochrondria and modulating inflammatory responses. By influencing the biological function of a variety of cell types, it is able to exert a range of several beneficial effects upon inflammation and healing. (Moritz-Oral Laser Applications)

25. Background
There is evidence that 940 nm light can trigger mast cell degranulation. Mast cells are distributed preferentially about the microvascular endothelium in skin, oral mucosa and dental pulp.
Because mast cells play a pivotal role in controlling leukocyte traffic, modulation of mast cell functions by LLLT can be of considerable importance in the treatment of sites of inflammation in the oral cavity.
For fibroblasts, increased proliferation, maturation and locomotion have been noted, as well as transformation to myofibroblasts, reduced productionof pro-inflammation prostaglandin E2 and increased production of basic fibroblast growth factor.
LLLT effects on macrophages include phagocytosis, secretion of fibroblast growth factors and fibrin resorption
Lymphocytes become activated and proliferate more quickly. There is increased motility in epithelial cells.

26. Background
For endothelium, there is increased granulation tissue and relaxation of vascular smooth muscle
For neural tissue we have reduced synthesis of inflammatory mediators, and axonal growth with maturation and regeneration
The above listed effects are a function of various wavelengths, dosage and method of application among other parameters such as pulse characteristics, distance to tissue, speed of movement.
Recent LLLT clinical research in dentistry covers applications from movement of teeth to accelerate orthodontic treatment to bone regeneration

27. Clinical Research Examples
4/19/20174/19/2017

29. ezlase 940 nm Therapeutic Indications
FDA cleared indications
Temporary relief of minor muscle and joint pain and stiffness
Temporary relaxation of muscle
Temporary increase in local blood circulation
Applicable Dental Procedures
TMJ Arthralgia (treatment of the Joint)
Myofacial Pain related to TMJ (treatment of the muscle related to painful trigger point)
Muscle relaxation related to pain and muscle stiffness after dental procedures or in general(Trismus)

30. Temporo-Mandibular Joint Dysfunction Affects Many People
10.8 million people in the US suffer from TMD (NIH report); 90 % of this number are women
Very complex origin – it is the only joint in the body that is associated with a psychological element as a very high correlation with stress.
The condition is associated with pain in the joint that affects the mastication muscles. Pain can extend to the neck and the back.

31. Temporo-Mandibular Joint Dysfunction Conventional Treatments
Non surgical
Modified diet (soft food)
Cold/Hot Packs
Medication
Injection with Steroid
Occlusal mouth guards
Surgical
Arthrosynthesis (washing of the joint)
Arthroscopy/arthroplasy (removing adhesions within the joint)
Discetomy/enectomy (joint replacement surgery)

32. Temporo-Mandibular Joint Dysfunction Treatment Prices and Professional Organizations
Cost of Treatment
Non- Surgical
Up to $600 for diagnosis
$500-$1,500 for occlusal mouth guard treatment
Follow-up cost ~ $150 per visit
Surgical
~ $2,000 and more per procedure
Organizations with focus on TMJ
American Academy of Orofacial Pain (AAOP) ~ 300 members
American Academy of Pain Management ~ 6,000 members
TMJ associations

33. ezlase 940 nm Surgical vs. Therapeutic Effects
Surgical laser beam
therapeutic laser beam
Ø= mm
Laser Treatment Beam Size :
2.8 cm2
(x20 larger than surgical tip)
Laser Treatment Beam Size:
0.13 cm2

34. What are the 4 Laser-Tissue Interactions?

35. ezlase 940 nm Surgical vs. Therapeutic Effects
A diffused beam of energy size 35 x 8 mm is delivered to the tissue site over a period of time. The level of laser energy is low enough to have a therapeutic effect without any tissue destruction.
A concentrated beam of energy is delivered to tissue via a small diameter µm fiber tip, and upon contact tissue is vaporized and removed.

36. ezlase 940 nm Surgical vs. Therapeutic Use
Diffused laser energy is transmitted through tissue to treat. The image is of an ezlase beam transmitted through tissue as it was captured by an Infrared camera.
The Process – Scattering ( or Diffusion) through tissue.
The Effect - Pain relief and improved functionality immediately post-treatment or over a few treatments.
Concentrated laser energy is applied to an outer layer of the fiber tip (absorber coating produced after tip initiation).
The Process – Absorption.
The Effect - Immediate tissue vaporization and removal.

37. ezlase 940 nm Therapeutic Mechanisms of Action
Increased micro-circulation in tissue
Photo-activation of inactive enzymes (catalysts) present in painful muscle cells
Normal Cell
Improved cellular functions through
increase of ATP (fuel for the cell) production
in cells
Swollen Cell

38. ezlase 940 nm TMD Clinical Protocol – Therapeutic Settings
4/19/2017
ezlase 940 nm TMD Clinical Protocol – Therapeutic Settings
Method
Contact Mode
Power Setting (P)
Power Density 1
contact
2.5 W
0.89 W/cm2 2
4.1 W
1.46 W/cm2 3
non-contact
5.5 W
1.96 W/cm2
Laser Coverage Area = 2.80 cm2 (35 x 8 mm)
Exposure Time (t) = 1 min and up to 10 min
Settings vary depending on the type of skin and patient response
Start at the lowest recommended setting (power and exposure time), and increase as necessary
Therapeutic energies applied to any muscle or joint are measured in “Dose of energy”
The formula to calculate the Dose is as follows: Dose [J] = P (W) x t (s)

39. ezlase 940 nm TMD Clinical Protocol – Treatment Schedule Example
SUN
MON
TUES
WED
THU
FRI
SAT
Treatment 1
Treatment 2
WEEK 1
Treatment 3
Treatment 4
WEEK 2
Treatment 5
WEEK 3

40. ezlase 940 nm TMD Clinical Treatment Protocol
4/19/2017
ezlase 940 nm TMD Clinical Treatment Protocol
Temporalis
Masseter
Treatment of Painful Trigger Points (Myofacial Pain)
Palpate masseter and temporalis to identify painful trigger points; mark each point with a small dot and the covered area.
VAS Pain measurements for each point pre- and post-
Treatment of the Joint (TMJ Arthralgia)
Treat the joint at the three locations provided in the image to the right

41. Proven Clinical Results!

42. Proven Clinical Results!

43. Proven Clinical Results!

44. Proven Clinical Results!

45. ezlase 940 nm Therapeutic Applications - Clinical Benefits
Progressive/immediate relief of pain
Reduction in muscle tenderness and stiffness
Improved functionality of the affected
Improve quality of life
Gentle to tissue in comparison to other alternatives such as steroid injections, or appliances such as mouth guards

46. Q & A

47. Easy to use

48. Touchscreen Interface
Very intuitive, and easy to use
Current power settings
Touch to decrease power
Touch to increase power
Touch to change pulse interval
Touch to change pulse length
Touch for continuous wave or pulsed mode
Current pulse settings

49. Custom Presets
15 pre-sets available for customization by the clinician
Touch to access or change a pre-set

50. comparisons

51. ezlase™ Offers the Most Solutions & Most Portable Power
(Biolase)
Picasso
(AMD)
Styla
(Zap)
Odyssey Navigator
(Ivoclar)
SIROLaser
(Sirona)
DioDent Micro 980
(Hoya)
GENTLERay 980 Premium
(Kavo)
Maximum Power (W) 7 2 3
3.5
7 CW, 12 pulsed
Battery Power ü
Wavelength (nm)
940
810
980
Multiple Pulsed Modes
Customizable Pulsed Modes
Customizable Pre-Sets
Whitening
[1]
[2]
Pain Therapy
Water Cooling of Tissue
Wireless Foot Pedal
Finger Switch
Touchscreen Control
Disposable Tips
Bendable
Various Diameters
Various Lengths
Key Strengths
Most solutions; most portable power
Price
Portable; Integrated System
Portable
Power; Water Cooling
[1] Whitening is claimed, but not available at time of this printing
[2] Whitening only for a single tooth at a time is available

52. Summary of ezlase™ Specifications
Category
Value
Benefit
Maximum Power Output
7 Watts, Continuous Wave
No other portable laser diode has more power
Wavelength
940 nm
Developed specifically for dental applications
Pulse Length & Interval
50 µsec to 10 sec, for pulse repetition rate up to 10 KHz
ComfortPulse™ for efficient cutting and greater patient comfort
Hundreds of pulse combinations
Size & Weight
3.5”x7.0”x2.5”; 2 lbs
Compact, and true portability
Battery Pack
(sold separately)
Provides power for a typical day of soft-tissue procedures, plus some whitening cases
Eliminates power cord
Allows optimal placement when in use
Easy to transport between operatories
ezTips™
Single-use, bendable, many sizes; can be changed in seconds
Reduces chair time
More choices for different procedures
Footswitch
Wireless option
Eliminates cord
Allows optimal placement

53. Ordering information

54. Ordering Information – ezlase™ 940nm Laser
Biolase Part #:
Includes:
ezlase™ 940nm Laser
Soft-tissue handpiece
2 boxes of ezTips™ (30 tips per box)
3 pairs of laser safety glasses
Footswitch
Power supply with cord
Set of peel-off clear covers for touchscreen

55. Ordering Information – ezlase™ Accessories
ezlase™ Whitening Handpiece Biolase Part #: Suggested US Retail Price: $1,250 LaserWhite20 Whitening Gel Biolase Part #: Suggested US Retail Price: $295 for a package of 5 kits Includes: whitening base gel, activator gel, liquid dam, desensitizer gel, applicator & brushed applicator tips, syringe caps, disposable clear cap for Whitening Handpiece ezlase™ Battery Pack Biolase Part #: Suggested US Retail Price: $750 Delivers power for a typical day's worth of soft-tissue procedures plus 3 whitening procedures ezlase™ Wall Mount Biolase Part #: Suggested US Retail Price: $295

56. Ordering Information – ezTips™
All tips sold in boxes of 30
Surgical Tips Biolase Part #: Diameter & Length: 200µm, 4mm Suggested US Retail Price: $250 Biolase Part #: Diameter & Length: 300µm, 4mm Biolase Part #: Diameter & Length: 400µm, 4mm
Perio Tips
Biolase Part #:
Diameter & Length: 300µm, 7mm & 9mm
Suggested US Retail Price: $250
Biolase Part #:
Diameter & Length: 400µm, 7mm & 9mm
Endo Tips
Biolase Part #:
Diameter & Length: 200µm, 14mm
Suggested US Retail Price: $299

57. Thank You.

58. APPENDIX

59. ezlase Solutions for the Top 7 Soft-Tissue Dental Challenges

60. ezlase™ Whitening Handpiece
Contoured to treat an entire quadrant of teeth at once, consistently, and comfortably
Ergonomically designed to fit comfortably in your hand
Elegant, small and extremely lightweight
Proprietary handpiece design ensures safety to you and your patient

61. LaserWhite20 Whitening Gel
Proprietary gel, chromophore engineered and designed to work with Biolase diode laser systems
Laser energy is absorbed by special particles in the gel to activate the H2O2 (38% concentration, after mixing with activator gel), accelerating the whitening procedure
Desensitizer gel included to help reduce sensitivity if necessary
Each kit good for one full-mouth whitening case

62. How to Use ezlase ™ Whitening System
Note: Listed here is just a quick summary. Please carefully follow the Instructions for Use included with the LaserWhite20 gel and ezlase™ Whitening Handpiece.
Apply liquid dam to the gingiva, and cure with a standard curing light
Mix the activator and base gels by connecting the two syringes together and pushing the gels back and forth
Apply a thin layer of the mixed gel with a brushed applicator tip to each quadrant of teeth
Ensure that the doctor, patient, and all persons in the room wear protective eyewear before starting the laser
Place a disposable clear plastic cap over the whitening handpiece, and place the handpiece in close proximity (~ 1mm) to the first quadrant, without touching the gel
Deliver 200 Joules of laser energy at 7 Watts to the quadrant (~30 seconds), and then repeat for all quadrants
Repeat step 6 one more time
Allow the gel to remain on the teeth for 5 more minutes, then remove with high-speed suction, and flush with an air and water spray
Replace the brushed applicator tip with a new one, and repeat Steps 3 through 8 one more time
Remove liquid dam
Mixing activator & base gels
Brushed applicator tip
Liquid dam on gingiva
Applying gel to teeth
Delivering laser energy
Removing gel from teeth

63. Gel Application 1 Laser Cycle 1
Quadrant 1

64. Gel Application 1
Laser Cycle 1
Quadrant 2

65. Gel Application 1
Laser Cycle 1
Quadrant 3

66. Gel Application 1
Laser Cycle 1
Quadrant 4

67. Gel Application 1
Laser Cycle 2
Quadrant 1

68. Gel Application 1
Laser Cycle 2
Quadrant 2

69. Gel Application 1
Laser Cycle 2
Quadrant 3

70. Gel Application 1
Laser Cycle 2
Quadrant 4

71. Gel Application 1
Resting Time

72. Repeat Same Steps for Gel Application 2