presented by name

Science

one of the most well-researched implant lines in the industry prospective & retrospective large patient cohorts 10 year follow-up immediate placement & load poor quality bone sinus augmentation short length implants overall success rate of 99.2%

Science

global leader for tissue regenerative solutions

AlloDerm
regenerative tissue matrix

Mem-Lok
cell occlusive resorbable collagen membrane

MINEROSS
mineralized allograft cortical and cancellous particles

GRAFTON DBM
osteoinductive demineralized bone matrix with bone fiber technology

Innovation

Laser-Lok microchannels
esthetics enhanced by technology only surface shown using human histology to attract a physical, connective tissue attachment1 superior crestal bone maintenance when compared to traditional implants2

1Based

on human histology published in IJPRD, vol 28, no 2, 2008 compared to a pubmed search in June 2009 on other systems.
2Based

on a 3yr study published in Implant Dentistry, vol 18, no 1, 2009 compared to the 1.5-2mm of bone loss commonly reported with traditional implants.

Innovation

VIP 2.1
interactive 2D and 3D treatment planning software - intuitive, user-friendly interface - self-processing DICOM converter - improved case predictability and confidence

Innovation

3inOne abutment
comes packaged with every bone-level implant 1) implant mount 2) impression coping 3) esthetic, gold-hued abutment

Service

over 70 countries served one hundred direct reps fifty-eight distributors seven direct markets
- US, Spain, Canada, UK, Germany, Australia, Chile

Service

Worldwide distribution network

Canada

United States

Mexico El Salvador Costa Rica Colombia Ecuador

Sweden Finland Norway Estonia Denmark Latvia United Kingdom Netherlands Lithuania Ireland Germany Poland Belgium Liechtenstein Czech Republic Kazakhstan Luxembourg Switzerland Austria Slovakia Ukraine France Slovenia Hungary Romania Italy Serbia Bulgaria Portugal Spain Greece Turkey Malta Cyprus Lebanon Iran Morocco Pakistan Israel Jordan Kuwait Libya Egypt United Arab Emirates Saudi Arabia India Yemen Iceland Nigeria

Russia

Japan China Korea

Taiwan Hong Kong Thailand Vietnam Malaysia Singapore Indonesia Philippines

Peru

Chile South Africa Argentina

Australia

New Zealand

Over 70 countries served

biologic width around natural teeth 3mm avg. dimension

1mm Sulcus 1mm Epithelial Attachment 1mm Connective Tissue

implants get close but are not quite there

tissue level at the time of placement

bone level at the time of placement

microgap

typical bone loss

1-2mm commonly accepted

laser-lok more uniform than other surfaces

blast textured

SLA

Laser-Lok microchannels

acid-etched

Anodic oxidation (TiUnite)

all random surfaces

0.72-1.34 microns avg. surface roughness *

uniform micro/nano structure

8-12 micron channels

*Resonance frequency measurements in vivo and related surface properties of magnesium-incorproated, micropatterned and magnesium-incorporated TiUnite, Osseotite, SLA and TiOblast implants. Sul YT, Jnsson J, Yoon GS, Johansson C. Clin Oral Implants Res. 2009 Oct;20(10):1146-55.

laser-lok is cell-sized unlike microthreads

30X magnification

Astra

NobelBiocare

BioHorizons

courtesy of Jack Ricci PhD (NYU)

Astra

~250m

cells respond to the surface treatment

BioHorizons

16-24m

NobelBiocare

~200m

300x magnification
courtesy of Jack Ricci PhD (NYU)

laser-lok encourages an optimal & consistent cell response

ostoeblasts assume a flattened fibroblastic morphology and spread

ostoeblasts perceive a smooth surface

ostoeblasts are unable to flatten and spread and anchor to the surface

on a mixed topography the behavior reflects the average of the morphologies

Boyan and Schwartz, chapter 21, Bone Engineering, 2000.

landmark study Myron Nevins, DDS, Harvard University

laser-lok attracts a true physical connective tissue attachment

- inhibit epithelial downgrowth - establish a predetermined site for connective tissue - preserve the coronal level of the bone

human histology shows epithelial downgrowth inhibited

courtesy of Myron Nevins, DDS

polarized light shows functionally-oriented collagen fibers

natural tooth

Laser-Lok implant

functionally-oriented collagen fibers

bone how attached?

Sharpey fibers in cementum
IJPRD 1998 18;321-331 images courtesy of Myron Nevins, DDS

SEMs show a physical connective tissue attachment

scanning electron microscopy courtesy of Myron Nevins, DDS

prospective, controlled study published

two identical implants

- one with Laser-Lok - one without Laser-Lok - placed in pairs

OE ES EA

four investigators 15 patients 20 pairs of implants

CT
CB

Clinical evaluation of laser microtexturing for soft tissue and bone attachment to dental implants. GE Pecora, R Ceccarelli, M. Bonelli, H. Alexander, JL Ricci. Implant Dentistry, Vol 18(1). Feb 2009. pp.57-66.

prospective, controlled study protocol

single stage, temporary out of occlusion restored at 4 months post-op none lost to follow-up evaluated every other month from 1 to 37 months
crestal bone loss probing depth plaque index sulcular bleeding index

Clinical evaluation of laser microtexturing for soft tissue and bone attachment to dental implants. GE Pecora, R Ceccarelli, M. Bonelli, H. Alexander, JL Ricci. Implant Dentistry, Vol 18(1). Feb 2009. pp.57-66.

improved crestal bone maintenance

control Lase r- Lok

2.5 2.0 1.5

1.94mm
laser-lok benefit 0.59mm

mm
1.0 0.5 0.0 1 3 5 7 9 11 13 15 17 19 21 23 25 29 33 37 months

P<0.005 after month 5

shorter sulcus depth

control

Laser-Lok

4.0 3.5 3.0 2.5

mm

3.60mm laser-lok benefit 2.30mm

2.0 1.5 1.0 0.5 0 1 3 5 7 9 11 13 15 17 19 21 23 25 29 33 37

time (months)

P<0.005 for all time periods

laser-lok showed no increased bleeding

control

Laser- Lok

0.60 0.50 0.40 0.30 0.20 0.10 0.00 1 -0.10

time (in months)

11

13

15

17

19

21

23

25

29

33

37

results not significantly different except months 21 and 37 where laser-lok was superior

sample study case

pre-op

at placement

2 months post-op

4 months post-op

6 months post-op

a controlled study of the bone retention qualities of the Laser-Lok dental implant
12 mos. overdenture model 60 implants
- 30 Laser-Lok (15 loaded) - 30 Nobel (15 loaded)

unloaded bone loss

- 0.29 vs 0.55mm (p=0.01)

loaded bone loss

- 0.42 vs 1.13mm (p<0.001)

plaque & bleeding similar submitted for publication

Spyros Botos, DDS, MSD / Hoda Yousef, DMD, MS / Barry Zweig, DMD / Saul Weiner, DDS. New Jersey Dental School, Newark, NJ, USA

marginal tissue response to different implant neck design

canine model implants placed in healed ridges harvested at 8 & 12 weeks @ 8 weeks
bone-implant contact (%) marginal bone loss (mm) machined 22.3 1.61 micro-thread 21.8 0.79 Laser-Lok 35.5 0.4

@ 12 weeks
bone-implant contact (%) marginal bone loss (mm)

machined 30.5 1.63

micro-thread 22.6 0.56

Laser-Lok 41.0 0.26

Marginal tissue response to different implant neck design. HE Bae, BDS, MDS, MK Chung, DDS, PhD, IH Cha, DDS, PhD, DH Han, DDS, PhD. J Korean Acad Prosthodont 2008 Vol 46 No 6.

Dr. Shapoffs retrospective study

41 patients / mean age 62 yrs 50 laser-lok implants 41 implants up to 2yrs post-restoration

0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 2 yr 3 yr

30 implants up to 3yrs post-restoration

- crestal bone change: 0.46 0.12mm

accepted to IJPRD

C res tal B one L os s (mm)

- crestal bone change: 0.44 0.10mm

the mean crestal bone level change (mm) during two different time frames (courtesy of Cary Shapoff, DDS)

laser-lok achieves faster osseointegration and higher bone in-growth*

100

80

% bone in-growth

60

40

grit blasted (titanium alloy) grit blasted (cp titanium)

20
microgrooved

*Osseointegration on metallic implant surfaces: effects of microgeometry and growth factor treatment. Frenkel SR, Simon J, Alexander H, Dennis M, Ricci JL. J Biomed Res. 2002:63(6):706-13.

0 6 weeks

case review

Stuart Froum, DDS New York University

pre-op

2 years post-op

at placement

Cary Shapoff, DDS Fairfield, CT

bone on collar at two years

Cary Shapoff, DDS Fairfield, CT

Male, 68, non-smoker failed endo-fracture immediate extraction placement 3mm gap (facial-palatal) freeze-dried bone, enamel matrix derivative, connective tissue graft 2nd stage surgery 3 mo

one year post-loading

second stage

1 year

courtesy of Cary Shapoff, DDS

Cary Shapoff, DDS, Fairfield, CT

female, high lip line esthetic zone
6 months crestal bone retention at 8 years

8 years
note high bone level on 1mm prototype collar

supracrestal biologic width with Laser-Lok

tissue level at the time of placement

random
bone level at the time of placement

Laser-Lok micro channels

roughened surface

a symbiotic relationship

preserve the bone

preserve the tissue

courtesy of Myron Nevins, DDS

laser-lok is available on

internal, single-stage, tapered internal

summary

Laser-Lok is a series of precision-engineered cell-sized channels laser machined onto BioHorizons implants developed from over 15 years of in vitro, animal and human studies at leading universities only surface treatment shown to establish a physical connective tissue attachment multi-center prospective study showing only 0.59mm of bone loss compared to 1.94mm for traditional implants overdenture study showing only 0.42mm of bone loss compared to 1.13 for Nobel Replace Select 8-year case study showing superior bone & tissue maintenance

thank you

shop online at www.biohorizons.com

MLV144 REV C APR 2010