Intro to Picasso Laser Technology

AMD LASERS

Picasso Laser Technology

Why AMD Lasers?

Introduction to AMD LASERS

• Our mission is to equip every operatory in every dental practice around the world with Picasso laser technology – affordable, high-quality, and innovatively designed laser devices at an unprecedented price point.

• The world leader in providing affordable laser technology to dental professionals around the world.

• Using a combination of innovative design, economies of scale, and lean manufacturing, AMD LASERS ushered in the era of accessible, affordable laser dentistry.

• Picasso laser technology literally transforms a dental practice once it is implemented and put into use.

• Located in Indianapolis, Indiana, with a satellite office in Laguna Niguel, California.

From launch to market leaderAMD’s keys to success:

- Right place, right time- Economies of scale to reduce COGs Economic conditions - Accessible pricing helped soft tissue lasers “cross the chasm”- Strong focus on education & training- Influential opinion leaders insisting on great products at affordable prices2009

2008

50% less expensive than other soft tissue

lasers at the time

Picasso™ launched

DENTSPLY acquires AMD

2011First iPad laser education app

iCLE formed

3 of every 5 soft tissue lasers sold in 2011 is a

Picasso Lite(Source: Internal data, management analysis)

2010

Picasso™ Lite launched

Wireless foot pedal

Disposable laser tips

Bendable tips introduced

#1 in total US market share in just 3 years

2010AMD Lasers 26%

Ivoclar 23%

Biolase 17%

Millennium 12%

Discus/Zap 10%

Sirona 4%

Hoya 3%

Other 4%

2009Ivoclar 27%

Biolase 20%

Millennium 13%

AMD Lasers 9%

Zap 8%

Sirona 5%

Hoya 2%

Other 3%

Late 2008Ivoclar 28%

Biolase 23%

Millennium 19%

Sirona 9%

Hoya 8%

Zap 7%

Other 6%

AMD Lasers 0%

Source: Dentaltown Research, 2008-11, internal data.

2011AMD Lasers 30%

Ivoclar 22%

Biolase 18%

Millennium 12%

Philips Discus 6%

Sirona 5%

Hoya 3%

Other 3%

Strong commitment to education & service

iPad app

Live CE

Online

Surgical manuals

DVD certification

Awards and recognition

Support from lecturers and authors

Online coverage

Why Lasers?

Continuous wave

Output Setting: 3.0 WattsRep Rate: None, since it is in ‘Continuous’ modePulse Duration: N/A (on continuously)Average Power = 3.0 Watts, Peak Power = 3.0 Watts

0 5 10 15 20 sec time

3.0 W

For example:

Gated/Chopped/Pulsed mode

0 0.05 sec

0.1 sec

0.15 sec

0.2 sec

time

3.0 W

1.5 W

Output Setting: 3.0 WattsRep Rate: 10 Hz (Hz = pulses per second)Pulse Duration: 0.05 sec (50 msec) Average Power = 1.5 Watts, Peak Power = 3.0 Watts

For example:

Soft tissue lasers – Indications for use

• Gingival troughing• Gingivectomies• Gingivoplasty• Gingival incision and excision• Hemostasis and coagulation• Excision and incision biopsies• Exposure of unerupted teeth• Fibroma removal• Frenectomy and frenotomy• Implant recovery• Incision and drainage of abscess• Leukoplakia

• Operculectomy• Oral papillectomies• Pulpotomy• Pulpotomy as an adjunct to root

canal therapy• Reduction of gingival hypertrophy• Soft tissue crown lengthening• Treatment of canker sores, herpetic

lesions, aphthous ulcers• Vestibuloplasty• Laser-assisted whitening/bleaching of

teeth• Light activation for bleaching

materials for teeth whitening

Clinical Indications Cleared by the United States Food and Drug Administration

Soft tissue diode laser advantages

• A viable alternative to conventional surgical systems (scalpel, electrocautery, electrosurge) (1).

• Greater precision (2).• Relatively bloodless during and after a surgical procedure (3).• Bacterial reduction in the surgical area (3).• Minimal swelling and scarring (4)• More predictable tissue response; little to no tissue rebound or post-operative

recession (4).• Minimal or no suturing (4).• Less postsurgical discomfort & pain (4).• Safe when used near underlying tooth

and bone structure (4).• Safe when used around metal (6).• Great patient acceptance.• Simple and easy to use.

References1. Liboon J, Funkhauser W, Terris D. Comparison of mucosal incisions

made by scalpel, CO2 laser, electrocautery and constant-voltage electrocautery. Otolaryngol Head Neck Surg 1997;116:379-385.

2. Pick RM, Colvard MD. Current status of lasers in soft tissue dental surgery. J Periodontol 1993;63:586-602.

3. Gold SI, Vilardi MA. Pulsed laser beam effects on gingiva. J Clin Periodontol 1994;21:391-396.

4. Romanos G, Nentwig GH. Diode laser in oral and maxillofacial surgical procedures: clinical observations based on clinical applications. J Clin Laser Med Surg. October 1999;17(5):193-197.

5. Perry D, Goodis HE, Rose CL. Use of the pulsed Nd:YAG laser for intraoral soft tissue. Lasers Surg Med 1991;11:455-461.

6. Walsh LJ. Emerging applications for infrared lasers in implantology. J Periodontol 2002;23:8-15.

Diode laser vs. scalpel

• Many dentists refer any cases requiring surgical removal of tissue with a scalpel to an oral surgeon. A diode laser enables them to retain some or most of these procedures.

• Retained procedures = incremental revenue.• Completing the work in a single visit for the patient = happier patients.• Diode lasers actually have been shown to have faster healing, less swelling

and less discomfort over scalpel wounds (1).• Tissue sliced with a scalpel almost always rebounds; tissue cut with a diode

laser does not (2).

1. Liboon J, Funkhauser W, Terris D. Comparison of mucosal incisions made by scalpel, CO2 laser, electrocautery and constant-voltage electrocautery. Otolaryngol Head Neck Surg 1997;116:379-385.2. Pick RM, Colvard MD. Current status of lasers in soft tissue dental surgery. J Periodontol 1993;63:586-602.

Diode laser vs. electrosurge

• Electrosurge devices have a much larger zone of necrosis and inflammation – up to 500 to 1,000 cell layers of tissue damage vs. 3 to 5 with a diode laser

• Unlike electrosurge devices, a diode laser will cauterize nerve endings, minimizing discomfort intra- and post-operatively (1).

• Tissue treated with a diode laser stays exactly where the clinician leaves it post-operatively; no worry of rebound or recession (4).

Zone of Inflammation

Laser Cut Electro-surgery Cut

Zone of coagulation

Laser cut

Superficial coagulation

Heat dissipation with little/no edema

A soft tissue laser incision at 1000x magnification

Clinical Cases

Getting to Know the Picasso Units

Picasso

• Received FDA approval mid-2009

• 7.0 Watts peak power

• Higher power allows for whitening

• (8) pre-sets

• Touch screen interface

• Multiple languages

• Adjustable aiming beam

• Pulse/Continuous Mode

• 2-year warranty

• Unprecedented versatility, low operating cost, and affordability

Picasso Lite

• 2.5 Watts peak power• (3) pre-sets• Membrane screen with simplified

three-button interface• Adjustable aiming beam• Pulse/continuous mode• 2-year warranty• World’s easiest laser at an

ultra-affordable price point• Perfect for first-time laser dentist

Two types of delivery systems for Picasso laser technology

Strippable fiber used with surgical handpieceMore economical

A fixed fiber that attaches to the laser that uses disposable tips

More convenient

Hands On

LASER safety

• While the unit is very safe there are certain protocol that you must understand and follow.

• For safety there is no compromise!• The lasers are built with safety mechanisms to protect you in case of a

problem.• Examples of these are:

– Key

– Covered footswitch

– Disconnecting plug in back of unit

– When powering on, unit goes to lowest setting first

– Standby mode

– E stop

LASER safety – Protective eyewear

Laser Plume Face MaskProtection from bacterial and viral particles < .1 microns in size.

Infection control from laser plume

Documentation and signage

• Laser warning signs and “Authorized Personnel Only” signs need to be out and in clear view for all to see.

• Chart documentation must be clear and concise• Documentation must include laser type, tooth number, procedure, Watts

used, air/water settings, tip size and HZ and mode if applicable.

Final notes on laser safety

• Dispose of disposable tips and cleaved fibers in the sharps container.• Laser Plume needs to be evacuated during procedures.

– Laser generated air contaminants.• Impairs vision.

• Smells terrible.

• May contain bacteria, viruses and gases.

• Caution should be used when activating lasers around combustible materials and/or gases.

– Nitrous-Oxide.

– Portable Oxygen.

– Aerosol products.

– Alcohol-based materials.