Transcript ezlase Overview

ezlase™ Soft-Tissue, Whitening, and
Pain Therapy System
May 2009
Why compromise on your soft-tissue laser?
Why Buy a Soft-Tissue Laser???
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
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
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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
SOFT-TISSUE PROCEDURES
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
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Optically perfect every time
Single-use, disposable tips can be changed in seconds
No more stripping and cleaving of tips
Diameters from 200-400µm, lengths from 4-14 mm
Bendable for various procedures
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!
Ezlase Procedures for Added Practice Revenue
continued
Ezlase Procedures for Added Practice Revenue
WHITENING
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
How many have performed whitening with the ezlase?
Comparison of TreatmentTimes
Product
Light Source
Treatment Cycle*
[none]
60 min
LED
90 min
NUPRO White Gold
[none]
60 min
Opalescence Xtra Boost
[none]
60 min
Sapphire
Plasma Arc
40 min
Zoom2**
Mercury Metal
45 min
LaserSmile
Diode Laser
40 min
ezlase 940 nm
Diode Laser
20 min
35% H2O2 Gel
BriteSmile
* 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
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
Laboratory Results on Hydroxyapatite Discs
Total Gel
Contact Time
Laser Exposure
Time
Approximate Improvement in
Shade*
LaserWhite10
16.5 min
3 min
9
LaserWhite20
5 min
1 min
13
Gel
* 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%)
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
Another reason for ezlase over all other whitening
modalities?
Another reason for ezlase over all other whitening
modalities?
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
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
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: Highconcentrated carbamide peroxide bleaching agents effects on enamel
surface
Journal of Oral Rehabilitation
Volume 31 Issue 2 Page 155 - February 2004
PAIN THERAPY
Photobiomodulation/LLLT
Bill Brown
VP, International
Background
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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)
Background
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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 proinflammation 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.
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
Clinical Research Examples
27 4/10/2
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)
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.
Temporo-Mandibular Joint Dysfunction
Conventional Treatments
• Non surgical
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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)
Temporo-Mandibular Joint Dysfunction
Treatment Prices and Professional Organizations
• Cost of Treatment
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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
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American Academy of Orofacial Pain (AAOP) ~ 300 members
American Academy of Pain Management ~ 6,000 members
TMJ associations
ezlase 940 nm
Surgical vs. Therapeutic Effects
Surgical
Therapeutic
Surgical laser beam
therapeutic laser beam
Ø=0.2-0.4 mm
Laser Treatment Beam Size:
0.13 cm2
Laser Treatment Beam Size :
2.8 cm2
(x20 larger than surgical tip)
What are the 4 Laser-Tissue Interactions?
ezlase 940 nm
Surgical vs. Therapeutic Effects
Surgical
A concentrated beam of energy is delivered to
tissue via a small diameter 200-400 µm fiber tip,
and upon contact tissue is vaporized and
removed.
Therapeutic
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.
ezlase 940 nm
Surgical vs. Therapeutic Use
Surgical
• 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.
Therapeutic
• 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.
ezlase 940 nm
Therapeutic Mechanisms of Action
• Increased micro-circulation in tissue
• Photo-activation of inactive enzymes (catalysts) present
in painful muscle cells
Swollen Cell
Normal Cell
• Improved cellular functions through
increase of ATP (fuel for the cell) production
in cells
ezlase 940 nm
TMD Clinical Protocol – Therapeutic Settings
Method
Contact Mode
Power Setting (P)
Power Density
contact
2.5 W
0.89 W/cm2
2
contact
4.1 W
1.46 W/cm2
3
non-contact
5.5 W
1.96 W/cm2
= 2.80 cm2 (35 1x 8 mm)
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)
ezlase 940 nm
TMD Clinical Protocol – Treatment Schedule Example
SUN
MON
TUES
WED
WEEK 1
Treatment 1
Treatment 2
WEEK 2
Treatment 3
Treatment 4
WEEK 3
Treatment 5
THU
FRI
SAT
ezlase 940 nm
TMD Clinical Treatment Protocol
Temporalis
Masseter
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Treatment of Painful Trigger Points (Myofacial Pain)
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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 postTreatment of the Joint (TMJ Arthralgia)
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Treat the joint at the three locations provided in the image to the right
Proven Clinical Results!
Proven Clinical Results!
Proven Clinical Results!
Proven Clinical Results!
ezlase 940 nm
Therapeutic Applications - Clinical Benefits
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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
Q&A
EASY TO USE
Touchscreen Interface
Very intuitive, and easy to use
Current power
settings
Touch to
increase
power
Touch to
decrease
power
Touch to change
pulse interval
Touch for continuous
wave or pulsed
mode
Touch to change
pulse length
Current pulse settings
Custom Presets
15 pre-sets available for customization by the clinician
Touch to
access or
change a preset
COMPARISONS
ezlase™ Offers the Most Solutions & Most Portable Power
ezlase
(Biolase)
Picasso
(AMD)
Styla
(Zap)
Odyssey
Navigator
(Ivoclar)
SIROLaser
(Sirona)
DioDent Micro
980
(Hoya)
GENTLERay 980
Premium
(Kavo)
Maximum Power (W)
7
7
2
3
7
3.5
7 CW, 12 pulsed
Battery Power
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Wavelength (nm)
940
810
810
810
980
980
980
Multiple Pulsed Modes
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Customizable Pulsed Modes
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Customizable Pre-Sets
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Whitening
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[1]
Pain Therapy
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[2]
Water Cooling of Tissue
Wireless Foot Pedal
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Finger Switch
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Touchscreen Control
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Disposable Tips
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Bendable
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Various Diameters
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Various Lengths
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Key Strengths
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Most solutions; most
portable power
[1] Whitening is claimed, but not available at time of this printing
[2] Whitening only for a single tooth at a time is available
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Price
Power; Water
Cooling
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Price
Portable; Integrated
System
Portable
Finger Switch
Summary of ezlase™ Specifications
Category
Maximum Power
Output
Wavelength
Value
Benefit
7 Watts, Continuous Wave
• No other portable laser diode has more power
940 nm
• Developed specifically for dental applications
Pulse Length &
Interval
50 µsec to 10 sec, for pulse repetition
rate up to 10 KHz
Size & Weight
3.5”x7.0”x2.5”; 2 lbs
Battery Pack
(sold separately)
ezTips™
Footswitch
Provides power for a typical day of softtissue procedures, plus some whitening
cases
• ComfortPulse™ for efficient cutting and
greater patient comfort
• Hundreds of pulse combinations
• Compact, and true portability
• Eliminates power cord
• Allows optimal placement when in use
• Easy to transport between operatories
Single-use, bendable, many sizes; can be • Reduces chair time
changed in seconds
• More choices for different procedures
Wireless option
• Eliminates cord
• Allows optimal placement
ORDERING INFORMATION
Ordering Information – ezlase™ 940nm Laser
ezlase™ 940 nm Laser
Biolase Part #: 7400001
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
Ordering Information – ezlase™ Accessories
ezlase™ Whitening Handpiece
Biolase Part #: 7400022
Suggested US Retail Price: $1,250
LaserWhite20 Whitening Gel
Biolase Part #: 7400030
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 #: 7400024
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 #: 7400023
Suggested US Retail Price: $295
Ordering Information – ezTips™
All tips sold in boxes of 30
Surgical Tips
Biolase Part #: 7400018
Diameter & Length: 200µm, 4mm
Suggested US Retail Price: $250
Perio Tips
Biolase Part #: 7400020
Diameter & Length: 300µm, 7mm & 9mm
Suggested US Retail Price: $250
Biolase Part #: 7400017
Diameter & Length: 300µm, 4mm
Suggested US Retail Price: $250
Biolase Part #: 7400019
Diameter & Length: 400µm, 7mm & 9mm
Suggested US Retail Price: $250
Biolase Part #: 7400016
Diameter & Length: 400µm, 4mm
Suggested US Retail Price: $250
Endo Tips
Biolase Part #: 7400021
Diameter & Length: 200µm, 14mm
Suggested US Retail Price: $299
Thank You.
APPENDIX
ezlase Solutions for the Top 7 Soft-Tissue Dental Challenges
Procedure
Clinical Images
Challenge
Solution
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Referral/Pt. Compliance
Local Anesthetic
Extended Treatment Time
Improper Bracket Location
Post-op Sensitivity
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In-office Procedure
Topical Anesthetic
Accelerated Treatment
Proper Bracket Location
Decreased Post-op Sensitivity
Frenectomy
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Referral/Pt. Compliance
Local Anesthetic
Zone of Necrosis
Sutures
Post-op Discomfort
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In-office Procedure
Topical Anesthetic
Minimal Collateral Tissue Damage
No Sutures/Laser Band-aid
Minimal Post-op Discomfort
Gingival Recontouring &
Hyperplastic Tissue
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Referral/Pt. Compliance
Biologic Width Violation/Flap
Zone of Necrosis
Extended Treatment Time
Post-op Discomfort
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In-office Procedure
Minimally Invasive
Minimal Collateral Tissue Damage
Accelerated Treatment
Minimal Post-op Discomfort
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Recurrent Perio after SRP
Referral
Flap Surgery
Impaired Access & Field of Vision
Extended Treatment Time
Post-op Discomfort
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Decreased Occurrence
In-office Procedure
Minimally Invasive
Improved Access & Field of Vision
Faster Healing
Minimal Post-op Discomfort
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Packing Cord
Extended Treatment Time
Impression Re-takes
Post-op Discomfort
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No Cord Required
Accelerated Treatment
Decreased Impression Re-takes
Minimal Post-op Discomfort
Uncovering Unerupted
Tooth
Pre-op
Pre-op
Post-op
Post-op
Laser Curettage /
Sulcular Debridement
Troughing for C&B
Impressions
Pre-op
Impression
Aphthous Ulcers &
Herpetic Lesions
Aphthous Ulcer
 N/A
 Immediate Pain Relief
 Reduced Healing Time
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Herpetic Lesion
Operculectomy
Pre-op
 Rx
 Prolonged Discomfort
 Extended Healing Time
Post-op
Referral/Pt. Compliance
Caries
Local Anesthetic
Zone of Necrosis
Sutures
Post-op Discomfort
In-office Procedure
Prevent Caries
Topical Anesthetic
Minimal Collateral Tissue Damage
No Sutures/Laser Band-aid
Minimal Post-op Discomfort
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
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
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.
1.Apply liquid dam to the gingiva, and cure with a standard curing light
2.Mix the activator and base gels by connecting the two syringes together and pushing the gels back and forth
3.Apply a thin layer of the mixed gel with a brushed applicator tip to each quadrant of teeth
4.Ensure that the doctor, patient, and all persons in the room wear protective eyewear before starting the laser
5.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
6.Deliver 200 Joules of laser energy at 7 Watts to the quadrant (~30 seconds), and then repeat for all quadrants
7.Repeat step 6 one more time
8.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
9.Replace the brushed applicator tip with a new one, and repeat Steps 3 through 8 one more time
10.Remove liquid dam
Mixing activator & base gels
Liquid dam on
gingiva
Brushed
applicator tip
Applying gel to
teeth
Delivering laser
energy
Removing gel from
teeth
Gel Application 1
Laser Cycle 1
Quadrant 1
Gel Application 1
Laser Cycle 1
Quadrant 2
Gel Application 1
Laser Cycle 1
Quadrant 3
Gel Application 1
Laser Cycle 1
Quadrant 4
Gel Application 1
Laser Cycle 2
Quadrant 1
Gel Application 1
Laser Cycle 2
Quadrant 2
Gel Application 1
Laser Cycle 2
Quadrant 3
Gel Application 1
Laser Cycle 2
Quadrant 4
Gel Application 1
Resting Time
Repeat Same Steps for
Gel Application 2