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GUIDED BIOFILMTHERAPYCARIES AND PERIO PREVENTION AND MAINTENANCEREvidence-basedprotocols forbiofilm managementon teeth, softtissues and implants.2019MAKE ME SMILE.

MINIMALLY INVASIVEMAXIMALLY PREVENTIVE1AIRFLOW PERIOFLOWMAKE ME SMILE. PIEZONPSMAKEME SMILE.MAKE ME SMILE.1. MAKE BIOFILM VISIBLE2. AIRFLOW FIRST3. PS INSTRUMENT FOR REMAINING CALCULUS4. LESS POWDER AND HAND INSTRUMENTS5. NO MORE RUBBER CUPS, NO MORE PASTE1 Throughout this document, NO PAIN applies when used in accordance with EMS instructions and/or training by the Swiss Dental Academy.2

GBT - THE NEWAND MODERN WAYRONLY THE VERY BEST FOR MY PATIENTSONLY THE SWISS ORIGINALS3

ABOVECVALINGIGRA-ENAMEL JUNTONCETEMIONSUPGBT SAVES TEETH, IMPLANTS22APPLICATIONSSUPRA&OF GBTSUBGINGIVALIVALGINGBSUOSED SUBALGIVGINCATIONSFUROT9MMIMPLANTSDNUROSUPRA &IN ROPLANTSMIDUN3MM

AND MUCH MORERND BRACKAROUETSUND BRACKETSORAPSRON PRIMARY TEETINTERDENTALDFITS AN ISSURESPINE AND PALATENGUOTPOSITE RESE COMTORROAEFONRRESTORATIONSONNSTIOORE BLEACHINGFEBBHPRIMARY TEETHONATIONSROTES5

THE GBT COMPASS AND ITS08 RECALLHEALTHY PATIENT HAPPY PATIENTSchedule recall frequencyaccording to risk assessmentAsk your patient if heor she liked the treatment07 CHECKMAKE YOUR PATIENT SMILEDo a final check for remaining biofilmEnsure calculus is fully removedAccurately diagnose cariesProtect with fluoride06 PIEZON REMOVE REMAINING CALCULUSUse the minimally invasive EMSPIEZON PS Instrument supra- andsubgingivally up to 10 mmClean 10 mm pockets with mini curetteUse EMS PIEZON PI Instrumentaround implants up to 3 mmsubgingivally and on restorations05 PERIOFLOW REMOVE BIOFILM IN 4 TO 9 MM POCKETSUse AIRFLOW PLUS Powderon natural teeth in deep pockets and rootfurcations and on implantsUse new and slimmer PERIOFLOW Nozzle6

8-STEP PROTOCOLR01 ASSESSPROBE AND SCREEN EVERY CLINICAL CASEHealthy teeth, caries,gingivitis, periodontitis   Healthyimplants, mucositis, peri-implantitisStart by rinsing with BacterX Promouthwash02 DISCLOSEMAKE BIOFILM VISIBLEHighlight to patients the disclosedbiofilm and their problematic areaswith EMS Biofilm DiscloserThe color will guide biofilm removalOnce biofilm is removed, calculusis easier to detectR03 MOTIVATERAISE AWARENESS AND TEACHEmphasize preventionInstruct your patientsin oral hygiene   EMS recommendsPhilips Sonicare toothbrushes,interdental brushes andAirfloss Ultra04 AIRFLOW REMOVE BIOFILM, STAINSAND EARLY CALCULUSUse AIRFLOW for natural teeth,restorations and implants   Remove biofilmsupra- and subgingivally up to 4 mmusing AIRFLOW PLUS 14 μm PowderAlso remove biofilm from gingiva, tongueand palate    Remove remaining stainson enamel using AIRFLOW CLASSICComfort Powder7

THE AIM OF GBT ISGINGIVITISEMS Biofilm Discloser visibly reveals thepresence of early and mature biofilm.The sulcus area (gingival margin) showsmature biofilm due to an inappropriatebrushing technique leaving biofilm untouched.In this case, GBT was limited to AIRFLOW PLUS Powder up to 3mm. Some bleeding from the gingivalmargin (red line) indicates low-grade gingivitis. GBT fosters thepatient’s motivation to use correct tooth brushing techniques.BEFORE DISCLOSINGGBT prevents and treats gingivitisBEFORE DISCLOSINGCARIES DETECTIONAccurate caries detection requires cleanteeth. Here, the EMS Biofilm Discloser showsthe presence of biofilm, interdentally as wellas at the gingival margin. Finally, GBTreveals interdental caries at an advancedstage.GBT helps detect caries with precision.No more biofilm: No more caries.BEFORE DISCLOSINGIMPLANTSIn this sequence of peri-implantitis,AIRFLOW removes supra- and subgingivalbiofilm up to 4mm. The EMS BiofilmDiscloser helps to minimize treatment time.PERIOFLOW removes biofilm in periimplant pockets up to 9mm. Finally, thePIEZON PI Instrument removes the remaining calculusaround the implant.GBT contributes to the treatment of peri-implantitis in aminimally invasive way.8AFTER DISCLOSING

TO ELIMINATE ALL BIOFILM ON TEETH,IMPLANTS AND SOFT TISSUES.AFTER DISCLOSINGAFTER GBTAFTER DISCLOSINGAFTER GBTRPhotos: Courtesy, Prof. Magda MensiAFTER DISCLOSINGAFTER GBTPhotos: Courtesy, Beverly WatsonAIRFLOW PERIOFLOW PIEZON Photos: Courtesy, Prof. Magda Mensi9

BEFORE DISCLOSINGGUIDED BIOFILM THERAPYCHILDRENIn this case, using a 2-tone disclosing agentvisibly reveals cariogenic biofilm and helpsmotivate the young patient.Children love AIRFLOW – it is “cool” andthey lose the fear of the treatment.The pain-free GBT method motivateschildren and helps prevent caries.BEFORE DISCLOSINGORTHODONTICSOrthodontic appliances are a challenge for patientsand professionals performing biofilm management.Using a 3-tone disclosing agent reveals cariogenicbiofilm (pH 4,5) in areas difficult to access duringhome care and helps to motivate the young patient.AIRFLOW PLUS Powder during GBT revealsdemineralized white spots which were impossible to identify before.GBT prevents caries during orthodontic treatment.GBT maintains orthodontic appliances.BEFORE DISCLOSINGEXPOSED DENTINEBiofilm and calculus removal on exposed dentinesurfaces is usually critical in terms of patientcomfort (dentine hypersensitivity) and risk ofover instrumentation. The disclosed biofilmhelps to minimize AIRFLOW treatment andto save time. No more color (of the disclosingagent) - no more biofilm. AIRFLOW PLUS Powder andPIEZON NO PAIN with PS Instrument are the bestassurance for high quality and painfree treatments.GBT preserves exposed dentine preventing sensitivity.BEFORE DISCLOSINGSTAINS AND CALCULUSAIRFLOW removes stains and facilitatesfurther calculus removal with PIEZON PSInstrument,minimizingpowerinstrumentation.GBT will make your patient smile again.BEFORE GBT10

AFTER DISCLOSINGAFTER GBTMORE CASESAFTER DISCLOSINGRAFTER GBTPhotos: Courtesy, Dr. Gleb AseevAFTER DISCLOSINGAFTER GBTPhotos: Courtesy, Dr. Gleb AseevAFTER DISCLOSINGAFTER GBTPhotos: Courtesy, Prof. Magda MensiAFTER GBTAFTER GBTCourtesy of Beverly Watson11

WHY GBT IS THE.Dental biofilm is the main etiological factor for caries, periodontitis and peri-implantinfections. Periodontitis may increase the risk of systemic diseases, such as cardiovascularand respiratory disorders, arthritis or diabetes.Regular oral hygiene, combined with professional measures, keeps biofilm under control –for a better oral and systemic health. Axelsson and Lindhe pioneered preventive dentistry inthe 1970‘s with studies and clinical protocols based on prophylaxis in “recall hours”.1–2GBT follows the recommendations on Professional Mechanical Plaque Removal (PMPR)and Oral Hygiene Instructions (OHI) for Home Care issued by the European Federation ofPeriodontology (EFP).3–5 .“Periodontal Health for a Better Life!”PROFESSIONAL TOOTH CLEANING PATIENTS DO NOT LIKE IT ANDCAN BE A PAINFUL EXPERIENCE OFTEN STAY AWAY FROM RECALLSBEFORE DISCLOSINGAFTER DISCLOSINGThis shows that dental biofilm is not always visible.1surfacesRemoving calculus with hand instruments can often be painful for the patients. Dentaland implants often will be scratched.2WithPolishingwith rotary rubber cups and brushes is time-consuming and often messy.many areas not reachable, the gingiva will be affected mechanically. Dentalhygienists and assistants know that traditional cleaning may be a painful experience.For this reason, patient compliance is not often very high. Now, almost fifty years later,it is time for change.1. Axelsson P. Preventive Materials, Methods and Programs: Quintessence Publishing, 2004. 2. AxelssonP, Nystrom B, Lindhe J. The long-term effect of a plaque control program on tooth mortality, caries andperiodontal disease in adults. Results after 30 years of maintenance. Journal of Clinical Periodontology2004;31:749-757. 3. Tonetti MS, Chapple ILC, Jepsen S, Sanz M. Primary and secondary preventionof periodontal and peri-implant diseases. Journal of Clinical Periodontology 2015;42:S1-S4. 4. TonettiMS, Eickholz P, Loos BG, Papapanou P, van der Velden U, Armitage G, et al. Principles in prevention ofperiodontal diseases. Journal of Clinical Periodontology 2015;42:S5-S11. 5. Sanz M, Bäumer A, BuduneliN, Dommisch H, Farina R, Kononen E, et al. Effect of professional mechanical plaque removal on secondaryprevention of periodontitis and the complications of gingival and periodontal preventive measures. Journalof Clinical Periodontology 2015;42:S214-S220.12

GAME CHANGERRGBT IS THE NEW AND PATIENT ORIENTED CONCEPT1areBeforeremoval, biofilm is always disclosed with a dye solution. Biofilm and early calculuseasily removed with AIRFLOW and PERIOFLOW – supra- and subgingivally.2 If needed, this is followed by debridement with PIEZON PS NO PAIN piezoceramic instruments.3toothGuidedBiofilm Therapy means that the clinician is guided by the disclosed biofilm duringcleaning procedures.4Guided Biofilm Therapy is truly minimally invasive and reduces the need for hand andsonic/ultrasonic instrumentation. It is safe, effective and gentle to teeth and soft tissues, implants and restorations.1–45ThisGBTis very comfortable for patients and practitioners. It is efficient and timesaving.also valid for primary caries and perio prevention in children and teenagers.56SMILE IS INTHE AIR6– andGBTto ismakepart of a comprehensive preventive concept – to preserve your patients’ oral healththe patients feel good.7polishingSince 1982 EMS has provided dental practices all over the world with AIRFLOW airand PIEZON PS NO PAIN piezoceramic scaling technology.8particleIn 2012 EMS added the high-tech erythritol-based AIRFLOW PLUS Powder with asize of only 14 μm.9cooperationGuided Biofilm Therapy is based on clinically proven technologies invented by EMS. It was developed inwith highly respected and experienced periodontologists, caries specialists and dental hygienists.10GBT is a systematic, predictable, risk-oriented and user-friendly treatment for all agegroups and each individual patient. 1. Wennstrom JL, Dahlen G, Ramberg P. Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonicinstrumentation during maintenance therapy. Journal of Clinical Periodontology 2011;38:820-827. 2. Ronay V, Merlini A, Attin T, etal. In vitro cleaning potential of three implant debridement methods. Simulation of the non-surgical approach. Clinical Oral ImplantsResearch 2017;28:151-155. 3. Bühler J, Amato M, Weiger R, Walter C. A systematic review on the effects of air polishing devices onoral tissues. International Journal of Dental Hygiene 2016;14:15-28. 4. Barnes CM, Covey D, Watanabe H, et al. An in vitro comparisonof the effects of various air polishing powders on enamel and selected esthetic restorative materials. The Journal of Clinical Dentistry2014;25:76-87. 5. Aslund M, Suvan J, Moles DR, et al. Effects of two different methods of non-surgical periodontal therapy on patientperception of pain and quality of life: a randomized controlled clinical trial. Journal of Periodontology 2008;79:1031-1040. 6. O‘HehirTE. How subgingival air polishing will turn dental hygiene upside down. Interview with Prof. Dr. Thomas Flemmig. dentaltown.com2014:94-96. 7. Flemmig TF, Arushanov D, Daubert D, et al. Randomized controlled trial assessing efficacy and safety of glycine powderair polishing in moderate-to-deep periodontal pockets. Journal of Periodontology 2012;83:444-452.13

PROBABLY THE BEST PROFESSIONAL1. WHY MAKE BIOFILM VISIBLE?With GBT we intend to eliminate all the biofilm, includingareas which are difficult to access.If biofilm is made visible, it is removed much faster with GBT.What you see is what you remove.Color removal Biofilm removal. Also on soft tissues.The users of hand instruments, rubber cups and “polishing”paste do not like to disclose biofilm as they would need much moretime to finish the treatment.The German Stiftung Warentest reported that the conventionalprophylaxis only removes 50% of Biofilm in the difficult to access areas.Colored teeth and gums will also help motivate the patient toimprove their homecare – OHI.This 14 year old patient has a significant lack of oral hygiene.Disclosing agent reveals massive acidogenic biofilm.Courtesy, Dr. Gleb Aseev2. WHY AIRFLOW FIRST?AIRFLOW removes biofilm, stains and colorations first as well as the thinlayers of early forming calculus. Now you will see the remaining calculus betterand it will be easier to eliminate it with the PIEZON NO PAIN PS Instrument.With GBT the removal of calculus in supra- and subgingival areas is easier,faster and truly minimal invasive.This pain free and comfortable GBT treatment method, if done correctly bytrained GBT dental professionals will help create happy and loyal patients for yourrecall practice.AIRFLOW CASH FLOW.14

TOOTH CLEANING EVER.R3. WHY ONLY THE PS INSTRUMENT?The PIEZON PS (Perio Slim) Instrument is slim and smooth like a probe.It is gum-friendly, minimally invasive, maximally preventive and preserves theepithelium due to its absolute linear movements.By using only one instrument to do 95% of the work, things will be easier.For the 5% that remain we recommend our new curved PIEZON PSL and PSR(Perio Slim Left and Right) Instruments. The PIEZON PS Instrument gives theclinician a good haptic and secure feeling when working subgingival.THE GLASS PLATE TEST:Touch the glass plate with the PS instrument on its side as shown on the left, set thePiezon to medium power, apply gentle pressure, turn on the spray and you won’t hearanything – acoustic proof that you have the right instrument in your hand.Now allow a small lump of dental cement to harden on the glass plate. Then lay theinstrument to one side on the glass plate as in the previous test and guide it towardsthe “tartar”. You will notice that it disappears instantly. That is precisely whatmakes it so different from other instruments which do not move in such a controlledand consistent fashion.The treatment with the PS instrument is Pain Free if used the correct way.A Pain Free and pleasant treatment is the dream of every patient.This is the key for patient loyalty and satisfaction.The cost of a PS instrument is only 5 cents per treatment and per patient!It is absolute nonsense to buy copy or “compatible” tips.If EMS handpieces get damaged (e.g. the thread) with a “compatible“ tip you willlose your EMS warranty.The PIEZON PS Instrument, the PIEZON Handpiece and the PIEZON NO PAINelectronic module were made/matched for each other. This Trilogy works in harmony.4. WHY NO MORE „POLISHING“ PASTE?TOOTH ENAMEL x2000BEFORE CLEANING,TOOTH ENAMEL x2000TOOTH ENAMEL x2000AFTER „POLISHING“ WITH AFTER CLEANING WITHRESIDUAL BIOFILMLOW-ABRASIVE PASTE RDA 27 AIRFLOW PLUS POWDERThe enamel prisms of thenatural tooth enamel areeasily recognizable.The photo shows the remnantsof the bacteria killed off withsodium hypochlorite.1The vital enamel prisms havebeen „polished“ away. Pasteshave caused scratches. Biofilmhas spread into natural crevices.Overall abrasive pastes causea loss of valuable enamel. Noimprovement of the dentalsurface.1The biofilm has been removedwith AIRFLOW . The surfaceis clean down to the pores. Noabrasion. The enamel prismsremain intact and the surface isperfectly smooth.The tongue no longer feels anyroughness - no need to „polish“with abrasive paste. Save enameland treatment time.11 Camboni S, Donnet M. The Journal of Clinical Dentistry 2016;27:13-18.15

ONE POWDER ONLYFOR 90% OF ALL CASESROPTIMAL COMFORTMINIMALLY INVASIVEMAXIMALLY PREVENTIVETEETHPrimary and permanent teethInterdental spacesCrowded teethExposed dentinePits and fissuresDemineralized enamelCARIES MANAGEMENTBefore caries detectionBefore sealingBefore fluoridationSOFT TISSUESSulcusShallow pockets up to 4mmDeep pockets 4 to 9mmTongue and palateORTHODONTICSOrthodontic bracketsPatients with InvisalignAESTHETIC DENTISTRYCrowns and veneersBefore placing restorationsBefore bleachingIMPLANTSPeri-implant sulcusDeep peri-implant pockets.16

ONE INSTRUMENT ONLYFOR 95% OF ALL CASESOPTIMAL COMFORTMINIMALLY INVASIVEMAXIMALLY PREVENTIVESUPRAGINGIVALPrimary and permanent teethBest interproximal access1Crowded teethExposed dentineSUBGINGIVALSulcular depositsPreserves the epitheliumPockets up to 10mmORTHODONTICSAround orthodontic brackets1 Clinical Reasearch Associates, Newsletter.17

THE SWISS ORIGINAL.THE AIRFLOW PROPHYLAXIS MASTER1GOODDESIGNTHE CHICAGOAT H E N A E U M2018The original from the Inventor. Guaranteed Swiss precision andsuperb design. Highest performance, reliability and know-how.Experts in prophylaxis since 1981.1 GOOD DESIGN , one of the most important design awards in the world from the Chicago Athenaeum Museum of Architecture and Design.18

THE SWISS MASTER.RTHE PROPHYLAXIS STATIONThe Swiss-Made AIRFLOW Prophylaxis Master wasdeveloped at the EMS Research Centre with more than100 000 hours of technical and clinical testing in collaborationwith leading dental professionals worldwide.19

04 AIRFLOW AIRFLOW REMOVES BIOFILM, STAINS & EARLY CALCULUS.CLEANS AND POLISHES AT THE SAME TIME.After the use of AIRFLOW no extra polishing with rubber cups/paste isnecessary any more.Dental practices using AIRFLOW and GBT have more and happier recall patients.Professional prophylaxis is becoming an important economic factor.1AIRFLOW removes biofilm and early calculus in all these situations.It also cleans the gingival or peri-implant sulcus to a depth of 4mm.2–4At the same time AIRFLOW is fast, efficient and comfortable for the patient.Fine tune the air pressure/power for all clinical situations.1. O‘Hehir TE. dentaltown.com 2014(1):94-96. 2. Patil SS, et al. J Intern Soc Prev & Commun Denti2015;5:457-462. 3. Flemmig TF, et al. J Periodontol 2007;78:10021010. 4. Botti RH, et al. Eur J Paediatr Dent 2010;11:15-18.20

-ENAMEL JUNTONCETEMSUBGINGIVALUND BRACKETSAROOSED DENTINEEXPE AND PALATENGUOTPRIMARY TEETHONINTERDENTALDFITS AN ISSURESPINPOSITE RESE COMTORROAEFARESTORATIONSONNSTIOORE BLEACHINGBEFBIONABOVECTHE MULTITASKERRMPLANTSND IURO4MM21

AIRFLOW POWDERS STUDY FROM BARNES, ET AL J CLIN DENT 2014, 25-76-87 ON POWDER ABRASITIVITY.Objective: The purpose of this study1 was to investigate the effects of each of the commercially available airpolishing powders on the surface characterization of human enamel, hybrid composite, and glass ionomerusing a highly standardized protocol. The air polishing powders utilized in the study included aluminumtrihydroxide, calcium carbonate, calcium sodium phosphosilicate, glycine, and sodium bicarbonate.THERE ARE DAMAGING POWDERS IN THE MARKETBased on the results of this study, the air polishing powders that are compatible with use on hybridcomposite and glass ionomer cements are EMS glycine and EMS sodium bicarbonate. The air polishingpowders that are compatible for use on enamel include EMS glycine, Dentsply sodium bicarbonate,and EMS sodium bicarbonate. In the study a particle size of 65μm of the EMS powder was used.Since 2013, EMS has reduced the particle size of its Comfort sodium bicarbonate Powder to only 40μm.“The results of this research indicate that there are air polishing powders that are significantly less abrasivethan others, even with similar ingredients,specifically sodium bicarbonate.“Please read the full study, justdownload the QR code below.ERYTHRITOL 14μm PLUS POWDERToday, EMS offers an even bettererythritol based prophylaxis powder,which enables supra- and subgingivaltreatment with superior comfort andefficiency than glycine powder.OSSPRAYCALCIUM SODIUM 1PHOSPHOSILICATEEMS AIRFLOW PLUS 2POWDER ERYTHRITOLEMS SODIUMBICARBONATE3EFFECT OF 5 SEC AIR POLISHING ON HUMAN ENAMELEFFECT OF 5 SEC AIR POLISHING ON GLASS IONOMER1. Barnes CM, et al. J Clin Dent 2014;25:76-87. 2. For AIRFLOW PLUS Powder, complimentarytests have been submitted to the J Clin Dent (Barnes CM, et al.). 3. Barnes CM, et al. J ClinDent 2014;25:76-87. The EMS sodium bicarbonate had a particle size of 65 μm. New PowderAIRFLOW CLASSIC Comfort has 40 μm particle size, for more smoothness and patient comfort.22Download full study

EMS POWDER GUIDERWith 2 chemical laboratories in Germany and Switzerland, EMS is the only company producingits own powder. With 35 years of clinical research and testing, many scientific studies and millions ofpatients treated, EMS recommends the following 2 powders for all clinical cases.RECOMMENDEDOTHER EMS EGLYCINEParticle size 14μm 40μm 65μm 65μm 25μm 7 8.1 8.1 6 6pHStains and early calculusEnamelTeethEnamel white spotsPits and fissuresDentineSoft tissuesRestorationsGingivaTongue and palateHybrid compositeGlass ionomerImplants.and peri-implant tissuesOrthodonticsBrackets and appliancesBeware of so-called „EMS compatible“ powders in the market,which can damage oral tissues and the device. See here anozzle completely damaged by such aggressive powders.Use only EMS powders with your EMS devices.The use of not authorized powders by EMS will result in a loss of warranty.23

05 PERIOFLOW RNEW PERIOFLOW NOZZLESubgingival biofilm removal (debridement) in 4 to 9 mm periodontal1and peri-implant2 pocketsInitial and follow-up (SPT) periodontal therapy 3Prevention of mucositis / peri-implantitis4Initial and follow-up treatment of mucositis / peri-implantitis53POWDERSPRAYS water rinsing1. Sculean A, et al. Quintessence Int 2013;44:475-477. 2. Schwarz F, et al. Quintessence Int2016;47:293-296. 3. Flemmig TF, et al. J Periodontol 2012;83:444-452. 4. Muller N, et al. J ClinPeriodontol 2014;41:883-889. 5. Riben-Grundstrom C, et al. J Clin Periodontol 2015;42:462-46924

FIRST TO GO SUBGINGIVALRNEW PERIOFLOW NOZZLEEMS invested in research on safety matters before it decided to offer the subgingivalPERIOFLOW application.EMS‘ main concern was to limit risks of emphysema.In 2019 at IDS, EMS will offer for sale the third generation new PERIOFLOW exchangeablenozzle - slimmer, safer and easier to use.9 mm7 mm5 mm3 mmThe new PERIOFLOW Nozzles are thinner and more flexible and able to adapt to thetopography of periodontal/peri-implant pockets. A pressure release groove limits pressure inperiodontal/peri-implant pockets.PERIOFLOW APPLICATIONS9MMPERIODONTAL POCKETSPLANTSMIDUNIN RO9MMPERI-IMPLANT POCKETSCATIONSFUROTAROGINGIVALBUSROOT FURCATION25

06 PS INSTRUMENTAFTER USINGAIRFLOW ,REMOVE REMAININGSUPRA- AND SUBGINGIVALCALCULUS WITH THE PIEZON NO PAIN1 PS INSTRUMENT.Linear movement of the PS Instrument no damage to tooth surfaces and soft tissues.Minimally invasive with regard to root cementum.Dynamic power setting.“EMS PS (Perio Slim) Instrument delivers the bestinterproximal and subgingival access.”2Patients will be surprised as the treatment withthe PIEZON PS Instrument will be entirely Pain Freewhen used in the correct way by Dental Professionals.1. NO PAIN: when used in accordance with EMS instructions and/or the training by the SwissDental Academy.2. CRA, Clinical Research Associates, USA. Newsletter June 1998.26

95% OF ALL CASESRAFTERPIEZON AFTERAIRFLOW PHOTOS: COURTESY, PROF. MAGDA MENSICALCULUS REMOVAL WITH EMS PIEZON PS INSTRUMENTEMS PSPERIO SLIMINSTRUMENTIVALGINGBSUON PRIMARY TEETHSUPRA&PS - THE ONE AND ONLY10MMIS INDICATED FOR 95%OF ALL CASES.27

07 CARIES CHECKCARIES DETECTION REQUIRES CLEAN TEETHThe following dental surfaces are most at risk for caries1,2:1 - Occlusal.2 - Approximal.3 - Cervical areas.123In these areas:GBT helps effectively remove the biofilm and preventcaries in a minimally invasive way.At an early stage of demineralization, caries is often hard to detect even with X-rays. Biofilm andcalculus may conceal them. The International Caries Detection and Assessment System - ICDAS(2011) underscores the importance of „clean and dry“ surfaces for accurate detection.1 OCCLUSALBEFORE GBTThe caries is not detectable2 APPROXIMALBEFORE TREATMENTCarious lesions may be hiddenAFTER GBTDentine caries is revealedCOURTESY, PROF. DENT. HERVÉ TASSERY , MARSEILLE/FRANCEAFTER GBTLesions are fully visible on clean teethCOURTESY, DR. WOLFGANG GUTWERK ASCHAFFENBURG/GERMANY3 CERVICALBEFORE GBTIn this case: biofilm, no white spot.AFTER GBTIn this case: white spots are revealed.COURTESY, PROF. DENT. ADRIAN LUSSI , BERN/SWITZERLAND28

AND EARLY TREATMENTR14µm PLUS POWDER AND EARLY TREATMENTBEFORE GBTDISCLOSEDAIRFLOW MAGNIFIEDSEALEDCOURTESY, PROF. DENT. HERVÉ TASSERY , MARSEILLE/FRANCEThe width of occlusal fissures of cavities is often less than 100μm. This is less than toothbrushbristles and any hand instrument.Disclosing AIRFLOW sequence supporting early caries treatment:After an initial biofilm disclosure, the fissure is cleaned with AIRFLOW PLUS 14μm Powder.If needed, enlarge the fissure with 40μm CLASSIC Comfort Powder and polish with PLUS Powder.Burs can be used selectively 2 in addition to AIRFLOW if the lesion is still present.Clean with AIRFLOW erythritol prior to sealing enables optimal adhesion.DFITS AN ISSURESIN POMPOSITE RESTRE CORAEFONSTIOBAIRFLOW BEFORE COMPOSITE Y, PROF. DENT. HERVÉ TASSERY , MARSEILLE/FRANCE29

EMS AND PHILIPS COOPERATECLEAN TEETH,Philips and EMS have decided to combine forces to improve the oral health ofpatients as any successful Prophylaxis is based on two pillars: Homecare andProfessional Oral Care.Professional prophylaxMany years ago both companies envisioned the future importance of Preventionand Prophylaxis and consequently focused their efforts to continue offering betteroral healthcare – Philips for Dental Care at Home and EMS for Dental Professionals.01 INTERDENTAL CLEANING0102 TOOTH CLEANINGpsPhilie HomecarinoSmlfiBio ementagMan03 TONGUE CLEANING0704 MOUTHWASH30REC

TO IMPROVE ORAL HEALTHR, HEALTHY LIFEGBT is a modern clinical protocol for Professional Tooth Cleaning. Philips joinsGBT with its Homecare Oral Hygiene Consultation.many yearsand EMS have been leaders in oral healthcare,xis in Forpractice& Philipsat homeso today’s cooperation was predictable and logical.This will help Patients and Dental Professionals to maintain and to improveoral health daily in a modern, efficient, gentle and pain-free way. In the spirit of:„Healthy Mouth - Healthy Body“02 DISCLOSEASSESS03 MOTIVATE04 AIRFLOW RCALL05 PERIOFLOW 7 CHECK06 PIEZON 31

GBT IS COOL.*“I do not want to do withoutAirflow technology or airpolishing in my everyday work.Gentle on substance, clean,pleasant for patients andquicker, particularly in theinterdental spaces. Theresults are accordingly good.Less inflammation, and thetooth necks are no longersensitive after treatment.”PETRA NATTER,DENTAL HYGIENIST“I’m so happy with GBT, Icould not accept any othertooth cleaning methodanymore. Due to GBT I seemy dentist regularly andgladly for my prophylaxis.And each time I leave theoffice I’m happy with myclean and brilliant whitesmile! To me prophylaxiswith GBT has become agreat experience and Idearly recommend it!”SABINE PAVICIC, PATIENT“The devices of the company EMS helped usvery much to simplify the procedure protocolof our “prophylaxis sessions”, to make itmore gentle on substance and more patientfriendly (less pain). After more than 3years, prophylaxis has become atechnically and economically veryimportant part of our dental practicethanks also to the scientific andtechnical competence (e.g. NO PAINwith PS tip, PLUS Powder) of EMS.”DR. NADINE STRAFELA-BASTENDORF,DENTIST“Due to the small particlesize of the product, especiallythe Plus powder, there ispractically no traumaticgingivitis anymore We wereable to increase turnover inthe area of prophylaxis byapprox. 50 percent from 2015to 2016, which is surely alsodue to the now much morepleasant treatment.The reactions were positivewithout exception.”DIRK PALME, DENTIST“Patients started to book in particularly withme. They thought I was more gentle than theother hygienists and their mouths were feelingbetter than ever.The bosses had also noticed a seemingly higherstandard of treatment being delivered withlower bleeding scores and cleaner mouthscoming from my surgery.They thought it was me. They thought I wasmore skilled. A better motivator.An exceptional communicator.It wasn’t me. It was the AIRFLOW .”FAYE DONALD, BEST UK DENTAL HYGIENIST 2014AND 201732“With the EMSdevices, we canmotivate ourpatients in terms ofprophylaxis. Througha pleasant feeling inthe mouth –WELLNESS factor.Removal of stains –BEAUTY factor.100% plaque removal –HEALTH factor.”MICHAELA GRUL

PATIENTS AND USERS ARE FANSREARS) WOLF“AIR OOL IS C ERSUP L.”COOYER (9 YMORRIS ME33

CLINICAL EVIDENCE01 ASSESSAnamnesis: review the case history1 of your patient and raise awareness of cariespromoting and reducing factors2.Pre-rinse with BacterX Pro3.After patient and clinician preparation4, perform the periodontal probingand screening5.02 DISCLOSEApply disclosing solution6,7, then rinse with water.03 MOTIVATEShow your patients the disclosed biofilm6,7 and provideappropriate oral hygiene instruction6.EMS recommends Philips Sonicare8,9.04 AIRFLOW Remove stains10, biofilm11,12 and early calculus supra- and subgingivally up to 4mm on natural teeth13, implants14, restorations,orthodontic brackets13, dentine15 and soft tissues16,17,18.05 PERIOFLOW Remove biofilm in 4-9 mm periodontaland peri-implant pockets11,17,18,19.06 PIEZON Remove calculus20,21 on naturalteeth up to 10 mm subgingivally22,23 with PS Instrument NOPAIN*24 and on implants up to 3 mmsubgingivally with PI Instrument.07 CHECKCheck for any remaining biofilm, stainsand calculus. Diagnose caries2 andother dental hard-tissue defects, protectwith fluoride25 and inform the patienton personal preventive measures26.08 RECALLSchedule next recall appointmentadapting recall frequency toindividual risk27,28.1. NO PAIN applies when used in accordance

In this case, GBT was limited to AIRFLOW PLUS Powder up to 3mm. Some bleeding from the gingival margin (red line) indicates low-grade gingivitis. GBT fosters the patient’s motivation to use correct tooth brushing techniques. GBT prevents and treats gingivitis IMPLANTS In this sequ