US Implant Market Trends

1. US Implant Market Trends Louis F. Rose, DDS, MD.

2. What is a dental implant? Present state of implant dentistry Implant market trends Nobel Biocare future plans Topics

3. Replace multiple missing teeth Replace an edentulous arch What Is A Dental Implant? • Dental implants are used to:

6. Revolutionary and unique, NobelActive™ Internal and External implants

7. Pre Op Post Op

10. Implant vs Conventional Bridges vs. Removable Dentures • There is a clear benefit to receiving dental implants • Quality of life improves • Diet and nutrition are positively impacted • Positive impact on leisure activities • Disadvantage of cutting down perfectly healthy teeth G.Heydecke, J.M.Thomason, J.Lund, J. Feinc, Journal of Dentistry, 854-13/2/2005

11. Present State of Implant Dentistry • The industry has seen dramatic growth over the past 5 years • However, the number of GPs treatment planning for implants has not increased at the same rate • The economy has had a negative impact on case acceptance of the larger cases • Uncertainty with the future value of one’s home • Uncertainty with the economic outlook

12. What Is The Impact? • With a decline in growth, clinicians are looking for ways to maintain practice profitability • Huge increase in the number of low cost dental implant suppliers • The dental schools have responded by adding implant treatment to the pre-doctoral programs • New clinical delivery models are emerging

13. Low Cost Suppliers • There has been a huge increase in low cost suppliers over the past couple of years • With slowing growth of the implant market, they offer the clinician a short term practice profitability opportunity • The question remains whether they will be able to offer the scientific data and support necessary to maintain clinician relationships

14. Dental Implant Centers • Centers optimized for dental implant procedures • No other traditional or specialty dental services are provided • Rely upon direct-to-consumer advertising to attract patients • Tap into a market demographic not currently touched by the referral system • 50% of their patients are reported to have not visited their dentist in the past 10 years

15. Large Practice Groups • The consolidation of private dental practices into the large group organizations is an ongoing trend • Driven by insurance coverage • Dramatically increases the number of patients who will be offered implants

16. Implant Market Trends • By 2010 approximately 100 million Americans will be missing one or more teeth • 36 million of them will be edentulous in one or both arches Sources: Chester W. Douglass, DMD, PhD, et al, “The Journal of Prosthetic Dentistry,” January 2002; American Dental Association, 2006

17. The Pace of Change In The World Is Accelerating Rapidly Today’s Consumers Have: • Higher expectations • More information • More choices • More influence on the types of products and services provided to them

18. Impact of Change To Those Who Ignore It Consider: • Based upon a shift to online music, 48 million fewer albums were purchased in 2005 than in 2004 • Sales declined 16% more in 2006 Rolling Stone Magazine, 2005; Reuters, May 2007

19. Breaking The Logjam • The 75% of GPs who are not treatment planning for implants will be pressured to do so • New graduates will be treatment planning • The large GP groups will be treatment planning • Consumers will be better educated • Value-added services will become important to support these new trends

20. Education and Research Patient Friendly Procedures Generational Changes Direct to Consumer Advertising Trends Affecting The Implant Industry

21. Education And Research • Dental school graduates are increasing to over 4000 a year • Implants are taught as the standard of care • Over 25% of GPs now treatment plan for implants • By 2012 this figure is expected to increase by 35% iData Research Inc. July 2007

22. Fast procedures Minimally invasive procedures Long lasting results Good esthetics Patient Friendly Procedures Patients want:

23. Doctor Friendly Procedures • Transition from 2-stage to 1-stage procedures • Immediate load implants • Less invasive dental implant therapy • Tilted implants, guided flapless surgery • Advances in ceramic materials create a shift from function to esthetics

24. Generational Trends • Major transition in the patient base • 87 million baby boomers- turned 60 in 2006 • This generation is the major purchaser of elective plastic surgery procedures and anti-aging remedies • Baby boomers will inherit the largest inflation-adjusted transfer of wealth in the history of man ($10 trillion) Business Week, Oct. 24, 2005;American Society of Plastic Surgeons, Business Week, March 18, 2005; www.genpolicy.com

25. Direct To Consumer Advertising • Medical, pharmaceutical and now dental advertising is on the increase • Consumer awareness of dental implants is increasing • Patients seek more information regarding treatment

26. Nobel Biocare • New CEO, Domenico Scala • Straight shooter • Transparent to the investment community • His philosophy is to provide information, so people understand what Nobel Biocare is doing and thus can make good investment decisions

27. Nobel Biocare • Nobel Biocare will seek growth in the future by driving the fundamentals upon which the company was established • Their products are based on solid scientific data

28. Growth Will Come From Educating general dentists to treatment plan for implants, rather than surgically placing implants

29. Nobel Biocare’s Focus Will Be • To develop relationships with general dentists through the Procera restorative products on natural teeth, e.g. porcelain • Once the relationships are developed, the objective will be to educate, train and move the general dentists toward restorative implant dentistry

30. Conclusions • Trends have emerged, which will accelerate the rate at which GPs get involved with treatment planning for implants • Although the temporary slow down in growth has enabled the low cost suppliers to emerge, these trends will favor the value-addeddental implant suppliers going forward • Growth will be further fueled by an increase in consumer awareness • With the supply side (clinical delivery) opening up, the strong growth seen in recent years should return…even making a weaker economy irrelevant

31. Thank You!