1. Advanced Surgical and Therapeutic Modalities are now Possible with the Pilot Class IV Veterinary Diode Laser System!

2. LASER L ight A mplification by S timulated E mission of R adiation

3. Solid State Nd:YAG –1064 nm, 532 nm(KTP) Alexandrite -755 nm, HoYAG (2100 nm) Ti Sapphire -700 to 1000nm Diode Lasers 635 nm,820 nm ,940 nm, 980 nm Fiber Lasers Typically between 1000nm and 1700 nm Dye Lasers Typically visible Gas Lasers CO2(10,000 nm), Excimer (193 nm, 248 nm) Laser Types

4. The Pilot DVM-S/T (Surgical/Therapy) Laser – What Can It Do For Your Practice? Identifies Your Practice as a State of the Art Technology Veterinarian Care Provider Immediately Introduce a New Profit Center which Does Not Require the Doctor to Administer Treatment (therapeutic applications) Allow your Technicians to Become More Valuable Team Members Delivers More Advanced and Effective Treatments

5. • No sedation • No clipping hair • 3 - 5 min. treatments per site (based on size of pet) • 6 total treatments for chronic problems • Follow-up treatments required every 3 to 8 weeks • Preset protocols • Client prepays for treatments • Client brings pet to appointment Benefits of Pilot DVM-S/T Laser Therapy

7. Wavelengths INFRA-RED 193 nm 400 to 700 visible 532 nm 1064 nm 755 nm 10.2 μ m

10. MONOCHROMATIC The light emitted from a laser is monochromatic , on other words, one wavelength (color). In contrast, ordinary white light is a combination of many different wavelengths (colors). LASER PROPERTIES

11. Laser Properties COHERENT VS. INCOHERENT

12. LASER PROPERTIES COLLIMATED A laser has a very tight beam that is strong and concentrated. A flashlight, by comparison, releases light in many directions, the light is weak and diffuse.

14. Pulsed Emmissions The words pulsing and frequency are used interchangeably to describe the same concept, which is the interruption of energy flow on a predetermined basis. Some manufacturers have laid claim to special frequencies, claiming that they produce better clinical outcomes. Peak Power = pulse energy/pulse x duration A 75 W peak power system with a 1 ms pulse has a pulse energy of 75 mJ… Power = pulse energy x rep rate; 75 mJ laser at 10 Hz = 750 mW

15. Continuous Wave Emission Continuous wave emission lasers have no interruption during the delivery of their energy

17. The main difference is coherency Laser vs. LED “ Whenever LED and lasers have been compared in studies (13 studies found), laser has come out on top.” Jan Tuner @ (www.laser.nu)

18. Class 1 Class 2 Laser Printers, CD Players Low Power, Diffused Output

19. Laser Classification Erchonia LLLT Lasers Class 3A Lasers Class 3B Lasers LLLT 500 mW Lasers Laser Pointers

20. Pilot Class IV Laser Laser Classification

21. Pilot DVM-T/S Class IV Medical Laser Surgical and Therapeutic Laser Surgical Laser: Used to cut, coagulate and evaporate tissues. This type of laser replaces the scalpel. Therapeutic Laser: Used for the stimulation of cell function. The biological effect is photochemical as well as thermal, unlike surgical lasers.

22. Laser-Tissue Interaction PHOTO-THERMAL long pulses, biological effect due to heating, hair removal, most surgical lasers PHOTO-MECHANICAL S hort-pulsed (q-switched) lasers cause ablation tattoo removal PHOTO-CHEMICAL laser causes chemical change or response-pain relief

23. Photo Chemical A photo-chemical treatment is where the light has a chemical impact on the tissue being treated. Examples include: Photo Dynamic Therapy (PDT) Cancer treatment, ophthalmic treatments Laser Therapy pain relief

25. Absorbtion Cellular action spectra has been determined to be from 500 nm to 1100 nm The Chromophore (photoreceptor) is believed to be Cytochrome C Oxidase, which is in the mitochondria and is instrumental in cellular respiration .

26. Important Factors For effective penetration, light needs to avoid scattering and surface absorption.

27. Scattering A beam of light focused on tissue may be reflected, absorbed, or scattered. Scattering is wavelength dependent. Longer wavelengths have less scattering. Scattering in tissue broadens the incident beam, decreasing the effective fluency in the intended target area. Doubling the spot size will increase the effective volume by a factor of eight.

28. The Importance of Power The main reason cited for negative findings in therapeutic laser studies have primarily been because of the use of very low dosages.

29. The Power of the Pilot DVM Laser Power = Energy/Time 1 Watt = 1 Joule/Second Your 9 watt Pilot DVM Therapy Laser™ delivers 9 joules/sec. Over a period of one minute your laser delivers 9 joules/sec x 60 sec/min = 5400 Joules/min .

30. Power Density vs. Energy Density Power Density (irradiance) The power of the laser per unit area Irradiance (PD) = W/cm2 Energy Density (fluence) The power density multiplied by the exposure time, measured in Joules/square centimeter Fluence (ED) = Joules/cm2

31. Power Comparison The Erchonia 3LT™ laser PL3000 5mW laser delivers 0.005 joules/sec. Over a period of one minute this device delivers 0.005 joules/sec x 60 sec/min. = 0.3 joules /min. The Respond 2400XL500P™ has a 500mW head delivering .5 joules/sec. Over a period of one minute this device delivers .5 joules/sec x 60 sec/min. = 30 joules/min. The Pilot DVM Therapy Laser™ delivers 540 joules/min

32. Spot Size & Power Density Spot Size The advanced solid state technology and the innovative hand-piece of the Pilot Therapy Laser™ safely delivers a high dose of photons over a large area Power Density Indicates the degree of concentration of the power output. It is measured in watts per centimeter squared (W/cm2). PD = W/cm2

33. Conclusion Energy Density is the dosage of energy applied to a specific anatomical area THE AMOUNT OF ENERGY DELIVERED DETERMINES THE MAGNITUDE OF THE LASER INTERACTION WITHIN THE TISSUES AND EVEN THE INDIVIDUAL CELLS

34. Physics Summary

35. Results The Pilot DVM Laser delivers: LARGE SPOT BEST WAVELENGTH HIGH POWER SAFEST and FASTEST APPLICATION Which Means You Have the Safest, Fastest, and Most Effective Therapeutic Laser Currently Available

36. Current Nomenclature LLLT : Low-Level Laser Therapy LILT : Low-Intensity Laser Therapy CLT: Cold Laser Therapy Soft Laser Therapy Low Reactive Laser Therapy Low Power Laser Therapy Light Emitting Diode Therapy Low Energy Photon Therapy Bio-stimulation Laser Therapeutic Laser Bio-regulating Laser Medical Laser Phototherapy Class III Laser Therapy Class IV Laser Therapy HPLT : High Power Laser Therapy

37. How Laser Therapy Works Laser Therapy

38. Physiological Effects of Photobiostimulation • ANTI-INFLAMMATORY, ANALGESIC, AND ANTI-EDEMATOUS • INCREASED MICROCIRCULATION • INCREASED SYNTHESIS OF ATP, RNA AND DNA • INCREASED TISSUE OXYGENATION AND NUTRITION • INCREASED RATE OF TISSUE REGENERATION

41. Acute Inflammation Reduction How does Photobiomodulation reduce inflammation? Stabilization of the Cellular Membrane • Ca++, Na+ and K+ concentrations, as well as the proton gradient over the mitochondria membrane are positively influenced. This is accomplished in part by the production of beneficial Reactive Oxygen Species aka (ROS). • These ROS’s modulate intracellular Ca++ concentrations and laser therapy improves Ca++ uptake in the mitochondria.

42. Acute Inflammation Reduction Stabilization of the cellular membrane Enhancement of ATP Production and Synthesis ATP production and synthesis are significantly enhanced, contributing to cellular repair, reproduction and functional ability Photonic stimulation of Cytochromec Oxidase, a chromophore found on the mitochondria of cells, plays a major role in this rapid increase in production and synthesis of ATP.

52. Acute Inflammation Cascade Pilot DVM Therapy Laser Treatment Cytochrome Activation Cell Membrane Changes ATP Increase Increased Leukocyte Activity Angiogenesis Proton Gradient Change Enhanced Lymphocyte Response SOD Production Ros Production Ca, Na, K Ion Changes IL-1 Decrease Temperature Modulation Vasodilation PG Synthesis

53. Analgesia How Does Photobiomodulation with the Pilot DVM Therapy Laser™ Reduce Pain? Increase in beta endorphins The localized and systemic increase of this endogenous peptide after laser therapy irradiation has been clinically reported in multiple studies with subsequent pain reductions.

61. Mechanisms Behind Tissue Healing Enhanced Leukocyte Infiltration The PILOT DVM THERAPY LASER™ stimulates activity involving neutrophils, monocytes and lymphocytes.

62. Mechanisms Behind Tissue Healing Enhanced leukocyte infiltration The PILOT DVM THERAPY LASER™ accelerates macrophage activity in phagocytosis, growth factor secretion and stimulation of collagen synthesis .

71. Healing Cascade PILOT DVM THERAPY LASER™ Increased Leukocyte Activity Increased Vascular Regeneration Early Cell Regeneration Increased Tensile Strength Increased Macrophage Activity Increased Fibroblast Proliferation Enhanced Cell Differentiation Accelerated Wound Healing REDUCED HEALING TIMES

72. Laser Safety FOLLOW ALL OF THE MANUFACTURERS RECOMMENDATIONS AND WARNINGS!

73. Laser Safety THE NUMBER ONE SAFETY CONCERN WITH ANY CLASS III OR IV LASER USE IS PROTECTION OF THE EYES The PILOT DVM THERAPY LASER™ emits both visible and invisible radiation

74. Laser Safety Safety training begins with YOU!!! Protective eyewear is necessary for everyone in the treatment area including the animal!

78. Contraindications Contraindications for the PILOT DVM THERAPY LASER™ are often based on anecdotal evidence as well as scientific or clinical data. Contraindications are presented as precautions for safe and effective treatment and care.