Good day, and welcome to the ZimVie Investment Day 2022 conference call. All participants will be in a listen-only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by 0. After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star then 1 on your telephone keypad. To withdraw your question, please press star then 2. Please note this event is being recorded. I would now like to turn the conference over to Vafa Jamali. Please go ahead. Hi, everybody, welcome to ZimVie's first Investor Day. My name is Vafa Jamali. I am the CEO of soon to be independent ZimVie. I welcome all of you. Before we begin, I'd like to remind you that we may be making some forward-looking statements during today's presentation. These forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from the forward-looking statements. Please review the disclaimer presented here and refer to our Form 10 for a detailed discussion of these risks and uncertainties. Additionally, we will be discussing GAAP financial measures. Reconciliations of these measures to the most directly comparable GAAP financial measure are included in the appendix of the presentation. With that out of the way, our agenda for today will include myself with some introductory notes around ZimVie and some highlights, an overview of the dental opportunity, an overview of the spine business, a financial overview, and then a wrap up and a live Q&A. Today's presenters, myself, Vafa Jamali, Indraneel Kanaglekar as our SVP and President of Global Dental, Rebecca Whitney is our SVP and President of Global Spine, and Richard Heppenstall is our Chief Financial Officer. Why are we spinning off? You know, this was a question that I you know, really had to look at and understand myself as I was looking at this opportunity, and there were a lot of reasons why it was the right opportunity to spin off, and it was the right opportunity for me personally. I've had a long career in the medical device industry, you know, running large divisions inside either, you know, the early stage businesses of maturity or in some cases, the very mature businesses. In each case, the business needed to find purpose, and they needed to find growth. Typically, these businesses are, you know, they're overshadowed by other priorities of the larger organization, so the larger organization, you know, doesn't have the attention or focus on these particular businesses. What happens, which is very interesting to me, is the highlights and the gems inside these portfolios are largely hidden. You know, the lessons that I learned and the successes that we had in these circumstances really prepared me well for the situation at ZimVie. You know, spine and dental both have exceptional market development opportunities. When I speak about market development, I'm really speaking about opportunities that are larger than the current served market and ways to actually expand markets. As well, they have significant tangible operational efficiencies that we can tap into. I see a clear path to growth and a margin expansion for ZimVie within two very good end markets. You know, this list here really looks a lot like the list that I created for myself when making this decision. It really mirrors my list very well. If I could just summarize in my words, you know, there are six key reasons why we can get to growth. One is, you know, this enhanced management focus will create a more nimble organization to capitalize on these best and largest market opportunities. We will be able to maximize the value of the full portfolio and the brands to target innovation in the fastest-growing segments. We're participating in very large markets, but we get to participate, we get to choose to be in the fastest-growing segments. We can leverage our strength in clinical evidence to expand within growing procedure categories. I'll spend a little more time on clinical evidence, why I think it's so important in our portfolio. We have a commercial infrastructure with global reach. That speaks for itself, but it really gives us a lot of options in terms of how we grow, where we grow, and what infrastructure is already existing, what we can leverage to improve upon. We have development teams here, so primarily I'm speaking about or research and development teams that have a history of innovation. You know, so many of our flagship products were actually created by these teams, and they're still here with us. Our decision to create ZimVie and to make ZimVie independent has really inspired them. I'm excited about what's next for us and the portfolio to come through this same excellent group that's there right now. Then finally, our experienced management group will focus on driving growth and reducing organizational complexity. We think these are big opportunities for us to capture. Let me now go into a little bit more of an introduction to ZimVie, a little more of the details behind the company itself. At a glance, like I said, we participate in approximately $20 billion global market opportunity. We're the fifth largest player in dental and sixth in spine. We have over 20 brands trusted by clinicians and surgeons worldwide. We operate in 70-plus countries, and we have approximately 2,700 team members. We have 20 years of clinical evidence supporting our brands. This is really critical as you look at the opportunities ahead of us and how much evidence do we have to really support the procedures and the interventions that we are really looking at as growth drivers for us. Within that business, within this market, our margin was 66%. Management adjusted gross margin for 2021 was 66%, which gave us about $132 million adjusted EBITDA for 2021. Our business is 46% dental, 54% spine. When we look at geographical representation, we're largely in the Americas. We've got 75% in the Americas, 13% in EMEA, and 12% in APAC. The two businesses are a little bit different there, where dental would be much more balanced between the U.S. sales. Spine is much heavier in the U.S., where it is the biggest spine market, and we do most of our revenue in the U.S. This represents ZimVie as a whole. I mentioned that we have established brands. The name ZimVie isn't gonna resonate with anybody. It's a brand new name that we created. But if you look at what our brands represent, they represent names and companies that our clinicians trust. Going back to 1988 with EBI, which is our bone healing franchise, that name is very recognizable. Pre-2006, the company made a number of acquisitions in both spine and dental, and many of these brands are still the way that our products are identified and our clinicians identify them. In 2016, the company made a very large acquisition of LDR, which gave us the Mobi-C, which is the market leading cervical disc replacement. In the last couple years, we made a number of what I'd suggest would be tuck-in acquisitions in dental that gave us technology that gave us basically workflow technology to get further into dental, digital dentistry. What we were able to do is put these into our portfolio, scale them, and then really get pull through of the implant business. I'm really impressed with the way that we took those technologies and actually scaled them. In 2021, Zimmer Biomet decided to carve out ZimVie, and here we are in 2022, ZimVie going public as an independent company. The last several months, we've been talking about what do we want our company to represent and who we wanna be. We have a vision that everyone deserves to feel better, healthier, and stronger. We create solutions for people to enjoy and experience life. Our mission is to advance clinical technology foundational to restoring daily life. When we said what would be the values that we want to, you know, present, you know, I would say, you know, intellectual curiosity to listen, to learn, and to try. Authenticity and empathy with how we treat each other, how we treat our stakeholders. Accountability. The view here is that accountability would go down through the organization, and ultimately a great company would be a company where decision rights and accountability go all the way down the company, and that's what we aspire to. Finally, having a growth mindset, which is a can-do growth mindset that gives us the energy and the inspiration to do more. When we looked at the growth plan, we said, "How will we transform this company into a growth business?" We looked at three critical areas. Basically, when you look at the top, you know, leadership and talent, you know, we have to leverage our experienced management team to identify and focus on the best opportunities for growth. With leaders that wanna be here, the leaders that have experience, and with a talented workforce that sees this as an opportunity to improve their own careers and to really participate here, make decisions, be empowered, this is a critical area for us to invest in and to build upon for the next chapter. We look more foundationally around systems and operations. Here we have an opportunity to strengthen the foundation strategically, operationally, and commercially. I'll go into a little bit of detail what we've done so far there, but this is a really, really important one. Whatever we do here can free up some dry powder for us, which we can then invest in what we really need to do as a med tech leader, which is innovation and top line growth. That's the third pillar, where we really will get to a place where we will drive sustainable growth through innovation and market development in focused categories. It's critical that we're not everything to everyone, but we participate and win in the categories that we choose to. What have we done so far? You know, if I look at those same three categories, you know, we've really focused on value creation. I can tell you what we've done recently and then what we plan to do in the future. Recently, with respect to leadership and talent, you know, we traditionally had engagement scores in and around the 60-point mark. Most recently, our engagement scores came back at 80. What that meant was people liked what we were doing, they were engaged, they were interested in the changes we were making, and they wanted to see this company be successful. It gave us a lot of hope that we have the right people on the team, and that we can make great strides even though we haven't even really in earnest started yet. Feeling very confident about that. Historically, you know, we've had a revolving leadership. We've been able to refresh that with a strong and experienced executive team, and their teams, and that's been a really great change for this group. We got some stability built in. Then we're establishing a basic mission, and this is really important for the technologies and the growth drivers that we've chosen. Beyond 2022, you know, I look, again, like I said before, driving accountability throughout the organization, decision rights down through the company. If we do that right, we can become a destination workplace, and we will have to have a growth mindset. With systems and operations, again, more foundational here. We have exited a number of unprofitable geographies to focus on the greatest opportunities. So we were commercializing in countries where we were losing money every day, and we left those, and instead, we are gonna focus on driving growth in the ones that we know we can be more successful in. Important move that we made that kind of carries us into the transformation for the future. We made a number of investments in digitization and automation of manufacturing. This is really around gross margin improvement. We insourced some spine manufacturing, and we rationalized some brands. The company has had a number of brands over the years, like I showed on the second slide, and really, they haven't rationalized all that often. Beyond 2022, I would say I don't wanna wait for a spin to do continuous improvement. I'd like to do it continuously. Really systematic continuous improvement is a real critical area for us to focus on and make sure we don't forget that. Integration and automation of systems is really key for us and our ability to be an efficient provider. Around performance and innovation, we implemented disciplined portfolio management, and what this really meant tangibly was that instead of having, you know, 100 projects, we would focus down on the number of projects that we could actually deliver on. So by paring down the number of projects, we were able to really commit to the most important ones, the biggest drivers, the ones that will please our customers the most, and really focus on that. We had some operating model improvements and lessons we learned from COVID, and I would characterize those as two ways. One is what we learned internally in terms of what we could do remotely more efficiently, and then secondarily, what did we learn from customers? We have customers, for example, in dental that adjusted very quickly to COVID with PPE, et cetera, and adjusted their models so they could keep seeing patients. We also see some of those similar trends within spine and how well we can adjust to that and our portfolio to that is gonna be really critical from here on. Beyond 2022, I would like us to be measured on our performance in the fastest-growing segments. Again, picking those best markets and those best segments. Our innovation should be around our growth drivers. Ultimately, with financial flexibility that this would create for us to do M&A. A little bit about the base of ZimVie. Really, we mentioned the patient, and what's important here is that for our patient-centric, you know, mission, we looked at what is it that we need to deliver and what are the problems that we need to solve for. Within dental, approximately 8 million patients seek treatment for tooth loss annually. However, only 25% of them receive tooth replacement. Really the opportunity here is to focus on increasing access to treatments with better outcomes for patients. If we make investments in terms of better outcomes and also better workflow solutions and in better training, we can help this category of patient get really more than 25% of them actually get tooth replacement, which is the ideal scenario for them. Within spine, we know that spine-related disability is the number one reason people seek medical treatment. So we know that to be true. However, it's also true that clinical outcomes have a lot of room to improve. So our innovations need to focus on providing better outcomes for patients. So this is an area we'll continue to work on with novel new technology, with clinical studies, and also with technology that supports that. ZimVie has the fortune of being a leading player in the large and growing $20 billion market opportunity. When I break that down across our portfolio of dental and spine, within dental, there's 3 key categories for us. Dental implant solutions, which is our largest contributor with a market size of $5 billion, and a segment growth of, you know, mid-single digits. We have biomaterials, which is really supporting the implant, the durability and the sustainability of the implant, the stability of the implant. That's about a $1 billion market growing mid-single digits. Then we have digital dentistry, which is an emerging technology, a $2 billion market growing high single digits that really very much supports both the workflow in terms of the clinician, the workflow in their office, and then secondarily, the time that a patient spends in a chair. These are great innovations. There's a lot to go in this particular segment, and we're very excited about our position there and our ability there to capture more interest and therefore drive more implants. Within spine, the largest category is core and complex solutions, and that's about an $8.5 billion market, growing low single digits. This is an area that you know, much of the share change between competitors happens here. It's a very, very competitive area, and a lot of the share shifts happen within that category. Then we have bone healing, which has similar dynamics to core and complex, obviously quite a bit smaller at $500 million, growing low single digits. Then we have these two emerging businesses or categories, minimally invasive surgery, which really requires some sort of enabling technology to be really, really effective typically. So either the tools or the visualization, what's needed to be able to make less incisions versus the open procedures that are done most often. That's about a $2.2 billion market, and that's growing mid-single digits to high teens. A very important market for us to pay attention to and make sure that we're our portfolio is fresh there. Finally, motion preservation devices. This is an area we're really excited about. This includes the Mobi-C cervical disc as well as the Tether for pediatric scoliosis. This is about a $400 million market and is growing high single digits. The opportunity here is to transition more patients from fusion to one of these two modalities, and that's a great market development opportunity. It requires clinical evidence. It requires clinical selling. The tools that we need to kind of grow that market are much different than what's required in the core business. We're very, very excited about our growth drivers associated with motion preservation devices. At a glance is our opportunity and how we look at our business. Around the portfolio, if I look at, I'll share a slide on dental and on spine. The capabilities on the left are the same. We have approximately 300 in-house R&D employees across spine and dental. Like I said, many of this team has been here through some of our best innovations. We're really, really pleased that we have this team to continue it in ZimVie's future. We are collaborating with clinicians, surgeons and KOLs. We have, where we've needed to, we've had very, very successful strategic partnerships, and we've been very effective at elegantly tucking in acquisitions that have either given us scale or given us technology that we needed to scale on. When you look at Dental, the top of this chart is really where the largest segment is for us, and that's our Dental implants. Those are the premium Dental implants that we represent. Then the biomaterials down the middle are again used in support of the Dental implant to ensure a better implant, a more durable implant and a stable implant. Then digital dentistry is really an investment in the workflow that not only helps the clinician, but it also helps the patient spend less time in the chair. These are really an emerging space, an excellent space, and a space that we're very excited about, and we think our success there will ultimately drive dental implant growth as well. When I look at spine, the same capabilities on the left, and then if you look at the portfolio, the largest portfolio by far is core and complex solutions. You know, we have to be broad there, and our portfolio covers degenerative deformity, tumor and trauma. We have to be broad there, and we need to continue to make sure that our portfolio is full. We feel very fortunate that we have a great portfolio there of brands that can satisfy those particular solutions or those particular conditions. We have an area of minimally invasive surgery, and this is again an area that has not quite adopted to the level. Most procedures are done open versus MIS. We do think that there's a great future there. Between the devices, the interventions and the technology, there's an opportunity there to expand that marketplace. Within motion preservation devices, again, this is an area where this is all about market growth. We have the Mobi-C cervical disc, and we have the Tether for pediatric scoliosis. We'll continue to look at our growth drivers as categories that we would invest in this space, in these spaces. I've mentioned our clinical evidence a couple of times, and really why is that so important? Well, it's important because it's a great strength that ZimVie has. I'll just give three examples here. One is Mobi-C. Mobi-C is the first PMA approved cervical disc in the United States, proven statistically superior to fusion at 10 years for two-level disc replacement. Fusion is by far done much more than cervical disc replacement. We have clinical papers that support that we have better outcomes when we use a cervical disc like Mobi-C. Mobi-C also has an extensive clinical history with over 150,000 patients treated. This would be a category where we would say we would like Mobi-C taken in instead of necessarily worrying about share capture, really look at expanding that market and having more fusions converted to cervical disc. The Tether is another novel technology developed here, which is the only FDA-approved device for treating pediatric scoliosis. This is a device with over seven years of data. We have really passionate, really tremendous surgeons and KOLs that are performing this procedure. The way that the procedure works is versus fusion, where you are fusing the child, you are allowing the tension in the cord as the child grows to actually be the regulator of the curve of the spine. That's how the mechanism works, is that the cord, the tension in the cord really straightens out the spine. This is a very novel approach. It obviously provides great mobility to that child versus a fusion. Again, a new category. We're growing it. We'll spend a lot of time continuing to market that to the right people and providing the right evidence to make people comfortable with the right patient, right intervention. Finally, within dental, you know, allografts have been studied for a long time. Again, this is what's used to improve the stability and improve the durability of the implant. The Puros allograft has been used in over 3.5 million implants. This is what gives clinicians great confidence in using Puros, as it has been extensively used, widely used, and has been shown to be effective. Three examples of how clinical evidence and I would suggest that we will continue to be using clinical selling and clinical evidence in our strategy moving forward. Around our infrastructure. Our sales and distribution, you know, for dental is pretty much 95% direct. We go through some third-party mixed distributors outside of the U.S. as a large percent of our sales are direct. Our customers are oral surgeons, general dentists, dental labs, and DSOs. For spine, in the U.S., we largely use independent sales agents. These are exceptionally well-trained teams that have very strong end user knowledge and relationships. We believe that's the best channel for us in the U.S., and they do a great job for us. Internationally, we have a bit of a mix in terms of how we approach sales. Our customers are spine surgeons, hospitals and ambulatory surgery centers. Our head office will be Windsor, Colorado, which is located between Denver and Boulder. We have over 40 facilities owned or leased, and with 6 manufacturing sites and 5 world-class medical education centers that we use for training and education. Long term, how do we get there? We looked at this and we said, you know, "What are the market trends? What are our growth objectives and what are the growth drivers that match those?" When we look at market trends, we look at, obviously, the aging global population, which is in the favor of this portfolio. Then we have increasing healthcare consumerism. That takes a little bit of thought. What that really means is as patients or parents of patients or loved ones research modalities and interventions for their physician, they are going to be drawn to some of the newer, less adopted technologies and really study them for the outcomes. That provides them an opportunity to have that conversation with their physicians, their clinicians, and really potentially ask for that intervention. I think that healthcare consumerism lends itself really well with adoption of new technologies and new interventions. I think that's definitely in our favor. The last two market trends, you know, economic pressures and adoption of technology for outcomes, these kind of go together. What that really means is there's a lot of pressure to do things better, do things more economically. One of the methods for doing that is through adoption of technology. With tech, we can either improve workflows for the patient or workflows for the provider. In both cases, we need to participate there and make sure that we have an offering that matches that. When we look at our growth drivers, you know, driving commercial and operational focus means improving efficiency, profitability and cash flow. Promoting clinically superior, you know, continue to differentiate through extensive clinical evidence. We have to have the evidence to support new interventions. Finally, delivering advanced workflow solutions. Nothing more obvious than our digital dentistry portfolio. But really what these do is they drive pull-through. We'll continue to look at improving, helping providers with their workflow solutions and us being a part of it. The growth drivers that we've identified with you will be within dental is implant growth. You know, that's primary part of our portfolio. Biomaterials pull-through. We have found a very strong position in the market with biomaterials pull-through more implants. Digital dentistry is an emerging space that we are very happy with our portfolio and our ability to pull through business there. Geographic expansion. What's unique about dental is there may be some markets that we're identifying that are very good markets, where we have actual commercial operations there, but we aren't quite growing. We're not quite as penetrated as we need to be, and those are the areas that we'll focus on in the near future and get growth there. Within spine, the Mobi-C cervical disc replacement, again, this is a market that will be growing, and we have the world's most widely used cervical disc replacement. We have the Tether, which is a novel intervention for pediatric scoliosis. That'll also be a market development opportunity. Then we'll continue to look at MIS procedural solutions. This is really minimally invasive versus open procedures and how do we help that market grow with our offering. I'm very excited to be in this next phase with this executive leadership team. This crew has joined me over the last, you know, several months. They're a very experienced team with a lot of passion, a lot of drive. We are very excited about being independent and driving growth and creating a great work environment for everybody. With support of our board of directors, we're excited about the future of ZimVie. We've got our Chair-elect is David King, who's a former Chairman and CEO of LabCorp. With David King come a number of wonderful executives that we look forward to working with and learning with, collaborating with, and ultimately growing with. We're very excited about that as well. We are positioned to capitalize on multiple opportunities for growth. In the near term, look for, you know, flat growth as we organize and we plan and we build and we get efficiencies. Over the three to five year period, look for mid-single digit growth from us regularly. We think, again, the markets are very, very large, very, very good markets to be in. We believe our portfolio can be attractive and competitive. We think we have great differentiation that's supported by clinical evidence that's gonna allow us to grow on fair share in those markets. We have an established commercial infrastructure already, so we can choose where to be and how to grow. We have a track record of successful innovation, which means we've got the right marketers and the right R&D talent on board. Finally, we have an experienced management team that's gonna do things nimbly with a focus on driving long-term sustainable growth and a focus on reducing organizational complexity. That is really the. Again, that's what I said was the list that I created for myself when I made this move, and I think it's a list that's valid today and a very, very exciting opportunity for us. I'd like to now go into a little bit more detail with our portfolios, and this gives me a great opportunity to introduce Indraneel Kanaglekar, our Senior Vice President and President of Global Dental, who will be taking you through the dental opportunity. Thanks, Vafa. Hello, everyone. I'm Indraneel Kanaglekar. I'm the president of the dental business. I've been in the operational leadership role with the dental business for over four years now, and I'm very excited to share our dental business strategy and really looking forward to this interaction. Today, we will start with an overview of our market, our business, and then more importantly, get into the details of our growth drivers that will allow us to drive mid-single-digit growth in the near and medium term. ZimVie Dental, we are a business with strong momentum and great market opportunity. We participate in $8 billion tooth replacement market that's growing in mid-single digits. There are three segments in our market: implants, biomaterials, and digital dentistry. We are the number two player in the biomaterials segment. We have a best-in-class portfolio with a legacy of innovation that positions us well to win. 93% of our revenue comes from countries where we have a direct presence. That's where we sell to customers directly via our sales force. This is important because you need to be direct in this market to win. Sales team members provide valuable service to dentists and dental practices and increase loyalty and stickiness. We sell our products in over 70 countries, and 43% of our revenue comes from outside the U.S. That makes our business truly global. We ended the year 2021 with $469 million in revenue. That represents over 6% compounded annual growth rate over 2019, and we have a strong momentum behind us. Let's talk about the tooth replacement market in more detail. As I mentioned, we participate in $8 billion market that consists of three sub-segments. Implants, which is the largest market that comprises $5 billion, and it's growing in mid-single digits. Biomaterials market is about $1 billion, and it's also growing in mid-single-digit range. Then digital dentistry market, where our addressable portion of that market is approximately $2 billion, and that's growing at high single digits. There are certain macro factors that are driving market growth, such as demographic trends, which is aging population, and also healthcare consumerism, where patients are increasingly demanding better treatments. For example, implant treatment provides a much better functional and aesthetic solution for patients than crown and bridge dentistry, and that is what is driving the demand. More importantly, there are industry-specific trends that are aiding the market growth. The most important of those trends is under-penetration of implant dentistry. In the U.S. market, for example, we estimate that over 120 million people are missing at least one or more teeth. Our best view suggests that only 2 million people in the U.S. actually get treated with dental implants. This creates a huge opportunity to drive volume in future. Why is implant dentistry under-penetrated? There are two main reasons. One, the learning curve for dentists is steep. Dentists don't spend a lot of time placing and restoring implants unless they are in a specialty residency program. This reason also makes medical education in our industry particularly important. The second is efficiency and economics of the procedure. It's largely a private pay procedure, and the cost could be a barrier, as well as the number of visits it takes to complete the procedure, the time taken, et cetera. Another trend that's helping the market grow is adoption of digital technologies. From taking an impression to CT scanning, replacing X-rays, to software-based treatment planning, designing, and producing patient-specific products using CAD/CAM technology or 3D printing technology is changing how implant dentistry is practiced, and it's also helping to democratize the implant dentistry. Ultimately, it's helping patients with better and more efficient solutions. Also, we see a significant trend of end user consolidation, where dental offices are being consolidated into big chains that we refer to as DSOs, dental service organizations, that are typically owned by financial institutions. The rapid growth of this customer segment makes it important for us to target that segment going forward. We remain very bullish on this market and its growth prospect, primarily driven by the superior results of implant dentistry for the patients and its current under-penetration. Now, as far as our product overview goes, as I mentioned, we participate in three segments in the tooth replacement market. In implants, our flagship products are TSV, which is Tapered Screw-Vent implant, and T3. We have listed our main competitors on this slide. In the biomaterials segment, our flagship product is Puros, which is human-derived bone graft. We are the number two dental player in biomaterials segment. Here, we compete against all the implant companies that typically carry biomaterials and some other niche players. In the digital dentistry segment, we offer iTero intraoral scanners, our RealGUIDE software for planning and designing surgical guides, our guided surgery services under the Implant Concierge brand, our differentiated and good impression technology, and a broad portfolio of patient-specific products that help dentists in being more efficient and deliver better aesthetic and clinical results for the patients. In this segment, we compete against the same implant companies as well as some specialty digital dentistry companies. To win in this space and to drive above-market growth, we need to focus on four things. One, drive implants growth via innovation and commercial execution. Two, maintain and leverage our biomaterials leadership position to drive implants growth and gain share. Three, win in the digital workflow space primarily to drive implants pull-through. Four, opportunistically invest in geographies with low share where we have a path to win. We remain confident in our execution ability. Let's talk about our implants growth strategy. When it comes to implant system, we have a very comprehensive portfolio with two market-leading brands, TSV, Tapered Screw-Vent, and T3, and a variety of legacy brands that have a very loyal customer base. This is the most profitable part of our business, and it drives more than 60% of our revenue. We have a very differentiated product portfolio, especially when it comes to our flagship brands. In dental implants, dentists rely on brand and clinical data, but besides that, there are three things that they look for. Here is an enlarged model of a dental implant. The clinicians typically first look for geometry. What is the shape of this implant, and how aggressive are the threads that allows it to stabilize after placement? This allows clinician to restore the implant right after placement. The second factor is surface. Optimal surface roughness kind of enhances or helps to integrate the with the bone over the long run, but it also should minimize the chance of infection. Finally, the third piece is the connection where this abutment goes into. That needs to be tight so that it can offer appropriate seal as well as optimal soft tissue and bone growth around the implant. Now, our implants, especially TSV and T3, have tapered macro geometries that offer immediate stability as well as long-term stability. We have in-house developed surface technology that improve bone integration while reducing the risk of infection and bone loss. In fact, we are pioneers in the hybrid surface technology that promotes long-term bone integration and minimizes the risk of infection and bone loss around it. What I mean by hybrid technology is the top part of the implant has a relatively smoother surface compared to the rest of the implants. We have a lot of clinical data based on our in-house hybrid surface technologies. We have connections that ensure bone and soft tissue growth delivers optimum aesthetic outcomes and provides seal integrity. We sell more than a million implants every year with a long-term success rate of over 98%. This gives us confidence that we have a great portfolio to build upon. To drive growth in this space, we will focus on continuous innovation and augment it with medical education and commercial execution. In terms of innovation, we have three flagship implant launches coming up in the next 24 months, including the next generation T3 and TSV implants. Both these implants will have more aggressive thread designs and more pronounced taper that will improve immediate stability and offer a better solution for the patients with immediate placement and restoration. These next generation implants will also come with in-house innovative surface technologies with a lot of clinical data associated with it. We offer best-in-class medical education. This is important because clinicians don't learn implant dentistry unless they do a specialized residency program. It also offers training on safe and effective use of our products, and that increases loyalty to our portfolio. Our strategy here would be to offer tailored curriculum where clinicians can choose the content, whether they want to learn on science, product knowledge, hands-on skills, practice management curriculum, and the mode of delivery, which is whether they want to consume it web-based or in our institute or do cadaver courses or in-field education delivered by an expert. We want to marry those two aspects and deliver kind of tailored program that will allow us to differentiate. While we have strong momentum when it comes to commercial execution, we want to continue to refine our commercial execution. One area where we will invest incrementally and pay more attention is the growing DSO, the dental service organizations, which are typically investor-owned multi-office practices, while we'll do that while continuing to focus on our specialist segment. These DSOs typically want to deal with vendors that are reputable with a broad product portfolio. They also employ many dentists with varied experience levels, and they require vendors to provide support that can help them with standardization of treatment protocols and skill improvement. With the large sales force that we have and the excellent medical education capabilities as well as the portfolio and the brand name, we are confident of driving penetration in this particular segment. Now, moving on to biomaterials. We are very proud of our position in the biomaterials segment. We are the number two company in this segment and number one allograft company. We want to maintain our leadership and leverage our position to drive implants pull-through. Now biomaterials are used in implant surgery when patients don't have sufficient bone for an implant placement. Clinicians can use biomaterials to repair defects and build sufficient bone, after which they can place an implant. Biomaterials can also be used in patients where they have sufficient bone, but to improve aesthetic and long-term clinical outcomes. Thus, biomaterials are being increasingly used in implant dentistry to offer better implant solutions for patients. Now we have the best and broadest portfolio in biomaterials with Puros as the market leading allograft or human-derived bone graft. To drive implants pull-through, we need to focus on two things. One, maintain leadership in this segment, which we will do via innovation. Innovation in this context means a cadence of new product launches and supplementing our market-leading products with more clinical data that provides more confidence to clinicians to use our product line. Second, we will focus on converting a large customer base, for example, our customer base of Puros, who do not currently use our implants to become our implants customer. We have a strong opportunity in North America, and our recent success in winning new customers provides us confidence in executing this strategy where we already have relationship with these customers. Now moving on to digital workflow solutions for implant dentistry. At a high level, we know implant dentistry is under-penetrated. Why is that? Again, the reasons are learning curve for dentists, that is steep. Second, the procedure economics in terms of cost, time, number of visits could be a barrier. Of course, you can always improve aesthetic and long-term clinical outcomes. Now our digital workflow solutions are helping to break down all these barriers. When it comes to learning curve, our guided surgery solutions based on RealGUIDE software and Implant Concierge services are helping dentists. Our iTero intraoral scanning technologies that we distribute are making it easier to participate in implant dentistry. These solutions also improve efficiencies in terms of time and cost. Finally, we can offer range of patient-specific products which also improve aesthetic and long-term clinical outcomes for patients. Let's get into the details of what we mean by digital workflow solutions. Now, digital workflow for surgery starts with imaging using a CBCT scanner and an intraoral scanner. Now that data is transferred to a software that is used to plan a case and then design a guide. You can print a guide using a 3D printer. Using this guide and specialized instrumentation for guided surgery, you can place an implant. Now this becomes a minimally invasive procedure as well as a more accurate procedure. On the restorative side, similarly, there are 3 steps. First is imaging or impression taking. Now it is done by intraoral scanner instead of biting on a goo. Transferring that data to software to design patient-specific prosthesis. Finally producing the prosthesis using CAD/CAM or 3D printing equipment. Now we have a product portfolio where we can offer complete end-to-end workflow solution. Let's look at our product portfolio and innovation pipeline. First, we offer a range of iTero intraoral scanners, and our RealGUIDE software is compatible with all CBCT scanners in the market used for imaging. We offer this best-in-class RealGUIDE software and instrumentation that makes guided surgery easy. Additionally, we also offer planning and design services under the Implant Concierge brand if the clinicians need help. On the restorative side, we again offer the intraoral scanners, and we have a differentiated technology in terms of Encode that simplifies impression taking. What do I mean by that? Again, let me use this enlarged implant model. Typically, when implant is placed, you have a healing abutment or a healing screw used as a cap. Now, when you need to take an implant impression, which you need to do to understand where the implant is placed, how and what is the orientation of the implant to ultimately design the final artificial crown and the prosthesis. To do that, you need to typically take out the healing abutment, place a pin, which is called impression coping, and take the impression of that coping. Now, we have a healing abutment called Encode. This is again the enlarged replica of it, which has certain codes on top of it. You can take an impression of this Encode abutment that allows you to reduce steps because you do not need to take the cap out, insert the pin in and take the impression. It also allows you to minimize parts and pieces used in surgery or impression taking, and it also minimizes the time. This is a very differentiated technology that we offer for restorative implant dentistry. Besides that, we also have a range of patient-specific abutments to complete the workflow where a final prosthesis can be delivered. Besides our existing portfolio, we have an attractive pipeline of products and workflow solutions. We will expand our guided surgery service offerings under the Implant Concierge brand in Europe and in Japan in the next 24 months. We will also soon be launching our next generation Encode technology sometime in this year, 2022. We also have plans to expand capabilities of our RealGUIDE software to provide CAD/CAM functionalities, where you can design and produce restorative parts for dentistry. We are excited about pipeline of our workflow solutions, which will make our implants offering more attractive. Again, we have a complete end-to-end workflow active innovation pipeline that will make our implants more attractive to clinicians. Now that we have looked at our digital workflow solutions, how do we drive implants growth leveraging these? First, similar to the other two growth drivers, innovation is key. We talked about our attractive pipeline. We will continue to aggressively work on our pipeline of products, aimed primarily at simplifying the procedure to help dentists and patients and improving practice and procedure efficiencies. Because these are very new technologies and they interface with a variety of hardware, we want to provide strong technical support and service so that our customers can easily adopt our workflows. Mostly, we want to be deliberate about tying our implant solutions or these digital solutions to our implant sales. One such example would be our Encode system that I talked about, which is proprietary to our implants, and when clinicians adopt it drives our implant volumes. Another example would be a Smiles Today product that we recently launched, where we provide all the parts and pieces, the treatment plan, and the guided surgery template, along with the implant on the day of the surgery. This solution provides confidence to the clinicians because the surgery is pre-planned. It will be done in a minimally invasive manner, and it's more accurate. It also includes all the parts and pieces, making it easier for the dentist to treat. Overall it improves clinicians' confidence, and it also improves practice efficiency, thereby pushing our implant sales. Now moving on to the geographic expansion part of our strategy. We talked about direct business driving 93% of our revenue. To be successful in this business, you need to be direct in all key geographies because the direct sales force provides valuable service to the clinicians and their practices and increases loyalty and stickiness. We have direct organizations in U.S. and Canada, in key European markets, in Japan, in China, in Australia, New Zealand, and in India. We have a medical infrastructure supported by world-class institutes in Carlsbad, California, in Switzerland, in Shanghai and in Palm Beach Gardens. We have state-of-the-art TV studios in Palm Beach Gardens, Florida, and in Switzerland for producing high-quality web-based programs. Our go-to-market model relies on the sales rep supported by this clinical specialist for biomaterials or technical specialist for digital dentistry, also aided by inside sales team, a customer service team, and a dedicated medical education team supporting the customer. This sort of go-to-market model has proven to be very successful for us, and we have the playbook that has given us success in large geographies. However, there are certain geographies where we have low market share. Now, we will identify these geographies where we have right to win, and it's an attractive market in terms of size, growth profile, and gross margins. In these geographies, we will focus on three things. One, strong country leadership. Second, our ability to provide our complete portfolio and end-to-end digital workflow solutions along with our medical education offerings. Finally, in these geographies, we'll make opportunistic investment in sales force expansion and focus on commercial execution to ensure we can drive share gain. Again, we are confident of driving success in these identified under-penetrated geographies, deploying the same playbook. With these four growth pillars, we have a clear strategy to drive above-market growth, and we have demonstrated over the last two years that we can execute against that strategy. We exited 2021 with $469 million in revenue, which represents over 6% compounded annual growth rate over 2019. The attractiveness of this market, coupled with our recent performance, means we are very confident that we can continue to drive this type of growth in the near and medium term. If you want to, again, get into the specifics of our growth. To drive implants growth, we invested in expanding the DSO channel in the last couple of years. Going forward, we'll continue to do that, but we'll also augment that with innovation with three flagship implant launches coming up in the next 24 months. On the biomaterials pull-through side, we have launched quite a few new products in the past couple of years, such as Puros Allograft Block, Puros Ci, which is a conductive inductive mix, custom mesh in Europe. Going forward, we'll continue this healthy cadence of new product launches, and we'll be far more deliberate about driving implants pull-through. On the digital workflow front, we have launched guided surgery solutions and also introduced a variety of patient-specific products. Moving forward, we'll continue with this cadence of new product launches. We have discussed our pipeline. We're very excited about that. We'll be very deliberate about driving implants growth. On the geographic expansion front, we made investment in the Japanese market in 2019, and that has panned out well for us. In the next two years, we will make opportunistic investments in other geographies where we have a right to win with low market share. Moreover, we have established that we can identify and execute well on tuck-in acquisitions besides these organic growth strategies. In the last three years, we have acquired our Japanese distributor in Japan. We have also made two small investments that Vafa mentioned in the digital dentistry domain. All these three acquisitions have panned out really well for us. Tuck-in acquisitions will continue to be a focus to augment our organic growth strategy. Our recent successes that will provide us confidence, or they do provide us confidence in continuing on this path and complementing our organic growth strategy. Here are the key takeaways. We participate in an attractive tooth replacement market that's $8 billion and growing in mid-single digits. We have a system behind us. We have a clear growth path that relies on four strategic drivers. One, implants growth via innovation and commercial execution. Second, biomaterials pull-through, leveraging clinical data, innovation, and cross-selling opportunities. Third, pushing our adoption of digital dentistry workflows and driving pull-through of our implants by seamlessly integrating our implants in our workflows. Fourth, geographic expansion via opportunistic investments. We are confident that we can execute well on these strategies and deliver consistent profitable mid-single-digit growth in near and medium term. Thank you for your time, and I really look forward to interacting with you more in the Q&A session. Thank you, Indraneel. My name is Rebecca Whitney, and I lead our global spine business for ZimVie. I am really excited for the opportunity to talk with you all today. I'm going to focus our conversation around three main topics. First, I'll provide a snapshot of our spine business today, including an overview of our market. Then I'll outline our strategy to stabilize and grow our business, including what really differentiates us and sets us apart. Finally, I want to spend a few minutes talking through some of the changes that we both have made and are in the process of making to drive lasting transformation of our business. All right, so let's jump right in. Starting off, here is our business at a glance. We believe we have a very solid foundation to build upon as we move forward as ZimVie Spine. We play in a $12 billion global market, and we have a broad portfolio of products and solutions designed to meet the needs of our surgeon customers and the patients that they serve. These solutions really run the gamut throughout the entire market that we play in, including degenerative disease, deformity, and trauma. We're proud to have solutions for all of these different pathologies. We're also the market leader in two notable high-growth sub-segments, both in the areas of motion preservation. The first is cervical disc replacement with our market-leading Mobi-C. The second is pediatric scoliosis, where we have a novel new approach to treat pediatric scoliosis, which is called the Tether. I'll talk about both of these products and solutions a little bit later in much more detail. Finally, we have an established global business with a well-understood infrastructure. We have over 700 team members throughout the world. We participate in business in over 50 countries, and we have over 4,500 surgeon customers that we serve each year. We delivered $540 million in revenue in 2021, with approximately 70% of that business coming from the U.S., which is the primary geography where our business is located today. We're projecting three to five year growth rates in the low- to single-digit. I'd like to orient you to the left-hand side of the slide to start this off, because I think this is a pretty compelling statistic. There are over 5 million global spine procedures performed each year. That's a pretty staggering number. We know it's the number one reason that people seek medical treatment, which means that the majority of people will experience some type of spine-related issue throughout the course of their lifetime. This is a pretty major impacting issue that is facing many of us, and that's why this market is growing at such a sizable rate and is as big as it is today. As you can see on the right-hand side of the chart, this is part of what's driving this growth between 2021 and 2026. Additionally, we're looking at both macro trends as well as some that are specific to the spine industry that we believe will not only further grow the market as a whole, but also start to provide some color into some of the sub-segments of this market in terms of why certain portions are growing faster than others. Aging global population, that's something that we've all experienced in the med tech space. I think at the macro level, what's perhaps most interesting to me and has the most applicability to the spine market is the increase we're seeing in healthcare consumerism. We know that patients today are showing up more informed, more educated, and oftentimes having done the research to understand what treatment options are available to them as they seek care for themselves or their loved ones. I definitely fall into this category, whether it's for myself or a family member, I'm constantly researching the latest treatment options available so that I can be an informed participant in seeking the best path forward, for treatment in a variety of capacities. Translating to the spine industry, it's actually kind of interesting here. Two of the three major trends we're seeing tie right into this. The first, we know, that patients are expecting better outcomes. They're no longer just accepting what was previously accepted as the status quo, especially as it relates to clinical results. They're really becoming more and more informed and therefore opinionated about what it is they're seeking. As part of that, we're seeing an increased demand for less invasive treatments. Now that patients are aware that there are other solutions out there, that is something that they're in many cases seeking out actively to find surgeons and institutions that offer better and other solutions that have typically become available. Then finally, we are definitely seeing a shift in spine procedure volume moving from the hospital setting to the fast-growing ambulatory surgery center market. This is an area that is of particular interest to us because it truly is better for the three major customer stakeholders that we serve. Better for the patients, because that patient is able to return home same day in most instances and can recover in the comfort of their own home. It's usually better for the surgeon because they're given a greater autonomy over their choice as it relates to both their clinical practice as well as how they run their business. Finally, it's better for the provider and the payer because typically the total cost of care is significantly less when taking place in a standalone surgery center market. All of these trends, both macro and industry-specific, we believe are driving faster than overall growth rates, specifically in the area of minimally invasive surgery and motion preservation devices. Because it ties right back to that informed consumer that is seeking out better treatment options that have typically been made available, and basically demanding better improved patient outcomes. We're proud of the products and the solutions that we've brought to market. As a number six market share competitor in the space, we do span the gamuts of the four different segments of the spine market. This slide matches up our offerings to these different segments that we play in. Starting with core and complex. This is really the foundation of the spine market, and it's where the majority of spine procedures take place today. It's also a very crowded space with over 200 competitors throughout the globe participating in this space. As we talked about previously, there's a lot of share exchange taking place in this market. While very important, are largely commoditized, and we are experiencing price pressures in this segment as well. The bone healing market performs very similarly to the core and complex spine. Both of these segments are growing at low single digits. As you move down throughout the slide, we get into the two segments that we see growing at a much faster rate than the market as a whole. First, the MIS space. We do have solutions for this segment as well. Specifically and most notably, our Vital MIS is a new product launch that is built off of our Vital Pedicle Screw system to round out that offering and to allow us to compete in this fast-growing space. This is an area of importance to us, and we'll continue to watch it closely to ensure that we're capitalizing on the growing demand for minimally invasive surgery procedures. Finally, motion preservation. These are non-fusion alternatives to restore mobility and flexibility to the patients that receive these devices. We're gonna be spending quite a bit of time talking about both Mobi-C and the Tether, which are leading products in the motion preservation space. Our strategy for ZimVie Spine is simple. We will drive the turnaround of our base business to stabilize while in parallel, focusing on our growth drivers, which are three and very specific that have been thoughtfully selected. Starting with our base. As mentioned, this is the majority of the spine market today. It's the majority of our ex-MIS business. It's a very strategic segment of the market, and it's very critical that we continue to have a very strong foundation and a healthy core spine business. We have three initiatives that are in place to stabilize and drive this turnaround, and those are first, optimizing our portfolio. We need to be sure that we have an up-to-date, current, relevant, and impactful portfolio in core spine. That includes both filling portfolio gaps as well as eliminating and reducing any redundancy in our portfolio that is simply increasing our cost to serve. Second, we are driving commercial execution specifically in the U.S. market, which is where the majority of our business is located today. Then finally, we are looking at ways to improve our operational efficiencies, both to improve service levels to customers as well as reduce our total cost to serve. Getting that core business healthy is a critical part of our strategy. In parallel, we are doubling down in the markets where we believe we have differentiated technology and a real patient benefit with a clear path to leadership. The first of these is Mobi-C, our cervical disc replacement device that leads the space, and we will leverage our leadership position in that segment to both grow the cervical disc market as well as pull through our core fusion implants. We have a broad portfolio of cervical fusion implants, so in addition to a market-leading motion preservation device, we also can offer the full range of what surgeons are looking for when seeking treatment options for their patients. Our second focus growth driver is the Tether, and here we will continue to lead the development of this segment, which is pediatric scoliosis with first-to-market technology. The Tether offers a non-fusion alternative for children seeking treatment for scoliosis treatment. Finally, the MIS procedural solution space is something that is also of significant interest to us. We will pull through our implants by selling this full procedural solution, ensuring that we're all catering our offerings to the fast-growing surgery center side of care. As we continue to focus on these three growth drivers, we will fund innovation in this space, which will allow us to grow and differentiate while at the same time pulling through increased amounts of our base business, which makes our core business that much stronger and healthier. As we get going, this cycle will continue to repeat itself. The more we grow in our focus spaces and markets, the more we pull through our base business, increasing, which then again then allows us to fund future innovation into our areas of growth. I wanted to spend just a minute talking about our base business, which is really core and complex spine, because the majority of spine received care, 77%, in fact, and it is strategically important to the foundation of our business. I talked through on the previous slide the three initiatives we have in place to ensure that business is as healthy as it can possibly be. I also wanted to add that we have strategies in place to ensure that we grow share in core spine in addition to making sure we have a healthy foundation there. Those strategies are all centered on innovation that falls beyond the implant itself. Mentioned the fact that we have a strong core portfolio of brands that we're very proud of. Now we're looking at ways to innovate beyond the implant in the areas of efficiency and value-based solutions, because we also believe that will drive more implant pull-through. We want solutions that are focused on both clinical and operational efficiencies. By doing that, we'll be able to utilize value-based contracting to ensure that we're driving that implant pull-through, by working with the larger hospital institutions as well as the standalone surgery center market to ensure that we are that bringing that full exchange of value with not just our implants, but everything else that we can offer from both a hospital and a clinical efficiency perspective. Building upon our base business foundation, it's exciting to me that we are very well positioned in attractive sub-segments of the market. This is where we will really focus our efforts moving forward. The growth drivers are what excite me the most about this, because through this thoughtful market selection, we've been able to identify not only where the growth opportunities are, but more importantly, where we believe we are well-positioned to expand patient access to best-in-class solutions. Starting with Mobi-C. Mobi-C is a pretty exciting product. It restores quality of life by preserving motions for patients who have cervical disc disease. What this means is that patients now have another option where instead of having their neck fused, which limits mobility and flexibility, leads to subsequent surgeries. There's now an option to instead replace the disc, which significantly improves flexibility and allows the patient to live a much more healthier lifestyle long term. We have treated over 150,000 patients with Mobi-C since we first introduced the product in 2004. We've trained over 4,500 surgeons on the device, and annually there are approximately 3,200 surgeons who are actively embracing and performing Mobi-C each year. The second growth area for us is the Tether. Again, this is a new treatment option for pediatric scoliosis. We believe we are truly transforming scoliosis care for children because we now offer a solution that preserves their motion. Not unlike Mobi-C, previously the option was to fuse a child's back to first correct the curve and then putting rods in place to stabilize that curve. The Tether offers another option that allows the child to grow and naturally straighten out their curve, which significantly improves their motion and allows them to get back to a very healthy and active lifestyle. Since launching this product in August of 2019, we've been able to treat over 1,000 children throughout the globe with The Tether since receiving FDA approval. We have approximately 30 surgeons who are actively performing tethering today. We're just getting started in this market, and we're looking forward to continuing to develop this to expand this wonderful solution to more children who are seeking treatment for pediatric scoliosis. Finally, the minimally invasive surgery market. We are very focused on delivering MIS procedural solutions in a way that enables faster recovery for patients who are suffering from lumbar spine disease. As referenced previously, this is one of the biggest reasons people seek medical treatment, and the vast majority of spine patients are still being treated via an invasive open approach. We know that the benefits of minimally invasive surgery are many, especially for the patient. Yet that adoption has not transferred as quickly as we believe it should. We'll be very focused on this market to ensure that we're bringing not only the right procedural solutions to the space, but also the right techniques and technology beyond the implant itself to help give surgeons the confidence level they need to perform a minimally invasive approach on a more regular basis. We're focused on these developments, which is a very interesting theme between these three growth drivers I just went through. The first key theme that these markets share is that they are poorly served today. Just taking cervical disc as an example, only 33% of eligible patients are receiving cervical disc today instead of fusion. That means two out of three times a patient is still having their neck fused when we know there's a better option available, and they're indicated. They fall right within that, those approved guidelines for patients who should qualify for a cervical disc replacement. The Tether is in a very similar situation. Only 10% of the time eligible children are receiving tethering today, which means 9 out of 10 times they are still having their backs fused via a very invasive approach that I just discussed. MIS and open, very, very similar theme here. Only 37% of the time patients are receiving a minimally invasive approach when they go in for surgery. That's the first theme. All three markets are underserved today, and all three markets, we believe, present a very significant opportunity for us to expand patient access to better solutions. The second theme that these three markets share is that they're all growing faster than the spine market as a whole, as well as the subs that they're pulling from. Whether it's cervical disc, tether, or MIS surgery, these are sub-segments of the market that we anticipate will continue to grow at a much faster rate as patient adoption continues to grow within these spaces. The final common theme here is that the competitive landscape starts to narrow quite a bit as you get into these sub-segments. Other than the 200+ competitors that we see in the global spine business as a whole, you can see here that within the cervical disc replacement market, there are just five major companies, including ZimVie, who participate in the space. For tethering, it's just two. ZimVie really leads the space, and we have only one major competitor so far. In the minimally invasive space, yes, we have a significant amount of people who dabble in it, but really seven major competitors to speak of. That's exactly how we will grow our spine business. We will be expanding patient access to these best-in-class solutions by tapping into the portion of the market that is underserved, continuing to defend our leadership position in the portions of the market that are already developed and mature. Some themes are leveraged throughout our three growth areas here in terms of how we go about doing this. The first is leveraging our long-term clinical evidence. Mobi-C is probably the best example of this, where we have over 10 years of proven clinical outcomes that prove that Mobi-C is, in many cases, a better alternative to fusion. The Tether, while we're still a little bit early on in that cycle, we have very promising results from the clinical research that we have, and we have almost seven years of data on the Tether as well. Patient awareness campaigns is another key theme here that is resonating throughout all three of our growth segments. In many instances, patients either aren't aware or don't fully appreciate these various treatment options that are made available to them. We will continue to inform both patients and in the case of the Tether, the parents of these patients, to help people understand that there are other options out there and what these other options offer in terms of benefits. We need to ensure that we continue to train and educate both our surgeon customers and our sales force so that everybody's very clear on proper indications for these newer techniques as well as the benefits they offer. Of course, innovating on both the implants and the instruments that provide these solutions, as well as beyond that to ensure that we continue to lead in the space backed by strong clinical data and always thinking about new ways to ensure that we are bringing this technology to the market in a way that's going to resonate with surgeons as well as the patients that they treat. Finally, making sure that we're thinking about the site of care optimization opportunities for these different spaces. Both cervical disc replacement and minimally invasive surgery are perfectly positioned for the fast-growing ASC market. We'll ensure that we continue to cater our solutions to that space. Let's go a little bit deeper now on these three growth drivers. I love talking about Mobi-C. When we acquired LDR almost five years ago now, six years ago, I remember being really excited about the fact that we were going to have what I consider to be a very innovative, and disruptive technology to add to our portfolio. I can honestly say that six years later, I'm no less excited because it still is a wonderful device that really leads this space. More importantly, I believe we've just scratched the surface in terms of where we can take this device and by giving more patients a better option here. The mission across the top here is really kind of telling the story. We've mentioned the fact that this is a poorly served market. I think what's even more interesting to me is the fact that Mobi-C offers such clear benefits compared to fusion, and we have over 10 years of clinical data to support this. First, faster recovery. We know that Mobi-C patients return to work up to 20 days faster than those that receive a fusion. 20 days is a significant amount of time. I think anybody who's been through a surgery or watched a loved one go through a surgery can acknowledge that that recovery time period is significant. Limiting that and allowing patients to get back to their everyday lifestyle as quickly as possible has a real benefit to the patient. Also, we know that our Mobi-C patients have better outcomes with only 1/3 the rate of subsequent surgeries compared to a fusion patient. That means that two out of three times the patient is not having to go back in for surgery on adjacent levels of their neck. Again, a huge benefit to patients and as well as surgeons because they're having better patient outcomes. Finally, there's an economic story here. We know that Mobi-C offers a much more cost-effective treatment long term than fusion. The opportunity is there. We have strong clinical data backed by 10 years of proven clinical outcomes, and we lead the space with over 50% market share in cervical disc. As I mentioned, I think what's more important to us than continuing to pick up share within the already developed market is the fact that we have the opportunity to tap into the broader portion of the universe of patients who are still receiving a fusion instead of a cervical disc replacement. We intend to aggressively grow that market, and we'll be doing that by using our longitudinal data as well as advocacy from both patients and surgeons to help us continue to publish the benefits of cervical disc replacement over fusion. We'll also be focusing on the ASC market, where there are fewer reimbursement hurdles. As I mentioned before, it's an ideal setting for these patients to go in and have the surgery performed and then return home same day. We'll continue to educate surgeons on proper patient indications to ensure that everybody understands the broad variety of patients who actually qualify today to receive this device as an alternative to fusion. We'll make sure that we continue to drive demand by informing that educated consumer on the options that are available to them today. We'll build a sales team that's skilled in creating these markets as well, because there is a sales cycle that requires creating belief in this new approach. I could talk about Mobi-C all day long and the benefits that I see, but I think what's even more hearing this from a patient directly. We're going to cut to Tanya, who received a Mobi-C product, and she's going to tell us about her experience firsthand. 10 months post-op, I forget that I ever had surgery. Once in a while, I'll get a glimpse of my scar and, oh yeah, you had neck surgery, but with my daily life, I would never know. I mean, there's no pain, there's no numbness, there's no sleeping on the floor with a towel under my neck anymore. I sleep like a baby now. It's great. I hadn't had that for years. It's changed my life. It's amazing to me. I woke up and the pain was gone. Like, I still think about that day. Like, he told me, "You will wake up and you will be surprised how good you feel." I did. The pain was gone. I couldn't believe how good I felt. My name is Tanya DeGregorio, and this is my Mobi-C. As much as I love talking about Mobi-C, I think the Tether is an equally, if not even more impressive technology. As I said previously, the Tether is transforming scoliosis care for children by preserving their motion. This is an initiative, and this project means a lot to me personally, as well as so many of our Zimmer Biomet Spine team members who have worked so hard over many, many years to bring this technology to market. It's truly a passion project for many of us, and I can honestly say one of the initiatives that I'm the most proud to be associated with throughout the course of my career. I know that our surgeon customers that we've been working closely with to bring this technology to market would feel the same. That's because we are truly changing the standard of care for these children who are seeking alternative treatments for pediatric scoliosis. This is also a poorly served market. As I mentioned, 90% of the time, children are still being fused instead of receiving this device. This motion-preserving option is a great alternative to fusion for children who qualify and are indicated because it improves and sustains life long-term. We're seeing very promising results with greater than 92% success rate at initial follow-up, with a 5.4-year average follow-up time for the patients we've treated so far. Just like Mobi-C, there's recovery here where children are able to return to full physical activity as soon as four weeks after they finish their surgery. We were very privileged to hear from a Tether patient at one of our internal town halls just a few months ago, and hearing this 14-year-old girl talk about her ability to get back to horseback riding and playing sports in a matter of weeks was incredibly inspiring, frankly. I think is very motivating for all of us to continue to ensure that we develop this market to expand patient access to the solution. In terms of our opportunity, we are the only FDA-approved system to treat pediatric scoliosis via tethering, and we received that approval from the FDA in August of 2019. Also, we are very, very fortunate to be closely partnered with world-renowned, thought-leading surgeons in the pediatric scoliosis space who share our passion for this technology and are working hand in hand with us to ensure that we not only grow the market but continue to innovate in this space to ensure that the products and solutions we're bringing to the market really hit the mark for this very special patient population. In terms of some of the barriers, they're pretty typical for a new technology in a newer market. Reimbursement coverage is somewhat limited and frequently requires some additional discussion to help insurers and payers really understand the benefits of this technology. Parents are often unaware that this is even an available solution. There's limited access to surgeons that families can find that are actually performing tethering today. Again, we take this as a very important responsibility and honor to continue to build this market in a way that brings this knowledge and awareness to parents who are making these critical decisions for their children. We are going to continue to build out our clinical evidence in partnership with the surgeon advocates I mentioned, as well as the thought-leading research societies in this space. We know that by doing so, we'll be able to increase surgeon confidence with this newer technique, as well as expand payer coverage. We will also be looking at ways to develop predictive analytics and patient selection tools to help improve clinical outcomes to ensure that the right patient is being treated with this device at the right time. We will keep educating parents so that they are aware there's another option out there, and we'll be sure that we make these patients aware that there are surgeons out there performing this technology today. By doing this, we know that we'll be able to continue to grow the market and we will be actively promoting the fact that there is a non-fusion option to traditional ways of treating pediatric scoliosis. Just like before, I'm going to let us hear firsthand from a Tether patient herself to talk to us about her experience with this device. Our scoliosis brace provider, who's a chiropractor, had an X-ray on his wall of VBT, and we looked at it and asked, "What, what is that?" He said, "That's what everyone should be doing. Non-fused, no rods." I had never heard of it before. I was so relieved that there was an option. Emma's always been an active, energetic little girl, and she is still all of those things today. I don't have to wear the brace anymore. It's been three months after my surgery, and my life is completely back to normal. It changed my life. It really did, and I'm very grateful for it. The third area of focus for us is the MIS space, and we believe this is an important segment of the market because it enables faster recovery for patients who are suffering from lumbar spine disease. Like the other two growth areas we're focused in on, this is a poorly served market today. 60% of the time, patients are still receiving surgery via an invasive open approach. We know that a minimally invasive approach allows for a much faster recovery for patients due to the muscle-sparing approaches that are utilized when performing surgery minimally invasively. We also know that there's a shorter length of stay tied into an MIS approach, which reduces the total cost of care. There are a lot of reasons to continue to accelerate the shift from an open approach to a minimally invasive approach. We also know that one of the existing barriers is that trying to do surgery through smaller incisions makes it difficult and challenging to see the anatomy because visualization is restricted. At times, this can reduce surgeon confidence, especially as they're first learning the technique. Enabling technology such as navigation can improve visualization, but can also be cost prohibitive. What happens is initially, as that learning curve is first being approached, the MIS approach can initially increase both procedure time and cost. We're very focused on finding ways to reduce both procedure time and cost as we bring solutions to this space. We want to be sure that we are bringing the right enabling technology to assist surgeons in a way that allows them to gain that confidence quickly that is also cost effective for today's market. To show that we are customizing these solutions to the fast-growing surgery center market, because again, we know that this is a perfect setting and site of care to perform these surgeries in a minimally invasive setting or manner, I should say. Then we'll be sure that we continue to highlight and promote the benefits of MIS surgery over open so that both patients and surgeons understand what we can bring to the table here. These three markets that we're focused on do share these common characteristics. One, all are poorly served today, and two, more importantly, all offer clear patient benefits to the traditional standard of care. What this means is that we are very passionate and committed to continuing to develop these three markets in a way that expands access to best-in-care solutions. We'll be doing this by leveraging programs that support these underserved markets, and we'll be doing that in a way that leverages our market development expertise and experience to apply across all three markets. What's nice here is we're not reinventing the strategy for each of our growth areas. Instead, we're able to take tried-and-true principles that we know work and apply them into all three of these growth areas. Taking just one example here in the Mobi-C space as it relates to marketing campaigns, ensuring that we are informing that patient. Again, going back to that increase we're seeing in healthcare consumerism, we need to be sure that the patient is aware that there is a better option out there, as well as the surgeon. In the case of the Tether, we're doing the exact same thing. Only this time, we're targeting the parents because the parents are the ones making that healthcare decision for their child. Regardless of the segment that we're playing in, we're able to take these key themes of market development and utilize them across all three of our growth segments, knowing that by doing this, we'll be able to continue to grow those markets and not only protect our leadership position in the parts of the market that are developed, but really expand that overall access to both increase our opportunity and drive more patients to a better solution. I wanted to spend just a few minutes now talking about some of the changes that we are making and that we will be making to transform our business. Pre-2021, this business has been faced with several challenges. We were basically stuck in the middle without a unique identity, and a lot of that is a direct result of the several integrations and acquisitions that we have completed over the last five to six years. As part of those acquisitions and integrations, one of the things that came out of that was a fairly significant amount of U.S. sales disruption. The sales channel was consolidated several times as we put companies together, one after the next. The integration work also resulted in a redundant portfolio where we did have several overlapping products, which results in a cluttered offering, which is also expensive to support and maintain. The other challenge there is it does reduce focus with our sales force and with the market as a whole, and it led to a lack of discipline in some instances because the organization was trying to be all things to all people many of the time. We had too many projects. We were doing business in too many countries that were unprofitable. We had too many brands that weren't necessarily driving the profit to the level that we needed. All of this resulted in a very high cost to serve our customers. Taking a hard look at our business starting about nine months ago, we really said what needs to happen here to transform this business? One of the exciting things about separating and becoming our own company is that we can really drive that focus. We know that to do this, we need to run this business differently. We've already, and we're well underway in transforming this business by making a series of very thoughtful changes. The first is we focus our strategy on pursuing growth in these key sub-segments where we know we have differentiated solutions. I just talked through those at length. I think Vafa mentioned in his comments that sometimes you have these hidden gems in the portfolio that tend to get lost in the noise. With Mobi-C and Tether leading the charge here, I couldn't be more excited about the differentiated solutions that we have to offer. We'll be doubling down in those key markets and ensuring that we continue to invest and innovate in areas where we already enjoy a strong market leadership position and have a clear right to win. Second, discipline commercial execution, especially in the United States, which is where most of our business resides. We know that we can do the basics better here. Whether it's aligning our sales channel to our most important business priorities, ensuring that we have the right financial incentives in place to have us all marching in the same direction, and then just driving that execution from a sales perspective. We're already well underway in implementing these changes, and we are confident that through this disciplined commercial execution, we will start to see change. Third, our portfolio by both streamlining our offering to eliminate redundancy and filling some of our key portfolio gaps. I've talked about this already, but wanted to spend a few minutes talking about some of the tangible things we've done in this space. We've been very active at rationalizing the brands that are no longer fresh or current or in some cases are redundant. Most of that work has already been completed, and we'll be continuing to hone and fine-tune our portfolio as we move forward, making that a regular part of our DNA. Not a one-time event, but an annual continuous process to ensure that we always are deploying active portfolio management and keeping our portfolio as fresh and as competitive as it needs to be. We are refocusing innovation around our growth drivers. We are also taking a hard look and have taken a hard look at the number of projects and initiatives that we are investing in. Frankly, we had far too many projects, and we were making far too little progress because the teams had so much on their plates. We whittled down that list by a considerable amount and are now investing in those areas where we know we have the greatest opportunity and the greatest return. We're in the process of exiting several unprofitable countries in both Europe and Asia Pacific to ensure that we are set up in the right countries with a profitable growth story where we can focus and deliver. Finally, continuous improvement is a concept that we are embracing heavily and truly integrating into the way this business will operate moving forward. Whether that means right-sizing our cost infrastructure, taking a hard look at the way we manage our inventory, both internally and looking at all things operations. We are assuming that we have room to improve and take waste out of our system, while at the same time honing our focus to ensure that we are bringing the most important solutions to the customers that we serve and our patients. By doing all of these things, we know that we will be able to stabilize and then grow this business by taking these transformative initiatives and truly running the business differently than the way it's been run in the past. The traction that we've been receiving over the many things we've put in place already is pointing us in the right direction, and that will only continue as we make more concerted efforts to change and transform the way this business is run. In summary, I'm very enthusiastic about the future of this business. I believe this is a business that is full of potential. We are a number six market share player in an attractive $12 billion global market. We are very well positioned with a global footprint that currently exists, 700 team members throughout the world, doing business in 50 countries, serving over 4,500 spine surgeon customers today. We have a broad portfolio that serves all segments of the spine market. We have a clear strategy to both stabilize and grow our business, and we will do this by turning around our base business, while in parallel, focusing on three main growth drivers. The first, Mobi-C. We will aggressively promote cervical disc replacement as a better alternative to fusion to protect and grow our leadership position. Second, the Tether. We will drive demand for a motion and growth preserving alternative to fusion for children seeking treatment for scoliosis. Third, MIS procedural solutions. We will capitalize on the growing demand that we're seeing for minimally invasive options while catering these solutions and offerings to the fast-growing ASC side of care. We will do all of this by utilizing proven market development principles so that we can ultimately expand patient access to what we believe are truly best in class options for them. I'm confident in our strategy, our portfolio, and our team members. I also very much enjoy and I'm passionate about the surgeon customers we work with and the patients that we serve. All of this makes me very excited for the future of ZimVie Spine. Like I said, I believe this is a business that is full of potential. With that, I thank you for your time. I will turn the time over to Richard Heppenstall, our Chief Financial Officer. Thanks, Rebecca, and hello, everyone. My name is Richard Heppenstall, and I'm the CFO here at ZimVie. Over the next several slides, I'm gonna walk you through three main areas. First, I'll provide an overview at a relatively high level of our financial performance over the past few years. Then I'll explain how we plan to deploy a disciplined financial framework to generate expanded adjusted EBITDA margins to enable increased financial flexibility. I will be providing ZimVie's financial guidance for the full year 2022. From a recent historical perspective, ZimVie, like many other companies, has had to endure a number of challenges, most notably the impact of COVID-19. In 2020, the onset of the pandemic significantly disrupted our revenue and EBITDA performance, resulting in a year-over-year decrease of third-party sales and management adjusted EBITDA of 13.6% and 36% respectively. COVID-related market disruptions continued in 2021 as new variants surfaced, but these disruptions were generally more intermittent and had different impacts to our business's financial performance, which I will talk more about shortly. Now that we've concluded 2021, ZimVie's unaudited consolidated financial performance is expected to be largely consistent with 2019, ending at $1.009 billion in estimated third-party revenue and adjusted management EBITDA margins of 13.1%. How has the COVID pandemic impacted our dental and spine businesses? As I mentioned a moment ago, COVID-19 has had varied impacts on our dental and spine markets. Both markets suffered significant disruption during the first half of 2020 as elective surgeries were deferred or canceled in spine and dental offices and labs closed. The dental market bounced back relatively quickly in the second half of 2020 and recovered all of the pent-up demand by the end of the year. In 2021, U.S. dental markets operated with minimal COVID disruption, while certain geographies outside of the U.S., more specifically those with strict COVID lockdown protocols, continued to show periodic disruption. We expect 2022 to be very similar to 2021 for both the U.S. and those markets outside of the U.S. with stricter protocols. Our expectation is that our dental revenue will grow in the mid-single digits in 2022. Spine demand recovered slower in 2020 but returned to approximately pre-COVID levels in Q4. 2021 started strongly as elective surgeries continued. However, market uncertainty reemerged in Q2 and Q3 as new COVID variants and staffing shortages limited hospital capacity for elective surgeries in certain geographies around the world. The emergence of the Omicron strain at the end of 2021 resulted in a softer than expected Q4 and has carried forward into the first part of 2022. We expect continued periods of spine market uncertainty, particularly in the first half of 2022, and expect spine revenue to contract mid-single digits for the full year of 2022. Over the past couple of hours or so, Vafa, Indraneel, and Rebecca have been describing who we are as a company, have provided a detailed description of ZimVie's businesses, and discussed our focus areas to deliver long-term sustainable growth. All of those points underscored by our foundational strength provide us with the opportunity to drive significant value and financial flexibility via expanded, adjusted EBITDA margins and ultimately higher free cash flow. What's important to highlight is that our financial success strategy is predicated on our execution in two key areas: sales growth and operational excellence, and that we do it in these areas concurrently. Our ability to drive our digital dentistry solutions to pull through revenue, leveraging our clinically superior spine products, and our heightened commercial focus and execution enables accelerated sales growth. This sales growth, when combined with our targeted initiatives to optimize manufacturing, distribution, and supply chain, and by applying a disciplined fiscal approach to expanding operating leverage, we expect to be able to deliver expanded EBITDA margin greater than 400 basis points over the medium term. This outcome will provide greater capital allocation flexibility, enabling us to reduce leverage, invest in higher growth submarkets, invest in high return on investment initiatives within our businesses. Moving on to our 2022 guidance. Firstly, revenue. Our 2022 total revenue outlook is flat to 2021 or approximately $1 billion in 2022 sales. Please note that total ZimVie guidance is comprised exclusively of third-party revenue. Growth in our dental business to continue in 2022, offsetting our expectation of declines in our spine business as a result of end market uncertainty driven by the pandemic and the timing with which our spine growth initiatives begin to gain traction. Next, on adjusted EBITDA margin, we expect 2022 adjusted EBITDA margin to be flat to 50 basis points higher than 2021 as we deploy our financial framework and look to operationalize the business. This results in an adjusted EBITDA margin range of 13.1%-13.6% of sales. Adjusted earnings per share in 2022 is expected to be $2.10 and $2.30 a share on an undiluted basis. In addition to the financial guidance I just presented, we're calling a one-time spin guidance to assist you with your financial models. This additional color is meant to provide additional transparency into our expectations for 2022 and is located in the appendix of this presentation. As we look past our 2022 guidance, we're targeting mid-single-digit sales growth over the next three to five years and over 400 basis points of adjusted EBITDA margin expansion over the medium term, which we are defining as three to four years. We expect to facilitate sales growth and margin expansion in the near term by augmenting our teams, launching new products, and improving the utilization of our manufacturing and operations footprint. We intend to build on these near-term initiatives with additional initiatives, including new product innovation, geographic expansion, and leveraging our channel into the medium term. We expect that our execution on the sales and operations previously discussed will provide the financial flexibility necessary to selectively deploy capital to the highest ROI opportunities. With that, I will go ahead and hand it back to Vafa Jamali, our CEO. Thanks very much, Indraneel, Rebecca, and Richard. You know, carve-outs are just terrific opportunities. Here we get to revitalize the greatest aspects of the portfolio with the greatest clinical impact and put all of our focus right on those. ZimVie will declutter for efficiency and focus on the best opportunities for growth within our $20 billion markets. We're in the markets we wanna be in. We have some opportunities to expand our presence in select geographies as well as expand some key markets. We've invigorated our engineers and will spark their creativity and innovation. Our experienced management team is focused on long-term growth. We will push decision-making and accountability down through the organization and reduce organizational complexity. We are really, really excited about this opportunity, very excited about our future, and we look forward to any questions you might have in the Q&A session to follow. Thanks. And now we'll be taking a fifteen-minute short intermission to allow participants to join for questions. To ask a question, you may press star then 1 on your telephone keypad. If you're using a speakerphone, please pick up your handset before pressing the keys. And to withdraw your question, please press star then 2. Please stay connected for our Q&A session approaching shortly. Thank you. Pardon me. This is the operator. Our question and answer session will start in three minutes. I repeat, the question and answer session will start in three minutes. Thank you. Thank you, ladies and gentlemen. At this time, we will begin our question and answer session. To ask a question, you may press star then 1 on your telephone keypad. If you are using a speakerphone, please pick up your handset before pressing the keys. To withdraw your question, please press star then 2. At this time, we will just pause momentarily to assemble our roster. The first question will come from Robbie Marcus with JPMorgan. Please go ahead. Great. First off, thanks for putting today together. It was really helpful. Maybe two questions from me. First, bigger picture question. You know, we don't have all of the exact details over, let's say, the past five years, but we can make our assumptions. It's been a while since this business has grown in the mid-single digits. Maybe help bridge how you get from where you are today. Where you've historically been and then sustainably grow, you know, at a higher rate all while expanding margins at the same time. Thanks for the question. That's a great question. I think, Rich, probably we can take a little bit of a look through the history and then why we think we can get some mix of the LDR's numbers. Yeah. Thanks. Nice to meet you virtually, of course. Just quickly historically, over the few years, as mentioned in the presentation, we've had a certain amount of volatility, particularly in the spine business relative to COVID. If you wash that out, I'll bifurcate the businesses into two different sections. Starting first with the dental business. The dental business made a number of investments a few years ago that has really served to generate pretty good momentum, which as you see, has been generating a 6% CAGR over the last few years. The dental business has been able to drive you know pretty good momentum based on when compared to historical perspective earlier than when those investments were made. Indraneel Kanaglekar and his team have put really good focus in the business to grow that business over the last couple of years. On the spine business, as you would expect, there's been pretty good disruption relative to COVID. You know, I mean, the spine business has been losing a couple points a year over the last few years, which is why we are guiding the spine business to the mid-single digits contraction in 2022, which largely is offset by the mid-single digit growth on the dental side of the business. As you look at sustainability later on, you know, we're really looking at focusing on areas that we think we can be differentiated and grow better than the rest of the market or faster growing segments of the market. That really differentiates us. You know, in a three to five year period, that's when we can get sustainable growth out of these segments that are growing quicker. We can have better focus. Probably most importantly, we won't be, you know, wasting management time and focus on areas that aren't able to deliver that kind of growth for us. Thanks for the question. Got it. Maybe just a quick follow-up. You know, in the spine segment, you have Mobi-C, you have some of the other competitors, newer competitors coming out with some new product launches. In the dental side, you've had some of the competition making really good progress attacking those DSO accounts. You know, you highlight in the segment, but just walk us through the strategy of how you're going to not only defend the competition, but also improve from here would be really helpful. Thanks a lot. Right. Both spaces are extraordinarily competitive. We do believe that we are making strides in terms of differentiation. The two businesses will have different approaches to it. Rebecca, would you like to share a little bit of insight into how we look at spine? Sure. Absolutely. First of all, the emerging entrants into the cervical disc category, we believe gives further relevance and credibility to the space. The way we intend to compete is by going back on the offense to not just competing for share trade within the established part of the market, but more importantly, capturing that larger portion of opportunity. Because two out of three times, we know that patients are still getting their necks fused when there is a better solution available out there. We're very confident in our growth strategy for Mobi-C and believe that by expanding patient access to a better solution, that's the way that we'll really drive that market, at least in that space. Indraneel, would you like to share a little bit? Sure, sure. Thanks, Vafa. From the dental side, we feel fairly confident about driving this mid-single digit growth in the near and medium term. That's predicated on a few things. One is our leadership in the premium segment, as well as the leadership in biomaterials. That gives us a good basis to build upon. The four strategies that we laid out are driving implant growth through innovation and execution, maintaining our biomaterials leadership and driving pull-through and through cross-selling, driving digital dentistry workflows, again, to drive pull-through and investment in particular geographies. We have kind of demonstrated that these four strategies have worked well for us in the last couple of years and allowed us to grow at market, and we remain confident that going forward, we can continue to do the same. In both cases, you'll see us focusing more on markets that we believe can expand. Less about necessarily just share capture or share trade, but more around expanding markets and making our technologies more available to more patients. That's really a cornerstone to our growth strategy. Great. I appreciate the answers. The next question will come from Josh Jennings from td TD Cowen. Please go ahead. Hi. Good afternoon. Thanks for taking the questions and hosting the event. I was hoping to ask just two questions on the spine franchise and understand some of the dynamics that are baked into your guidance for a decline in the mid-single digits in 2022, the product rationalization and exiting some non-profitable regions. Wanted to hear more about your sales force. Has there been any attrition around the spine, and how are you thinking about adding or bolstering feet on the street? Then the follow-up would just be on enabling technologies and your thoughts on incorporating any enabling technology in your portfolio, your need to have enabling technologies. I just didn't hear anything about ROSA ONE Spine on the presentation, and so assuming that you don't have access to the robotic spine platform. Just wanted to get some better understanding on your future with enabling technologies and any commentary specific to ROSA ONE would be great. Thanks for taking the questions. Thanks, Josh. I'll start, then I'll pass it to you, Rebecca. On the sales force, we have not had significant turn or churn as a result of the spin. We're really pleased with the agencies on the spine side that we're very happy with those teams and the leadership there and their ability to really keep our customers motivated and excited about the future of ZimVie. Hats off to them and no, that has not been a concern for us. You're correct on exiting some of the unprofitable geographies. That's really important to us. That's part of the cleanup that really is necessary here and I think ultimately will allow Rebecca and her team to really focus in on the winning parts of it. On your second question on the enabling technologies, we have access to the ROSA Spine. However, we really looked at that market, and we see that, you know, right now, robotics within spine is very much under-penetrated. We look at maybe probably 5% or single-digit percentages of customers actually have a robot. And then the penetration of procedures is an even lower percentage than that. You see that whatever we've done in terms of the industry to bring technology, we haven't quite captured what we need to, which is either workflow improvements or patient outcome improvements. Because we haven't been able to quite capture that, I think it's still upon us in the industry to invest more time and more energy into, you know, technologies that can enable better procedures that will either enable, you know, better workflow in terms of time, and secondarily, better outcomes. We are actively looking for that, and we are eager to find solutions for that. We don't believe that we've invested enough in ROSA Spine. It's very different than the great work that Zimmer Biomet's done on knees and hips. It's very different than that for spine right now. We think we need a different solution to really capturing that one. We still think enabling technology is a critical point of getting procedures like MIS more adopted. Rebecca, would you like to add any more color to that? Yeah. Thanks, Vafa. I would just add that as we hone our focus and our strategic growth drivers, we want to be sure that we're bringing the right enabling technology solution to each of these growth driver areas that we've identified and that I talked through. Rather than a one-size-fits-all approach, we're laser focused on identifying the right clinical problems to be solved and then ensuring that we bring the right enabling technology solution to those key areas of growth and focus for us. Excellent. Thanks for those answers. Just a quick follow-up on the sales force. Is there in the United States, do you feel like you are fully represented in all regions, or is there a sales force expansion channel that you can pursue that will add to growth as we think about 2023, specifically for the spine business? Thanks for taking all the questions again. Sure. Yeah. In the United States, we have broad coverage, which is fantastic. As Vafa mentioned, we have not experienced much attrition at all, especially as we go through the separation. I mentioned in my comments earlier that one of our key growth drivers is stabilizing our base business, and a huge area of focus for us within that is focusing on our U.S. sales channel. It's where the majority of our revenue in our business exists today. Ensuring that we have strong coverage as well as an aligned growth strategy is critically important to us. Those efforts are well underway. Very pleased with the progress that we've seen over the last several months, and we'll be further accelerating those efforts to ensure that we are driving that best focus in the geographies throughout the United States. Some of that will come with optimizing the opportunity in certain markets, perhaps by adding supplementary coverage for some of our key growth drivers. Overall, we're very pleased with the team we have intact and believe we have adequate and sufficient coverage to drive our initiatives forward. Great. Thank you. Thank you. The next question will come from Vik Chopra from Wells Fargo. Please go ahead. Hey. Thanks so much for taking the questions and for putting the day together. Just two for me. First one on dental, you've talked a little bit about your plans to deliver that mid-single digit growth. Can you just help us understand if you have any plans to enter the clear aligner market and any plans to invest across value implants as well as your premium offerings? And my second question is on spine. You know, we've heard a lot from Zimmer on their ASC strategy. I'm just kind of wondering what specific steps that you're planning on taking to strengthen your competitive position in the ASC as it relates to spine surgeries. Thanks so much for taking my questions. Thanks, Vik. Clear aligners and value implants are big segments within dental, and of interest to us, so we've studied it a lot. I think, Anil's best positioned to Sure. to detail. As we said, we are currently focused on the tooth replacement market, which is dental implants. In the near term, that will be our focus. We remain confident about driving our growth with the existing portfolio and innovations we have, which is largely related to the premium segment. That said, value segment is a big part of the tooth replacement market. We won't rule out that opportunity, but in the near term, we are focused on premium segment, and we will continue to evaluate if and how we tackle value segment. ASC market, Rebecca. Yes. We absolutely have identified this as an opportunity for spine. We see that procedural volume continue to shift from the hospital side of care to the standalone surgery center market. We also know that we need to compete differently to really make the impact that's necessary in that space. What I mean by that is the implant itself, while obviously a key part of the equation here, is just a starting point because these surgeons that are operating at the surgery center market are owner-operators. They're looking for solutions beyond the implant itself, primarily as it relates to Operational efficiencies, for example. We are working on a strategy to basically streamline the way we deliver our implants to these ASCs, recognizing that the value hierarchy as it relates to decision-making differs slightly and in some ways significantly from the hospital setting. Those efforts are underway to ensure that we're bringing not only clinical value to that site of care, but probably equally, if not more importantly, operational efficiencies and overall workflow improvements as well. Excited about the opportunity ahead of us to continue to double down on that fast-growing side of care. Thank you. The next question will come from Drew Ranieri with Morgan Stanley. Please go ahead. Hi, everyone. Thanks for putting the day together. It’s been really helpful. I guess first just kind of given dental and spine, why do you think dental and spine fit together from your perspective? And how can these potentially complement each other over time to drive growth or margin expansion? I mean, we’ve heard kind of through the day about optimizing the portfolio and then expanding into markets. Just maybe help us kinda think through that as well as maybe what inorganic opportunities you see across each of the segments. Thanks, Drew. You know, we love both those markets. As we said earlier, you know, it allows us to be in a $20 billion market, gets us about $1 billion in sales, which is great scale. When you look at both markets on their own, they stand up well, and then you look at what synergies or why they should be together. You look at the terrific opportunity in terms of back office synergy that we have, which is probably the most obvious. You know, the back office synergy that we gain from two of them together. If you look at OUS, which you know largely for a U.S.-based company, you know, the infrastructure's primarily here. You look OUS, it really helps us in terms of expansion opportunities, choosing where to go, where to be great, where to be excellent. I think that gives us another opportunity. Then another layer further, which we haven't really focused on too much, but you can see operationally, whether it be distribution center consolidation or integration, again, some more back office integration there. Then finally, we have had some preliminary manufacturing synergies where we've been able to insource some of the spine activities into the dental office, so into the dental manufacturing plant. You look at that as kind of an evolution. The materials are very similar. The general idea is similar. Different sizes of course, but the idea is very similar. We haven't extracted too much of that in terms of our plan, in terms of putting it down on paper. It's definitely the things that we're looking at is how do we maximize the value of having these two great portfolios together. Hopefully that gave you a general overview on we think those belong together. Yes, thank you. Thank you. Just a follow-up. It looks like you're spending about 6% of sales on R&D. Just curious about how you're prioritizing spending. Where is it going for R&D between the portfolio? What should we expect near term from product launches? Is there any real product gap that you would seek to fill sooner rather than later? Thank you. The R&D—what we've implemented, we've implemented active portfolio management, which is the most dispassionate way to pick the best projects with the best return. They could be within spine, they could be within dental, inside dental or inside spine. Really, that's a critical way for us to decide, not in terms of what's fair or fifty-fifty, but in terms of what are the best opportunities. As we look at all the opportunities within spine and dental, we're fortunate to have lots and lots of opportunities for growth inside these submarkets that we think are better than possibly the core markets. This allows us to give a great unbiased, objective look at it. Then Rich, obviously we will look at other methods of determining where the next dollar of capital should go. I think, you know, that's something that we're implementing right now as well. Yeah. Just in addition to what Vafa just mentioned, you know, I think what's key and underscores how we're looking at the businesses we spin out from Zimmer Biomet here over the next, you know, 25 days or so, give or take, is that we're gonna be deploying a really rigid financial framework to be able to assess opportunities based on their merits. We're gonna really look at the organization as a meritocracy, and whichever investments have the best return over the long term are the investments that we will invest in. That includes, you know, your prior question around inorganic opportunities is, you know, our main focus is to stand up the business and to separate from Zimmer Biomet. You know, with that being said, we're spinning off. We've got $60 million of working capital at spin, and then $175 million of revolver that is gonna be undrawn. Although M&A is not our focus in the near term, it does give us the opportunity to be able to evaluate those. Yeah. Then Drew, also on the portfolio gaps, I think when we look at gaps, we look at like the core segment, both in terms of the dental and in terms of spine core. Those areas we have to have a full portfolio to compete. Those are the areas that we would constantly be evaluating, making sure that we have the right portfolio to be able to capture the maximum number of procedures within the procedures that we want to be inside. Yeah, we will continue to look at that and that will be determined by the teams, and again, put it through the rigorous process to ensure that we're picking the right choices, making the right choices. Thanks for taking the questions. Pleasure. The next question will be from Jeff Johnson with Baird. Please go ahead. Thank you. Good morning, guys, or good afternoon. Again, thanks for all the information today. Very helpful. I guess where I wanted to start was just on the dental implant side. You know, there's been some talk of a VBP plan there. Obviously, your Zimmer Biomet cohorts have had to deal with that on the hip and knee side quite a bit. Just are you hearing anything about China tenders being nationalized at this point? Maybe if you could help us understand what percentage of your implant business might be in China and what the split might be, private versus public. Any details you could provide there would be helpful. Thank you. Thanks, Jeff. It's a question that, you know, we've been working through, and obviously you're referring to China VBP, and it's impacting all of the healthcare space and the device space. We aren't certain, so there's not enough clarity yet in terms of when it will apply to either spine or dental. However, in our case, which is slightly different, is that we don't have a large percentage of our business in China. So, it gives us a great opportunity to evaluate whether to go in earnest stronger or not. I think we have the fortune of being able to evaluate that after the determination's been made, whether it's gonna be provincial or whether it's going to be a national VBP tender. In terms of private, Indraneel, does that have a big impact in China? Do you feel like that's- Yes. Just to add to what Vafa said, very rightly, not a large portion of our business comes from China, so we're not too worried about that impact. The business that we have in China is catering to both those channels. We won't go into specifics, but given the percentage of revenue, we are not too concerned. All right. That's helpful. Maybe just a financial question, if I could, a follow-up. When I look at your EBITDA guidance and the D&A that you're attributing to the business then in 2022, it looks like your operating margin is going to come in somewhere in the low- to mid-9% range. I understand Zimmer Biomet is retaining the $75 million or so in stranded costs, but I'm wondering in that 9%-9.5% operating margin for you specifically, what are standup costs in that? Or I guess it's another way I'd ask it is what the standup costs are or what your operating margin would have been if not being spun out, what your operating margin as part of Zimmer Biomet would have been this year if not for the spin. Thank you. Sure. There's about $61 million of standup costs in corporate. What that $61 million represents is obviously standing up the business as a stand-alone company, including of course executive management, public company costs, and then also the cost of standing up insurance. In that $61 million, that number just from, like, a high level perspective, is probably about $10-15 million higher than what it would be under Zimmer Biomet, you know, embedded in that company. Thank you. You're welcome. The next question is from Chris Pasquale with Guggenheim. Please go ahead. Thanks. One question on Mobi-C and then 1 on Tether. On Mobi-C, you know, the poor economics of disc replacement relative to fusion has been a sticking point for a long time. I'd love to just understand what's different now, where you think you can really change that, and what's a realistic timeframe for improving reimbursement? Rebecca? Yeah. You're absolutely right. That continues to be one of the barriers that we are actively addressing. With Mobi-C, where we have over 10 years of clinical data with proven clinical outcomes that shows the superiority to fusion in many instances, we believe that we will continue to advocate by leveraging that strong clinical history in close partnership with cervical surgeon advocates and in many cases, patient advocates to help advocate for that change. You're exactly right that there continues to be an economic disincentive for a surgeon to perform a cervical disc replacement over a fusion. That is a key part of our strategy to grow and develop that market and ensure that we are continuing to tackle that to expand patient access to what we know in many cases is a better solution for them. That's how we intend to do it. We recognize it, and we've got strategies in place to continue to tackle that. There's another element. Sorry, go ahead. There's another element that adds to what Rebecca's saying, and it's around this trend of, you know, healthcare consumerism, which is something that, you know, many of us who've grown up in devices hadn't really experienced. But if you think about tooth loss replacement or Mobi-C, which is your example, you know, consumerism is good for us in the sense that it will allow patients to advocate for their own health and to really choose if they're the right indication or not, if the right patient or not for the indication. I think that that's, you know, we're watching it closely right now. There's some activity that we'll do around reimbursement of course. There's also some just high profile disc replacement that's recently happened that continues to just add to the debate over, you know, fusion or disc replacement. Again, that debate isn't about the economics of it's about what's the best outcome for me as a patient. I think that's a trend that we look to capitalize on in a way that's aligned with our clinical evidence and the investments we'll make in clinical research that'll support what we advocate for. I think you had a follow on, sorry, Chris. Yeah, I was just gonna say, just to be clear on the long term kinda three to five-year outlook, does that assume that you have some material change in the economics there, or if that were to occur, would that represent upside? Relating to reimbursement specifically, no, our plans do not include a significant shift there, so we will continue to aggressively pursue it, but we're also very confident that we've got ample opportunity within the undeveloped market for the reasons Vafa just mentioned, as well as our strong clinical history. That would be upside if and when that policy changes. Our thesis is to grow the cervical disc market, not to take share from others. To do that, we have to make the economics better, we have to make the evidence more clear, and ultimately, we have to get more clarity on who is the right patient for it versus fusion. Those would all be upside to our plan, but they would be our long-term growth strategy. Okay. That's helpful. On Tether, just looking over some of the clinical data there, it looks like it was studied in patients with maybe less baseline curvature than those who typically get expandable rods. How much overlap is there between the target populations between those two technologies? What impact did the recall and then return to market of rods have on your sales there? Was that either a big tailwind or headwind as we look at historical periods? There are actually two slightly different subsegments of the market. The Tether really targets adolescent idiopathic scoliosis, whereas expandable rods is more targeted toward early-onset scoliosis. There's actually very little overlap between those two segments. There's a little bit, but it's very minimal. The Tether is really focused on, again, developing that market within the fusion portion of the segment. We pull a little bit from bracing, but it's really targeting that adolescent patients versus the early-onset scoliosis patient, which is typically a lot younger. Great. Thanks. The next question will come from Shagun Singh with RBC. Please go ahead. Thank you so much for taking the question and for the presentation. I guess my first one is on enabling technologies. I'm just curious, are you more focused on you know, bringing something you know, getting something out to market? Like, would you work externally? Would you look externally or you know, invest in the ROSA platform internally? The second question I had was on the financial profile. You know, you talked about mid-single digit growth business and 400 basis points of EBITDA margin expansion in three to four years. You know, how are you thinking about the annual progression there and you know, and also you know, the long-term target? Thank you. Let me answer enabling, and then Rich, you can answer the financial targets. On enabling, we believe that we have to find the right solution. Like I said, I think visualization and access are really important elements of an enabling technology. I don't believe that we have the luxury of a long drawn out internal program. I do think that we would likely be more interested in externally partnering or developing than trying to develop our own platform inside. From a margin expansion perspective, our margin expansion opportunity is basically predicated upon the concurrent execution of sales growth and then also operationalization of the businesses. There's a reason why businesses are spun so that we're thinking about it in a few different areas. Number one is we're looking to drive operating leverage on sales growth by deploying the financial discipline that I mentioned a little while ago and is also contained in the presentation. Secondarily, you know, we also have a really broad and diverse and flexible manufacturing footprint, and so being able to optimize our manufacturing and supply chain footprint is a second opportunity. The third opportunity is around some of the things that Vafa was mentioning around our cost to serve and lowering our cost to serve by driving optimization in some of our distribution and other areas. To your specific question around calendarization, we're looking at, like I mentioned, and like you mentioned also, 400 basis points over the next three to four years in margin expansion. We haven't calendarized it, but that is our long-term goal, and we're gonna get started here as soon as possible. Got it. If I could just squeeze in one more. I'm just curious what you're assuming for growth in your end markets in 2022. Thank you for taking the question. Low single digits, spine, mid-single digits dental. Thank you. Our last question will come from Matt Miksic with Credit Suisse. Please go ahead. Hey. Great. Thanks for squeezing me in. I just had one follow-up on Josh's question earlier on the sales force, and then just one clarification on Shagun's question just here on guidance, if I could. You know, Zimmer in the past had operated, I think, you know, mostly through independent distributors in the U.S. for both spine and orthopedics and through a lot of the same, call it companies, to carry those contracts for distribution. I would imagine that those have been sort of split or re-spun under the spin so that you now have, you know, independent contracts with those same independent distributors. I'm just wondering, you know, what that looks like going forward if you're dialing in any anticipated change as a result of, you know, you now carrying those contracts versus a larger Zimmer combined orthopedic and spine business carrying those contracts. Also whether you'd be, you know, expecting to follow the same kind of hybrid, you know, direct and indirect model that many of the other larger players in spine have followed over time. And then as I said, just one quick clarification on guidance, if I could. Okay. Let me answer the sales force question. We do not have any overlap with Zimmer Orthopedics in terms of our agencies. Our agents are very, very focused on spine. They have outstanding end user relationships and very, very good sales forces. We're very comfortable with the relationship that we inherit from the past, and we have a desire to continue that way. Secondarily, we don't really look at a mix. Unlike some of the other parties in the business, we actually are committed to this approach in terms of the U.S. sales force, which is through agencies, and we believe that they do an outstanding job and will continue to reinforce and improve our brand with our surgeons. We have no intention of having a mixed model there. We may support them with clinical expertise. Like I mentioned, you know, clinical evidence and clinical selling is an important part of our story. We may support them with that, but we wouldn't take from that relationship. I think you had a follow-up with respect to guidance. Sure. Go ahead. I'm sorry. Oh, I had one follow-up. Yeah, sorry. Go ahead. On the growth, you just mentioned that you're assuming kind of low single digits. I think market growth in spine and mid-single for dental. Just to maybe understand the mid-single digit decline that you sort of sketched out for spine this year as part of your guidance to get to the flat year-over-year guidance. You know, when we look at a business like LDR and Mobi-C, I should say, growing, you know, when you talk about the market growing in the high single digits, is it fair to say that, you know, that you'd expect that, you know, you'd expect to be growing that business kind of with the market or at, you know, at the market or better than market or whatever high single digit growth for that segment, and it's the other businesses that, you know, that get you to that minus mid-single digit growth for this year before you're able to kind of re-accelerate in the years that follow. Is that a fair way to think about sort of the composition of growth? It's kind of a mix. I'll start and then Richard and Rebecca show me. You know, there's also. Remember we've exited a number of countries which will have a top line impact. They are not profitable, but certainly they will leave a mark in terms of top line declines for the spine business. They were not markets that we should have been in, and they're not markets that we should remain in. Around the second question around how do we calculate it, Rebecca you'll address that one. Yeah. A couple of things. I think it's three factors. Vafa touched on the first, which is we are exiting unprofitable countries and brands, so as part of our cleanup and setting us up for a healthier future. Second, COVID has really made an impact on the spine business over the last couple of years, so that's factored in as well. Third, we have not historically in recent years done a good job of focusing in on our key differentiated growth drivers. So as we double down on Mobi-C, Tether, and MIS solutions, that's what will start to turn the business into a growth driver for the overall. That's going to take a little bit of time. We're building in that transition period so that we can orient our sales force around our most important growth drivers and really go back to playing offense in the world of market development. That's the reason for the transition period that goes from essentially the guidance we've provided to building to a low single digit growth projection over the next three to five years. Yeah, just Great. Thanks so much. Okay. I was just gonna say, sorry, one just little quick comment in there regarding our spine guidance with the single digit contraction in 2022. There's a couple of things going on in there. Obviously, there's uncertainty relative to COVID that we saw disruption and we saw softness at the end of Q4, which will carry forward into Q1. Right now we're expecting procedures to turn to pre-COVID levels in kind of mid-2022 timeframe. That obviously is a drag. The way that I'd suggest you think about the other portion of guidance is if you look at kind of trajectory around kind of certain products and continue those forward, because that's the way we're thinking about 2022 until Rebecca and her team, you know, gain traction on the initiatives that she just mentioned. Thank you. Ladies and gentlemen, this concludes our question and answer session. I would like to turn the conference back over to Vafa Jamali for any closing remarks. Thank you very much for sitting through our day with us. We're very, very excited about it. Hopefully it's coming across that this is a wonderful opportunity and I think that the team is really eager to get going and we look forward to sharing with you more in the quarters to come. Thanks very much. Really appreciate your questions. Thank you. The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.