Good day, everyone, and welcome to the Vivos Therapeutics Fourth Quarter and Full Year 2021 Earnings Conference Call. At this time, participants are in a listen-only mode. A question-and-answer session will follow management's remarks. This conference call is being recorded and a replay of today's call will be available on the Investor Relations section of Vivos Web site and will remain posted there for the next 30 days. I'll now hand the call over to Julie Gannon, Vivos' Investor Relations Officer for introductions and the reading of the Safe Harbor statement. Please go ahead.

Thank you, operator. Hello, everyone, and welcome to the Vivos Therapeutics fourth quarter and full year 2021 earnings conference call. A copy of our earnings press release is available on the Investor Relations section of our Web site at www.vivos.com. With us on today's call are Kirk Huntsman, Vivos' Chairman and Chief Executive Officer; and Brad Amman, Chief Financial Officer. Today, we'll review the highlights and financial results for the fourth quarter and full year 2021 as well as more recent developments. Following these more formal remarks, we will be prepared to answer your questions. I would also like to remind everyone that today's call will contain certain forward-looking statements from our management made within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities and Exchange Act of 1934, as amended, concerning future events. Words such as aim, may, could, should, projects, expects, intends, plans, believes, anticipates, hopes, estimates and variations of such words and similar expressions are intended to identify forward-looking statements. These statements involve known and unknown risks that are based upon a number of assumptions and estimates, which are inherently subject to significant uncertainties and contingencies, many of which are beyond the company's control. Actual results, including the results of Vivos' growth strategies, operational plans, future potential results of operations, or operating metrics, and other matters to be addressed by Vivos management in this conference call, may differ materially from those expressed or implied by such forward-looking statements. Factors that could cause actual results to differ materially include, but are not limited to, the risk factors described in other disclosures contained in Vivos' filings with the Securities and Exchange Commission, including our 2021 10-K, which was filed today and is accessible on the Investor Relations section of the Vivos Web site. Except to the extent required by law, Vivos assumes no obligation to update statements as circumstances change. Now at this time, it is my pleasure to introduce Kirk Huntsman, Chairman and CEO of Vivos. Kirk, please go ahead.

Thanks, Julie, and thank you everyone for joining us today on our fourth quarter and full year 2021 earnings conference call, which follows our first full year as a public company. I'm excited to review our results and provide you with an update on our progress. Afterwards, our Chief Financial Officer, Brad Amman, will review the highlights of our fourth quarter and full year financial results. Following that, we'll be happy to take your questions. Both the fourth quarter and full year 2021 marked periods of continuing market penetration and growth for Vivos. In the fourth quarter, we generated strong year-over-year revenue growth of 33%. And for the full year, we grew revenue by 29%. We were particularly pleased by this performance in sales growth given that it came about despite significant headwinds throughout our core customer base, mostly driven by COVID-19 variant resurgences in the middle and latter part of the year. In December 2021, the American Dental Association reported that just 60% of dental practices were open and operating with business as usual. Another industry source reported that 92% of dental practices were struggling to hire or replace hygienists, and 77% recorded difficulty hiring front desk positions. These operational challenges across the dental community have a direct impact on both enrollments of dentists and our VIP program and patient case starts, as replacement dental personnel must be trained and The Vivos Method reintegrated into practice routines. Regardless of such headwinds, throughout 2021 we continued to successfully execute on our three key performance metrics of one, new VIP dentist enrollment; two, total home sleep tests, or HSTs performed; and three, new case starts. In addition, during 2021, we also saw significant advancements in our regulatory status as well as ongoing research and publication efforts that we believe greatly strengthen…

Thank you, Kirk, and good afternoon, everyone. Today, I'll review our fourth quarter and full year 2021 financial results. We reported total revenue of $4.4 million for the fourth quarter of 2021, a 33% increase compared to $3.3 million for the fourth quarter of 2020. This increase was mainly due to increased revenue from VIP enrollments, appliance sales due to volume increases, management fees from our Medical Integration Division, or MID program, Billing Intelligence Service, subscriptions and additional revenue sources not present in 2020, including our MyoCorrect Orofacial Myofunctional Therapy or OMT services and sponsorship revenue. Fourth quarter 2021 revenue growth was partially impacted by lower VIP enrollments due in part to the COVID-19 Delta and Omicron variant resurgences. However, VIP enrollment revenue was actually up year-over-year due to recognition of revenue from prior periods. During the fourth quarter, we enrolled 35 VIPs net of cancellations and recognized revenue of approximately $2.1 million compared to 54 VIPs and revenue of approximately $1.7 million during the same period last year. During the three months ended December 31, 2021, we sold 2,707 total oral appliance arches for revenue of approximately $1.5 million, an increase from the three months ended December 31, 2020 where we sold 2,525 total oral appliance arches for revenue of approximately $1.3 million. The increase in appliance revenue is due to volume increases. For the full year 2021, revenue increased 29% to $16.9 million compared to $13.1 million for the full year of 2020. This increase was attributable to the same factors I just mentioned. During the 12 months ended December 31, 2021, we enrolled 197 VIPs net of cancellations for revenue of approximately $8.5 million, a 13% revenue increase compared to 248 VIPs and revenue of $7.5 million for 2020. The roughly 13% revenue increase was primarily driven…

Thank you. [Operator Instructions]. We'll take our first question from Alex Nowak with Craig-Hallum Capital. Please go ahead.

Good afternoon, everyone. This is Chase on for Alex. First for me, given the revamped SleepImage sales strategy, did it contribute any sales in Q4? And how do you expect this to trend over the next several quarters?

Great question. So we did not see any revenue recognition from sales of the SleepImage product in Q4. That was a time when we were transitioning the program over from what was essentially a loss leader to a profit center for us. And so it's here in the first quarter, and really going into the second quarter of the year that we'll start to see some revenue contributions. And we'll have to explore just to what extent those revenue contributions are as we see how the rollout goes.

That's helpful. Thank you. Then second, could you expand at all on the revamping of the marketing initiative to not only gain more VIPs, but also more arches from those VIPs that you already have signed on?

Yes. So we have seen over the course of time, especially throughout COVID, we see providers coming on and dropping off in terms of their production for implementing sleep in their practices. There have been a lot of distractions for dentists. They've wrestled with practice closures and loss of staff, et cetera. So we have been out there actively in the market retraining new staff personnel, getting systems reinstalled back in their offices, helping them to navigate these things. And we're seeing quite a great degree of reception to that. And we're seeing a great uptick from new purchases, new case starts from these doctors who had been either -- their production had fallen off or they had sort of lost their way a little bit. So we are continuing to devote a considerable amount of our resources to reactivating or encouraging doctors to continue to grow their sleep visits in their practices. And we're having some very, very encouraging success with that.

That's helpful color. Thank you. And then that 220 patient study you mentioned, it sounds exciting. Any other specific publications we should be watching for in the near to mid-term here?

Yes, I think you'll see in the next -- the next little while you'll see some announcements from us with respect to important studies that have been ongoing, and we'll have announcements coming out about that. But we're very, very excited about what we're seeing on the research and development front.

That sounds great. And then concerning the departure of your CMO, any updates there you can provide on the search for a replacement?

No. At this point in time, Dr. Singh had already somewhat scaled back his time and efforts here because of his sabbatical. And so we had previously taken steps to allocate responsibilities and various aspects of what he was doing to other personnel within the organization or contract personnel that we hired. So we feel like we are well positioned to navigate that. And we are in discussions with a number of potential replacements. We aren't yet prepared to make any announcements about that. But we're evaluating a number of different candidates at the moment.

And then just lastly for me, just a little housekeeping for Brad. Could you provide us the specific share count for the end of Q4, not the full fiscal year? I might have missed that in the release, that'd be helpful.

We had 23 million shares outstanding at the end of the year.

Okay. Thank you very much.

Thank you.

Thank you. And that does conclude today's question-and-answer session. I'd like to turn the conference back over to management for any additional or closing remarks.

I would like to thank everyone for joining us on today's call and for your continued interest in Vivos. I hope that throughout this call, you've been able to sense the optimism that we have here for this company and its prospects as we move headlong into 2022. I don't think we've ever felt better about where we are in the stream of things and the potential that lies before us. So we are very excited about what's happening. We're very excited about what the future holds. And we appreciate each and every one of our shareholders and investors for supporting us and for all that you do. I'd also like to extend a thank you to our amazing Board of Directors for the guidance and direction that they have provided this company. They've done an absolutely amazing job of leading this company and doing the things that are necessary to position us for what lies ahead. So I want to express on behalf of all of the management here, our appreciation for the active role that our Board of Directors is playing in our future. And also that extends as well to our Medical and Clinical Advisory Boards and all the good work that's being done out there on behalf of this company. We really truly wouldn't be able to do what we do without them. So appreciate everyone and their contributions here. And we look forward to having more positive results to report in the future. Thank you very much. Have a great day. And we'll see you again soon.

Thank you. And that does conclude today's conference. We thank you all for your participation. You may now disconnect.