Octacalcium Phosphate Bone Substitute (Bontree®): From Basic Research to Clinical Case Study

Abstract

Bone grafts used in alveolar bone regeneration can be categorized into autografts, allografts, xenografts, and synthetic bones, depending on their origin. The purpose of this study was to evaluate the effect of a commercialized octacalcium phosphate (OCP)-based synthetic bone substitute material (Bontree®) in vitro, in vivo, and in clinical cases. Material characterization of Bontree® granules (0.5 mm and 1.0 mm) using scanning electron microscopy and X-ray diffraction showed that both 0.5 mm and 1.0 mm Bontree® granules were uniformly composed mainly of OCP. The receptor activator of NF-κB ligand (RANKL) and alkaline phosphatase (ALP) activities of MG63 cells were assessed and used to compare Bontree® with a commercial biphasic calcium phosphate ceramic (MBCP+TM). Compared with MBCP+TM, Bontree® suppressed RANKL and increased ALP activity. A rabbit tibia model used to examine the effects of granule size of Bontree® grafts showed that 1.0 mm Bontree® granules had a higher new bone formation ability than 0.5 mm Bontree® granules. Three clinical cases using Bontree® for ridge or sinus augmentation are described. All eight implants in the three patients showed a 100% success rate after 1 year of functional loading. This basic research and clinical application demonstrated the safety and efficacy of Bontree® for bone regeneration.

Radiographic and Histomorphometric Evaluation of Sinus Floor Augmentation Using Biomimetic Octacalcium Phosphate Alloplasts: A Prospective Pilot Study

“…These are demineralized bovine bone materials (DBBM) coated with OCP or Bonarc TM (Toyobo Co. Ltd., Osaka, Japan), which is a mixture of OCP and collagen. However, unlike these products, which are not fully composed of Ca-and P-containing apatites, the recently introduced OCP bone graft Bontree ® is fully composed of apatite compounds with 80 wt.% OCP and 20 wt.% HA [9]. Therefore, to our knowledge, this is the first clinical study on maxillary sinus grafts using a pure OCP-based synthetic bone substitute.…”

“…However, the recent developments in mass production technology at room temperature, which does not require a sintering process, have opened up the possibility of clinical applications with improved physical properties and an inherently high osteogenic capacity of OCP. Our previous studies have demonstrated the efficacy and safety of bone regeneration using this commercialized biomimetic OCP synthetic bone substitute material (Bontree ® ; HudensBio Co., Gwangju, Korea) in preclinical and clinical studies [9,10].…”

CORR Insights®: Octacalcium Phosphate/Gelatin Composite (OCP/Gel) Enhances Bone Repair in a Critical-sized Transcortical Femoral Defect Rat Model

“…The field of bone graft substitutes is crowded, but the holy grail has yet to be found. Therefore, despite the challenges to OCP, based on the encouraging results presented by Hamada et al [2] and other results in dental reconstructive surgery [4][5][6], a careful stepwise approach to clinical trials could be used in orthopaedics. The trials would likely be initiated by an institution working on critical research and development or a commercial company interested in adding to the field of bone graft substitutes.…”

Granular honeycomb scaffolds composed of carbonate apatite for simultaneous intra- and inter-granular osteogenesis and angiogenesis

“…Granular, rather than blockish, scaffolds (<2 ​mm) are used in clinical dentistry because their defect sizes in bone are usually small [ [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ]. Macroporous granules are more favorable than dense granules (DGs) for the rapid ingrowth of bone [ [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] ].…”