Preclinical Evaluation of an Innovative Bone Graft of Marine Origin for the Treatment of Critical-Sized Bone Defects in an Animal Model

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

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.