1. combioss

2. The Bionic Solution Learning from nature...
humerus head, µ-CT, © Scanco AG
...to create the optimal bone void filler: porous inside, stable outside.
combioss

3. Morphology Spherical granules
available in the range of 315 < ø < 1600µm
Macroporous granules
Porosity > 50%
Interconnected micro-porosity
Pore size ≈ 5µm

4. Morphology Comparison
combioss
Competitor: dense structure

5. Crystal phase purity
X-ray diffraction- (left) and infrared-spectrum (right) prove
b-phase purity of > 99%

6. Chemical Composition Chemical pure b-TCP
Transmission [%]
Transmission [%]
combioss
Competitor K
Competitor C
Competitor B
Wavelength [cm-1]
Wavelength [cm-1]
Chemical pure b-TCP
b-TCP with calcium pyrophosphate (K)
b-TCP containing HA (B)

7. Solubility combioss is completely soluble! (ISO 109913-14)F B K
Solubility tests: pH 3, T = 37°C, 3 hours

8. Physical Properties Porosity Bulk density Abrasion Porosity [%]
Bulk density [gcm-3]
C competitor
combioss
C competitor
combioss
C competitor
combioss
Porosity
Bulk density
Abrasion

9. Properties Pure-phase b-tricalciumphosphate (>99% b -TCP)
Interconnected porosity
Porosity > 50%
Osteoconductive
100% synthetic
Spherical granules
 315µm µm
Simultaneous resorption to bone growth
Complete resorption proven

10. Analytics Identity Phase purity by XRD and IR Porosity Bulk Density
All production processes are validated. The following parameters are analyzed for each production lot:
Identity
Phase purity by XRD and IR
Porosity
Bulk Density
Mechanical stability of granules, Abrasion
Granules geometry and color
Complete solubility by ISO
Heavy metals

11. Biocompatibility and Bone Formation
Light blue:
pre existing bone
Good biocompatibility
Good osteoconductivity
Granules are osteointegrated
Degradation and resorption via solubility, osteoclastic action and macrophages
Resorption rate depends on implantation site (loads, fluid exchange): months
Complete resorption proven in scientific study in animal model
Dark blue: new bone
Combioss granules
Sheep, super critical size hole model of 8mm in femur, after 2 months

12. Human Histology
Osteointegration process of RootReplica™ (combioss) after 6 months, human histology of alveolar process
Dark green: new bone
Combioss granules
Osteoid (red): bone formation in progress, Bone Formation within combioss granules
Light green: undifferentiated tissue invaded by osteoids

13. Advantages Porous inside, stable outside Less material to fill defect
Taking up blood
Minimal generation of small
particles
Complete resorption
Pure b-phase >99%
Purity > ASTM

14. Indications Filling of bone defects after extirpation of cysts
Defects in corrective osteotomy
Defects after the extraction of a tooth
Sinus floor elevation surgery
Periodontal and peri-implants defects
Defects after harvesting of
autogenous bone
Augmentation of alveolar bone

15. Available Sizes Ref-Nr. Content Granule Size CBO-0500-05 5 x 0.5 ml

16. Case Report
Initial X-rays
Detachment

17. Case Report
Detachment
Detachment

18. Case Report
Impacted canine tooth
Extraction of impacted canine tooth

19. Case Report
Post-extraction socket
Cavity filling with Combioss

20. Case Report Cavity filling with Combioss and CGF
Cavity filling with CGF membrane

21. Case Report Cavity filling with CGF membrane
Stitched wound, covered with serum

22. Case Report
Stitched wound, covered with serum
3 days after surgery

23. Case Report
Quality of the tissues after 3 days
X-rays after 45 days