Study On Modern Bone Grafts
Bone regeneration remains one of the biggest challenges in implant dentistry and oral surgery. While autogenous bone is still often called the “gold standard,” anyone who has harvested it knows the downsides: added surgery, increased morbidity, and limited availability. It’s no surprise that synthetic bone substitutes continue to attract attention. [i]
Among these, β‑tricalcium phosphate (β‑TCP) has been used for decades. More recently, β‑TCP combined with calcium sulfate (CS), commercially known as EthOss®, has been promoted as an alternative that will resorb and be replaced by bone within 6-12 months. This is the heart of bone regeneration because we believe success shouldn’t lie in simply filling a defect. Success is also knowing what has been left behind once healing has happened.
So how does EthOss perform?
A published clinical case series with histological evaluation investigated the use of a β‑TCP/calcium sulfate graft material (EthOss) in human patients undergoing implant site development.
How the Study Was Designed
The study followed multiple clinical cases where EthOss was used for bone regeneration prior to implant placement.
The approach included:
- Use of β‑TCP/CS (EthOss) in extraction sockets and bone defects
- Healing periods appropriate for implant placement
- Retrieval of bone samples during implant osteotomy
- Histological analysis of the regenerated sites
- This design is particularly important because it moves beyond laboratory or animal models and evaluates outcomes directly in human clinical scenarios.
What Did They Find?
The findings were consistent and clinically relevant.
“The results of this case series suggest that the alloplastic bone product is 50% resorbed and replaced by new host bone at 12 weeks, with further consistent resorption to 85% at 33 weeks. These results suggest that this alloplastic product can be successfully used in a wide variety of intra-oral bone grafting protocols leading to consistent resorption of the material and its replacement with new host bone, independent of clinician and established histological analytical protocol used.” [ii]
This bone was well organised, properly vascularised and structurally suitable for implant placement.
One of the most important findings was the absence or near absence of residual graft material in the biopsy samples. This demonstrates that the graft resorbed during the healing phase and was replaced by native bone rather than remaining in situ.
“Further, minimal particles of graft material was noted histologically, supporting conversion of the EthOss graft material to host bone and vascularization of the graft to support that conversion process to vital bone. The material was well tolerated and at the 12-week re-entry overlaying soft tissue demonstrated a lack of inflammation and healthy keratinized gingiva.” [iii]
Across the cases, the regenerated sites allowed for successful implant placement, indicating that the quality and quantity of bone formed were sufficient for functional loading.
What Does This Mean for Practice?
Bone grafting materials don’t just need to fill space, they need to resorb at the right pace and be replaced by real bone.
In this clinical case series, EthOss demonstrates exactly that, with clear examples of predictable resorption, formation of vital bone and minimal residual material.
For clinicians weighing synthetic graft options, this highlights an important point, not all β‑TCP-based materials behave the same once placed in the body.
As expectations for long-term outcomes continue to rise, materials that work in harmony with the body’s natural healing processes are likely to define the future of bone regeneration.
Further Reading
To explore the study in detail, you can access the full publication here:
https://ethoss.dental/uploads/files/Bone-Regeneration-Using-and-Alloplastic-Graft-Material-that-Combines-beta-tricalcium-phospate-and-calcium-sulphate-A-case-series-report-with-histology.pdf
Our other publications and papers can be found on our website:
https://ethoss.dental/publications
Sources
[i] https://www.sciencedirect.com/science/article/pii/S0020138321000942
