COWELL® BMP

Osteoinductive Bone Graft

rhBMP-2 + BCP
COWELL® BMP Osteoinductive Bone Graft
rhBMP-2 + BCP
4. Mechanism of Action of COWELL BMP
A. Migration of Cells with lamellipodia

1. Composition of COWELL® BMP A

filopodium
lamellipodium
A. Filopodial extensions
Ror2 Brld
cdc42 brll
Myo-x LIMK
• COWELL® BMP is bone graft material based on the E.rhBMP-2 (E.Coli derived Recombinant Human Bone
B adhesions
Morphogenetic Protein type 2), developed for the first time in the world. COWELL® BMP is supported with B. Cell protrusion
10 years of clinical data and over 40 studies. extracellalar space P13K Rho-
Intergrins GTPase
stationary cell actin filaments FAK
• BCP as a carrier allows maintenance of space.
microtubule
microtubule C. Nuclear effectors
GTP GDP organizing center R-smad MAPK
2. Features of COWELL® BMP Rho-GDP Rho-GTP C nucleus
I-smad p38

LIMK1
• Primary closure for soft tissue regeneration is not required. Cofilin
D adhesions D. Retraction
Intergrins FAK
• Regenerates adherent gingiva.
Actin remodeling cytoplasm polarized cell
migrating cell
• Simplifies challenging bone grafting and soft tissue regeneration.

• Acts directly on stem cells.

• Induces bone regeneration without infection in extraction socket.

• Contains 1mg of bone morphogenic protein per 1g of the particle.

(1g of autologous bone contains 2ng of bone morphogenic protein) B. Cellular mechanisms
A : BISC BMP-2 B : PFC

3. Application
BRII BRI

A. Orthopedics
DRM Clsthrin-
coated
Bone grafts Injection Device pit • BMP-2 adheres to the membrane of
stem cell and induces expression of
• Fractures : Tibia, Radius, Ulna. • Lengthening : Distraction osteogenesis. genes of nucleus. Then, BMP-2 migrates
• Spine Fusion (Degenerative Disc Disease) : • Osteoporosis : Hip joint fracture. non-transcriptional to recipient site.
responses early
endosome
Interbody cage, Posteolateral. • Bone Defect : Bone cyst. • BMP-2 growth factor, Twist-2
• Bone Fusion : Foot/shoulder revision. cytoskeletal transcriptional factor, and VEGF growth
rearrangements
factor synthesize and secrete
caveosome
endogenous growth factor.

crosstalk • Proliferation of osteoblast of osteocyte,

non-Smad & Smad
pathway pathway R-Smad1/5/8 and proliferation of fibroblast in dermis
B. Dentistry C. Dermatology fine tuning
and keratinocyte of the skin.
p38 co-smad4
• Twist-2 transcriptional factor induces
Bone grafts Soft Tissue grafts ERK miRNA
P13K tissue regeneration in osseous tissue
and adherent gingival area.
• Severely resorbed alveolar ridges. • Damaged skin regeneration.
• Tooth extraction socket. • Diabetes ulcer.
• Alveolar bone loss.
• Maxillary sinus bone loss.
• Bone-inductive implant : Coated implant.
• Maxillofacial reconstruction. non-smad-responsive genes smad-responsive genes

002 COWELL® BMP COWELL® BMP 003

5. Product Type COWELL® BMP Plus (Two vials)

COWELL® BMP (One vial)

BMP Powder BCP Particle

BMP Coated
BCP Particle
BMP + BCP
BMP Powder
BMP BMP Powder
+ BMP Coated BCP Particle

• Dose and particle size of the COWELL® BMP Plus.

• Dose and particle size of the COWELL® BMP BMP 0.1mg BMP 0.25mg

Product Code BMP Dose Particle Dose Particle Size Product Code BMP Dose Particle Dose Particle Size

EBB0125 0.1mg 0.25g 0.41~1.0mm EBB2525 0.25mg 0.25g 0.41~1.0mm

EBB0105 0.1mg 0.5g 0.41~1.0mm EBB2505 0.25mg 0.5g 0.41~1.0mm
EBB1110 0.1mg 1g 0.41~1.0mm EBB1125 0.25mg 1g 0.41~1.0mm
EBB1220 0.1mg 2g 0.41~1.0mm EBB1225 0.25mg 2g 0.41~1.0mm

BMP 0.5mg BMP 1mg

Product Code BMP Dose Particle Dose Particle Size Product Code BMP Dose Particle Dose Particle Size

EBB0525 0.5mg 0.25g 0.41~1.0mm EBB1025 1mg 0.25g 0.41~1.0mm

EBB0505 0.5mg 0.5g 0.41~1.0mm EBB1050 1mg 0.5g 0.41~1.0mm
Product Code Particle Size Product Code Particle Size Product Code Particle Size
EBB1150 0.5mg 1g 0.41~1.0mm EBB1011 1mg 1g 0.41~1.0mm
BB1010 0.41~1.0mm BB1025 0.41~1.0mm BB1050 0.41~1.0mm
EBB1250 0.5mg 2g 0.41~1.0mm EBB1012 1mg 2g 0.41~1.0mm
※ A vial of 0.1g can be used for less than one extraction socket, while 0.25g/0.5g can be used for maxillary sinus or for the wide bone defect area.

BMP 2mg

Product Code BMP Dose Particle Dose Particle Size

EBB2025 2mg 0.25g 0.41~1.0mm

EBB2050 2mg 0.5g 0.41~1.0mm
EBB2011 2mg 1g 0.41~1.0mm
EBB2012 2mg 2g 0.41~1.0mm

004 COWELL® BMP COWELL® BMP 005

INNO GF Kit (Two vials + Saline Solution + Syringe) 6. User Guide COWELL® BMP
A. Method I

BMP Powder BCP Particle Saline Solution

+ +
& Syringe

BMP BCP

• Dose and particle size of the INNO GF Kit.

a. Transfer BCP graft material (Vial I). b. Inject distilled water into vial II with lyophilized
BMP 0.1mg BMP 0.25mg rhBMP-2 power in it and mix with the powder.

Product Code BMP Dose Particle Dose Particle Size Product Code BMP Dose Particle Dose Particle Size

IBB0125 0.1mg 0.25g 0.41~1.0mm IBB2525 0.25mg 0.25g 0.41~1.0mm

IBB0105 0.1mg 0.5g 0.41~1.0mm IBB2505 0.25mg 0.5g 0.41~1.0mm
IBB1110 0.1mg 1g 0.41~1.0mm IBB1125 0.25mg 1g 0.41~1.0mm
IBB1220 0.1mg 2g 0.41~1.0mm IBB1225 0.25mg 2g 0.41~1.0mm

BMP 0.5mg BMP 1mg c. Mix BMP solution with BCP or plus autogenic d. Cover the defect area using a barrier membrane or
/ allograft and apply into the recipient site. suture natural soft tissue without membrane.
Product Code BMP Dose Particle Dose Particle Size Product Code BMP Dose Particle Dose Particle Size

IBB0525 0.5mg 0.25g 0.41~1.0mm IBB1025 1mg 0.25g 0.41~1.0mm

IBB0505 0.5mg 0.5g 0.41~1.0mm IBB1050 1mg 0.5g 0.41~1.0mm B. Method II
IBB1150 0.5mg 1g 0.41~1.0mm IBB1011 1mg 1g 0.41~1.0mm
IBB1250 0.5mg 2g 0.41~1.0mm IBB1012 1mg 2g 0.41~1.0mm

BMP 2mg

Product Code BMP Dose Particle Dose Particle Size

IBB2025 2mg 0.25g 0.41~1.0mm

IBB2050 2mg 0.5g 0.41~1.0mm
IBB2011 2mg 1g 0.41~1.0mm
IBB2012 2mg 2g 0.41~1.0mm
a. Transfer BCP graft material b. Apply BCP into the recipient site and cover the c. Inject distilled water into
(Vial I) into a container. defect area using a barrier membrane or suture lyophilized rhBMP-2 powder
natural soft tissue without membrane. (vial II).

d. Mix rhBMP-2 with distilled water e. Aspirate the mixture using a syringe. f. Inject BMP solution through
(saline solution) and wait for soft tissue until needle
10 to 15 seconds before using. of syringe reaches bone.

006 COWELL® BMP COWELL® BMP 007

 C. Method III 7. Study Result on COWELL® BMP
In Vivo Study
Control group BMP group

At surgery

4 weeks
after surgery

8 weeks
after surgery

a. Inject distilled water into vial II with lyophilized b. Aspirate the mixture using a syringe.
rhBMP-2 power in it and mix with the powder. Jung-Bo Huh, et al., Alveolar ridge augmentation using anodized implants coated with Escherichia coli-derived recombinant human bone
morphogenetic protein 2 (Beagle dog).

- Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011.

Histologic Findings : Tissue specimen collected approximately four months

after the maxillary sinus grafting (human)
X400 • New bone was formed around the graft material.
• No inflammatory reaction was observed in connective tissue.
c. Hydrate BMP-2 solution into membrane. d. Apply BMP-2 solution socked membrane X200
to damaged site. • Proliferation of collagen fiber was observed.
• Proliferation of fibrocyte was observed.
• Osteoblast was observed on the surface of newly formed bone.

Dose of distilled water to make the mixture (BMP-2 Solution)

BMP Dose Distilled Water Dose BMP Dose Distilled Water Dose
8. Clinical Data of COWELL® BMP
• Vertical height of surrounding bone was compared three months after grafting in extraction socket.
0.1mg 0.1ml 2mg 1.6ml • The study was conducted at Seoul National University Bundang Hospital, Yonsei University Dental Hospital, and Korea University Guro Hospital.
0.25mg 0.2ml 5mg 4ml
Group Average SD 95%CI †P value
0.5mg 0.4ml 10mg 8ml
Control -1.087 1.413 (-1.565, -0.609)
1mg 0.8ml 20mg 16ml Height 0.0006**
Experiment -0.059 0.960 (-0.384, 0.266)
Control 1.405 1.753 (0.812, 1.998)
Width at 75% ESL 0.346
Experiment 1.863 2.310 (1.081, 2.644)
Control 0.542 1.157 (0.15, 0.934)
Width at 50% ESL 0.016*
Experiment 1.239 1.249 (0.816, 1.662)
Control 0.006 1.149 (-0.383, 0.395)
Width at 25% ESL <0.0001**
Experiment 1.279 1.387 (0.81, 1.749)

ESL : Extraction Socket Level *:P<.05, **:P<.01, †: Student t-test

Jung-Bo Huh, et al., Multicenter, randomized clinical trial on the efficacy and safety of Escherichia-coli-derived rhBMP-2
with β-Tricalcium phosphate and hydroxyapatite in human extraction sockets.
- J Adv Prosthodont 2011;4 -134.

008 COWELL® BMP COWELL® BMP 009

 COWELL® BMP

Cowellmedi Co.,Ltd Cowell R&D Institute

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