The motto behind the collaboration between Straumann and botiss is: “More than a partnership. A synergy of strengths.” Dirk Probst, Head of Regeneration at  Straumann, spoke to Straumann CEO Marco Gadola and botiss Managing Partner Oliver Bielenstein about motivations and prospects.

How did you decide to join forces in the field of regeneration?

Gadola: For a leading implant manufacturer like Straumann, which aims to offer a complete portfolio, regenerative solutions are an important element. There is no other way, as we know that regenerative products are needed and used in almost every second implant treatment. And this is exactly what we strive to achieve: to offer the customer a complete solution from a single source. Straumann, of course, has not only just started work in the complex field of regeneration. On the contrary, we are still one of the few companies in the dental implant market that also has its own regenerative portfolio – for example with Emdogain® as a highly interesting and scientifically extremely well documented product in the field of periodontal regeneration.

In order to help us achieve this ambition of a complete portfolio a little more quickly, however, we made some new strategic decisions six months ago. We would like to continue with existing products and projects, and invest in them further – in identifying new indications for Emdogain®, for example. When it comes to bone substitutes or membranes, however, we believe that the only efficient and targeted way to complete our portfolio is to collaborate with a strong partner such as botiss.

For a leading implant manufacturer and distributor like Straumann, which aims to offer a complete portfolio, regenerative solutions are an important element. There is no other way, as we know that regenerative products are needed and used in almost every second implant treatment. Marco Gadola

Bielenstein: A collaboration with Straumann offers a great opportunity to increase our share of existing markets or obtain faster access to other markets such as North and South America via Straumann. We will now be able to do this much more quickly than we would on our own. The support we receive in the areas of market access, marketing and sales will enable us to focus more closely on our core competencies: product development, clinical research, training and continuing education. The prospect of working together on regenerative projects such as the further development of Emdogain® is also highly appealing.

The support we will receive in the areas of market access, marketing and sales will enable us to focus more closely on our core competencies: product development, clinical research, training and continuing education. Oliver Bielenstein

Marco Gadola, why botiss? After all, here in Switzerland there’s another clear candidate who is a leading player in this area.

Gadola: It’s not just about size. botiss has already established itself in a number of major regenerative markets such as Europe and the Middle East, as well as certain Asian countries, all under its own steam. In Europe, botiss is now Number 2. Naturally, a young firm like botiss can’t be compared with the market leader just yet. But if we look at the company’s product portfolio, then I think we can say it’s considerably more comprehensive than that of the market leader.

Bielenstein: Despite having only been on the market for five years, we’re already Number 1 in various countries and a strong contender in others. Our company has therefore achieved in just a short time what others take decades to achieve. This fills us with confidence that a partnership with Straumann will generate a great deal of market power for us to be setting new benchmarks together.

botiss’s portfolio is broadly based, and at first glance appears highly complex. What is the principle behind its structure, Oliver Bielenstein?

Bielenstein: Our product range has been composed in a systematic approach, with nothing having been left to chance. This means that we offer a coherent regenerative system in which none of the products are “coincidental” – all indications are taken into account. Based on the current state of scientific knowledge, of course, we all know that there is no single regenerative material that meets all needs. Instead, the broadly based botiss system provides medical professionals with the possibility to choose between and use hard and soft tissue products depending on the indication and the patient’s biological situation, as well as other factors. And this is precisely why we need this broad range, which may well seem a little complex at first glance. We will be providing further illustration of this concept in the summer when we launch our “Regeneration Matrix”, which will also include concrete indication recommendations. Why? Bovine material is unsuitable for building vertical bones, for example – it just doesn’t work on a biological level. Allografts, however, do.

Based on the current state of scientific knowledge, of course, we all know that there is no single regenerative to meet all needs. Instead of this, the broadly based botiss system now provides dentists with the possibility to choose according to the indication and the patient’s biological situation. Oliver Bielenstein

At the same time, bovine material is the product of choice in various indications, such as preserving the alveolar ridge contour in aesthetic treatment. When it comes to soft tissue materials, we now need membranes with varying life cycles, depending on the size of the defect and the healing time. Or take soft tissue regeneration in recession treatment, for example: here I need various materials with various properties and capabilities. And it is precisely this diversity that we have incorporated in a conscious and systematic approach. This can be compared very well with a modern implant system. Here too, it takes more than just one implant with just one diameter and one length – various models with various properties are needed: various diameters and lengths at the bone and soft tissue level, but also, depending on individual preferences, various finishes and materials. After all, dentists don’t choose the patient to fit the product, the product must be right for the respective indication. This is precisely where the dentist has to have a choice. And this is precisely what we have to offer.

We have systematically and consciously incorporated diversity into our system. This can be compared very well with a modern implant system. Here too, it takes more than just one implant with just one diameter and one length – various models with various properties are needed. Oliver Bielenstein

Gadola: Diversity in regeneration is nothing new for our sales force, whose members are well aware of the significance of regenerative solutions in implant therapy. I am therefore convinced that, given the appropriate training and support for our staff, we will learn how to apply this broad range to the benefit of everyone involved.

How about the scientific evidence behind botiss’s products?

Bielenstein: botiss has an outstanding internal and external team and a network of scientists, clinicians and academic institutions. Our scientific activities are based on the highest possible standards – this is essential both for us and for the field in which we work. botiss’s products have been used successfully several thousand times over, and are currently being tested and researched in numerous studies with renowned clinicians. Naturally, after just five years we are not yet in a position to provide the kind of data that other companies have spent decades collecting. At the same time, however, we would all still be driving around in VW Beetles had it not been for continuous development and competition – progress would have come to a complete halt. botiss has its roots in orthopaedic surgery. The materials we work with have all been tried and tested, and our motto is: “Predictability and a high success rate”. Dentists who work with botiss products know that they have something that has been proven to work and can reliably be expected to do so.

Were botiss’s products all developed in-house?

Bielenstein: Around 85 percent of the products we sell were developed by us in collaboration with universities and other academic research institutes – the Fraunhofer Society, for example – and are also manufactured by us.

Where do you both see the concrete synergies in a collaboration such as yours?

Gadola: botiss has a series of solutions that are extremely interesting for Straumann, such as its “bonebuilder” technology that can be adapted to suit the individual patient. A perfect symbiosis of regenerative material and digital technology, a field in which Straumann is well represented. Here, therefore, the dentist can put together a holistic and comprehensive plan for any given situation – not only when it comes to implants and reconstruction, but also including all regenerative aspects. This is helping us to go one step further in our efforts to become a holistic solution provider.

We will continue to maintain our efforts with Emdogain®, and will by no means ease off in this area. I am confident that botiss will contribute valuable ideas here for driving the success of this product forward. Marco Gadola

Bielenstein: The bonebuilder is indeed a fascinating product. Just to explain things a little: we receive a DVT or CT scan of a defect and design a bone block tailored to the individual patient using CAD/CAM software, which is then milled from human donor bone at our tissue bank in Austria. Four to six weeks later it arrives in a sterile condition with the dentist, who opens the defect, inserts the bone block, screws it in place and covers it again. Within a period of approximately 20 minutes, therefore, the dentist is able to carry out an extremely complex augmentation, naturally on the condition that the dentist has the corresponding skills in soft tissue surgery. This procedure enables the length of surgery, as well as the risk of infection and error, to be reduced dramatically, thereby significantly increasing the chance of success in the case of large defects. This process of integration into the digital workflow, into preoperative planning, is absolutely fascinating. And we will be continuing to look into other materials and material classes in this context.

When and in which markets will the botiss products be available via Straumann, and how will botiss ensure that the necessary know-how transfer takes place?

Gadola: We will start with Europe and be in a position to distribute botiss products via our Straumann sales force by the end of this year. In larger markets such as Brazil, the USA and also Japan, we will first have to complete the registration process, which unfortunately tends to take a longer. Our aim, however, is to be able to make botiss products available worldwide by the end of 2017.

Bielenstein: We are currently already present in around 90 countries – botiss therefore already has extensive experience of training sales staff, product managers, clinicians and other specialists on an international level – this is one of our core competencies. We currently have an internal team of ten scientists who are able to provide this training in multiple languages, in real time and above all in parallel. In addition, various clinicians are also in the process of putting all the material together for e-learning purposes.

How would you describe your collaboration on Emdogain®?

Gadola: Emdogain® is sold in Germany via both the Straumann and the botiss sales force, and botiss operates its own direct sales in Germany. In certain Eastern European countries we are also discussing the possibility of using botiss or botiss distributors to sell Emdogain® in the future. We will continue to maintain our efforts with the product, and will by no means ease off in this area. I am confident that botiss will contribute valuable ideas here for driving the success of this product forward.

Clinicians can now achieve significantly better results with the materials currently available, provided they are prepared to learn about the appropriate indication and handling. This calls for improved abilities in soft tissue surgery in particular, and we at botiss have to offer learning and teaching content that actively communicates this necessity of active continuing education to the clinician. Oliver Bielenstein

Bielenstein: For us, Emdogain® is a fascinating product that has previously been missing from our portfolio. I believe that it offers significant potential, particularly in combination with our soft tissue substitute product Mucoderm.

Will Straumann continue to run its own regenerative projects in future, or can we expect to see a development partnership with botiss?

Gadola: As I said, there is still potential for expansion in connection with Emdogain® that we would like to look into together. With a strong partner at its side, however, Straumann now no longer needs to develop collagen membranes or xenograft or allograft solutions. Our aim is not to compete with one another, but to pool and concentrate our resources in the field of development.

Bielenstein: When I look at Straumann’s general product pipeline, I feel excited and know that this is really going to be a rewarding partnership. Our company has grown up around collaboration and cooperation, and has developed so quickly not least due to the fact that we are so open, transparent and partnership-oriented. We believe that really great results can be achieved when two strong partners with varying competencies join forces in a focussed approach based on openness and trust. There is a great deal of know-how within our company, and particularly in the networks established by both parties. In any case, to put it bluntly I think the perception that development takes place primarily within a single company is rather outmoded. No – in our business, development takes place primarily in the networks we are now bringing together. And the lack of complexity that we are consciously aiming to achieve will also help to increase the pace of this development. Watch this space…

What will be the greatest challenges to come in the near future – for Straumann and for botiss?

Gadola: We have to ensure that we also remain focussed in our sales activities. This means keeping the regenerative portfolio on the radar at every visit, identifying needs and actively informing our customers about the wide range of new possibilities. As I said earlier, we are now in a position to provide everything from a single source, and this is what we intend to do.

Bielenstein: Training is a challenging issue. Clinicians can now achieve significantly better results with the materials currently available, provided they are prepared to learn about the appropriate indication and handling. Naturally, as a manufacturer we will also continue to improve and optimise existing concepts, materials and products, as well as their handling. But this is an evolutionary process. There are no technological leaps, or rather: there must not be any leaps in our field, as dentists and patients must not be used as test objects. Here we have to work with an extremely high level of predictability and reliability. This calls for improved abilities in soft tissue surgery in particular, and we at botiss have to offer learning and teaching content that actively communicates this necessity of active continuing education to the clinician, via e-learning, courses, congresses or cadaver courses. We will address this challenge via the botiss academy. Naturally, we now have another strong basis with the ITI: an organisation of clinicians that teaches and learns on its own initiative. Here too, we can make our contribution, and fully intend to do so.