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1606539

全球鈦及鈦合金牙植體市場 - 2024-2031

Global Titanium & Titanium Alloys Dental Implants Market - 2024-2031

出版日期: 2024年12月04日 | 出版商:

DataM Intelligence | 英文 176 Pages | 商品交期: 最快1-2個工作天內

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簡介目錄

概述

2023年，全球鈦及鈦合金牙植體市場規模達58.6億美元，預計2031年將達到123.3億美元，2024-2031年預測期間複合年成長率為9.8%。

鈦及鈦合金植牙是由鈦或鈦合金設計的假體裝置，透過手術植入下顎骨，作為缺牙的人工牙根。植體透過骨整合過程與骨骼結合，為各種牙齒修復（包括牙冠、牙橋或假牙）提供穩定的基礎。

這些材料是透過將鈦與其他元素結合形成的，以增強特定的機械性能，例如強度和延展性。牙科植體中常用的鈦合金包括Ti-6Al-4V（含6%鋁和4%釩）和Ti-5Al-2.5Fe。與商業純鈦相比，這些合金因其卓越的機械性能而受到認可。

全球鈦及鈦合金植牙市場是鈦及其合金的廣泛應用，其優越的性能符合當代牙科的要求而受到青睞。隨著技術的不斷進步，特別是積層製造等製造方法的進步，鈦在牙植體中的多功能性和應用預計將進一步成長。正在進行的旨在改進植體設計和表面修飾的研究預計將提高其性能和壽命，使其成為更有效的牙齒替換和修復解決方案。這些因素推動了全球鈦及鈦合金植體市場的擴張。

市場動態：

驅動程式和限制

牙齒疾病的盛行率不斷增加

牙科疾病的日益流行極大地推動了全球鈦及鈦合金牙種植體市場的成長。預計它將在整個市場預測期內推動。

牙科疾病，特別是牙周病和齲齒的發生率不斷增加，是全球鈦及鈦合金牙植體市場需求的重要驅動力。這種需求主要是由於對有效的牙齒替換解決方案的需求所推動的，因為越來越多的人因這些情況而經歷牙齒脫落。

根據世界衛生組織（WHO）2022年資料，全球口腔健康狀況報告估計，全球有近35億人受到口腔疾病的影響，其中75%的受影響者生活在中等收入國家。此外，據估計，約有 20 億人的恆牙患有齲齒，而 5.14 億兒童的乳牙則患有齲齒。這種情況不僅影響口腔健康，還會產生系統性影響，增加了植牙等有效治療方案的緊迫性。

由於幾個令人信服的原因，鈦已成為牙科植體的標準材料。它與人體骨組織的相容性無與倫比，使其成為牙科應用的理想選擇。鈦及其合金具有優異的生物相容性、耐腐蝕性和尺寸穩定性。牙科界將從不斷開發新型鈦合金的研究中獲益匪淺，這種合金可以提高植體的性能。

此外，產業研究的主要參與者將推動全球鈦及鈦合金牙植體市場的成長。根據 2024 年 1 月的 ScienceDirect 研究出版物，積層製造 (AM) 技術在製造植牙方面的優勢日益受到認可。研究人員正在積極研究鈦牙植體的生物功能，採用各種表徵技術來確定提高其有效性的方法。

鈦及其合金仍然是植牙的絕佳選擇，正在進行的研究可能會證實它們對於植牙的適用性。所有這些因素都對全球鈦及鈦合金牙植體市場提出了需求。

此外，對技術進步的需求不斷成長有助於全球鈦及鈦合金牙植體市場的擴大。

超敏反應與過敏反應

超敏反應和過敏反應將阻礙全球鈦及鈦合金植體市場的成長。雖然鈦因其生物相容性而被廣泛使用，並且通常被認為對於牙科應用是安全的，但過敏反應的情況也不容忽視。鈦過敏相對不常見，但在臨床病例中已有記錄。反應可能表現為輕度至重度植體周圍組織過敏，可能導致發炎、疼痛甚至植體失敗等併發症。

根據 ResearchGate 報道，2021 年 4 月發布的一份病例報告描述了一名 64 歲女性患者在接受鈦植入物後不久出現了急性過敏症狀，包括疼痛、濕疹和腫脹。該患者先前的金屬過敏史有助於診斷出鈦過敏症，最終導致植入物的移除和隨後的康復。

同樣，2022 年3 月《醫學和牙科科學研究雜誌》發表的文章中，儘管沒有足夠的證據研究來明確證明鈦牙種植體具有生物相容性，但報告的對鈦及其合金過敏反應的病例也不容忽視。迫切需要開發能夠準確檢測口腔環境中對金屬和合金（包括鈦）過敏的測試。這些進步將促進對植入物過敏的進一步研究。臨床醫生也應評估植體失敗時對鈦及其合金的過敏。因此，上述因素可能限制全球鈦及鈦合金植體市場的潛在成長。

有關此報告的更多詳細資訊 - 索取樣本

Titanium & titanium alloys dental implants are prosthetic devices designed from titanium or titanium alloys that are surgically inserted into the jawbone, acting as artificial roots for missing teeth. The implants bond with the bone through a process known as osseointegration, which provides a stable foundation for various dental restorations, including crowns, bridges, or dentures.

These materials are formed by combining titanium with other elements to enhance specific mechanical properties, such as strength and ductility. Common titanium alloys used in dental implants include Ti-6Al-4V, which contains 6% aluminum and 4% vanadium, and Ti-5Al-2.5Fe. These alloys are recognized for their superior mechanical performance compared to commercially pure titanium.

The global titanium & titanium alloys dental implants market is the widespread utilization of titanium and its alloys, which are favored for their advantageous properties that meet the requirements of contemporary dentistry. As technological advancements continue, particularly in manufacturing methods such as additive manufacturing, the versatility and application of titanium in dental implants are anticipated to grow further. Ongoing research aimed at improving implant designs and surface modifications is expected to enhance their performance and longevity, making them even more effective solutions for tooth replacement and restoration. These factors have driven the global titanium & titanium alloys dental implants market expansion.

Market Dynamics: Drivers & Restraints

Increasing Prevalence of Dental Disorders

The increasing prevalence of dental disorders is significantly driving the growth of the global titanium & titanium alloys dental implants market. It is expected to drive throughout the market forecast period.

The increasing incidence of dental diseases, particularly periodontal disease and dental caries, is a significant driver of demand in the global titanium & titanium alloys dental implants market. This demand is primarily fueled by the need for effective tooth replacement solutions as more individuals experience tooth loss due to these conditions.

According to the World Health Organization (WHO) data in 2022, the global oral health status report estimated that nearly 3.5 billion people worldwide are affected by oral diseases, with 75% of those affected living in middle-income countries. Additionally, it is estimated that around 2 billion people suffer from caries in their permanent teeth, while 514 million children are affected by caries in their primary teeth. This condition not only affects oral health but can also have systemic implications, increasing the urgency for effective treatment options like dental implants.

Titanium has become the standard material for dental implants for several compelling reasons. Its compatibility with human bone tissue is unmatched, making it an ideal choice for dental applications. Titanium and its alloys excel due to their biocompatibility, corrosion resistance, and dimensional stability. The dental community stands to gain significantly from ongoing research into developing new titanium alloys, which can enhance implant performance.

Furthermore, key players in the industry research studies that would drive this global titanium & titanium alloys dental implants market growth. According to the ScienceDirect research publication in January 2024, the advantages of additive manufacturing (AM) technology in creating dental implants are increasingly recognized. Researchers are actively studying the bio-functionality of titanium dental implants, employing various characterization techniques to identify ways to improve their effectiveness.

Titanium and its alloys remain an excellent choice for dental implants, with ongoing studies likely to confirm their suitability for dental implantology. All these factors demand the global titanium & titanium alloys dental implants market.

Moreover, the rising demand for technological advancements contributes to the expansion of the global titanium and titanium alloys dental implants market.

Hypersensitivity and Allergic Reactions

The hypersensitivity and allergic reactions will hinder the growth of the global titanium and titanium alloys dental implants market. While titanium is widely used in its biocompatibility and is generally deemed safe for dental applications, instances of hypersensitivity reactions must not be ignored. Titanium hypersensitivity is relatively uncommon, but it has been documented in clinical cases. Reactions may present as mild to severe peri-implant tissue hypersensitivity, potentially leading to complications such as inflammation, pain, and even implant failure.

According to ResearchGate, a case report published in April 2021, described a 64-year-old female patient who experienced acute allergic symptoms including pain, eczema, and swelling shortly after receiving a titanium implant. The patient's prior history of metal allergies contributed to the diagnosis of titanium hypersensitivity, which ultimately led to the removal of the implant and her subsequent recovery.

Similarly, Journal of Research in Medical and Dental Science publication in March 2022, although there is insufficient evidence-based research to definitively prove that titanium dental implants are biocompatible, reported cases of hypersensitivity reactions to titanium and its alloys cannot be ignored. There is a pressing need to develop tests that can accurately detect hypersensitivity to metals and alloys, including titanium, in the oral environment. Such advancements would facilitate further studies on implant hypersensitivity. Clinicians should also assess for hypersensitivity to titanium and its alloys in instances of implant failure. Thus, the above factors could be limiting the global titanium & titanium alloys dental implants market's potential growth.

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Segment Analysis

The global titanium & titanium alloys dental implants market is segmented based on product type, type of implant, application, end-user, and region.

Product Type:

The commercially pure titanium (CPTi) segment is expected to dominate the global titanium & titanium alloys dental implants market share

The commercially pure titanium (CPTi) segment holds a major portion of the global titanium & titanium alloys dental implants market share and is expected to continue to hold a significant portion of the global titanium & titanium alloys dental implants market share during the forecast period.

The commercially pure titanium (CPTi) segment is integral to the global titanium & titanium alloys dental implants market due to its distinctive properties that make it suitable for dental applications. Commercially pure titanium (CP-Ti) consists of over 99% titanium, with varying amounts of nitrogen, carbon, oxygen, iron, and hydrogen depending on the specific grade. It is classified as a low-to-moderate strength metal and is not suitable for use in aircraft structures or engines. The yield strength of high-purity titanium ranges from 170 to 480 MPa, which is insufficient for heavily loaded aerospace applications.

CP-Ti is utilized in applications where high ductility, excellent corrosion resistance, moderate strength, and good weldability are essential. These characteristics make it suitable for use in medical implants, as well as in aerospace and chemical processing industries.

In the United States, commercially pure titanium is categorized according to the ASTM standard, although this classification system is not universally adopted in other countries. The classification uses a numbering system, such as Grade 1, Grade 2, and so forth, to differentiate between the various types of commercially pure titanium based on their properties and composition.

One of the primary advantages of commercially pure titanium is its excellent biocompatibility. This property enables the material to integrate seamlessly with human bone, minimizing the risk of rejection and promoting successful osseointegration. Consequently, CPTi is extensively used in dental implants, ensuring that patients experience minimal adverse reactions. These factors have solidified the segment's position in the global titanium & titanium alloys dental implants market.

Geographical Analysis

North America is expected to hold a significant position in the global titanium & titanium alloys dental implants market share

North America holds a substantial position in the global titanium & titanium alloys dental implants market and is expected to hold most of the market share.

The rising incidence of dental disorders, particularly periodontal disease and dental caries, significantly drives the demand for titanium dental implants. According to the Federation Dentaire Internationale, (FDI) stated that between 15% to 20% of middle-aged adults suffer from severe periodontal disease, which can lead to tooth loss. Additionally, approximately 92% of adults aged 20 to 64 have experienced dental caries in their permanent teeth. This growing prevalence necessitates effective tooth replacement solutions like titanium implants.

North America has a substantial aging population that is more susceptible to dental issues requiring implants. The American Dental Association reports that 42% of adults aged 30 and older are affected by periodontitis, with around 7.8% experiencing severe cases. As the population ages, the demand for dental implants is expected to increase, further driving market growth.

Advances in dental technology, including computer-aided design (CAD) and computer-aided manufacturing (CAM), have improved the precision and effectiveness of dental implants. These innovations enhance overall patient experience and outcomes, making titanium implants more appealing to both practitioners and patients.

Furthermore, in this region, a major number of key players' presence, well-advanced healthcare infrastructure, government initiatives & regulatory support, technological advancements, and product launches & approvals would propel this global titanium & titanium alloys dental implants market.

For instance, in December 2021, Health Canada's approval of its first Canadian additively manufactured medical implant marks a significant advancement in the field of personalized medicine and surgical reconstruction. Developed at the 3D Anatomical Construction Laboratory (LARA 3D) in collaboration with Investissement Quebec - CRIQ and the CHU de Quebec-Universite Laval, this bespoke 3D Specifit mandibular plate is specifically designed for patients undergoing reconstruction due to oral cancer.

Thus, the above factors are consolidating the region's position as a dominant force in the global titanium & titanium alloys dental implants market.

Asia Pacific is growing at the fastest pace in the global titanium & titanium alloys dental implants market

Asia Pacific holds the fastest pace in the global titanium & titanium alloys dental implants market and is expected to hold most of the market share.

The aging population in the Asia-Pacific region significantly drives the demand for dental implants. As individuals grow older, they are more likely to face dental issues such as tooth loss and periodontal diseases, necessitating effective replacement solutions like titanium implants. The rise in elderly individuals seeking dental care contributes significantly to market expansion.

There is a growing awareness among consumers regarding the importance of oral health and the availability of advanced dental treatments. This heightened awareness leads to greater acceptance rates of dental implants, as patients recognize the long-term benefits of titanium implants for tooth replacement. Innovations in dental technology, including 3D imaging, computer-aided design (CAD), and computer-aided manufacturing (CAM), have enhanced the precision and success rates of dental implant procedures. These advancements attract both patients and dental professionals, further driving the demand for titanium implants.

Increased government spending on healthcare and supportive policies are facilitating market growth. Various Asia-Pacific countries are investing in healthcare infrastructure to enhance dental care services. Additionally, multinational companies are investing in local implant manufacturers to improve production capabilities and meet rising demand.

There is a rising demand for aesthetic dental solutions as consumers seek natural-looking replacements for missing teeth. Titanium implants are preferred due to their biocompatibility and ability to integrate with bone, providing a stable foundation for artificial teeth that look and function like natural ones.

Furthermore, key players in the region investments in dental implants that would drive this titanium & titanium alloys dental implants market growth. For instance, in October 2023, Mubadala Investment Company's recent investment in Osstem Implant, Korea's largest dental implant material manufacturer, signifies a strategic move within the global titanium and titanium alloys dental implants market. This partnership, alongside MBK Partners and Unison Capital, positions Osstem to leverage its established market presence while enhancing its capabilities in a competitive landscape.

Thus, the above factors are consolidating the region's position as the fastest-growing force in the global titanium & titanium alloys dental implants market.

Competitive Landscape

The major global players in the titanium & titanium alloys dental implants market include Institut Straumann AG, Nobel Biocare Services AG., Dentsply Sirona., Zimmer Biomet, OSSTEM IMPLANT CO., LTD., KYOCERA Medical Technologies, Inc., COWELLMEDI CO., LTD., ZimVie Inc., LeaderMedica SRL, and BioHorizons among others.

Key Developments

In May 2022, Osstem Europe, launched a next-generation implant system known as the Key Solution (KS) implant in Europe. This innovative system features a unique internal design that enhances the strength and durability of dental implants while providing a user-friendly platform for surgical procedures and prosthesis loading. According to Osstem, barium can attract blood to the titanium surface of implants, facilitating the rapid formation of woven bone. This process enhances the initial stability of the implants and improves their capacity for bone integration and remodeling.

Why Purchase the Report?

Pipeline & Innovations: Reviews ongoing clinical trials, and product pipelines, and forecasts upcoming advancements in medical devices and pharmaceuticals.
Product Performance & Market Positioning: Analyzes product performance, market positioning, and growth potential to optimize strategies.
Real-World Evidence: Integrates patient feedback and data into product development for improved outcomes.
Physician Preferences & Health System Impact: Examines healthcare provider behaviors and the impact of health system mergers on adoption strategies.
Market Updates & Industry Changes: Covers recent regulatory changes, new policies, and emerging technologies.
Competitive Strategies: Analyzes competitor strategies, market share, and emerging players.
Pricing & Market Access: Reviews pricing models, reimbursement trends, and market access strategies.
Market Entry & Expansion: Identifies optimal strategies for entering new markets and partnerships.
Regional Growth & Investment: Highlights high-growth regions and investment opportunities.
Supply Chain Optimization: Assesses supply chain risks and distribution strategies for efficient product delivery.
Sustainability & Regulatory Impact: Focuses on eco-friendly practices and evolving regulations in healthcare.
Post-market Surveillance: Uses post-market data to enhance product safety and access.
Pharmacoeconomics & Value-Based Pricing: Analyzes the shift to value-based pricing and data-driven decision-making in R&D.

The global titanium & titanium alloys dental implants market report delivers a detailed analysis with 60+ key tables, more than 50 visually impactful figures, and 176 pages of expert insights, providing a complete view of the market landscape.

Target Audience 2023

Manufacturers: Pharmaceutical, Medical Device, Biotech Companies, Contract Manufacturers, Distributors, Hospitals.
Regulatory & Policy: Compliance Officers, Government, Health Economists, Market Access Specialists.
Technology & Innovation: AI/Robotics Providers, R&D Professionals, Clinical Trial Managers, Pharmacovigilance Experts.
Investors: Healthcare Investors, Venture Fund Investors, Pharma Marketing & Sales.
Consulting & Advisory: Healthcare Consultants, Industry Associations, Analysts.
Supply Chain: Distribution and Supply Chain Managers.
Consumers & Advocacy: Patients, Advocacy Groups, Insurance Companies.
Academic & Research: Academic Institutions.

1. Methodology and Scope

1.1. Research Methodology
1.2. Research Objective and Scope of the Report

2. Definition and Overview

3. Executive Summary

3.1. Snippet by Product Type
3.2. Snippet by Type of Implant
3.3. Snippet by Application
3.4. Snippet by End-User
3.5. Snippet by Region

4. Dynamics

4.1. Impacting Factors
- 4.1.1. Drivers
  - 4.1.1.1. Increasing Prevalence of Dental Disorders
- 4.1.2. Restraints
  - 4.1.2.1. Hypersensitivity and Allergic Reactions
- 4.1.3. Opportunity
- 4.1.4. Impact Analysis

5. Industry Analysis

5.1. Porter's Five Force Analysis
5.2. Supply Chain Analysis
5.3. Pricing Analysis
5.4. Patent Analysis
5.5. Regulatory Analysis
5.6. SWOT Analysis
5.7. Unmet Needs

6. By Product Type

6.1. Introduction
- 6.1.1. Analysis and Y-o-Y Growth Analysis (%), By Product Type
- 6.1.2. Market Attractiveness Index, By Product Type
6.2. Commercially Pure Titanium (CPTi) *
- 6.2.1. Introduction
- 6.2.2. Market Size Analysis and Y-o-Y Growth Analysis (%)
- 6.2.3. Grade I
- 6.2.4. Grade II
- 6.2.5. Grade III
- 6.2.6. Grade IV
6.3. Titanium Alloys
- 6.3.1. Ti-6Al-4V
- 6.3.2. Ti-6Al-4V Extra Low Interstitial
- 6.3.3. Ti-5Al-2.5Fe
- 6.3.4. Ti-3Al-2.5V

7. By Type of Implant

7.1. Introduction
- 7.1.1. Market Size Analysis and Y-o-Y Growth Analysis (%), By Type of Implant
- 7.1.2. Market Attractiveness Index, By Type of Implant
7.2. Endosteal Implants*
- 7.2.1. Introduction
- 7.2.2. Market Size Analysis and Y-o-Y Growth Analysis (%)
7.3. Subperiosteal Implants
7.4. Transosteal Implants

8. By Application

8.1. Introduction
- 8.1.1. Market Size Analysis and Y-o-Y Growth Analysis (%), By Application
- 8.1.2. Market Attractiveness Index, By Application
8.2. Single Tooth Replacement*
- 8.2.1. Introduction
- 8.2.2. Market Size Analysis and Y-o-Y Growth Analysis (%)
8.3. Multi Tooth Replacement
8.4. Others

9. By End-User

9.1. Introduction
- 9.1.1. Market Size Analysis and Y-o-Y Growth Analysis (%), By End-User
- 9.1.2. Market Attractiveness Index, By End-User
9.2. Hospitals *
- 9.2.1. Introduction
- 9.2.2. Market Size Analysis and Y-o-Y Growth Analysis (%)
9.3. Dental Clinics
9.4. Others

10. By Region

10.1. Introduction
- 10.1.1. Market Size Analysis and Y-o-Y Growth Analysis (%), By Region
- 10.1.2. Market Attractiveness Index, By Region
10.2. North America
- 10.2.1. Introduction
- 10.2.2. Key Region-Specific Dynamics
- 10.2.3. Market Size Analysis and Y-o-Y Growth Analysis (%), By Product Type
- 10.2.4. Market Size Analysis and Y-o-Y Growth Analysis (%), By Type of Implant
- 10.2.5. Market Size Analysis and Y-o-Y Growth Analysis (%), By Application
- 10.2.6. Market Size Analysis and Y-o-Y Growth Analysis (%), By End-User
- 10.2.7. Market Size Analysis and Y-o-Y Growth Analysis (%), By Country
  - 10.2.7.1. U.S.
  - 10.2.7.2. Canada
  - 10.2.7.3. Mexico
10.3. Europe
- 10.3.1. Introduction
- 10.3.2. Key Region-Specific Dynamics
- 10.3.3. Market Size Analysis and Y-o-Y Growth Analysis (%), By Product Type
- 10.3.4. Market Size Analysis and Y-o-Y Growth Analysis (%), By Type of Implant
- 10.3.5. Market Size Analysis and Y-o-Y Growth Analysis (%), By Application
- 10.3.6. Market Size Analysis and Y-o-Y Growth Analysis (%), By End-User
- 10.3.7. Market Size Analysis and Y-o-Y Growth Analysis (%), By Country
  - 10.3.7.1. Germany
  - 10.3.7.2. U.K.
  - 10.3.7.3. France
  - 10.3.7.4. Spain
  - 10.3.7.5. Italy
  - 10.3.7.6. Rest of Europe
10.4. South America
- 10.4.1. Introduction
- 10.4.2. Key Region-Specific Dynamics
- 10.4.3. Market Size Analysis and Y-o-Y Growth Analysis (%), By Product Type
- 10.4.4. Market Size Analysis and Y-o-Y Growth Analysis (%), By Type of Implant
- 10.4.5. Market Size Analysis and Y-o-Y Growth Analysis (%), By Application
- 10.4.6. Market Size Analysis and Y-o-Y Growth Analysis (%), By End-User
- 10.4.7. Market Size Analysis and Y-o-Y Growth Analysis (%), By Country
  - 10.4.7.1. Brazil
  - 10.4.7.2. Argentina
  - 10.4.7.3. Rest of South America
10.5. Asia-Pacific
- 10.5.1. Introduction
- 10.5.2. Key Region-Specific Dynamics
- 10.5.3. Market Size Analysis and Y-o-Y Growth Analysis (%), By Product Type
- 10.5.4. Market Size Analysis and Y-o-Y Growth Analysis (%), By Type of Implant
- 10.5.5. Market Size Analysis and Y-o-Y Growth Analysis (%), By Application
- 10.5.6. Market Size Analysis and Y-o-Y Growth Analysis (%), By End-User
- 10.5.7. Market Size Analysis and Y-o-Y Growth Analysis (%), By Country
  - 10.5.7.1. China
  - 10.5.7.2. India
  - 10.5.7.3. Japan
  - 10.5.7.4. South Korea
  - 10.5.7.5. Rest of Asia-Pacific
10.6. Middle East and Africa
- 10.6.1. Introduction
- 10.6.2. Key Region-Specific Dynamics
- 10.6.3. Market Size Analysis and Y-o-Y Growth Analysis (%), By Product Type
- 10.6.4. Market Size Analysis and Y-o-Y Growth Analysis (%), By Type of Implant
- 10.6.5. Market Size Analysis and Y-o-Y Growth Analysis (%), By Application
- 10.6.6. Market Size Analysis and Y-o-Y Growth Analysis (%), By End-User

11. Competitive Landscape

11.1. Competitive Scenario
11.2. Market Positioning/Share Analysis
11.3. Mergers and Acquisitions Analysis

12. Company Profiles

12.1. Institut Straumann AG *
- 12.1.1. Company Overview
- 12.1.2. Product Portfolio and Description
- 12.1.3. Financial Overview
- 12.1.4. Key Developments
12.2. Nobel Biocare Services AG.
12.3. Dentsply Sirona.
12.4. Zimmer Biomet
12.5. OSSTEM IMPLANT CO., LTD.
12.6. KYOCERA Medical Technologies, Inc.
12.7. COWELLMEDI CO., LTD.
12.8. ZimVie Inc.
12.9. LeaderMedica SRL
12.10. BioHorizons (LIST NOT EXHAUSTIVE)