Low-temperature Versus High-temperature Sintering: Regenerative and Osteoimmunological Insights from Bio-Oss® and Ti-Oss® in Sinus Lift Surgery
Korzinskas T. Schnettler R. Rimashevskiy D. Malik B. Dakenov B. Bagdoniene D. Jung O. Barbeck M.
January-February 2026International Institute of Anticancer Research
In Vivo
2026#40Issue 1322 - 332 pp.
Background/Aim: Maxillary sinus floor elevation is a well-established procedure for increasing bone volume in the posterior maxilla, yet the regenerative outcome depends strongly on the choice of grafting material. This clinical study compared a high-temperature sintered xenograft (Bio-Oss®) and a low-temperature processed xenograft (Ti-Oss®) with regard to their regenerative and immunological profiles. Patients and Methods: Eight patients underwent split-mouth sinus augmentation with both materials, and biopsies were retrieved at 6 months after implant placement. Histological, histomorphometrical, and immunohistochemical analyses were performed to assess bone formation, material resorption, and tissue compatibility. Immunohistochemistry was applied to evaluate the local immune response, focusing on macrophage polarization and multinucleated giant cell activity. Quantitative histomorphometry determined the relative areas of newly formed bone, residual graft material, and connective tissue. Results: Histopathological and histomorphometrical analyses demonstrated comparable levels of new bone formation in both groups, confirming reliable osteoconduction. Immunohistochemical evaluation revealed tartrate-resistant acid phosphatase isoform 5a (TRAP5A) expression in multinucleated giant cells adherent to both materials. Interestingly, Bio-Oss® induced a higher proportion of anti-inflammatory (CD163+) macrophages, whereas Ti-Oss® triggered a significantly greater number of pro-inflammatory multinucleated giant cells (CD11c+). Conclusion: These findings indicate that although both xenogeneic substitutes (Bio-Oss® and Ti-Oss®) achieve bone regeneration, they elicit distinct immune responses, which may influence long-term remodeling and graft integration. Consideration of osteoimmunological properties is therefore essential when selecting biomaterials for clinical sinus augmentation.
bone regeneration , macrophage polarization , Maxillary sinus floor elevation , osteoimmunology , xenogeneic bone substitute
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Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Institute for Dental and Craniofacial Sciences, Benjamin Franklin Charité Campus, Berlin, Germany
Bokštu Street Dental Center, Klaipėda, Lithuania
University Medical Centre, Justus Liebig University of Giessen, Giessen, Germany
Department of Traumatology and Orthopedics, Peoples Friendship University of Russia, Moscow, Russian Federation
Department of Traumatology and Orthopedics, Astana Medical University, Astana, Kazakhstan
Leader Stom LLP, Astana, Kazakhstan
Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
Department of Prosthodontics
Bokštu Street Dental Center
University Medical Centre
Department of Traumatology and Orthopedics
Department of Traumatology and Orthopedics
Leader Stom LLP
Clinic and Policlinic for Dermatology and Venereology
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