Low-temperature Versus High-temperature Sintering - Regenerative and Osteoimmunological Insights from Bio-Oss® and Ti-Oss® in Sinus Lift Surgery

Sep 28, 2026

Maxillary sinus floor elevation depends on graft material choices that shape both regeneration and local immune reactions. This clinical study compared a high-temperature sintered xenograft (Bio-Oss®) with a low-temperature processed xenograft (Ti-Oss®), analyzing regenerative capacity and osteoimmunological profiles after sinus augmentation. Eight patients underwent split-mouth augmentation, with biopsies collected at 6 months for histological, histomorphometric, and immunohistochemical assessment of bone formation, resorption, and macrophage polarization, including multinucleated giant cell activity.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background/Aim

Patients and Methods

Results

Conclusion

Introduction

Maxillary sinus floor elevation and graft determinants

Bio-Oss® processing and immunological implications

Ti-Oss® processing and osteogenicity rationale

doi: 10.21873/invivo.14195 Low-temperature Versus High-temperature Sintering: Regenerative and Osteoimmunological Insights from Bio-Oss® and Ti-Oss® in Sinus Lift Surgery TADAS KORZINSKAS1,2, REINER SCHNETTLER3, DENIS RIMASHEVSKIY4, BIRZHAN MALIK5, BAURZHAN DAKENOV6, DIANA BAGDONIENE5, OLE JUNG7 and MIKE BARBECK7 1 Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Institute for Dental and Craniofacial Sciences, Benjamin Franklin Charité Campus, Berlin, Germany; 2 Bokštų Street Dental Center, Klaipėda, Lithuania; 3 University Medical Centre, Justus Liebig University of Giessen, Giessen, Germany; 4 Department of Traumatology and Orthopedics, Peoples Friendship University of Russia, Moscow, Russian Federation; 5 Department of Traumatology and Orthopedics, Astana Medical University, Astana, Kazakhstan; 6 Leader Stom LLP, Astana, Kazakhstan; 7Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany Abstract 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+) . continued ✉ Dr. Mike Barbeck, Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Strempelstrasse 13, 18057 Rostock, Germany. Tel: +49 17681022467, [e-mail: mike.barbeck@med.uni-rostock.de](e-mail: mike.barbeck@med.uni-rostock.de) Received September 9, 2025 | Revised October 8, 2025 | Accepted November 14, 2025 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. ©2026 The Author(s) . Anticancer Research is published by the International Institute of Anticancer Research. Conclusion:Thesefindingsindicatethatalthoughbothxenogeneicsubstitutes(Bio-Oss® andTi-Oss®)achieveboneregeneration, 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. Keywords: Maxillary sinus floor elevation, xenogeneic bone substitute, osteoimmunology, macrophage polarization, bone regeneration. Introduction Maxillary sinus floor elevation is a well-established surgical approach for increasing alveolar bone height in the posterior maxilla, allowing stable placement of dental implants. The biological success of this procedure depends not only on mechanical spa

FAQs

What was the objective of comparing Bio-Oss® and Ti-Oss®?

The study aimed to compare how a high-temperature sintered xenograft (Bio-Oss®) versus a low-temperature processed xenograft (Ti-Oss®) perform regarding regenerative outcomes and immunological profiles in sinus lift surgery.

How were regenerative and immune responses evaluated?

Eight patients underwent split-mouth sinus augmentation with both materials, and biopsies were retrieved at 6 months. Histological, histomorphometrical, and immunohistochemical analyses assessed new bone formation, material resorption, and local immune response, including macrophage polarization and multinucleated giant cell activity.

What immune-response differences were observed between the grafts?

Both materials supported comparable levels of new bone formation and showed TRAP5A expression in multinucleated giant cells adherent to them. However, Bio-Oss® induced a higher proportion of anti-inflammatory (CD163+) macrophages, while Ti-Oss® triggered more pro-inflammatory multinucleated giant cells (CD11c+).

Sep 28, 2026

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