Comparison of Two Xenograft Materials Used in Sinus Lift Procedures: Material Characterization and in Vivo Behavior

Detailed information about graft material characteristic is crucial to evaluate their clinical outcomes. The present study evaluates the physicochemical characteristics of two xenografts manufactured on an industrial scale deproteinized at different temperatures (non-sintered and sintered) in accordance with a protocol previously used in sinus lift procedures. It compares how the physico-chemical properties influence the material performance in vivo with a histomorphometric study in retrieved bone biopsies following maxillary sinus augmentation, in 10 clinical cases. X-ray diffraction analysis revealed typical structure of hydroxyapatite for both materials. Both xenografts are porous and exhibit intraparticle pores. Strong differences were observed in terms of porosity, cristallinity, and calcium/phosphate. Histomorphometric measurements on the bone biopsies showed statistically significant differences. The physicochemical assessment of both xenografts in accordance with the protocol developed at industrial scale confirmed that these products present excelent biocompatibilitity, with characteristics similar to natural bone. The sintered HAs xenograft exhibit higher osteoconductivity although were not complete resorbable (30.80±0.88% residual material). On the other hand, the non-sintered HAs xerograft induced about 25.92±1.61% of new bone and almost complete degradation after 6 months implantation. Differences in physico-chemical characteristics found between the two HAs xenograft determine different behavior of this material.