Bone regeneration using porous titanium particles vs. bovine hydroxyapatite: a sinus lift study in rabbits

Abstract

Background: The use of porous titanium particles as space filling biomaterials for intraoral bone regeneration might be of interest because of both the mechanical stability and nonresorbable properties. Titanium particles were recently described for bone regeneration in sinus lifts and in the treatment of periimplantitis. Nevertheless, tissue integration and 3D bone regeneration with titanium particles were poorly explored in these previous reports. Aim: The first objective of this study was to qualitatively and quantitatively assess the bone formation process, particularly the long-term behavior and 3D volume stability of subsinusal bone regeneration, using titanium or bovine hydroxyapatite granules, in a rabbit model. The second objective was to evaluate the effect of the hydration of the BHA particles with a therapeutic concentration of doxycycline solution on the osteogenesis and biomaterial resorption. Methods: Rabbits underwent a double sinus lift procedure using one of three materials: grade 1 porous titanium particles (Ti), bovine hydroxyapatite (BHA) or chemically modified bovine hydroxyapatite (BHATTC). Animals were sacrificed after 1 week, 5 weeks or 6 months. Samples were analyzed using mCT and nondecalcified histology. Results: The materials used in each of the three groups allowed an optimal bone formation; bone quantities and densities were not statistically different between the three groups. At 6 months, more stable 3D volume stability was found with TI and BHATTC (P¼0.0033). At 5 weeks and 6 months, bone to material contact (BMC) corroborating osteoconduction was significantly higher with BHA and BHATTC than with Ti (P < 0.0001). Conclusions and clinical implications: Even though the studied biomaterials displayed different architectures, they are relevant candidates for sinus lift bone augmentation before dental implants because they allow adequate 3D stability and osteogenesis. However, to recommend the clinical use of Ti, both an observation on the drilling effects of Ti particles and clinical trials are needed