Anorganic bovine-derived hydroxyapatite vs β-tricalcium phosphate in sinus augmentation: a comparative...

Sinus augmentation remains a standard procedure to restore bone volume for implant placement in the posterior maxilla. While multiple grafting materials are available, the optimal choice remains unclear. Prior research has shown that both bovine-derived hydroxyapatite (BHA) and beta-tricalcium phosphate (β-TCP) are commonly used in sinus augmentation. However, the relative performance of these materials has not been fully resolved. This uncertainty drives the need for comparative studies. Histomorphometric data on new bone formation and residual graft material are limited. No prior work had resolved the differences in osteoconduction between BHA and β-TCP. The lack of direct comparisons leaves clinicians uncertain about material selection. This gap motivated the current study to address these questions. The need for evidence-based guidance in material selection is evident.

This clinical study aimed to compare the biological performance of BHA and β-TCP in sinus augmentation. The specific problem addressed is the lack of clarity on which material promotes better osteoconduction. The motivation stems from the need to guide clinicians in material selection. The study focused on new bone formation and residual graft material as key metrics. Histomorphometric analysis was chosen as the primary method. The goal was to determine if BHA outperforms β-TCP in sinus augmentation. The study design aimed to provide direct evidence from patient data. This approach allows for a clear comparison of the two materials.

The study involved 23 patients requiring sinus augmentation for implant placement. Patients were divided into two groups: BHA (13 patients) and β-TCP (10 patients). A two-step sinus-grafting procedure was performed on each participant. Bone biopsies were collected after an average healing period of 6.5 months. Undecalcified sections were prepared for histomorphometric analysis. The analysis focused on new bone formation, residual graft particles, and soft-tissue areas. Statistical comparisons were made between the two groups. The methods ensured a controlled comparison of the two graft materials.

New bone formation was significantly higher in the BHA group compared to β-TCP. The mean new bone formation was 30.13% ± 3.45% for BHA versus 21.09% ± 2.86% for β-TCP. Residual graft particle area was 31.88% ± 6.05% in the BHA group and 34.05% ± 3.01% in the β-TCP group. Soft-tissue area was 37.99% ± 5.92% for BHA and 44.86% ± 4.28% for β-TCP. All differences were statistically significant (P < 0.05). Both materials demonstrated biocompatibility and osteoconductivity. BHA showed greater osteoconductive potential than β-TCP. These findings suggest a material-specific effect on bone regeneration.

The authors propose that BHA may be more efficient in promoting osteoconduction than β-TCP. Both materials demonstrated biocompatibility and successful integration. The findings suggest a potential advantage of BHA in new bone formation. The data support the use of BHA in sinus augmentation procedures. The study highlights the importance of histomorphometric evaluation in material assessment. The results do not suggest that β-TCP is ineffective, but rather that BHA may perform better. The authors caution against generalizing these findings beyond the study population. Further research is needed to confirm these results in larger cohorts.