Porous Titanium Granules for Sinus Floor Augmentation: A Case Series Study

Hamid Reza Arab1, Hamid Reza Boostani2, Amir Moeintaghavi3, *, Farid Shiezadeh1, *
1 Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2 Private Practice Periodontist, Tehran, Iran
3 Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

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Creative Commons License
© 2019 Arab et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Tel: 0098 511 6012189; Fax: 0098 511 8829500;
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Sinus grafting with autogenous bone and other bone substitutes has been shown to be a safe technique with high predictability of success, but it has not been determined which of these materials provide better osteogenic potential. The aim of the present study was to clinically and radiographically evaluate the use of Natix™ grafting material in maxillary sinus elevation procedures with simultaneous implant placement in humans.

Materials and Methods:

Fifteen patients (6 women and 9 men) requiring augmentation of the maxillary sinus before implant placement were voluntarily enrolled in this study. After the sinus graft procedure, a bone augmentation material of porous titanium granules (Natix™, TigranTecnologies, Malmö, Sweden) was placed into the sinus cavity. The primary stability of the fixtures was measured at baseline and 6 months following the implantation. Panoramic x-rays for objective measurements of bone height at the floor of sinus were repeated at 18 months, and 36 months postoperatively.


The 15 patients had in total 20 implants installed. Panoramic radiographs made 6 months post-insertion showed a radio-opaque area around the implants.Also at 6 months post-placement, all 18 implants were clinically stable and abutments were connected. Bone biopsies were taken from 1 grafted site in 1 patient. Excluding the one implant failing to achieve primary stability at baseline, the cumulative implant survival rate in this pilot study was 94.7%.


The results of the study showed that maxillary sinus augmentation with porous titanium granules provided predictable survival of implants in 36 months.

Keywords: Sinus floor augmentation, Guided bone regeneration, Porous titanium granule, Alveolar crest, Dental implants, Maxillary atrophy.