European Cells and Materials Vol. 24. Suppl. 1, 2012 (page 47)                                                         ISSN 1473-2262 
 

                                                http://www.ecmjournal.org 
 

Histometry and histomorphology of bone reactions after human sinus floor 
augmentation with Bio-Oss® or Endobon®  
D Hahn1, E Luvizuto2, H Plenk Jr1, M Weinlaender3 

1Bone & Biomaterials Res., Medical University of Vienna, Austria. 2Dept.Surgery & Integrated 
Clinic, Araçatuba Dental School, UNESP-Univ Estadual Paulista, Brazil. 3Private Dental Practice, 

Vienna, Austria 

INTRODUCTION: Augmentation of the atrophic 
maxillary sinus floor prior to endosseous dental 
implant placement is a well documented method. 
Over the last decade, deproteinized bovine bone 
mineral (Bio-Oss®, Geistlich Biomaterials) has 
emerged as the material of choice for most of the 
clinicians. The aim of this  maxillary sinus 
augmentation mirror study was to compare the 
amounts of new bone generated with Bio-Oss® to 
another bovine bone-derived material (Endobon®- 
Biomet 3i), produced by a high-temperature 
sintering process. 

METHODS: In a prospective and controlled 
multicenter study [1] a total number of 94 sinus 
augmentation procedures (38 unilateral/28 
bilateral) were performed in 66 patients by the 
„lateral window technique”. One of the two bovine 
bone-derived bone substitute materials (Bio-Oss®, 
Geistlich Biomaterials, 0.25-1.0 mm granulate) or 
(Endobon®, Biomet 3i, 0.5-1mm granulate) was 
used according to randomization. After six months 
healing trephine biopsies (2 mm inner/3 mm outer 
diameter) were retrieved before implant place-
ment. Only eight of the retrieved biopsies were 
processed in HP’s laboratory, and Giemsa-surface 
stained undecalcified ground sections were 
prepared for histomorphological and histometrical 
evaluation. For histometry digital micrographs 
were taken at 40x magnification and merged to 
overview images. Under microscopic control, new 
bone (NB) and bone substitute particles (BS) were 
identified, demarcated and false colour labelled, 
using Adobe Photoshop® CS5. On TIFF-images, 
the region of interest ROI (excluding the original 
sinus floor), area %NB and %BS per ROI, and  BS 
surface% with NB contact were measured in NIS-
Elements AR 3.2 (Nikon Laboratory Imaging Inc.), 
and calculations made with MSOffice Excel. 

RESULTS: Light microscopy of Bio-Oss® shows 
orderly lamellar bone structures with osteons and 
clearly visible empty osteocyte lacunae. The 
Endobone® particles have a more “ceramic” 
granular structure, but also empty osteocyte 
lacunae and former Haversian canals are visible.  

 

 

On both materials direct new bone apposition and 
growth into Haversian canals is visible (Fig.1), but 
no obvious signs of BS resorption. 

                       

   
 

 

Fig.1: Details (100xmagn.) from Giemsa-surface stained 
ground sections show direct apposition of purple stained 
new bone to Bio-Oss® and Endobon® granulate 
surfaces. 

 

 

DISCUSSION & CONCLUSIONS: Histometry 
demonstrated in this study that both bone substitute 
materials have similar “biological profiles” with 
regard to area% new bone formation and surface% 
contacts. However, histometric data varied greatly 
between biopsies of the same group, or even 
between sections of the same biopsy, making 
statistical significance calculations so far pointless.  
REFERENCES: 1 M.Weinlaender, G.Krennmair, 
S.Schmidinger, W.Lill, H.Plenk Jr (2011) 20th Ann.Meet. 
EAO, Athens, P 341.  

ACKNOWLEDGEMENTS: This study was sponsored by 
Biomet 3i, USA. 

mailto:%20hanns.plenk@meduniwien.ac.at
mailto:office@drweinlaender.at