PURPOSE: Slow-resorbing deproteinized bovine bone grafts have presented high success rates when used for sinus augmentation. However, histologic evaluation shows that this material is eventually excreted as a result of a foreign body reaction. The purpose of this study was to compare and to evaluate the performance of a recently introduced particulate porous graft material, consisting of pure titanium granule (PTG) to the deproteinized bovine bone grafts, when used as a sinus augmentation material. MATERIALS AND METHODS: To understand the histological aspects of PTG, deproteinized bovine particulates (Bio-Oss) and PTG were placed contralaterally as sinus grafting materials in 2 patients. After 9 months, biopsies were performed for histologic and 3-dimensional analysis. RESULTS: Both materials were in contact with newly formed bone. The Bio-Oss showed signs of foreign body reaction. In contrast, bone filled the space between the single PTG particulates, and no foreign body reaction was observed. CONCLUSIONS: From a bone formation perspective, PTG grafts were comparable with the commonly used Bio-Oss grafts and may be regarded as a possible alternative for permanent grafting in sinus augmentation.