You would need SIP trunk licenses to use native SIP trunks, and depending on your router or carrier, you may also need a session border controller of some kind (Mitel Border Gateway is recommended).
There should be no issues using a SIP to analog gateway, although depending on the quality of the gateway there are sometimes issues with things like positive disconnect. AudioCodes, Adtran, Grandstream, Multitech, and other quality devices should work fine as long as your carrier supports them or is standard enough it doesn't matter.