State of Osseointegrated Titanium Implant Surfaces in Topographical Aspect.

Titanium is a primary metallic biomaterial widely used in dental implants because of its favorable mechanical properties and osseointegration capability. Currently, increasing interests have been taken in the interaction between titanium implant surface and surrounding bone tissue, particularly in surface topographical aspect. There are currently several techniques developed to modify surface topographies in the world market of dental implant. In this review, state of titanium implant surfaces in topographical aspect is presented from relatively smooth surfaces to rougher ones with microtopographies and/or nanotopographies. Each surface is summarized with basic elaborations, preparation methods, mechanisms for cellular responses and current availabilities. It has been demonstrated that rough surfaces evolving from micro- to nano-scale, especially hierarchical micro-and nanotopographies, are favorable for faster and stronger osseointegration. Further experimental and clinical investigations will aid in the optimization of surface topography and clinical selection of suitable implants.