Surface treatments for titanium implants

The implant surface is considered one of the most important factors for osteointegration. A factor that proved to be crucial for a better, faster osteointegration is surface roughness. It has been widely shown that an increase in roughness corresponds to a better microretention between implant and bone macromolecules. Titanium surface can be prepared with different techniques in order to obtain an optimal degree of surface roughness, an increase of TiO2 thickness, or even to create a coating of osteoconductive material. This article describes the most widely used and investigated techniques to modify a titanium implant surface: Addition techniques: titanium oxide layer thickening, TPS (Titanium Plasma Spray), hydroxyapatite or calcium phosphate coatings; Subtraction techniques: sandblasting, acid etching, SLA, electropolishing, mechanical polishing, and electrochemical anodization; Surface modifications: ion implantation, laser treatment, electrothermal treatment.