Bone Apposition on Nanoporous Titanium Implants

Titanium and its alloys are widely used in the biomedical field for manufacturing dental and orthopedic implants. Upon implantation in the body, the surface of these implants interacts with numerous biological entities such as proteins and cells in the nanometer range; however, most of the surfaces commercially available exhibit features in the micrometer range and thus are far not optimal for controlling the biological response. Physicochemical features in the nanometer range may ultimately control the adsorption of proteins and the adhesion and differentiation of cells. In this chapter, the different methods for producing nanotubes of titania on the surface of implants are presented. The anodization process that produces titania nanotubes is emphasized in regard to its applicability to treat complex-shaped medical devices. Then, the biomedical applications of these nanoporous surfaces in the fields of dentistry and orthopedics are presented. Future perspectives with nanometer surfaces that would ultimately direct the nature of peri-implant tissues and improve their clinical success rate are discussed.