Multi-scale structural design of titanium implants for improved osseointegration
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Osseointegration success of bone-interfacing implants is reduced for many compromised patients, necessitating improved implant design. Though material and mechanical properties of titanium make it attractive for load-bearing dental and orthopaedic implants, limited advancements have been made to increase success and survival after placement in the body. Novel surface modifications inducing combined micro- and nano-roughness on Ti and Ti-6Al-4V substrates contribute to increased wettability and can be tailored to affect cell response. Additive manufacturing can produce three dimensional constructs with natural, trabeculae-inspired porosity. Osteoblasts and mesenchymal stem cells are responsive to the porosity and detail of these constructs, and exhibit increased production of osteoblastic differentiation and maturation factors on porous constructs compared to solid substrates. Implants with trabecular porosity lead to vertical bone growth on rat calvaria, and osseointegrate in the rabbit femur. These results indicate that structural micro- and nano-modification at the surface, combined with macro-scale porosity, can enhance osteoblastic differentiation and maturation in vitro, and osseointegration in vivo. These implants are now being evaluated in clinical studies.