Multifunctional micro/nano-textured titanium with bactericidal, osteogenic, angiogenic and anti-inflammatory properties: Insights from <i>in vitro</i> and <i>in vivo</i> studies

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Titanium (Ti) is widely used as an implantable material for bone repair in orthopedics and dentistry. However, Ti implants are vulnerable to bacterial infections, which can compromise patient recovery and lead to implant failure. While a controlled inflammatory response promotes bone regeneration, chronic inflammation caused by infections can lead to implant failure. Bone repair is a complex process in which inflammation, angiogenesis and osteogenesis are tightly interconnected, requiring cooperation between mesenchymal stem cells (MSC), macrophages and endothelial cells. Here, we fabricated bio-inspired Ti implants with either microstructured (Micro Ti) or nanostructured (Nano Ti) surface textures that exhibit robust mechano-bactericidal properties. In vitro , both textured surfaces improved blood coagulation and osteogenic marker expression compared to smooth Ti surfaces. Additionally, Nano Ti promoted macrophage polarization towards the M2 phenotype and enhanced the paracrine effects of MSCs on angiogenesis, key processes in tissue regeneration. In vivo kinetic analysis of bone reconstruction in a rat calvarial model showed that Nano Ti improved osseointegration, as evidenced by increased bone volume, mineral density, and bone-implant contact. Notably, the Micro Ti surface showed no significant differences from the control implants. These findings highlight the potential of

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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