Nanoscale modification of titanium implant surfaces: titanium nanotubes and their recent advances

OBJECTIVES A constant increase in the life expectancy of individuals worldwide has eventually led to the rising demand for the replacement of missing teeth, of which dental implants are an unswerving and widely used therapeutic approach. Among the different biomaterials utilized in dental implants, titanium implants have become a gold standard due to their biocompatibility and advantageous mechanical characteristics. This review addresses the recent nanoscale advances of titanium dental implants, such as the formation mechanism of titanium nanotubes, their structure and properties, and anodization parameters that could alter the nanotube fabrication. MATERIALS AND METHODS This review elaborates on the effect of titanium nanotubes on peri-implant bone healing, including protein adsorption, immune modulation, cell behavior, and bone remodeling. The theories of charge repulsion, membrane stretching, and surface roughness variations have described the inherent antibacterial properties of titanium oxide nanotubes. RESULTS AND DISCUSSION It ultimately summarizes the ability of titanium nanotubes to enhance bioactivity, biocompatibility, and corrosion resistance. The titanium nanotubes can also be loaded with several biomaterials, thereby modifying and strengthening the surface characteristics. Contemporary studies aim to incorporate rare earth elements into nanotubes. The rare earth elements, well known for their applications in modern technologies, have also been used to dope the titanium nanotubes. Exploring future challenges involves addressing aspects like the stability and sterilization capabilities of the nanotube, ensuring they do not compromise its bonding strength to both the implant and bone. CONCLUSIONS AND CLINICAL SIGNIFICANCE These surface modifications on titanium implants are ostentatious for their efficacy in achieving the long-term success of the implant.