Titanium offers excellent biocompatibility and extraordinary mechanical properties. As a result, it is used as a material for dental implants. Implants infected by peri-implantitis can be cleaned for successful re-osseointegration. Optimal surface properties, such as roughness and wettability, have a significant impact on cell adhesion. The aim of this study was to evaluate the adhesion and proliferation of osteoblasts on the surface of repeatedly cleaned nanostructured titanium samples. Human osteoblast-like cells MG-63 were seeded on nanostructured titanium specimens manufactured from rods produced by the equal channel angular pressing. For surface characterization, roughness and wettability were measured. Cell adhesion after 2 h as well as cell proliferation after 48 h from plating was assessed. We have found that this repeated cleaning of titanium surface reduced cell adhesion as well as proliferation. These events depend on interplay of surface properties, such as wettability, roughness and topography. It is difficult to distinguish which factors are responsible for these events and further investigations will be required. However, even after the several rounds of repeated cleaning, there was a certain rate of adhesion and proliferation recorded. Therefore the attempts to save failing implants by using in situ cleaning are promising.

Commercially pure (CP) titanium is widely used for long-term biomedical implants due to its high biocompatibility and corrosion resistance. However, its relatively low strength limits its use in highly loaded applications. Ultrafine-grained (UFG) titanium obtained through severe plastic deformation offers enhanced mechanical performance while maintaining the stability of CP titanium. This study investigates how electrochemical surface modification by anodization affects the corrosion, biological performance, and technological behavior of UFG titanium. TiO₂ layers with nanotubular and nanoporous morphologies were produced at anodization voltages between 20 and 60 V. Corrosion tests in physiological solution confirmed stable passive behavior with corrosion rates below 4 µm year⁻¹, and surface wettability increased markedly with anodization. Osteoblast-like MG-63 cells exhibited good viability on all anodized surfaces, with improved adhesion and proliferation on samples anodized at 60 V. The porous TiO₂ layers were successfully intercalated with dimethyl sulfoxide and ibuprofen, demonstrating potential for local drug delivery. Implantation simulations on real Nanoimplant^® prototypes confirmed sufficient mechanical stability of the anodized layer. Overall, the optimized anodization of UFG titanium enhances its biological response while maintaining corrosion resistance, supporting its clinical use in long-term dental and orthopedic implants with integrated drug-release functionality.