Alkali-treated titanium (Ti) with a porous, homogeneous, and uniform nanonetwork structure (TNS) that enables establishment of a more rapid and firmer osteointegration than titanium has recently been reported. However, the mechanisms underlying the enhanced osteogenic activity on TNS remains to be elucidated. This study aimed to evaluate the surface physicochemical properties of Ti and TNS, and investigate osteoinduction and osteointegration in vivo. Surface characteristics were evaluated using scanning electron microscopy (SEM), scanning probe microscopy (SPM), and X-ray photoelectron spectrometry (XPS), and the surface electrostatic force of TNS was determined using solid zeta potential. This study also evaluated the adsorption of bovine serum albumin (BSA) and human plasma fibronectin (HFN) on Ti and TNS surfaces using quartz crystal microbalance (QCM) sensors, and apatite formation on Ti and TNS surfaces was examined using a simulated body fluid (SBF) test. Compared with Ti, the newly developed TNS enhanced BSA and HFN absorbance capacity and promoted apatite formation. Furthermore, TNS held less negative charge than Ti. Notably, sequential fluorescence labeling and microcomputed tomography assessment indicated that TNS screws implanted into rat femurs exhibited remarkably enhanced osteointegration compared with Ti screws. These results indicate that alkali-treated titanium implant with a nanonetwork structure has considerable potential for future clinical applications in dentistry and orthopedics.

Alkali-treated titanate layer with nanonetwork structures (TNS) is a promising surface for improving osseointegration capacity in implants. Nevertheless, there is a risk of device failure as a result of insufficient resistance to biofilm contamination. This study tested whether treatment using a handheld non-thermal plasma device could efficiently eliminate biofilm contamination without destroying the surface nanostructure while re-establishing a surface that promoted new bone generation. TNS specimens were treated by a piezoelectric direct discharge (PDD) plasma generator. The effect of decontamination was performed utilizing Staphylococcus aureus. The evaluation of initial cell attachment with adhesion images, alkaline phosphatase activity, extracellular matrix mineralization, and expression of genes related to osteogenesis was performed using rat bone marrow mesenchymal stem cells, and the bone response were evaluated in vivo using a rat femur model. Nanotopography and surface roughness did not significantly differ before and after plasma treatments. Cell and bone formation activity were improved by TNS plasma treatment. Furthermore, plasma treatment effectively eliminated biofilm contamination from the surface. These results suggested that this plasma treatment may be a promising approach for the treatment of nanomaterials immediately before implantation and a therapeutic strategy for peri-implantitis.

Zirconium-based metallic glasses (Zr-MGs) are demonstrated to exhibit high mechanical strength, low elastic modulus and excellent biocompatibility, making them promising materials for endosseous implants. Meanwhile, tantalum (Ta) is also well known for its ideal corrosion resistance and biological effects. However, the metal has an elastic modulus as high as 186 GPa which is not comparable to the natural bone (10–30 GPa), and it also has a relative high cost. Here, to fully exploit the advantages of Ta as endosseous implants, a small amount of Ta (as low as 3 at. %) was successfully added into a Zr-MG to generate an advanced functional endosseous implant, Zr₅₈Cu₂₅Al₁₄Ta₃ MG, with superior comprehensive properties. Upon carefully dissecting the atomic structure and surface chemistry, the results show that amorphization of Ta enables the uniform distribution in material surface, leading to a significantly improved chemical stability and extensive material-cell contact regulation. Systematical analyses on the immunological, angiogenesis and osteogenesis capability of the material are carried out utilizing the next-generation sequencing, revealing that Zr₅₈Cu₂₅Al₁₄Ta₃ MG can regulate angiogenesis through VEGF signaling pathway and osteogenesis via BMP signaling pathway. Animal experiment further confirms a sound osseointegration of Zr₅₈Cu₂₅Al₁₄Ta₃ MG in achieving better bone-implant-contact and inducing faster peri-implant bone formation.