Physical Antibacterial Surface Modifications on Titanium- Based Implant Materials

Infections associated with titanium (Ti)-based implants present significant challenges in clinical treatments, especially when biofilms already form on the implant surface. Many antimicrobial agents, including antibiotics, metallic nanoparticles and antimicrobial peptides, have been extensively used to deal with Ti implant infections. However, these chemical approaches suffer from potential toxicity, antibiotic resistance and poor long-term antibacterial performance. Hence, physical antibacterial surfaces on Ti-based implants have attracted increasing attention. The antibacterial behavior of different surfaces on Ti-based biomaterials against various bacteria only by physical properties of the implants themselves (e.g., nanotopography) or exogenous physical stimulus (e.g., photocatalysis) was reviewed, as well as parameters influencing the physical antibacterial processes, such as size, shape and density of the surface nanotextures, and bacterial growth phases. Besides, mechanisms of different fabrication techniques for the physical antibacterial surfaces on Ti-based biomaterials were also summarized.