Design of biocompatible and self-antibacterial titanium surfaces for biomedical applications

Titanium and its alloys are widely used for orthopaedic and dental applications. The bio-interfacial interactions between implant surfaces and biomacromolecules control the biological performances including protein adsorption, cell adhesion, bacteria attachment and corrosion/degradation. These bio-interfacial interactions are regulated by surface properties like wettability/surface energy, surface charge, roughness and surface chemistry. Surface engineering is a technique to modify these surface properties to achieve desired biological performances. Poor osseointegration and biofilm formation are major challenges for titanium-based implants. This review mainly focuses on recent developments in the design of biocompatible and self-antibacterial titanium surfaces through surface modifications. Physical, chemical and biological routes of surface modifications applied on titanium surfaces have been discussed and their implications on the in-vitro and in -vivo biological responses have been highlighted. The biolog-ical responses have been correlated with the interfacial prop-erties of the surfaces. The design of multi-functional surfaces with both biocompatibility and antibacterial properties has been emphasized.