Titanium Surfaces with Nanostructures Influence on Osteoblasts Proliferation: a Systematic Review

OBJECTIVES Nanothechnology found to be increasingly implemented in implantology sphere over the recent years and it shows encouraging effect in this field. The aim of present review is to compare, based on the recent evidence, the influence of various nanostructure surface modifications of titanium for implants, on osteoblasts proliferation. MATERIAL AND METHODS A literature review of English articles was conducted by using MEDLINE database restricted to 2009 - 2014 and constructed according PRISMA guidelines. Search terms included "Titanium implant", "Titanium surface with nanostructure", "Osteoblast". Additional studies were identified in bibliographies. Only in vitro and/or in vivo studies on nano structured implant surfaces plus control sample, with specific evaluation method for osteoblasts proliferation and at least one Ti sample with nanostructure, were included in the review. RESULTS 32 studies with 122 groups of examined samples were selected for present review. Each study conducted in vitro experiment, two studies conducted additional in vivo experiments. All studies were dispensed by type of surface modification into two major groups; "Direct ablative titanium implant surface nano-modifications" with 19 studies and "Nanocomposite additive implant surface modifications" with 13 studies. Overall 24 studies reporting on positive effect of nanostructured surface, 2 studies found no significant advantage and 6 studies reported on negative effect compared to other structure scales. CONCLUSIONS From examination of selected articles we can notice marked advantage in implementation of various nanostructures onto implant surface. Yet for discovering the ultimate implant surface nanostructure, further comparable investigations of Ti surface nanostructures need to be done.