Metallic materials, for example, stainless steel, titanium and its alloys, and tantalum, are widely used for medical implants in trauma surgery, orthopedic and oral medicine. [1][2][3] Successful incorporation of these materials for design, fabrication and application of medical devices require that they meet several critical criteria. Paramount is their biocompatibility as expressed by their relative reactivity with human tissues. Another is their ability to provide sufficient mechanical strength, especially under cyclic loading conditions to ensure the durability of the medical devices made therefrom. Finally the material should be machinable and formable thereby enabling device fabrication at an affordable cost. In this paper we show that nanostructured commercial purity titanium produced by severe plastic deformation (SPD) opens new avenues and concepts for medical implants, providing benefits in all areas of medical device technology.Numerous clinical studies of medical devices fabricated from commercial purity (CP) titanium for trauma, orthopaedic and oral medicine has proven its excellent biocompatibility. [3] However the mechanical strength of CP titanium is relatively low compared to other metals used in biomedical devices. Whereas the strength of this material can be increased by either alloying or secondary processing, for example rolling, drawing, etc., these enhancements normally come with some degradation in biometric response and fatigue behaviour. Recently it has been shown that nanostructuring of CP titanium by SPD processing can provide a new and promising alternative method for improving the mechanical properties of this material. [4][5][6][7][8] This approach also has the benefit of enhancing the biological response of the CP titanium surface. [9] This paper reports the results of the first developments and studies of nanostructured titanium (n-Ti), produced as long-sized rods with superior mechanical and biomedical properties and demonstrates its applicability for dental implants. The effort was conducted using commercially pure Grade 4 titanium [C -0.052 %, O 2 -0.34 %, Fe -0.3 %, N -0.015 %, Ti-bal. (wt. pct.)]. Nanostructuring involved SPD processing by equal-channel angular pressing [10] followed by thermo-mechanical treatment (TMT) using forging and drawing to produce 7 mm diameter bars with a 3 m length. This processing resulted in a large reduction in grain size, from the 25 lm equiaxed grain structure of the initial titanium rods to 150 nm after combined SPD and TMT processing, as shown in Figure 1. The selected area electron diffraction pattern, Figure 1(c), further suggests that the ultra fine grains contained predominantly high-angle non-equilibrium grain boundaries with increased grain-to-grain internal stresses. [11] A similar structure for CP Ti can be produced in small discs using other SPD methods, for example -high pressure torsion (HPT) as studied in detail. [8] In the present work it was essential to produce homogeneous ultrafine-grained structure throughout a three-meter l...

Nanostructured titanium (nTi) with essential enhanced strength and fatigue characteristics is an advanced material for dental implant applications. Nano Ti is commercially pure titanium, that was nanostructured by a special technique of severe plastic deformation. It is bio inert, does not contain even potentially toxic or allergenetic additives and has significantly higher specific strength properties than any other titanium applied in dental implants. Cylindrical threaded screw implants Nanoimplant® sized 2.4 mm in diameter and 12 mm in length were made from nTi. It is the first application of nTi dental implant in the world reported. Recently more than 250 successful clinical applications dealing with surgery on the front teeth were carried out. No complications were noticed during the early postoperative period and early loading. Laboratory cytocompatibility tests undertaken so far on mice fibroblast cells have indicated that nanocrystalline Ti surface has a significantly better property for cell colonisation and healing of tissue consequently.

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The aim of this paper is to review the experimental methods currently being used to evaluate the osseointegration of nanostructured titanium implants using animal models. The material modifications are linked to the biocompatibility of various types of oral implants, such as laser-treated, acid-etched, plasma-coated, and sand-blasted surface modifications. The types of implants are reviewed according to their implantation site (endoosseous, subperiosteal, and transosseous implants). The animal species and target bones used in experimental implantology are carefully compared in terms of the ratio of compact to spongy bone. The surgical technique in animal experiments is briefly described, and all phases of the histological evaluation of osseointegration are described in detail, including harvesting tissue samples, processing undemineralized ground sections, and qualitative and quantitative histological assessment of the bone-implant interface. The results of histological staining methods used in implantology are illustrated and compared. A standardized and reproducible technique for stereological quantification of bone-implant contact is proposed and demonstrated. In conclusion, histological evaluation of the experimental osseointegration of dental implants requires careful selection of the experimental animals, bones, and implantation sites. It is also advisable to use larger animal models and older animals with a slower growth rate rather than small or growing experimental animals. Bones with a similar ratio of compact to spongy bone, such as the human maxilla and mandible, are preferred. A number of practical recommendations for the experimental procedures, harvesting of samples, tissue processing, and quantitative histological evaluations are provided.

Nanostructured titanium has become a useful material for biomedical applications such as dental implants. Certain surface properties (grain size, roughness, wettability) are highly expected to promote cell adhesion and osseointegration. The aim of this study was to compare the biocompatibilities of several titanium materials using human osteoblast cell line hFOB 1.19. Eight different types of specimens were examined: machined commercially pure grade 2 (cpTi2) and 4 (cpTi4) titanium, nanostructured titanium of the same grades (nTi2, nTi4), and corresponding specimens with laser-treated surfaces (cpTi2L, cpTi4L, nTi2L, nTi4L). Their surface topography was evaluated by means of scanning electron microscopy. Surface roughness was measured using a mechanical contact profilometer. Specimens with laser-treated surfaces had significantly higher surface roughness. Wettability was measured by the drop contact angle method. Nanostructured samples had significantly higher wettability. Cell proliferation after 48 hours from plating was assessed by viability and proliferation assay. The highest proliferation of osteoblasts was found in nTi4 specimens. The analysis of cell proliferation revealed a difference between machined and laser-treated specimens. The mean proliferation was lower on the laser-treated titanium materials. Although plain laser treatment increases surface roughness and wettability, it does not seem to lead to improved biocompatibility.