An ideal biomaterial should be biointegratable with minimum adverse immune response. Titanium (Ti) and its alloys are widely used biomaterials for manufacturing clinical implants because of their innate biocompatibility. However, the bioinert property of Ti may hinder tissue–implant integration and its bio compatibility nature allows for attachment of bacterial cells on implant surfaces. Nanoparticles (NPs) have been proposed as a possible intervention to overcome these biological shortcomings of Ti-based implants. The aim of the current systematic review was to identify literature that demonstrates enhanced biocompatibility of Ti-based implants by incorporating NPs. Electronic searches were conducted through the PubMed/MEDLINE, ScienceDirect, Web of Science and EBSCOhost databases. Studies published in English were extracted, without restrictions on the year of publication, using the following keywords: ‘biocompatibility’, ‘nanoparticles’, ‘titanium’ and ‘implant’. The guidelines stipulated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement were followed. A total of 630 articles were identified in the initial search and upon reviewing, 21 articles were selected according to the eligibility criteria. The selected literature showed robust evidence to support the hypothesis that the inclusion of NPs improves biocompatibility of Ti implants. The studies further indicated a close correlation between biocompatibility and antibacterial properties, of which NPs have been proven to characteristically achieve both.

The excellent combination of properties has seen a steep increase in the demand for titanium (Ti)-based material as biomedical implant devices. However, some features that promote biocompatibility are found to be lacking in Ti implants. The use of polymer nanofiber (NF) coating on the surfaces of the implants has been proven to remedy these setbacks. In particular, electrospun NFs are versatile as natural extracellular matrix mimics and as facilitators in the biocompatibility function of Ti-based implants. Therefore, various properties of Ti implants coated with polymer NFs and the correlations among these properties are explored in this review. Synthetic polymers are favorable in tissue engineering applications because they are biocompatible and have low toxicity and degradation rates. Several approved synthetic polymers and polymer hybrids have been electrospun onto Ti implant surfaces to successfully improve the biomedical applicability of the implants with regard to their physical (including diameter and porosity), chemical (including corrosion resistance), mechanical (including elastic modulus, strength and ductility) and biological properties (including tissue integration, antimicrobial and cytotoxicity).