Microbial colonization is one of the main causes of implant loosening and rejection. Pathogenic contamination and the subsequent biofilm formation reduce the implant’s chance of survival and can be life-threatening to a patient. Among the many strategies employed to reduce the infection probability of bioceramics, surface functionalization plays a key role. This chapter is dedicated to describing the different strategies available to prevent bacterial colonization and the proliferation of hydroxyapatite-coated implants. Moreover, the factors intervening in the bacteria-implant interaction will be described, detailing the mechanisms involved during the contact, adhesion, and proliferation of bacteria. Finally, the characterization methods will be discussed, emphasizing the bioactivity and antibacterial assays.
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