To compare the different surface topographies of titanium implants used in dentistry against the formation of bacterial biofilm. To identify relevant studies, the electronic databases PubMed, Science Direct and Springer Link were searched from inception until January 2019. A total of 38 studies were selected for the systematic review (n = 38). The most commonly used titanium surfaces were machined titanium (16.3%), sandblasted, large-grit, acid-etched titanium (10.9%), untreated or pure titanium (10.9%), polished titanium (9.8%), physically textured titanium (9.8%), acid-etched titanium (8.7%) and anodized titanium (5.4%). The majority of the studies (78.9%) found that surface topographies (with varying degrees of roughness) had a beneficial effect on the ability to allow low bacterial biofilm on the surfaces. A low roughness value (R a) of below 1 µm was found in 68% of these surfaces. Overall, no specific surface topography was found to be the ideal surface in allowing the least bacterial biofilm attachment. In this study, meta-analysis was not performed. This narrative systematic review provides a summary of the effects of surface topographies for future research and development of new dental implant surfaces and decontamination techniques.