“… 44–49 Porous bioactive glasses, as described for roughened titanium surfaces above, form a layer of HA, readily absorb proteins, reduce osteoblast adhesion and proliferation, and stimulate pre-osteoblast differentiation. 44–49 Furthermore, research including our own has shown that these cellular responses are largely driven by the material’s chemical and physical surface characteristics. 14 , 16 , 17 , 19 , 23 , 44 , 46 , 47 , 49 Taken together, it becomes clear that increasing surface roughness and porosity not only increase the reactive surface area of the biomaterial, but more importantly that osteoblastic cells are able to detect surface topology on a wide nanometer scale range (tens to hundreds of nanometers), and will react differently, according to specific surface parameters.…”