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As the global elderly population increases year by year, the demand for dental implants also increases significantly, Titanium (Ti) is widely used in dental implants due to its good mechanical properties, biocompatibility and corrosion resistance. However, titanium implant surfaces are biologically inert, it won’t react with cells actively and the implant may failed. The success of dental implants is highly associated with the osseointegration between the implant and the surrounding bone tissue, and the balanced osteoblast/osteoclast reaction is one of the key points during this process. However, with an increase in age, an imbalanced osteogenesis/osteoclastogenesis may occur, which will prolong the bone healing time and then affect the osseointegration of implants. This study intends to develop a multiple surface treatment process applied for dental implant application. So how to reduce its bioinertness and regulating the osteogenesis and osteoclastogenesis through surface treatment will be the important topic of this study. First is using the sand-blasting with large grit and acid-etching (SA), the most commonly used treatment in clinical dental titanium (Ti) implants. Second is using alkaline treatment to produce the micro/nano-scale network structure (SAA). In order to decrease the activity of osteoclast and enhance osteogenesis, the final step is using a natural cross-linker, epigallocatechin-3-gallate (EGCG), to immobilized type I collagen on the surface of SLA-A (SAAEC). The results indicate that the multiple surface treatment shows micro/submicro/nano-scale network structure and it has good cell responses, such as osteogensis cell adhesion, proliferation and mineralization. Moreover, the effects of the multiple surface treatment processes on osteoclastogenesis shows inhibition. The multiple surface treatment process in this study has the same osteogenic response as the clinical commercial sandblasting/acid etching treatment, and also has the effect of inhibiting the osteoclastogensis. In the future, it is still necessary to analyze the mechanism of the multiple surface treatment process on the effect of osteogenesis and osteoclastogensis through co-culture and gene expression.
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