Abstract
Dental implants are often used to replace missing teeth, for aesthetic and practical purposes. The most common
material used for dental implants is titanium, which has been used for over 40 years. New ceramic materials and
composites have been developed to replace titanium-based dentures. However, these materials can suffer from
discoloration, degradation, failure, and cause allergic reactions in patients. Recent studies have shown that the
surface of the material plays a significant role on its stability and osseointegration. In this study, we modified
the surface of a ceria-stabilized tetragonal ZrO2 polycrystalline ceramic-based nanostructured zirconia/alumina
composite (NANOZR) material and titanium-based materials, and evaluated their osteoblast response including
the gene expression of rat bone marrow cells on their surface. Modification of the NANOZR and titanium
implant surface by alkali treatment promoted osteogenic gene expression. The increase in the osteogenic gene
expression was attributed to the change in the mechanical and chemical surface properties. The findings indicate
nanotopographical surface modifications can improve the osseointegration of zirconium-based implants.
