Laser surface texturing for enhanced implant biocompatibility and osseointegration: A critical review of its effects on surface properties

An implant's biocompatibility is an important factor in the success of the implantation procedure, along with osseointegration, which is crucial for osseointegrated implants (e.g. cementless total hip prosthesis) that require direct adherence of surrounding bone tissue to the implant surface. Osseointegration is affected by several factors, including surface features (e.g. micro-topography, surface chemistry, wettability, and roughness) which collectively influence implant stability, a key element of osseointegration. These factors are directly impacted by surface preparation methods, which play a critical role in enhancing osseointegration. Laser surface texturing is an effective surface-preparation technique that has become common in recent times. Laser surface texturing alters an implant's surface through thermal effects, including changes in micro-topography, chemical composition, roughness, and wettability. These changes in surface characteristics improve the lifetime and performance of the implant. Laser surface texturing can be used to manufacture implant surfaces with improved osteoblast adherence and activity while increasing antibacterial capacity. This paper reviews the process of laser surface texturing and analyzes its impacts on surface properties and biological performance. It appraises past studies and experimental findings on the potential of laser surface texturing in developing implant technology for improvement in clinical outcomes.