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Microarc oxidation (MAO) coating containing Ca, P, Si, and Na elements on a titanium (Ti) implant has been steam-hydrothermally treated and further mediated by post-heat treatment to overcome the compromised bone-implant integration. The bone regeneration, bone-implant contact, and biomechanical push-out force of the modified Ti implants are discussed thoroughly in this work. The best in vivo performances for the steam-hydrothermally treated one is attributed to the synergistic effects of surface chemistry and topologic structure. Through post-heat treatment, we can decouple the effects of surface chemistry and the nanoscale topologic structure easily. Attributed to the excellent in vivo performance of the surface-modified Ti implant, the steam-hydrothermal treatment could be a promising strategy to improve the osseointegration of the MAO coating covered Ti implant.

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Macroporous Ti with macropores of 50-400 μm size is prepared by sintering Ti microbeads with different diameters of 100, 200, 400, and 600 μm. Bioactive microarc oxidation (MAO) coatings with micropores of 2-5 μm size are prepared on the macroporous Ti. The MAO coatings are composed of a few TiO2 nanocrystals and lots of amorphous phases with Si, Ca, Ti, Na, and O elements. Compared to compact Ti, the MC3T3-E1 cell attachment is prolonged on macroporous Ti without and with MAO coatings; however, the cell proliferation number increases. These results are contributed to the effects of the space structure of macroporous Ti and the surface chemical feature and element dissolution of the MAO coatings during the cell culture. Macroporous Ti both without and with MAO coatings does not cause any adverse effects in vivo. The new bone grows well into the macropores and micropores of macroporous Ti with MAO coatings, showing good mechanical properties in vivo compared to Ti, MAO-treated Ti, and macroporous Ti because of its excellent osseointegration. Moreover, the MAO coatings not only show a high interface bonding strength with new bones but also connect well with macroporous Ti. Furthermore, the pushing out force for macroporous Ti with MAO coatings increases significantly with increasing microbead diameter.

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