The influence of surface chemistry on implant interface histology: a theoretical basis for implant materials selection.

A theory is proposed stating that an ideal implant material must have a dynamic surface chemistry that induces histological changes at the implant interface which would normally occur if the implant were not present. Evidence for the validity of this theory is provided with a series of bone-implant studies which result in stable interfacial osteogenesis under specific implant surface chemistry conditions. Insufficient or excess surface ion concentrations produce negative osteogenesis and fixation results. Implantation of osteogenic implants in soft tissues also produces undesirable histological responses as proposed in the theory. A variety of surface chemical analyses of the implant are reviewed which provide a scientific basis for the implant surface theory.