Biomaterial and implant surfaces: on the role of cleanliness, contamination, and preparation procedures.

Material specificity in implant-tissue interactions derives primarily from the surface properties (chemical composition, microstructure, etc.) of the implant. This article addresses several questions related to implant and biomaterial surfaces: What is the status of real implant surfaces (composition, cleanliness, contamination, microstructure, etc.), and how does it vary with preparation procedures? Can the surface status be varied and analyzed in a controlled manner? How significant are surface status variations for in vivo function? And so on. We discuss clean surfaces, how they are contaminated, and how the contamination may affect the properties. We also discuss different preparation procedures, such as conventional machining, plasma treatment, and sterilization. Three important conclusions are drawn: (i) The surface status of a particular implant material may vary widely depending on its preparation and handling history. (ii) The surface status of implants is expected to be important for in vivo function, and should thus be controlled and standardized. (iii) It is usually not possible to predict how a change in surface status will affect the long-term, in vivo function of an implant.