Research progress on the effect of surface modification of titanium implants on the polarization of macrophages

Implant restoration has been more and more widely used in clinical practice, which can avoid the damage to the remaining teeth, restore the chewing function as much as possible, and ensure the beauty of the denture. Compared with traditional denture restoration, implant restoration has many advantages. The implantable implant will inevitably cause immune inflammatory reaction. As a biomaterial, the previous view has been that the implant should match the mechanical properties of the replaced tissue to minimize the host immune response.

Therefore, at this stage, the most widely used clinical inert metal titanium implant. However, a 19-year retrospective study has shown that approximately 47% of early implant failures are still due to adverse inflammatory responses after implantation. Therefore, the application of inert metal titanium can not fully meet the clinical requirements. It is necessary to modify the surface of titanium material so that it can regulate the immune inflammatory response of the body, promote the inflammatory response to the direction of tissue repair and regeneration, and ensure the success of implant implantation and long-term retention.

After implantation, the implant can cause the body's innate immune response, and macrophages, as the first line of defense of the innate immune system, play an important role in this process. In the past two decades, it has been concluded that macrophages not only have phagocytosis and digestion, but also play an important role in tissue repair and reconstruction by secreting chemokines and cytokines.

Macrophages were activated after migration to the site of injury, showing two polarization states related to function: M1 type and M2 type, which can promote inflammatory response and anti-inflammatory, and promote tissue repair, respectively. Relevant studies have shown that the surface physical and chemical characteristics and morphology of implants can affect the differentiation and function of macrophages. Therefore, it is important to understand the changes in the biological behavior of macrophages after implant implantation and the effects of implant surface modification on the polarization of macrophages. In this paper, the research on the relationship between implant surface modification and macrophage polarization was reviewed, in order to provide new ideas for implant surface design and improve the clinical application effect of implants.