'Implant Surface Modification Techniques': Past, Present, Advanced and Future Trends- A Review.

ABSTRACT Implant surface modification techniques have undergone significant evolution from the early smooth machined surfaces to the advanced multifunctional nanostructured and bioactive coatings used today. Past techniques predominantly involved mechanical alterations such as machining, sandblasting, and acid etching to increase surface roughness and promote mechanical interlocking with bone. These approaches, notably the sandblasted large-grit acid-etched (SLA) surface, vastly improved osseointegration compared to smooth surfaces. Present techniques integrate nanoscale topographies, bioactive coatings like hydroxyapatite and growth factors, and anodization to enhance biological performance, accelerating bone healing and enhancing implant stability. Advanced modifications combine nanoscale architecture with biofunctional molecules, enabling improved osteogenesis, antimicrobial properties, and host immune modulation. Future trends emphasize smart, responsive implant surfaces capable of on-demand drug release, immune modulation, and patient-specific customizable 3D-printed surface features. These innovations promise to surpass current clinical outcomes by offering multifunctional, tailored biointerfaces that actively interact with the host environment to optimize osseointegration and reduce complications. This historical and technological trajectory highlights the increasing sophistication and biological integration potential of implant surface modifications, shaping the future of implant dentistry. Keywords: Implant surface, Implant surface modification, Osseointegration, Nanostructures.