Titanium-based implants are predominantly adopted in orthopedic and dental applications, yet their clinical performance is constrained by enduring challenges such as stress shielding, infection susceptibility, and inadequate osseointegration. To address these hurdles, recent advances have shifted titanium implant design from static biomimetic models toward dynamic, bioadaptive systems capable of actively modifying their architectural, mechanical, and surface properties after implantation. These systems can respond adaptively to specific pathophysiological microenvironments or be activated by external energy sources (e.g., light, ultrasound, electricity, or magnetism), thus providing on-demand biofunctionalities, such as antibacterial, pro-angiogenic, osteogenic, and immune/metabolic regulatory effects, ultimately mitigating complications (e.g., infection, inflammation) while accelerating osteoregeneration and osteointegration. In this Perspective, we propose a strategic framework to guide the design and development of next-generation titanium implants aligned with this trend. It highlights the emerging need to converge a deeper understanding of implant-biology interplays with synergistic advances from materials science (e.g., metamaterial and stimuli-responsive interface design) and cutting-edge bone biology (e.g., immunometabolic and neuro-osseous engineering). This interdisciplinary integration is aimed at enabling expedited, robust, bioadaptive regeneration regimens, particularly for challenging bone defects such as infected, osteoporotic, or diabetic conditions.
Sang et al. (Thu,) studied this question.