Biomimetic Surface Engineering of Ti-15Zr (Roxolid™) Implants: Enhancing Osseointegration and Bone Regeneration — A Comprehensive Review

Titanium-based dental implants have evolved significantly, with the development of binary alloys like Ti-15Zr (Roxolid™) representing a pivotal advancement in mechanical performance. Current research focuses on biomimetic surface engineering to further accelerate osseointegration and optimize bone regeneration, particularly in clinically compromised sites. This review constitutes a narrative synthesis of how these strategies replicate the bone extracellular matrix (ECM) through a holistic framework of architectural, mechanical, and biochemical integration. A structured literature search across PubMed, Scopus, and Web of Science (2010–2026) identified relevant studies focusing on the synergy between Ti-15Zr substrates and surface modifications. Evidence confirms that the high fatigue strength of Roxolid™ alloys provides an ideal foundation for advanced, hierarchical surface engineering without compromising structural integrity. This strategy utilizes macro-topography for primary stability, nano-topography for protein adsorption, and bio-functionalization (e.g., RGD peptides, osteogenic ions) to direct mesenchymal stem cell (MSC) differentiation. This synergy accelerates the transition from passive to active osseointegration, effectively bridging the "biological gap" during early healing. Biomimetic engineering transforms implants into instructive biological platforms, improving outcomes for patients with compromised bone quality and facilitating predictable immediate loading protocols.