Materials Today: Proceedings 44 (2021) 2348–2355

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Materials Today: Proceedings

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Laser micro & nano surface texturing for enhancing osseointegration and
antimicrobial effect of biomaterials: A review
Neelesh Sirdeshmukh a,⇑, Ganesh Dongre b
a
Mechanical Engineering Department, Research Scholar at Vishwakarma Institute of Technology, Pune 412207, India
b
Vishwakarma Institute of Technology, Pune 411037, India

a r t i c l e i n f o a b s t r a c t

Article history: The worldwide significant rise of orthopedic and dental implant surgeries in the last decade is a matter of
Received 7 November 2020 concern. The rate of subsequent failure of implants and revision surgeries are also considerable.
Received in revised form 30 November 2020 Insufficient osseointegration and bacterial infections are the major causes of implant failure. The present
Accepted 10 December 2020
methods of surface coatings and surface modifications are inadequate for long term stability. Over this
Available online 21 January 2021
scenario, laser surface texturing (LST) is the most promising method which has precise control over sur-
face topography, morphology, wettability, and chemistry which makes this technique suitable for man-
Keywords:
ufacturing biocompatible, antibacterial, and early bone healing surfaces. Researchers experimented with
Laser surface texturing
Biocompatible
grooves, dimples, micro, and nano-texture patterns for optimizing cell adhesion and proliferation.
Antibacterial Nanopillars, nano-ripples, spikes, LIPSS surface structures are used for examining antibacterial behaviour.
Orthopedic implant Very few research papers discussed the combined approach for developing implant material having bio
Biomaterial activeness and antibacterial behaviour. This paper explores the improvement of physical, biocompatible,
antibacterial properties through LST. The introduction of challenges and future trends of the field will cer-
tainly help to investigate the new directions of biomaterial research.
Ó 2021 Elsevier Ltd. All rights reserved.
Selection and peer-review under responsibility of the scientific committee of the International Confer-
ence on Materials, Processing & Characterization.

1. Introduction surgery is expensive and painful accompanied by a low success

Arthritis is one of the severe diseases in the world. Around 0.18
billion people (15% of the total population) are facing problems
with arthritis in India. The rising number of elderly people and
obese, diabetes patients make this problem more serious [1]. Due
to this, the need for orthopedic procedures is rising strikingly.
The advanced implant surgery techniques, inventions of novel bio-
materials, and their processing made the life of patients comfort-
able. Due to worldwide rising demand, the orthopedic market is
expected to move from USD 105.18 billion in 2019 to USD
206.64 billion by 2024 [2]. Despite the extensive development of
orthopedic implant techniques, only a few percent of the implants
sustain for more than 20 years. Around 90% of the knee and hip
implants are lasting for 10 to 15 years [3]. In fewer cases, failure
is observed just after surgery. The rate of failure of total hip
replacements (THR) and dental implants is 5–20%. The revision
⇑ Corresponding author.
E-mail addresses: sirdeshmukh1@gmail.com, neelesh.sirdeshmukh@raisoni.net
(N. Sirdeshmukh).
rate [4]. The major reasons for these revision surgeries are aseptic
loosening, instability, infections, implant wear & tear, osteolysis
[3], and bone-implant fracture, etc. [5,6,7,8]. As per the Canadian
joint registry report 2016–17, out of total orthopedic surgeries per-
formed, 8.5% hip replacements and 6.8% knee replacement are revi-
sion surgeries where lack of osseointegration and infections are the
major reasons for failure [6] (Fig. 1). The present methods of sur-
face modification such as surface coating and surface chemistry
modification possess limitations. Surface coating is mechanically
weak and may be non-uniform. This decreases its stability over
an extended life. On the other hand, surface chemistry modifica-
tion may lead to chemical reactions [9]. To improve the scenario,
researchers are working hard for modifying the surface character-
istics and developing novel biomaterials. Biomaterial research
needs concurrent multidisciplinary efforts from various disciplines
of science such as biological, material, mechanical, chemical and
medical [10]. Laser surface texturing is a prominent method for tai-
loring surface characteristics of biomaterials. Laser surface textur-
ing (LST) has the potential of producing micro and nano-texture
patterns for a wide range of biomaterials. LST is a promising

https://doi.org/10.1016/j.matpr.2020.12.433
2214-7853/Ó 2021 Elsevier Ltd. All rights reserved.
Selection and peer-review under responsibility of the scientific committee of the International Conference on Materials, Processing & Characterization.
N. Sirdeshmukh and G. Dongre
Total Hip Replacement (THR)
aseptic loosening instability infection
28%
41%
16%
15%
(a)
Fig 1. Common reasons for THR and TKR implant failures. a. total hip replacement. b. total knee replacement [6].
method to tailor wettability, surface energy, surface topography
and morphology through which cell attachment and proliferation
can be modulated. Also these parameters are helpful to make the
surface antibacterial. Very few researchers covered combined
approach for developing biocompatible and antibacterial attributes
in their research [7,11]. In this review, the present research status
of physical property enhancement, ‘in vitro’ and ‘in vivo’ trials of
laser textured biomaterials are discussed. The emphasis is given
on the latest advancement of biomaterial surface towards improv-
ing bio-activeness and antibacterial effect. Research gaps are iden-
tified and future directions of investigations are introduced.
2. Methods of surface structuring of biomaterials
Bioenvironmental parameters mostly affect the outer layers of
bulk implants. Enhancing surface characteristics is the key to
reduce the failure of implants. Surface modification of biomaterial
is carried out to enhance the biocompatible, mechanical, chemical,
and physical properties. As per bone retrieval analysis, present
orthopedic implants have an average bone to implant contact
(BIC) of 70–80% [12]. Improving cell proliferation by 15–30% with
better osseointegration has the potential to reduce infections by
60–90% [13]. Hence it will have a large scope for improving surface
modification to enhance biomaterial performance. Surface modifi-
cation is divided into basic two categories such as surface concave
and convex structuring. Surface concave structuring uses material
removal methods such as electrochemical, chemical, and mechan-
ical methods. Mechanical methods utilize sandblasting, shot peen-
ing, and laser peening to create residual compressive surfaces for
modification. It varies parameters like coverage, arc height, media
size, and media material, etc. On the other hand, surface convex
texturing utilizes the way of material deposition by physical or
chemical methods. Surface convex structuring method includes
chemical vapor deposition (CVD), physical vapor deposition
(PVD), solid-state diffusion bonding, plasma spraying, etc. Ulti-
mately these methods are trying to vary the density and porosity
of the surface of bioimplants. These porous surfaces give more con-
tact surface area which in turn promotes better anchorage and cell
proliferation [12]. Sandblasting is a widely used method to create
surface structures on implant surfaces [14]. In this method, the
stream of abrasive particles is projected on the implant surface.
This creates the surface structure and removes the contaminations
from the implant substrate. The generated surface structure may
be irregular due to less control over depth and regularity. These
irregular surfaces may alter the chemical and mechanical charac-
teristics of the substrate which will have a risk of changing surface
configuration. Utilization of alumina abrasive particles may create
the problem of aluminum ions retention in structured surface lay-
ers. These retained aluminum ions may lead to infection and
Materials Today: Proceedings 44 (2021) 2348–2355
Total Knee Replacement (TKR)
other
aseptic loosening instability infection other
29%
32%
16%
23%
(b)
inflammation. This method can produce surface roughness below
10 mm. Chemical etching is another method which is capable of
creating the microstructures of 0.5 mm to 2 mm. This method pos-
sesses several limitations. Contamination of fluoride is one of the
substantial limitations. Possibility of micro cracks formation on
surface layer may decline mechanical properties and fatigue resis-
tance [15]. To overcome the limitations of conventional structuring
methods, scientists are investigating advanced machining tech-
niques for structuring biomaterial surfaces. Electric Discharge
Machining gives a structured surface having properties like corro-
sion and wear resistance along with hardness. But it has a major
limitation of recast layer development which further tends to
low fatigue performance. The problem of thermal effect is also
noticeable in EDM. This method applies to only electrically conduc-
tive materials [16]. Few researchers have tried to apply ultrasonic
vibrations for producing microstructures on the materials like sili-
con carbide, stainless steels, polymers, glasses, etc. This method is
more suitable for hard and brittle materials [15]. Electron Beam
Machined components have well dimensional accuracy however,
this method is only applicable to miniature components. Also, high
machining cost is a major hurdle.
Laser surface texturing (LST) is a cutting-edge technique having
the potential of producing regular, reproducible textures in micro
and nano sizes. It is becoming researched extensively for process-
ing on biomaterials as it is precise, flexible, and available at low
cost [13]. LST can be done on metals, composites, polymers, and
ceramics. This technique is most convenient to generate intricate
geometry and small features on the surfaces [15].
3. Laser surface texturing of biomaterials
High energy laser beam incidence on material surfaces causes
material ablation. This process comprises three basic phases viz.
melting, vaporing, and degradation of material bonds. The accuracy
of the geometry produced is influenced by laser power, wave-
length, pulse duration, and scanning speed, etc. Optimization of
laser parameters will lead to precise geometry, high material
removal rate, and minimal heat-affected zone [17]. Different types
of lasers are used for LST of biomaterials viz. Excimer, Fiber, Nd:
Yag, CO2 laser, Ti: sapphire, Yb: Yag, etc. Biomaterial surface tex-
turing research involves the following stages as mentioned in
Fig. 2 (as per ISO-10993).
3.1. Biomaterials: status of laser surface texturing for enhancing
physical properties
Orthopedic and dentistry essentially uses metal and alloys for
load-bearing and polymers for soft tissue replacement applica-
tions. Ceramics are preferred for their inert and bioactive nature.
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N. Sirdeshmukh and G. Dongre
Fig 2. Steps in Characterization of laser textured biomaterials [3,10,18].
Composite materials are being developed for achieving promising
biological and mechanical properties [19,10]. Commonly used
major biomaterials such as Ti and Ti alloys, Co-Cr alloys, Stainless
Steel, Al2O3 and ZrO2, and UHMWPE are discussed in context with
surface properties enhancement.
3.2. Titanium and its alloys
Titanium possesses good biocompatibility and better corrosion
resistance. These are preferred for hip, knee, wrist, shoulder, spine
implants due to their excellent specific strength. The modulus of
elasticity of Ti is nearer to natural bone material hence, stress
shielding effects are less [4]. However, due to its poorer tribological
properties such as low wear resistance and low fatigue resistance,
these are less preferred for load-bearing applications [20,21,22,23].
The interesting property of pure Ti is that it forms a thin passive
oxide layer (2–10 nm) when it is open to the air (within 9–10 s).
This oxide layer safeguards material from chemical attack and cor-
rosion which makes it more biocompatible [24,25,26]. Due to this,
these alloys are also preferred in applications such as orthopedic
wire leads, cardiovascular and vascular stents, part of a heart valve,
etc. [27]. The process of metal ablation refines the microstructure
which causes a significant improvement in hardness and surface
Young’s modulus [28,18]. Implant wear is a substantial problem
at prosthetic joints. Motion between sliding and rolling contact
of mating parts leads to friction and subsequent wear of prosthetic
joints. This wear debris is a cause of severe pain and affects the
immune responses [15]. The wear out material may lead to aseptic
loosening [29]. Surface textures traps wear debris and reduce the
contact area between wear-out particles and mating parts. This
helps to reduce friction wear. Additionally, it provides a cushioning
effect. This effect is more prominent in the dimple texture pattern
[30,31]. Qingchun Zheng et al. reported that Surface wettability can
be improved by increasing the width and pitch of grooves for Ti-
6Al-4 V [32]. Wetting behavior and friction between bone and
implant are influenced by the surface pattern [13]. It is observed
that short and high energy pulses may generate cracks [28]. The
cracks reduce the fatigue resistance of the implant surface.
Researchers have developed nano-pores, nano-protrusions [33],
nano-ripples [7], spikes [34], LIPSS, nanopillars [35], etc. surface
structures for boosting biocompatibility.
3.3. Aisi 316 L
Stainless steel as an implant material is known for its good bio-
compatibility, toughness, excellent manufacturing capability, and
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Materials Today: Proceedings 44 (2021) 2348–2355
low-cost availability [21]. AISI 316 L is preferred for its structural
applications and fabrication of temporary devices like screws,
plates, hip nails, and THR applications [20,27]. Its use is restricted
due to its high modulus of elasticity, susceptibility to corrosion,
and allergic reactions [19]. Corrosion attack due to crevice and pit-
ting is the main reason for more than 90% failures of stainless steel
implants [23]. Researchers produced microstructures [36], nanos-
tructure[37] patterns for biocompatibility assessment whereas
LIPSS, nanopillars [38], nano-ripples patterns [39] for achieving
antibacterial effect. A successful attempt is made for predicting
increasing hydrophobicity of AISI 316 L [40]. G. Lazzini et al. simu-
lated the model for understanding the interaction between coc-
coidal bacteria and nano-ripples texture surface [39]. It is
reported that the grooves and pits pattern have deeper and finer
nature in 316 L as compared to Ti-6Al-4V [41]. Literature indicates
that investigations of laser surface texturing of 316 L for biomedi-
cal applications are fewer.
3.4. Cobalt-Chromium alloys
Properties like good wear-resistant and fatigue strength made
this alloy convenient for applications such as THR cups, femoral
head [27,42]. It is also preferred for dental implants, bone plates
& wires, etc. The oxide layer generation on Chromium and Cobalt
surface made this alloy corrosion resistive. The addition of Mo
makes it mechanically and chemically stable [21]. However, the
release of Cobalt and Chromium ions may convert the implant sur-
rounding toxic. Wear debris formation of particles is one of the
major problems when Co-Cr- Mo is used for a prolonged period.
This leads to osteolysis and allergies. Also, a higher modulus is a
considerable limitation of these implants [19]. To overcome these
problems, researchers are trying to develop a wear and corrosion
resistive Co-Cr-Mo surface. Liguo Qin et al. used laser surface tex-
turing and fluoroalkyl silane for obtaining a range of wetting sur-
faces. The interrelation between wetting surfaces and tribological
properties has been researched [43]. Though Co-Cr-Mo is promi-
nent material for femoral head and cup prosthesis, it needs more
attention to improve its wear and corrosion resistance.
3.5. Magnesium alloys
Mg is biodegradable when used as implants. Hence it keeps
away the need for secondary surgery for the removal of implant
material. Moreover, biodegraded Mg gets extracted through urine.
Therefore, Mg alloys are used as temporary orthopedic devices
such as bone plates, pins, etc. Additionally, it reduces the problem
N. Sirdeshmukh and G. Dongre Materials Today: Proceedings 44 (2021) 2348–2355

of stress shielding as its elastic modulus is most nearer to natural
bone [44,27]. Still, Mg alloys have considerable limitations for
the use as an implant material. It has an unprotected surface oxide
layer which makes it more prone to corrosion. Besides, hydrogen
bubbles formation on its surface may lead to blood blockages
[21]. Laser shock peening generates strain hardened surface and
residual compressive stresses with distinctive surface topography
of Mg-calcium alloy [45]. The Corrosion resistance of Mg-calcium
alloy can be improved by 100 fold by laser shock peening method-
ology [46]. Chengpeng Ma et al. reported less corrosive Mg-Gd-Ca
surface after laser treatment due to change in solidification
microstructure [47]. Researchers are working to transform Mg-
alloy into one of the attractive bio-implant material by controlling
its degradation along with reducing corrosiveness.
3.6. Ceramics and polymers
Ceramics are known for their corrosion resistive and wear resis-
tive attributes. Additionally, ceramics possess appreciable biocom-
patibility. Al2O3 and ZrO2 are the most commonly used
biomaterials. The Femoral head, dental implants, and tissue engi-
neering scaffolds are the noticeable applications of ceramics. How-
ever, the high modulus of elasticity and brittleness of ceramics are
the major hurdles to use as implant material [23,25]. Albena et al.
reported that for generating specific surface structures on ceram-
ics, laser surface texturing is the most suitable method. Research-
ers have developed dimple and micro-pits [49,48] and grooves
[55,56] of varying dimensions.
Polymers are used in combination with a rigid prosthesis. Ultra-
high molecular weight polyethylene (UHMWPE) is well known for
its use in total hip replacement (THR) and total knee replacement
(TKR). UHMWPE is a good biocompatible and high abrasive resist-
ing material [57]. The chances of the submicron level wear debris
generation and high melt viscosity are the major concerns of poly-
mers. A. Riveiro et al. concludes that k = 532, 355 nm are more suit-
able for enhancing surface roughness and wettability of UHMWPE
polymer [58].
3.7. Status of biocompatibility and antibacterial characteristics of laser
surface textured materials
As per ISO 10933–1, biomaterials must be assessed with ‘in-
vitro’ and ‘in vivo’ tests before proceeding towards clinical trials.
‘In-vitro’ is a primary evaluation test where material interaction
with a single cell is observed. Cytotoxicity, genotoxicity, hemocom-
patibility are verified at lab scale simulated environment during
‘in vitro’ experiments. Further ‘in-vivo’ trials are conducted in a
humanoid environment. Sensitization, implantation, carcinogenic-
ity tests are usually carried at ‘in-vivo’ experimentations [10,3].
3.8. Biocompatibility testing: in-vitro experiments
3.8.1. Assessment of cell behavior
Biomaterials are processed with laser surface texturing for get-
ting control over cell responses [59]. Cell responses can be exam-
ined through basic cell mechanisms like cell adhesion,
proliferation, differentiation, and maturation [13] (Table 1). Macro,
micro, and nano-level implant surface roughness have a different
influence on the osseointegration process. Macro-level surface
roughness (millimeter to few microns) gives good stability by
forming biomechanical interlocking. This helps fixation of implant
for longer periods. Micro-level surface roughness (1–10 mm) helps
implant osseointegration by better cell growth and interlocking
[25]. Whereas nanoscale surface roughness (1–100 nm) promotes
excellent linkage of osteoblast cells and protein adsorption on
the surface layer [25,15]. Refer to Fig. 3
The laser textured samples showed better cell attachment and
proliferation as compared to surfaces generated by machining
and conventional structuring methods [60,61,62]. Narrow and
sharp edges promote cell proliferation and differentiation [63].
Results show that LST samples promote the early growth of osteo-
blast cells, which will help to early healing [64]. Liguo Qin et al.
proved that the response of osteoblast cells on Co-Cr-Mo varies
with the variation of surface topographies like the circle, triangle,
square structures [54]. Chengpeng Ma et al. found that Mg-Gd-Ca
surface which was possessing cytotoxicity due to its high degrada-

Table 1
Biocompatibility and antibacterial analysis of laser surface textured patterns.

material compatibility Cell/bacteria type Surface structure result obtained Study

design &
ref.
316 L S.S. antibacterial E. coli, S. aureus LIPSS Influence of surface morphology & wettability In vitro[38]
Nano pillars
99.7% pure Biocompatible stem cells and E. coli Nano-ripples biofilm reduction and improved biocompatibility in vitro[48]
titanium + antibacterial
Ti-6Al-4V Biocompatible S. aureus, Lewis rats Spike structure Biocompatible but could not provide the antibacterial effect In vivo[49]
+ antibacterial in vivo
AISI304 S.S. biocompatible M. Stem Cells Nanotextured precise control over cell differentiation in vitro
patterns LIPSS [37,37]
Grade II antibacterial S. aureus LIPSS & nanopillars considerably reduce biofilm formation below 0.3 lm roughness in vitro[35]
Titanium
AISI 316L Antibacterial coccoidal bacterium Nano ripples simulation of the interaction between a bacterial cell and a Modeling
textured substrate [39]
gold (Au) antibacterial E. Coli LIPSS superior antibacterial surface compared to others In vitro [50]
Conic & 1D rod like reduced bacterial adhesion
Spherical
nanostructure
LIPSS covered with
nanostructure
Ti-6Al-4V Biocompatible MC3T3-E1 Dimples & grooves ridges and corners favor cell attachment, LST reduces wear In vitro[51]
Mg-Gd-Ca biocompatible osteoblast cell microstructure enhanced corrosion resistance & biocompatibility in vitro [47]
Ti-6Al-4V antibacterial S. mutans, S. aureus, and Microstructured titanium oxide magneli phases, superior roughness, and dense in vitro [52]
P. aeruginosa features restrict the bacterial growth
AISI 316L toxicity Osteoblast cell nano topography Toxic Cr hexavalent oxide generation In vitro[53]
Co-Cr-Mo Biocompatible Osteoblast cell Micro textures Surface topography is a key factor for controlling cell in vitro [54]
alloy morphology and proliferation

2351
N. Sirdeshmukh and G. Dongre Materials Today: Proceedings 44 (2021) 2348–2355

Need to apply integrative micro & nano-scale surface

textures approach to enhance osseointegration

Macro surface roughness: good Nano-scale surface roughness: superb linkage of

biomechanical interlocking gives longer osteoblast cell, protein adsorption, rapid bone healing
life & stability

Micro surface roughness: helps

cell growth & interlocking

Fig 3. Influence of Surface topography on osseointegration process [25,80,3,15].

tion; get converted to biocompatible material after laser surface
treatment [47]. M. Martinez-Calderon et al. achieved precise con-
trol over mesenchymal stem cell adhesion and differentiation by
generating micro and nano-textured LIPSS patterns [37]. Renu
Kumari et al. concluded that ridges and corners promote cell
attachment [51]. Wettability plays a crucial role in cell attachment,
tissue response, and protein adsorption [65]. The fast healing and
good osseointegration are dependent on a synergic effect of topog-
raphy, surface pattern, and hydrophilicity [66].
3.8.2. Assessment of antibacterial properties of laser surface textured
biomaterials
One of the major reasons for dental and orthopedic implant fail-
ures is infection [67,56]. These infections are occurring due to bio-
film formation and bacterial colonization. The presence of biofilm
and bacterial colonies leads to poor osseointegration which can
affect patient health severely [68]. Despite the advancement of sur-
face modification techniques, the failure of the implant due to bio-
film formation and infection is a major concern [69,70,71]. It
signifies the need of developing antibacterial surfaces [35]. Laser
textured surfaces are more capable to limit bacterial adhesion than
present methods of surface structuring [72]. With the help of
nanostructured surfaces, the bacterial attachment can be reduced
[25]. Surface geometry, surface roughness, wettability, and chem-
istry have major roles in making surface antibacterial [17]. The
generated oxide layer of Ti4O7 & Ti3O5 plays a sterilizing effect
and limits the bacterial attachment [52,34,73,74]. Laser surface
texturing has the potential to develop micro and nanoscale surface
textures which in turn promotes the antibacterial effect [75].
Alexandre et al. succeeded to develop Titanium grade II surface
roughness 0.3 mm. The generated surface was having dense
topographies and roughness is a little small in size than s. aureus.
Topographical Small features (less than cell size) reduce the con-
tact area between bacteria and surface, which leads to a reduction
in biofilm formation and bacterial adhesion [35,76,38,77]. The tex-
tured surface causes stretch and rupture of bacteria which leads to
death [16,9,78]. Adrian H. A. et al. developed surface textures of
spikes, LIPSS, nanopillars for developing antibacterial surfaces.
LIPSS structure is capable to avoid the retention of E. Coli and s.
aureus bacteria with 99.8% and 84.7%. Results reveal that superhy-
drophobicity or nano surface roughness alone cannot reduce bacte-
rial adhesion and biofilm formation [38] (Table 2). The table shows
the significance of parameters for antibacterial effect. Optimization
of surface topography, wettability, surface energy, dense grain
structure, surface chemistry will result in antibacterial effect
[79].Researchers developed structure like LIPSS [35,37,50],
nanopillar [35], nano-ripples [7], Conic & 1D rod-like, Spherical
nanostructure, LIPSS covered with nanostructures [50] for achiev-
ing antibacterial effect. The details are shown in Table 3.
4. Biocompatibility: ‘in-vivo’ experiments
While inventing an ideal biomaterial surface, understanding the
host response is extremely crucial. Implanted material should have
sufficient biological and structural bonding. It should not produce
any negative impact on adjacent and distant tissues. The adverse
response from tissues may generate due to toxicity, accumulation
of wear out particles, and allergies. Considering the host responses,
the biomaterials are divided into bioinert or bio-tolerant, bioactive,
and bioresorbable materials [10].
M. L. Schroder et al. developed spike structure on Ti-6Al-4 V
with keeping the objective of enhancing biocompatibility and
antibacterial effect. The surface structured rod material was
implanted in the tibia of the rat along with seeding of s. aureus
bacteria. After 21 days the results were analyzed with histological
and radiological techniques. The bonding generated with nearby
tissues was quite good. But the antibacterial effect could not sup-
port the assumption [34]. Kimie Yasuno et al. produced laser tex-
tured surfaces with YVO4 laser and fiber laser. The structured
zirconia implant was planted in the tibia of SD rats. After comple-
tion of 28 days from the plantation, the samples were collected for
calculating Bone implant contact ratio (BIC) and implant removal
torque. The results reveal that both laser structured implants were

Table 2
Influence of surface structure and parameters on antibacterial effect [38].

Surface structure Wettability Nature Aerial surface roughness (mm) Peak separation (mm) Bacterial retention
S. aureus E. coli
Untreated surface – – 30 nm – 82.4 reduction Almost double
Mirror polished surface 1400 Hydrophobic 60 nm 0.8 to 1.3 79.9 reduction 99.2 reduction
LIPSS 1600 superhydrophobic 8.6 mm 20–40 69.8 reduction Increased 3 times
Nano pillars 1190 Hydrophobic 90 nm 0.5to 0.9 84.7 reduction 99.8% reduction

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N. Sirdeshmukh and G. Dongre
successful to improve osseointegration. Especially, the fiber laser-
treated implant was superior to YVO4 treated material [81]. Liter-
ature shows less number of ‘in vivo’ trials [82].
5. Challenges and future trends
Bacterial infection and aseptic loosening are one of the major
reasons for the failure of implants. The processes like surface coat-
ing and the use of antibiotics are having limitations on a long-term
basis. Over this scenario, the results from laser surface texturing
are promising due to the potential of modulating the surface
roughness, topography, wettability, chemistry, etc. The optimiza-
tion of parameters can develop a biocompatible and antibacterial
effect. The literature on combined effect enhancement through
LST is scarce. LIPSS, nano ripples, and nano-textures patterns are
having the potential to develop the bone analog material surface.
Bio mimicking of nature patterns such as Taro leaf, lotus leaf,
Gecko skin, Sharkskin, Cicada wing motivates us to develop the
implant micro and nano surface texture patterns [16]. Refer to
Fig. 4.
Despite the advancement of the LST, the following research
challenges need to be solved.
 Poor surface osseointegration and infections are significant
causes of implant failure. However, the majority of the
researchers are focusing on either upgrading cell adhesion & cell
mechanism or antibacterial surface properties. The research
papers focusing on the integrative approach of early bone heal-
ing, biocompatibility, and antibacterial effect are scarce.
 The need for the diversified design of experiments for investi-
gating the integrated influence of biocompatibility and antibac-
terial effect.
Key factors
-Cell dimensions
-Surface morphology
-Surface topography
(Dense nanostructure)
-Wettability
(hydrophobicity)
-surface chemistry
Antibacterial surface
Biomaterial surface
Implant material with good biocompatibility and antibacterial behaviour
(Surface structure like nano-ripples, nano-pillars, LIPSS, nano-textures,
scales with aligned micro grooves, etc. to be investigated.)
Fig 4. The direction of future research on implant laser surface structuring.
Materials Today: Proceedings 44 (2021) 2348–2355
 Micro and nano textures have their different cell response. For
long-term bone fixation and early bone healing effect, a combi-
nation of micro and nano-scale topography may provide effec-
tive results.
 Literature shows a limited amount of ‘in vivo’ trials for conform-
ing osseointegration.
 Researchers reported that surface roughness smaller than 0.3 m
and dense features with pellicles restrict bacterial growth. This
reflects the need for investigation for nanoscopic surface topog-
raphy and its implications. An in-depth understanding of nano-
scale topographical response requires more research.
 Need to optimize surface pattern and dimensions for the
intended effect.
 The elevated temperature during processing may transform to
undesired surface microstructure and thereby small surface
cracks. The cracks are prone to reduce the fatigue strength of
materials. This is one of the major concerns for LST. The Opti-
mization of laser parameters for getting desired geometry fea-
tures is a challenge.
6. Conclusion
The remarkable rate of increasing orthopedic surgeries and sub-
sequent rising percentage of revision procedures emphasize the
need of investigating failure causes. Laser surface texturing is
emerging as the most progressing technique to tackle these issues.
Laser surface texturing proved the edge over conventional bioma-
terial structuring methods like sandblasting, chemical etching, etc.
LST enables simplified control for creating precise and reproducible
geometry. Researchers demonstrate that LST is the most proficient
technique for controlling surface attributes like wetting behavior,
topography, surface roughness, etc. LST is successful for improving
Laser surface texturing Key factors
-Surface
morphology
-Topography
-Wettability-
(hydrophilicity)
-Surface energy
-surface chemistry
Cytocompatible surface
Micro + Nano
Surface textures
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N. Sirdeshmukh and G. Dongre
surface wear resistance, hardness, mechanical properties like ten-
sile strength, modulus of elasticity to some extent.
This review updates about the present status of laser surface
texturing of biomaterials research over lab-scale simulated exper-
iments and ‘in vitro’ and ‘in vivo’ trials. It provides directions for
researchers to improve biocompatibility and antibacterial effects.
The attributes such as good mechanical anchorage between natural
bone and prosthetic implant, early healing effect without infec-
tions are crucial to avoid failure of prosthetic implants. These con-
clusions are directed towards the development of micro and nano-
scale laser surface texturing.
CRediT authorship contribution statement
P. Neelesh Sirdeshmukh: Writing - original draft. G. Ganesh
Dongre: Conceptualization, Writing - review & editing,
Supervision.
Declaration of Competing Interest
The authors declare that they have no known competing finan-
cial interests or personal relationships that could have appeared
to influence the work reported in this paper.
Acknowledgements
I would like to thank Dr. R. D. Kharadkar (Principal), manage-
ment, and G. H. Raisoni Institute of Technology for their constant
motivation and support for writing this review paper.
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