The significance of the topography of implant surfaces for osseointegration of endosteal implants has been in the focus of research for many years. Up to now, the research was mainly concerned with the different grades of roughness and the parameters for the survival rate. Just recently, however, the cellular interactions have received more attention.
Latest studies have compared the reaction of osteoblasts on improved implant surfaces with earlier topographies.
The basic parameters such as protein adsorption, wettability and grade of hydrophilic property, but also the chemical modification of the surface are interpreted as specially advantageous for an accelerated healing and long-term success.
In our opinion, these promising interpretations could not lead to a confirmation by a clinically significant improvement of osseointegration. We have, therefore, conducted interdisciplinary basic research and developed a new generation of implant surfaces with biologic character. In our studies, we have aimed at parameters which are of definite clinical relevance.
The conclusions were to be based on facts instead of on interpretations with a speculative risk.
Based on the results of an earlier comparative study which concentrated on the cellular attachment and differentiation of seven different surfaces (TiUnite, Osseotite, SLA, TPS, machined, DPS and CellPlus), we focused on an optimum of cell attachment. The amount of cellular attachment is the decisive factor for both the differentiation reaction and the proliferation time as well as for the synthesis of an extracellular matrix.
In a comparison of different surface topographies, we have studied the relation of structures to the quality of the cellular attachment. We have found that the osteoblasts with their processes, the so-called filopodiae, regularly search contact with very fine structures of less than one micrometer.

From macro roughness to nanotechnology and biomimetics
The nanoscience is concerned with the preparation of surface structures in the scope of nanometers. The importance of nanostructures for cell attachment and differentiation has been documented.
We conclude that due to the similarity the osteoblasts identify these nanostructures as collagenous structures and show no foreign body rejection. This surface property is designated as biomimetic.
Different ways have led to the technologies for the production of nanostructured surfaces. Our goal was to produce a surface of pure titanium free of contamination, with a homogeneous distribution of nanoporous structures.
The comprehensive studies and test series in close cooperation with university institutes have resulted in the development of our technology for nanostructuring. We have succeeded in creating the first nanoporous titanium surface by a purely subtractive process.

Free of contamination
Puretex derives from tex = texture which is the surface topography and from pure for purity. We have implemented a new decontamination technology which creates an implant surface of utmost purity. In a comparative investigation of Puretex with other implants on the market, any of the contaminations applied were below the detection limit of high-sensitive measuring methods with our implants, while with the other implants in this study showed detectable contaminations.