Preparation methods, mechano-bactericidal performance and mechanisms of Ti-based nanostructure arrays: A review

Medical titanium (Ti) and its alloys have been widely employed in biomedical field, but Ti-based implants are prone to bacterial biofilm contamination, leading to implant failure. Nanostructure arrays, as a new strategy, exhibit effective bactericidal performance and biofilm inhibition only by using their own morphological characteristics, drawing extensive attention. This review mainly summarizes the progress on natural and biomimetic mechano-bactericidal nanostructure arrays, as well as the various preparation techniques for Ti-based bactericidal nanostructured surfaces, and highlights the necessity of developing controllable preparation methods. Furthermore, the critical discussion of the underlying mechano-bactericidal mechanisms is presented, identifying the need for additional experimental data to refine bacterial modeling and elucidate the complex interplay between nanostructure arrays and bacterial cells. Finally, the challenges and opportunities for Ti materials with bactericidal nanostructure arrays as implants or clinical devices are analyzed as well.