In vitro , BMSCs cultured on M appeared more rounded, while they were more elongated on GB or TCP. BMSCs attached preferentially to M. The matrix formed appeared as a thin layer covering M, while matrix was thicker on the GB and TCP surfaces, infilling topographical features. Surface modification appeared to have little effect on the osteogenic activity of BMSCs. However, titanium was found to suppress differentiation down the adipogenic pathway and expression of inflammatory cytokines compared to plastic. Surface modification appeared to have little effect on osteoblasts activity or osseointegration, although roughened surfaces may provide better mechanical interlocking with bone. In vivo, no differences in the progression of osseointegration around any of the modified surfaces were observed. In DM, osteoblasts activity was altered and bone healing was delayed. There is therefore clearly scope to investigate surface modifications such as biomimetic coatings for use in compromised clinical situations.
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