This study investigated the effects of combined titanium nano-/micron-scale roughness, induced by hydrogen peroxide pre-treatments, on bone marrow stromal cell responses and Porphyromonas gingivalis adherence in vitro. Untreated surfaces exhibited nano-scale features, while hydrogen peroxide treatments promoted increased nano-/micron-scale roughness. Bone marrow stromal cell attachment and proliferation were maintained with 6 h and 24 h treatments, but significantly decreased on 1-week and 4-week-treated surfaces. Bone marrow stromal cells on 6 h-4 week-treated titanium demonstrated enhanced osteogenic differentiation versus untreated surfaces. P. gingivalis adherence was significantly increased on 24 h–4 week surfaces. Results suggest that 6 h but less than 24 h treatments maintain or promote bone marrow stromal cell responses while minimizing microbial adherence, potentially enhancing titanium surface bio-activation for osseointegration.
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