Osseointegration, the direct bonding of titanium implant materials with bone, is critical for implant success where nanostructured surface features contribute to nano-osseointegration. However, we also know that features and processes on the microscale influence the biocompatibility of implant materials. We highlight the advantages of using mutlilength scale analyses, focusing on three-dimensional techniques, ranging from X-ray microcomputed tomography, to focused ion beam, to high resolution electron tomography to identify markers of osseointegration. A titanium implant with modified biomimetic coating studied in vitro and in vivo at various time points is used to exemplify the complementary information gained from three-dimensional analyses from the micro- to nanoscale.
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