| Summary: | Multi-directional forging (MDFing) of titanium drastically improved its mechanical properties due to the evolution of an ultrafine-grained structure. Forging strain was repeatedly applied while changing the forging axis during MDFing. Of note is the decreased elastic modulus of MDFed titanium (MDF-Ti) as compared to conventional coarse-grained pure Ti (Ti). In the present study, we evaluated bone’s response toward surface-treated MDF-Ti after implantation into the extraction sockets of rat maxillary molars. As surface treatments, acid (Acid, sulfuric acid at 120 °C for 75 s), alkali without post-heat (Alkali, NaOH at 60 °C for 24 h), and alkali with post-heat (Alkali-heat, subsequent heating at 600 °C for 1 h) treatments were employed. The presence of minute nanoscale dimples in the microscale dimples to form regular fractal structures on MDF-Ti surfaces was observed after Acid treatments. Structures of sponge-like porous networks after Alkali treatments and submicron fiber networks after Alkali-heat treatment were produced on the surfaces of both Ti and MDF-Ti. Surface-treated specimens were superhydrophilic. More crystal deposition was clearly observed on each surface-treated specimen after immersion in simulated body fluid for both Ti and MDF-Ti. The bone-to-implant contact (BIC) ratios of the Acid and Alkali-heat specimens were significantly higher than those of the untreated control (<i>p</i> < 0.05). Moreover, Acid and Alkali-heat treatment for MDF-Ti caused significantly greater BICs than that for Ti (<i>p</i> < 0.05). In conclusion, Acid or Alkali-heat treatment of MDF-Ti is useful for improving bone response.
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