Implant surface characteristics are of ongoing scientific interest. Implants made from titanium are still the most common to be used. Titanium implants are made from alpha-beta alloy which consists of 6% aluminum and 4% vanadium (Ti-6Al-4V). These materials have low density, high strength, and resistance to fatigue and corrosion, and their modulus of elasticity is closer to the bone than any other implant material [18]. However, titanium implants are discussed to trigger hypersensitivity reactions due to surface corrosion [1, 19]. Titanium implant surfaces are machined, etched, sandblasted, and sometimes coated with special (company-specific) coatings. For titanium implants, roughness values (Ra) around 1.5 μm are known to provide successful osseointegration [20].

Ceramic implants experienced a renaissance since their reentry into the market. New ceramic implants with yttria (Y₂O₃)-stabilized tetragonal zirconium polycrystalline (Y-TZP) material have superior corrosion and wear resistance in comparison to titanium implants as well as high flexural strength (800 to 1000 MPa) [18]. However, due to manufacturing imperfections or flaws created during zirconia implant fabrication and because of special surface treatments, their strength can be compromised [18, 21]. Due to their brittle nature, ceramic implants tend to fracture. Especially sharp, deep, and thin threads can easily lead to implant failures [18, 21]. The surface treatment on ceramic is developed due to a process of sandblasting, etching, and heat treatment [22]. Sandblasting is usually done with alumina particles that lead to sharp edges and scratches on the surface. The treatment with hydrofluoric acid as the following procedure may smoothen the surface again [22,23,24]. However, in zirconia implants, due to stress caused by sandblasting, a tetragonal to monoclinic phase transition may be caused [22, 25]. This monoclinic volume fraction can be seen in 10–15% of the cases [26] and initially leads to a surface compression of the zirconia material [22]. According to Fischer et al., the long-term effects and the implant stability after this procedure are not yet proven [22]. However, it can be reversed by a thermal treatment that is higher than the transition temperature [22, 27].