Dental implant surfaces represent one of the key factors that could influence the osseointegration processes [1]. Puleo et al. [2] confirmed that the surface topography, as well as the chemical nature and the implant macro and micro geometry, is involved in creating a clinical and histological efficient bone-implant interface. It was demonstrated that different superficial treatments could affect significantly both the amount of bone directly contacted to the titanium (bone to implant contact percentage) and the speed over the time of bone apposition onto implant surface [3, 4]_.

Implant surfaces are divided, on the microstructural point of view, into “smooth” (generally defined as “machined”) and “rough,” obtained by milling, sandblasting, and/or acid etching procedures [5]; normally, the distinction between smooth and rough surfaces is based on the measurement of surface roughness (Ra parameter) [6]. The bone amount onto the titanium surface is greater when using rough surfaces than smooth ones [7].

However, some authors theorized that bone-forming cells seem to be more influenced by the micromorphology of the surface than by its roughness [8]. Perrotti et al. [9] proposed the fractal analysis as surface analysis method and speculate that the best results, in terms of bone to implant contact percentage (BIC%), are obtained by using implants with uniform surface morphology instead of those with irregular surfaces characterized by peaks and troughs. These results were confirmed by other studies that showed that bone-forming cells seem to have a particular affinity for titanium surfaces with a regular and uniform roughness [10, 11].

Titanium implant treatments, which enhance bone apposition rate, inevitably create surfaces with irregular patterns, and some manufacturing contaminants could remain over the implant [12]. These materials could interfere with the new bone apposition process [13].

The laser treatment of titanium surfaces represents an innovative implant manufacturing technique that obtains a uniform and pure implant surface. This peculiar treatment uses high-density energy density by focalizing the laser source to melt, to heat, to sublimate, and to modify the superficial layers of the materials titanium by sublimation. Laser treatment allows setting the parameters that determine the roughness of the implant to obtain a micrometric porosity perfectly reproducible in shape, diameter, and depth. The laser surface treatment is also an effective method to obtain titanium surfaces free of contaminants because no acid or metal sand is needed during surface treatment processes [13]. Residual contaminants, which may remain onto the titanium surface after manufacturing procedures that involved acid or metals, could inhibit osseointegration [14].