The surface modification of titanium implants by NaOH has been widely investigated to improve their biocompatibility and bioactivity. It is very important to prepare an even network structure on titanium implants. In this work, ultrasonic irradiation (UI) is used along two different routes to obtain several modified surfaces on titanium plates: (1) the plates are first treated by a NaOH solution, and then UI is used to wash them in double distilled water; (2) the plates are modified by a NaOH solution in an ultrasonic cleaner with UI at 50 W. It is demonstrated that the UI energy can easily remove any weakly bound layers (WBL) on the titanium surface, leaving a strongly bound layer (SBL). The SBL is shown to enhance the proliferation of MC3T3-E1 preosteoblasts in comparison with the WBL. A dense and uniformly distributed nanostructure layer can be synthesized in situ on the surface of metallic titanium through a reaction between a NaOH solution and titanium under UI. The titanium plates prepared with NaOH and UI show better proliferation of preosteoblasts than titanium without UI.
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