Orthopaedic and dental implants hav

Orthopaedic and dental implants have become a staple of the medical industry and with an ageing population andgrowing culture for active lifestyles, this trend is forecast to continue. In accordance with the increased demand forimplants, failure rates, particularly those caused by bacterial infection, need to be reduced. The past two decades haveled to developments in antibiotics and antibacterial coatings to reduce revision surgery and death rates caused byinfection. The limited effectiveness of these approaches has spurred research into nano-textured surfaces, designedto mimic the bactericidal properties of some animal, plant and insect species, and their topographical features. Thisreview discusses the surface structures of cicada, dragonfly and butterfly wings, shark skin, gecko feet, taro and lotusleaves, emphasising the relationship between nano-structures and high surface contact angles on self-cleaning andbactericidal properties. Comparison of these surfaces shows large variations in structure dimension and configuration,indicating that there is no one particular surface structure that exhibits bactericidal behaviour against all types ofmicroorganisms. Recent bio-mimicking fabrication methods are explored, finding hydrothermal synthesis to be themost commonly used technique, due to its environmentally friendly nature and relative simplicity compared to othermethods. In addition, current proposed bactericidal mechanisms between bacteria cells and nano-textured surfacesare presented and discussed. These models could be improved by including additional parameters such as biologicalcell membrane properties, adhesion forces, bacteria dynamics and nano-structure mechanical properties. This paperlastly reviews the mechanical stability and cytotoxicity of micro and nano-structures and materials. While the futureof nano-biomaterials is promising, long-term effects of micro and nano-structures in the body must be establishedbefore nano-textures can be used on orthopaedic implant surfaces as way of inhibiting bacterial adhesion.