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Implants are gaining importance as the mainstay of all medical and surgical treatments. In dentistry several implant surface modifications have been used to improve the quantity and quality of the bone-to-implant interface. The future trends concern the modifications of surface roughness at the nanoscale level for promoting protein adsorption and cell adhesion, osteoconduction and the incorporation of biological drugs for accelerating the bone healing process in the peri-implant area. All these surface modifications have greatly influenced the performance of implants.