A holistic biointegration of percutaneous bone-anchored metallic prostheses with both hard and soft tissues dictates their longevity in the human body. While titanium (Ti) has nearly solved osseointegration, soft tissue integration of percutaneous metallic prostheses is a perennial problem. Unlike the firm soft tissue sealing in biological percutaneous structures (fingernails and teeth), foreign body response of the skin to titanium (Ti) leads to inflammation, epidermal downgrowth and inferior peri-implant soft tissue sealing. This review discusses various implant surface treatments/texturing and coatings for osseointegration, soft tissue integration, and against bacterial attachment. While surface microroughness by SLA (sandblasting with large grit and acid etched) and porous calcium phosphate (CaP) coatings improve Ti osseointegration, smooth and textured titania nanopores, nanotubes, microgrooves, and biomolecular coatings encourage soft tissue attachment. However, the inferior peri-implant soft tissue sealing compared to natural teeth can lead to peri-implantitis. Toward this end, the application of smart multifunctional bioadhesives with strong adhesion to soft tissues, mechanical resilience, durability, antibacterial, and immunomodulatory properties for soft tissue attachment to metallic prostheses is proposed.

中文翻译：

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经皮骨锚定钛假体周围的软硬组织整合：实现整体生物整合

经皮骨锚固金属假体与硬组织和软组织的整体生物整合决定了它们在人体内的寿命。虽然钛 (Ti) 几乎解决了骨整合问题，但经皮金属假体的软组织整合是一个长期存在的问题。与生物经皮结构（指甲和牙齿）中牢固的软组织密封不同，皮肤对钛（Ti）的异物反应会导致炎症、表皮向下生长和种植体周围软组织密封不良。本综述讨论了用于骨整合、软组织整合和防止细菌附着的各种种植体表面处理/纹理和涂层。虽然 SLA（大砂粒喷砂和酸蚀）和多孔磷酸钙 (CaP) 涂层的表面微观粗糙度可改善钛骨整合，但光滑和有纹理的二氧化钛纳米孔、纳米管、微槽和生物分子涂层可促进软组织附着。然而，与天然牙齿相比，种植体周围软组织密封性较差，可能导致种植体周围炎。为此，提出了应用具有对软组织强粘附力、机械弹性、耐用性、抗菌和免疫调节特性的智能多功能生物粘合剂来将软组织附着到金属假体上。