The excessive accumulation of reactive oxygen species (ROS) under osteoporosis precipitates a microenvironment with high levels of oxidative stress (OS). This could significantly interfere with the bioactivity of conventional titanium implants, impeding their early osseointegration with bone. We have prepared a series of strontium (Sr)-doped titanium implants via micro-arc oxidation (MAO) to verify their efficacy and differences in osteoinduction capabilities under normal and osteoporotic (high OS levels) conditions. Apart from the chemical composition, all groups exhibited similar physicochemical properties (morphology, roughness, crystal structure, and wettability). Among the groups, the low Sr group (Sr25%) was more conducive to osteogenesis under normal conditions. In contrast, by increasing the catalase (CAT)/superoxide dismutase (SOD) activity and decreasing ROS levels, the high Sr-doped samples (Sr75% and Sr100%) were superior to Sr25% in inducing osteogenic differentiation of MC3T3-E1 cells and the M2 phenotype polarization of RAW264.7 cells, thus enhancing early osseointegration. Furthermore, the results of both in vitro cell co-culture and in vivo studies also showed that the high Sr-doped samples (especially Sr100%) had positive effects on osteoimmunomodulation under the OS microenvironment. Ultimately, the collated findings indicated that the high proportion Sr-doped MAO coatings were more favorable for osteoporosis patients in implant restorations.

骨质疏松症下活性氧 (ROS) 的过度积累导致了具有高水平氧化应激 (OS) 的微环境。这可能会显着干扰传统钛植入物的生物活性，阻碍它们与骨骼的早期骨整合。我们通过微弧氧化 (MAO) 制备了一系列掺锶 (Sr) 钛植入物，以验证它们在正常和骨质疏松（高 OS 水平）条件下的功效和骨诱导能力的差异。除了化学成分外，所有组都表现出相似的物理化学性质（形态、粗糙度、晶体结构和润湿性）。各组中，低Sr组（Sr25%）在正常情况下更有利于成骨。相比之下，通过增加过氧化氢酶 (CAT)/超氧化物歧化酶 (SOD) 活性和降低 ROS 水平，高 Sr 掺杂样品（Sr75% 和 Sr100%）在诱导 MC3T3-E1 细胞成骨分化和 M2 表型方面优于 Sr25% RAW264.7 细胞极化，从而增强早期骨整合。此外，两者的结果体外细胞共培养和体内研究还表明，高 Sr 掺杂样品（尤其是 Sr100%）对 OS 微环境下的骨免疫调节具有积极作用。最终，整理的结果表明，高比例的 Sr 掺杂 MAO 涂层更适合种植体修复中的骨质疏松症患者。