Abstract From a biomaterials perspective, it is now understood that success in the osseointegration of a dental implant is conditioned by its “macro”, “micro” and “nano” scale features. Macro-scale roughness is necessary to improve primary stabilization in the post-surgical phase inducing a peri-implant thin fibrous layer. However, the more complex process in the true cell-material interaction is dependent on micro and nano scale phenomena. There is clear evidence that cell adhesion, proliferation, organization and phenotype are modulated at the micro-scale and that protein absorption is fundamentally a process conditioned at nano-scale.