This book provides the reader with the knowledge required in order to understand the chemical, physical, mechanical, and topographical aspects of implant surfaces, as well as their impact on the biological response. Common ways to modify implant surfaces are described, and methods for the evaluation of surface properties are presented in an easy-to-read style. Experimental results that have contributed to surface modifications relevant for commercial available implants are presented, with emphasis on in vivo and clinical studies. While the focus is primarily on surface modifications at the micrometer and nanometer levels, alterations at the millimeter level are also covered, including thread designs and their possible influence on stress distribution. In addition, it is analyzed how surface alterations have changed the clinical long-term results for certain groups of patients.