BACKGROUND:Titanium mesh has good clinical effect in repairing skul defects, but due to the lack of bone induction ability, the titanium mesh has a poor integration with the bone tissue. OBJECTIVE:To observe the biological properties of the gradient bioactive coating materials on the titanium surface in the skul repair. METHODS: Osteoblasts were co-cultured with the titanium mesh with or without gradient bioactive coatings for 14 days, and then cel proliferation was detected using MTT method. Seventy-one patients with skul defects were enroled, including 43 males and 28 females, aged 15-60 years, and were subjected to skul repair using the titanium mesh with (observation group, n=3) or without (control group, n=38) gradient bioactive coatings. During the postoperative folow-up of 12 months, the repairing effects and adverse reactions were observed in the two groups. RESULTS AND CONCLUSION:(1)In vitrocel culture: the cel proliferative ability was increased significantly in the observation group as compared with the control group at 8, 10, 12 and 14 days after cel culture. (2)In vivo repair: the hospital stay and wound healing time in the observation group were significantly lower than those in the control group (P< 0.05), and at the final folow-up, the postoperative recovery effect was significantly higher in the observation group than the control group (P < 0.05). The titanium meshes were fixed firmly in the two groups, with no floating, infection and exposure. These results show that the titanium mesh with gradient bioactive coating has good biocompatibility and osteoinduction capacity.