Metals such as titanium and alloys are commonly used for manufacturing orthopedic and dental implants because their surface properties provide a biocompatible interface with peri-implant tissues. Strategies for modifying the nature of this interface frequently involve changes to the surface at the nanometer level, thereby affecting protein adsorption, cell-substrate interactions and tissue development. Recent methods to control these biological interactions at the nanometer scale on the surface of implants are reviewed. Future strategies to control peri-implant tissue healing are also discussed.