In Situ Construction of β-TCP-Containing Bioactive Interfaces on Additively Manufactured Al2O3/Ce-TZP Ceramics for Enhanced Osseointegration.

High-performance zirconia ceramics possess excellent mechanical reliability but are limited by biological inertness for load-bearing implant applications. Herein, stereolithography (SLA) additive manufacturing combined with microwave-assisted liquid-phase deposition was developed to construct a β-tricalcium phosphate (β-TCP)-containing bioactive interface on Al2O3/Ce-TZP ceramics. Unlike conventional post-fabrication coating strategies, SLA was utilized as an interface-engineering approach by generating favorable near-surface characteristics for subsequent CaP integration. The SLA-derived interface exhibited a graded CaP/zirconia transition region of approximately 2 µm and enhanced interfacial resistance, with the mean nano-scratch critical load increasing from 10.15 ± 4.93 mN for DP to 21.68 ± 4.18 mN for SLA (n = 3). In vitro evaluations demonstrated low hemolytic response and favorable cytocompatibility, together with enhanced BMSC adhesion and osteogenic differentiation. In vivo rabbit tibial implantation further demonstrated favorable biocompatibility within the evaluated period and improved osseointegration, with 15Ca-TZP implants achieving a bone-implant contact value of 55.6% at 12 weeks. This study presents an interface-engineering strategy that integrates additive manufacturing-derived structural advantages with bioactive functionality for zirconia-based load-bearing implants.