In this study, for improving the bioactivity of titanium used as an implant material, alkali and heat treatments were carried out after formation of the nanotubes via anodization. Nanotubes with uniform length, diameter, and thickness were formed by anodization. The alkali and heat-treated TiO2 nanotubes were covered with the complex network structure, and the Na compound was generated on the surface of the specimens. In addition, after 5 and 10 days of immersion in the SBF, the crystallized OCP and HAp phase was significantly increased on the surface of the alkali-treated TiO2 nanotubes (PNA) and alkali and heat-treated TiO2 nanotubes (PNAH) groups. Cell proliferation was decreased due to the formation of amorphous sodium titanate (Na2TiO3) layer on the surface of the PNA group. However, anatase and crystalline sodium titanate were formed on the surface of the PNAH group after heat treatment at 550 degrees C, and cell proliferation was improved. Thus, PNA group had higher HAp forming ability in the simulated body fluid. Additional heat treatment affected on enhancement of the bioactivity and the attachment of osteoblasts for PNA group. (C) 2014 Elsevier B.V. All rights reserved.