3D printing was widely used for the modification of bioceramic structures. Here, Bioactive titanium dioxide (TiO2) ceramics with macropore structures were prepared by controlling the pore size through 3D printing, and further obtained secondary micropores by altering the sintering temperature. The structures and in vitro bioactivity of materials were characterized, and the properties of the ceramics for osteogenic differentiation of rabbits bone marrow mesenchymal stem cells (rBMSCs) were investigated. The results showed that titanium dioxide ceramics could induce apatite formation in SBF, which indicated it is bioactive. All materials exhibited porous structures, which could promote the proliferation and osteogenic differentiation of rBMSCs. Importantly, the structure with 200 μm pore size significantly promoted the proliferation and adhesion of cells. Furthermore, more secondary micropores formed on the surface of materials with the decreased sintering temperature, which promoted cell proliferation. The pore size of 400 μm significantly upregulated the expression of osteogenesis-related genes, including Col I, ALP, Runx2, and OPN. It had the strongest osteogenic ability when sintered at 1100 °C compared to other groups. This implies that the 3D-printed TiO2 ceramics have good osteogenic properties, and the hierarchical structure consisting of macroscopic pores and secondary micropores can control it well.
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