From 1967 to 2001, the dominant paradigm centered on establishing reliable biomaterial–tissue interfaces. The period saw systematic material classification into bioinert, bioactive ceramics, and resorbables, coupled with early surface engineering aimed at reducing infection and promoting tissue integration. Researchers integrated materials science with biology and biomechanics, emphasizing predictable tissue responses, biocompatibility, and the translation of laboratory concepts into clinically viable implants, while promoting biomimetic and hierarchical design philosophies for bone and connective tissues.