Abstract
Graphene oxide (GO) has emerged as a promising multifunctional surface modification for dental implants, addressing two persistent causes of implant failure: peri-implant infection and inadequate osseointegration. This review summarises current evidence on the antibacterial, soft tissue, osteogenic, and mechanical effects of GO-based coatings on titanium and polymeric implant substrates. GO exerts broad-spectrum antibacterial activity through a combination of membrane disruption, reactive oxygen species generation, electron-transfer interference, electrostatic interactions, and photothermal heating. Its efficacy can be further enhanced in composite systems incorporating ions such as silver, zinc, and copper, or biopolymers such as chitosan and collagen. At the tissue level, GO-modified surfaces improve protein adsorption, fibroblast and epithelial adhesion, and peri-implant soft-tissue sealing, while fostering osteogenic differentiation, mineralised matrix deposition, and increased bone-to-implant contact in vivo. Mechanically, GO fortifies ceramic, polymeric, and hybrid coatings, thereby improving hardness, toughness, corrosion resistance, and fatigue behavior. Recent manufacturing advancements, including electrophoretic deposition, micro-arc oxidation, and tailored covalent functionalisation, offer scalable methodologies for producing clinically applicable GO coatings. Nevertheless, significant challenges persist, such as variability in GO synthesis and immobilisation, incomplete knowledge of long-term cytotoxicity, immune modulation, and particle biostability, as well as the scarcity of large-animal and human clinical data. Future research should focus on standardised characterisation, long-term in vivo evaluations, and safety assessments aligned with regulatory standards, alongside the development of intelligent GO-based systems that facilitate local drug delivery, osteoimmunomodulation, and on-demand antimicrobial activation. Overall, the current evidence suggests that GO coatings possess the potential to support next-generation multifunctional dental implants with enhanced biological performance and improved long-term clinical outcomes.
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