Abstract
Ti and its alloys, widely utilized in orthopedic and dental implants, inherently lack antibacterial properties, posing significant infection risks, especially in the context of growing antibiotic resistance. This review critically evaluates non-antibiotic antibacterial strategies, with a particular focus on surface modifications and micro/nano-structured surfaces. Micro/nano-structured surfaces, inspired by natural topographies, utilize physical mechanisms to eradicate bacteria. Despite their potential, the antibacterial efficacy of these surfaces remains insufficient for clinical application. Titanium dioxide (TiO2), known for its excellent photocatalytic antibacterial activity and biocompatibility, is emerging as an ideal candidate for enhancing micro/nano-structured surfaces. By combining the photocatalytic antibacterial effects of TiO2 with the mechanical bactericidal properties of micro/nano-structured surfaces, superior antibacterial performance can be achieved. The hydrothermal method is frequently employed to fabricate TiO2 micro/nano-structured surfaces, and this area of research continues to thrive, particularly in the development of antibacterial strategies. With demonstrated efficacy, combined antibacterial strategies based on TiO2 micro/nano-structured surfaces have become a prominent focus in current research. Consequently, the integration of physical stimulation and chemical release mechanisms may represent the future direction for TiO2 micro/nano-structured surfaces. This review aims to advance the study of TiO2 micro/nano-structured surfaces in antibacterial applications and to inspire more effective non-antibiotic antibacterial solutions.
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