Advances of Metal‐Based Nanomaterials in the Prevention and Treatment of Oral Infections

In the complex oral environment, metal-based nanomaterials (MNMs) treat infectious diseases through the Hierarchical Response Strategy, ranging from spontaneous antimicrobial effects to precise microenvironment-responsive therapies, ultimately achieving multi-aspect functions.

Abstract

The complicated environment of the oral cavity presents significant challenges to traditional antibacterial approaches, which has driven the exploration of novel therapeutic strategies. Metal-based nanomaterials (MNMs), with diverse antibacterial mechanisms (e.g., membrane disruption, oxidative stress) and evolution from empirical to theory-guided design, exhibit immense potential. This review introduces the pioneering Hierarchical Response Strategy Framework, systematically classifying MNM therapeutic systems into three progressive levels: Primary category, comprising MNMs that exert spontaneous antibacterial effects based on inherent physicochemical properties (e.g., ion release); Secondary category, including MNMs with precisely controlled antibacterial actions by microenvironmental or stimulus-responsive mechanisms (e.g., light-induced ROS); and Tertiary category, encompassing MNMs that integrate antibacterial and regenerative functions for multidimensional therapy (e.g., remineralization). Through this framework, the authors elucidate MNMs’ transition from single-function to precision-controlled, multifunctional synergy, analyze the impact of metal elements and structural design on efficacy, and summarize their applications in dental caries, endodontic infections, and periodontal disease, etc. This framework offers a novel perspective on existing research and a theoretical foundation for the rational design of next-generation precise, smart, and comprehensive anti-infective materials.