Responsive Polyphenolic Coating Reduces the Risk of Peri-Implantitis Through Antibacterial Activity, Immunomodulation, and Enhanced Osseointegration

Implant failure is primarily caused by infection and dysregulated immune responses, highlighting the need to develop implants with tissue-friendly properties. This study introduces a novel one-step strategy for applying a polyphenol–aminoglycoside (PA) coating on various implant substrates, including titanium, in a simple and efficient manner. The multifunctional PA coating can reduce implant failure through its strong antibacterial, immunomodulatory, and osteoinductive activities. By eliminating bacterial infection, promoting the M2 macrophage phenotype, and restoring oxidative balance, PA-coated implants create a favorable osteoimmune microenvironment that supports the osteogenic differentiation of bone marrow mesenchymal stem cells. Furthermore, the PA-coated implants exhibit potent osseointegration in vivo. Collectively, these findings indicate that surface modification with a PA coating represents a promising strategy to meet the clinical requirements of next-generation dental and orthopedic implants in complex clinical environments.