This review summarizes the development of surface treatments applied to dental implants with the aim of improving their clinical performance. It covers the advancement of various techniques, from the conventional to the more advanced ones. Among the recent advancements, surface texturing has enabled atomic and structural modifications of implant surfaces at the micro- and nanoscales, improving tissue–material interactions. Acid etching and atomic layer deposition applied onto implant surfaces results in optimized osseointegration by stimulating the deposition and proliferation of osteoblasts and fibroblasts. The atomic layer deposition of TiO₂, ZnO, ZrO₂, and CaCO₃ has proven effective in improving osseointegration and tackling corrosion. Corrosion is still an important issue, whereby metals released from titanium implants and their associated degradation products cause local and systemic side effects, leaving a wide avenue for future research. The development of hybrid dental implants is envisaged through new materials and technologies, such as additive manufacturing, which may play a critical role in the fabrication of patient-specific implants with tailored nano-topography capable of enhancing such properties as antibacterial activity and osseointegration.

Objective: The Ti6Al4V titanium alloy is widely used for dental implants because of its excellent mechanical properties, corrosion resistance, and biocompatibility. However, its bioinert surface limits both osseointegration and resistance to bacterial colonization. Methods: To address these challenges, this study develops a composite coating based on calcium phosphate (CaP) and silver (Ag), reinforced with zirconium oxide (ZrO₂). The coating was deposited on Ti6Al4V using an immersion technique to improve the surface properties of the alloy. Electrochemical analyses (OCP, EIS, and potentiodynamic polarization) were performed in simulated physiological conditions to evaluate the corrosion behavior, while SEM/EDS was used to characterize the surface morphology and composition. Results: The Ag- and Zr-containing CaP coatings significantly improved the corrosion resistance of Ti6Al4V compared with uncoated and CaP-coated samples. Conclusions: This approach provides a promising strategy to enhance the electrochemical stability and long-term durability of titanium dental implants, thereby contributing to their reliable performance in the oral environment.

Background/Objectives: Titanium alloy Ti₆Al₄V remains the gold standard in dental implantology due to its excellent mechanical properties, corrosion resistance, and biocompatibility. However, implant-associated infections and insufficient osseointegration continue to represent major clinical challenges, mainly related to bacterial biofilm formation and suboptimal surface–tissue interactions. Biofilm formation refers to the adhesion, accumulation, and growth of microbial communities embedded within a self-produced extracellular polymeric matrix on implant surfaces, which contributes to bacterial persistence and resistance to host defense mechanisms. This review aims to critically evaluate recent advances in multifunctional bioceramic coatings for dental implants, with a particular focus on zirconia (ZrO₂)-based systems and their antibacterial mechanisms. Methods: A structured literature analysis was conducted using major scientific databases including PubMed, Scopus, and Web of Science, focusing mainly on studies published between 2015 and 2025 related to CaP, Ag, and ZrO₂-based coatings for dental implants. The review examines their physicochemical properties, antibacterial strategies, ion release behavior, and biological responses, including osteogenic activity and biofilm inhibition. Particular attention is given to hybrid systems integrating multiple functional phases. Results: CaP coatings exhibit excellent osteoconductivity and promote early osseointegration but show limited intrinsic antibacterial activity. Ag-based coatings provide strong broad-spectrum antimicrobial effects through controlled Ag⁺ ion release, although concerns regarding cytotoxicity and dose-dependent responses remain. ZrO₂ coatings significantly enhance corrosion resistance and surface stability, while their antibacterial performance can be improved through nanostructuring, laser surface modification, and ionic doping. Hybrid Ag–CaP–ZrO₂ coatings demonstrate improved antibacterial activity, enhanced corrosion resistance, and better regulation of ion release kinetics and osteogenic response compared with single-component coating systems. Conclusions: Multifunctional bioceramic coatings represent a promising strategy for improving the performance of dental implants and addressing the dual challenge of infection control and tissue integration. However, challenges remain regarding long-term stability, controlled ion release, and limited clinical validation. Future research should focus on the development of smart, stimuli-responsive coatings and standardized evaluation protocols to facilitate clinical translation.