Nanozymes for caries and periodontitis: Mechanisms, therapeutic applications, and future perspectives

Dental caries and periodontitis are the most common chronic oral diseases, their occurrence and progression are closely linked to the complex oral microenvironment. These processes involve pathogenic microbial colonization, biofilm formation, inflammatory responses, and oxidative stress imbalance. Reactive oxygen species (ROS) exhibit dual biological roles in oral diseases: they participate in antimicrobial defense while potentially exacerbating tissue damage and inflammation when excessively accumulated, rendering precise redox homeostasis regulation a critical challenge in localized therapy. In recent years, nanozymes have demonstrated unique advantages in oral disease prevention and treatment due to their enzyme-mimicking catalytic functions, high stability, and structural tunability. This review first outlines the catalytic mechanisms of nanozymes and their roles in oral disease-related pathological processes, focusing on ROS regulation, antimicrobial activity, biofilm disruption, and oral microenvironment modulation. The structural classification and mechanisms of different nanozymes are subsequently summarized, including metals and metal compounds, carbon-based materials, and organic framework materials. Importantly, this review compares the applications of ROS-generating and ROS-scavenging nanozymes in dental caries and periodontitis, highlighting their therapeutic mechanisms and disease-specific design strategies. Furthermore, within specific disease contexts, this review examines representative nanozyme applications in caries prevention and periodontitis treatment, encompassing monotherapy and multimodal synergistic strategies. Particular attention is given to three emerging trends in oral nanozyme research, including microenvironment-responsive systems, multimodal therapeutic approaches, and clinical translation potential. Finally, this paper explores key challenges and future directions for the clinical translation of nanozymes in oral diseases, aiming to provide insights into material design and therapeutic optimization strategies.