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REVIEW ARTICLE

3D-printed antimicrobial scaffolds for tissue repair: Intrinsic, stimuli-responsive, and topographical strategies

Zhixiang Nie1,2,3† ,  Zihan Qu1† ,  Shujing Wu1 ,  Yixuan Chen1 ,  Ke Li1,2 ,  Lanyang Liu1 ,  Yuhuai Liao1 ,  Zhiyao Zhang1 ,  Yunsong Shi1,2*
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1 School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
2 State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan, Hubei, China
3 Engineering Research Center of Ceramic Materials for Additive Manufacturing, Ministry of Education, Wuhan, Hubei, China
†These authors contributed equally to this work.
IJB, 026230232 https://doi.org/10.36922/IJB026230232
Received: 23 April 2026 | Revised: 4 June 2026 | Accepted: 23 June 2026 | Published online: 24 July 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The restoration of tissue defects using 3D-printed medical implants enables precise anatomical matching and customizable microarchitectures. However, implant-associated infections and biofilm formation constitute persistent challenges, frequently compromising the efficacy of systemic antibiotic therapy and promoting drug resistance. In light of these limitations, the development of advanced 3D-printed implants endowed with localized, multifunctional antimicrobial properties has emerged as a critical clinical imperative. This review provides a systematic overview of recent progress in 3D-printed antimicrobial scaffolds, with current innovations classified into three principal synergistic strategies. The first strategy concerns implants fabricated from intrinsically antibacterial materials, which are further categorized into non-metallic systems (e.g., chitosan, antimicrobial peptides, and graphene oxide) and metal-based systems (e.g., silver, copper, zinc, magnesium, and metal–organic frameworks). These constructs provide continuous antimicrobial defense through the sustained release of bioactive ions or reactive oxygen species. The second strategy involves stimuli-responsive platforms that harness exogenous physical fields—such as photothermal, sonodynamic, or electrical stimulation—as well as endogenous biochemical cues (e.g., pH variations) to realize spatiotemporally regulated, on-demand bactericidal effects and to address infections located within deep tissue compartments. The third strategy capitalizes on structural and topographical micro‑patterning that emulates bio‑inspired architectures, thereby eliciting drug‑free mechanobactericidal actions against adherent pathogens. Moreover, this review discusses key translational challenges, particularly balancing antimicrobial efficacy with the preservation of osteogenic activity and osseointegration, while addressing manufacturing complexities. By elucidating these mechanisms, this work provides forward-looking insights to inform the rational design and clinical translation of next-generation anti-infective medical scaffolds.

Graphical abstract
Keywords
3D bioprinting
Antimicrobial scaffolds
Stimuli-responsive materials
Surface topography
Tissue engineering
Funding
This work was supported by the National Key Research and Development Program (China, grant 2023YFB4604700), the National Natural Science Foundation (China, grant 52475355), and the Key Project of the Interdisciplinary Research Support Program of Huazhong University of Science and Technology (grant 2025JCYJ037).
Conflict of interest
The authors declare no conflict of interest.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing
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