Despite the great strides in healthcare during the last century, some challenges still remained unanswered. The development of multi-drug resistant bacteria, the alarming growth of fungal infections, the emerging/re-emerging of viral diseases are yet a worldwide threat. Since the discovery of natural antimicrobial peptides able to broadly hit several pathogens, peptide-based therapeutics have been under the lenses of the researchers. This review aims to focus on synthetic peptides and elucidate their multifaceted mechanisms of action as antiviral, antibacterial and antifungal agents. Antimicrobial peptides generally affect highly preserved structures, e.g., the phospholipid membrane via pore formation or other constitutive targets like peptidoglycans in Gram-negative and Gram-positive bacteria, and glucan in the fungal cell wall. Additionally, some peptides are particularly active on biofilm destabilizing the microbial communities. They can also act intracellularly, e.g., on protein biosynthesis or DNA replication. Their intracellular properties are extended upon viral infection since peptides can influence several steps along the virus life cycle starting from viral receptor-cell interaction to the budding. Besides their mode of action, improvements in manufacturing to increase their half-life and performances are also taken into consideration together with advantages and impairments in the clinical usage. Thus far, the progress of new synthetic peptide-based approaches is making them a promising tool to counteract emerging infections.
Since Brånemark discovered the favorable effects of titanium in bone healing in 1965, titanium has emerged as the gold standard bulk material for present-time dental implantology. In the course of years researchers aimed for improvement of the implants performance in bone even at compromised implant sites and multiple factors were investigated influencing osseointegration. This review summarizes and clarifies the four factors that are currently recognized being relevant to influence the tissue-implant contact ratio: bulk materials and coatings, topography, surface energy, and biofunctionalization. The macrodesigns of bulk materials (e.g., titanium, zirconium, stainless steel, tantalum, and magnesium) provide the mechanical stability and their influence on bone cells can be additionally improved by surface treatment with various materials (calcium phosphates, strontium, bioglasses, diamond-like carbon, and diamond). Surface topography can be modified via different techniques to increase the bone-implant contact, for example, plasma-spraying, grit-blasting, acid-etching, and microarc oxidation. Surface energy (e.g., wettability and polarity) showed a strong effect on cell behavior and cell adhesion. Functionalization with bioactive molecules (via physisorption, covalent binding, or carrier systems) targets enhanced osseointegration. Despite the satisfying clinical results of presently used dental implant materials, further research on innovative implant surfaces is inevitable to pursuit perfection in soft and hard tissue performance.
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