Advancements in Bimetallic Metal–Organic Frameworks for Oral Medicine

The characteristic oral environment – with its dynamic clearance, moisture, microbial load, and inflammatory potential – makes oral diseases highly prevalent and therapeutically challenging. Metal-organic frameworks (MOFs), an emerging class of inorganic–organic hybrid porous coordination materials, have become pivotal in modern biomedical engineering due to their facile synthesis, high surface area, large loading capacity, exceptional ion storage capability, tunable composition and pore size, and pH-responsive behaviour. To further enhance their performance, bimetallic metal-organic frameworks (BMOFs) have been constructed by incorporating two metal ions with functionalized organic ligands. Leveraging synergistic multimetallic effects and structural tunability, BMOFs exhibit significant potential in biomedical applications, including antibacterial activity, catalysis, and drug delivery. Exploratory applications of BMOFs in the prevention and treatment of oral diseases have already emerged, spanning periodontitis management, caries prevention, oral tissue regeneration, and targeted cancer therapy. Nevertheless, challenges remain in terms of biosafety, long-term stability, in vivo degradation behaviour, and scalable fabrication. This review summarizes the synthesis strategies and functionalization approaches of BMOFs, the selection of metal pairs, and their synergistic mechanisms, with a focus on their applications in oral biofilm infections, inflammatory diseases, oromaxillofacial bone tissue engineering scaffolds, and cancer therapy. Additionally, it discusses current challenges related to biocompatibility, technical limitations, and the clinical translation of these technologies. By correlating the fundamental design principles of BMOFs with the diagnostic and therapeutic demands of oral diseases, this review aims to facilitate translational research and promote the development of BMOFs as innovative and efficient strategies for addressing a range of oral pathologies.