Perspective on copper-enhanced titanium implants: functions, fabrication, and safety

• The review summarises copper’s biological roles and therapeutic effects in titanium • Copper-modified titanium promotes bone growth, vessels, and infection control. • Incorporation methods strongly affect copper form, release, and coating performance. • Mechanical, corrosion, and toxicity depend on copper content, form, and distribution. • Copper-doped titanium implants show strong potential for biomedical applications. Implant failures in modern implantology often result from peri -implant inflammation or insufficient osseointegration. Titanium-based implants, widely used for custom applications, are not inherently capable of preventing post-surgical infections without modifications. To address this, copper (Cu), a metal with well-documented antibacterial and bone-stimulating properties, has been incorporated into Ti-based implants. This review summarises recent strategies for integrating Cu into titanium alloys, including conventional methods such as ingot metallurgy and sintering, as well as modern approaches like additive manufacturing and surface modification. The effects of Cu addition on antibacterial activity, bone formation, wound healing, angiogenesis, immunomodulation, corrosion resistance, and mechanical properties are critically examined. The advantages and limitations of each fabrication or modification method are discussed to provide a comprehensive understanding of their potential. Overall, Cu-doped Ti alloys demonstrate strong antimicrobial activity, enhanced biocompatibility, and favourable mechanical properties, highlighting their significant potential for future biomedical applications.