Nanomaterials have emerged as powerful tools in biomedical research owing to their tunable physicochemical properties, large surface area-to-volume ratios, and ability to generate reactive oxygen species (ROS). Among these, TiO2 NPs have gained particular attention due to their cost-effectiveness, stability, biocompatibility, and strong photocatalytic properties. TiO2 exists in multiple crystalline phases, most notably anatase and rutile, which influence its photocatalytic activity and antimicrobial performance. This review provides a comprehensive overview of the most recent progress (2020–2025) in the development of TiO2 nanomaterials as antimicrobial agents, emphasizing innovative synthesis strategies, advanced surface modifications, and hybridization approaches that enhance visible-light activity and biological performance. Unlike previous reviews, this work highlights the integration of green synthesis methods and multifunctional TiO2 systems designed for improved safety, environmental compatibility, and clinical applicability. The discussion also explores the latest insights into antimicrobial mechanisms, including ROS generation, disruption of microbial membranes, inhibition of biofilm formation, and interference with intracellular functions. Furthermore, emerging applications in infection control, wound healing, and antimicrobial coatings are critically examined. This review aims to bridge recent advances with practical biomedical and environmental applications, offering new perspectives on the future design of TiO2-based nanomaterials as next-generation antimicrobial platforms.
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