A Redox Amplification Interface Linking Mitochondrial Dysfunction, Immune-Derived Oxidants, and Biomaterial Electrochemistry in Chronic Inflammation

Peri-implant inflammatory disease exhibits marked clinical heterogeneity that cannot be explained solely by microbial burden, indicating the involvement of host-driven amplification mechanisms. This review integrates evidence from redox biology, immunometabolism, and biomaterials science to describe a redox amplification interface (RAI) linking immune-derived reactive oxygen species (ROS), mitochondrial dysfunction, and biomaterial electrochemical reactivity at the host–implant interface. Persistent NADPH oxidase activation promotes mitochondrial oxidative damage, including electron transport chain disruption, cardiolipin oxidation, and ROS-induced ROS release, resulting in sustained intracellular oxidative flux. Mitochondrial dysfunction further contributes to inflammatory amplification through release of damage-associated molecular patterns and activation of inflammasome signaling. Concurrent impairment of antioxidant systems, particularly Nrf2-dependent pathways and glutathione depletion, reduces redox buffering capacity and facilitates propagation of oxidative stress. Inflammatory microenvironments also destabilize implant surface electrochemistry, promoting corrosion, ion release, and surface-mediated redox reactions that increase local oxidative burden. These interacting processes form a coupled system capable of sustaining inflammation independently of the initiating microbial stimulus. This framework provides a mechanistic basis for disease heterogeneity and identifies redox-targeted therapeutic and biomaterial design strategies.