A pH-Responsive Antimicrobial Peptide Coating with Efficient Antibacterial Activity and Preserved Oral Microbiota Homeostasis during Clear Aligner Treatment

Bacterial adhesion and biofilm formation pose significant clinical challenges in clear aligner therapy, adversely affecting both oral health and aesthetics. In this study, a machine learning-driven strategy was used to develop a novel antimicrobial peptide (AMP), IW (sequence: IDFYRKTHWWNKLLAKWWAMR), which was subsequently covalently immobilized onto the surface of clear aligners to construct a pH-responsive antibacterial coating. In response to cariogenic acidic microenvironments, the coating is specifically activated to effectively inhibit the proliferation of cariogenic bacteria and subsequent biofilm formation. Moreover, IW reduces the abundance of potential pathogens while enriching health-associated bacterial genera, exerting a beneficial modulatory effect on the oral microbiome. This dual-functional strategy, integrating antibacterial activity with microbiota homeostasis preservation, offers a promising approach to combat cariogenic bacterial infection and oral dysbiosis, presenting substantial potential for clinical translation in orthodontic applications.