Occlusion-activated autonomous piezoelectric implants for adaptive prevention of peri-implantitis

More than one-third of the global population suffers from dental defects, with osseointegrated implants being the gold-standard intervention; yet, their long-term functional performance is hindered by peri-implantitis. Here, we present an autonomous piezoelectric implant that delivers adaptive antibacterial and anti-inflammatory functionalities through physiological occlusal activation without any external intervention. The implant demonstrates good functional durability, sustaining consistent bioelectric outputs through over 1,000,000 loading-unloading cycles and exhibiting stable electrical performance in simulated physiological environments for over 30 days. Besides, integration with machine learning enables reliable, patient-specific prediction and real-time modulation of occlusal mechano-adaptive voltage responses. The autonomous implant achieves tri-modal therapeutic integration: (ⅰ) electrocatalytic bactericidal activity via controlled reactive oxygen species generation, (ⅱ) electrically induced immunomodulation of macrophages from pro- to anti-inflammatory phenotypes, and (ⅲ) electrostimulation-enhanced osteogenesis surpassing conventional titanium alloys, both in vitro and in vivo. These findings provide insights for occlusion-activated effective peri-implantitis intervention and a widely applicable strategy for developing autonomous and adaptable bioelectronic platforms.