Coinfection with hepatic cystic and alveolar echinococcosis with abdominal wall abscess and sinus tract formation:A case report

BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this unique presentation,discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.CASE SUMMARY A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis,accompanied by abdominal wall abscesses and sinus tract formation.Initial conventional imaging examinations suggested only hepatic cystic echinococcosis,but intraoperative and postoperative pathological examination revealed the coinfection.Following radical resection of the lesions,the patient’s condition improved,and she was discharged soon thereafter.Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing.Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare,the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.CONCLUSION Lesions involving the abdominal wall and sinus tract formation,may require radical resection.Long-term prognosis includes albendazole and follow-up examinations.

Brain abscess from oral microbiota approached by metagenomic next-generation sequencing: A case report and review of literature

BACKGROUND Brain abscess is a serious and potentially fatal disease caused primarily by microbial infection.Although progress has been made in the diagnosis and treatment of brain abscesses,the diagnostic timeliness of pathogens needs to be improved.CASE SUMMARY We report the case of a 54-year-old male with a brain abscess caused by oral bacteria.The patient recovered well after receiving a combination of metagenomic next-generation sequencing(mNGS)-assisted guided medication and surgery.CONCLUSION Therefore,mNGS may be widely applied to identify the pathogenic microor-ganisms of brain abscesses and guide precision medicine.

Study on the correlation of smoking with periodontal tissue inflammation and alveolar bone resorption in patients with chronic periodontitis

Objective:To study the relationship of smoking with periodontal tissue inflammation and alveolar bone resorption in patients with chronic periodontitis.Methods: The patients diagnosed with periodontitis in Yingkou Central Hospital between March 2015 and March 2017 were selected and divided into the periodontitis group A with smoking history and the periodontitis group B without smoking history;volunteers who received physical examination in Yingkou Central Hospital during the same period and were without history of periodontitis or smoking were collected as the control group. The gingival crevicular fluid was collected to measure the contents of inflammation indexes and alveolar bone resorption indexes.Results:ICAM1, HMGB1, IL-17, YKL40, CXCL16, NTX, CTX, RANKL, MMP9 and EA contents in gingival crevicular fluid of periodontitis group A and periodontitis group B were significantly higher than those of control group while PICP, PIIICP, OPG and Runx2 contents were significantly lower than those of control group;ICAM1, HMGB1, IL-17, YKL40, CXCL16, NTX, CTX, RANKL, MMP9 and EA contents in gingival crevicular fluid of periodontitis group A were significantly higher than periodontitis group B while PICP, PIIICP, OPG and Runx2 contents were significantly lower than those of periodontitis group B.Conclusion:Smoking can aggravate the periodontal tissue inflammation and promote the alveolar bone resorption in patients with chronic periodontitis.

Diabetes mellitus related bone metabolism and periodontal disease

Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide.Changed bone metabolism is one of the important long-term complications associated with diabetes mellitus.Alveolar bone loss is one of the main outcomes of periodontitis,and diabetes is among the primary risk factors for periodontal disease.In this review,we summarise the adverse effects of diabetes on the periodontium in periodontitis subjects,focusing on alveolar bone loss.Bone remodelling begins with osteoclasts resorbing bone,followed by new bone formation by osteoblasts in the resorption lacunae.Therefore,we discuss the potential mechanism of diabetes-enhanced bone loss in relation to osteoblasts and osteoclasts.

Temporal Fossa Abscess Caused by Apical Periodontitis: A Case Report

According to the progress of the antibiotic medicine, the severe infection case is decreasing recently. We recently experienced a case of temporal fossa abscess caused by periapical periodontitis the upper left side of the second molar. A 79-year-old woman visited to Showa University Dental Hospital complaining of the painful swelling at the left side of the temporal and trismus. The routine blood test exhibited a severe inflammation. We performed drainage treatment at temporal skin and normal oral bacterial flora was detected by the bacteriological examination. Under treatment included the administration of antibiotics, the inflammation healed without serious complication and she recovered completely.

Periodontal research contributions to basic sciences:From cell communication and host-parasite interactions to inflammation and bone biology

The periodontium comprises all structures surrounding the teeth,including gingiva,root cementum,periodontal ligament and alveolar bone.Those tissues aim to protect and support the teeth and are challenged by a residing microbiota that leads to subclinical inflammation even in physiological conditions.Periodontitis,a prevalent multicausal inflammatory and destructive disease,develops as a result from complex host-parasite interactions.This unique physiologic and pathologic scenario enables the development of research methods which allows conclusions beyond the simple understanding of periodontal homeostasis.The aim of this viewpoint was to explore potential contributions of periodontal research to a wide array of basic science specialties,such as cell and molecular biology,microbiology,immunology,endocrinology,rheumatology,among others.

Correlation of NLRP3 inflammasome expression in periodontitis tissue with inflammatory response and alveolar bone resorption

Objective: To study the correlation of NLRP3 inflammasome expression in periodontitis tissue with inflammatory response and alveolar bone resorption. Methods: Patients with chronic periodontitis who underwent tooth extraction in Jianghan Oilfield General Hospital between March 2015 and December 2015 were selected as the periodontitis group of the research, and patients who underwent tooth extraction due to impacted tooth or malposed tooth during the same period were selected as the control group. Appropriate amount of periodontal tissue was collected during tooth extraction to determine the expression of NLRP3 inflammasome components;gingival crevicular fluid samples were collected before tooth extraction to determine the contents of inflammatory response molecules and alveolar bone resorption molecules. Results: NLRP3, ACS, Caspase-1, IL-1β and IL-18 mRNA expression in periodontium tissue as well as ICAM-1, E-selectin, CXCL12, HMGB1, HSP60, ICTP, MMP1, MMP8 and Wnt5a levels in gingival crevicular fluid of periodontitis group were significantly higher than those of control group whereas TIMP1, BMAL1 and Runx2 levels in gingival crevicular fluid were lower than those of control group;NLRP3, ACS, Caspase-1, IL-1β and IL-18 mRNA expression in periodontium tissue of patients with periodontitis were positively correlated with ICAM-1, E-selectin, CXCL12, HMGB1, HSP60, ICTP, MMP1, MMP8 and Wnt5a levels in gingival crevicular fluid, and negatively correlated with TIMP1, BMAL1 and Runx2 levels in gingival crevicular fluid. Conclusion: The excessive expression of NLRP3 inflammasome in periodontitis tissue can aggravate the inflammatory response and alveolar bone resorption.

慢性牙周炎患者龈沟液miR-155、miR-21水平及其临床意义

目的检测慢性牙周炎(CP)患者龈沟液中微小RNA-155(miR-155)、微小RNA-21(miR-21)表达水平变化及其临床意义。方法选择2021年10月至2022年10月该院142例CP患者作为CP组,根据牙周炎严重程度分为轻度CP组、中度CP组、重度CP组。随访1个月,根据临床疗效分为疗效良好组、疗效较差组。同期142例健康志愿者作为对照组。采用实时荧光定量聚合酶链反应检测龈沟液miR-155、miR-21表达水平。利用Pearson相关分析CP患者龈沟液miR-155、miR-21表达水平与牙龈指数(GI)、牙槽骨吸收程度(ABL)、探诊深度(PD)、附着丧失(AL)的相关性。采用多因素Logistic回归分析CP患者疗效的影响因素,采用受试者工作特征(ROC)曲线评估miR-155、miR-21对CP患者疗效的预测价值。结果CP组miR-155、miR-21表达水平高于对照组(P<0.05)。CP组PD、AL、ABL、GI明显高于对照组(P<0.05)。轻度CP组、中度CP组、重度CP组miR-155、miR-21表达水平依次升高(P<0.05)。疗效较差组miR-155、miR-21表达水平高于疗效良好组(P<0.05)。龈沟液miR-155、miR-21表达水平均与PD、AL、ABL、GI呈正相关(P<0.05)。多因素Logistic回归分析显示,病情严重程度、miR-155、miR-21是CP患者疗效的影响因素(P<0.05)。ROC曲线分析结果显示,miR-155、miR-21预测CP患者疗效较差的曲线下面积(AUC)分别为0.937(95%CI:0.888~0.986)、0.818(95%CI:0.715~0.921),二者联合预测的AUC为0.960(95%CI:0.920~0.998),优于单一指标预测。结论CP患者龈沟液miR-155、miR-21表达水平升高,与牙周炎严重程度、牙周临床指标及临床疗效有关,2项指标或可作为CP患者疗效的潜在预测标志物。

上颌窦底黏膜增厚与牙槽骨高度及上颌窦解剖结构的关联性

目的通过观测上颌后牙缺失患者的锥形束CT,研究上颌窦底黏膜增厚与缺牙区部分解剖结构的关系,为上颌窦底黏膜增厚患者的上颌窦提升术与缺失牙种植治疗提供临床参考。方法收集2013年1月—2022年5月于天津医科大学附属口腔医院牙周科与广州医科大学附属口腔医院牙周科拍摄锥形束CT的患者资料,筛选出上颌单侧单颗后牙缺失的患者103例,通过CBCT三维重建,并以上颌窦底黏膜是否增厚(>2 mm)作为分组标准,测量牙槽骨高度、宽度、上颌窦外侧壁血管至窦底距离、上颌窦外侧壁厚度,以同一患者自身两侧指标的差值为统计值,分析上颌窦底黏膜增厚是否对缺牙区部分解剖结构存在影响。结果最终纳入上颌窦底黏膜增厚组56例,非上颌窦底黏膜增厚组47例。对其指标进行统计,其中两组患者的牙槽骨高度差值存在差异,上颌窦底黏膜增厚组大于非上颌窦底黏膜增厚组,差异有统计学意义(P=0.0246)。两组间的牙槽骨宽度、上颌窦外侧壁厚度、上颌窦外侧壁血管至窦底距离的差值,差异无统计学意义(P>0.05)。结论持续存在的上颌窦底黏膜增厚可能与缺牙后牙槽骨高度的变化存在关联。

骨膜蛋白在小鼠牙周炎进程中的时空表达规律研究

目的研究小鼠牙周炎进程中骨膜蛋白表达的时空变化规律。方法采用丝线结扎法构建小鼠牙周炎模型。设置对照组、栓丝4 d组、栓丝7 d组、栓丝14 d组、自愈组(栓丝14 d再去除丝线14 d),通过Micro-CT、组织学染色观察各组小鼠牙周组织的动态变化特征,利用RNAscope、免疫组织化学染色分析牙周膜内骨膜蛋白在牙周炎进程不同阶段的变化规律。培养人牙周膜细胞并随机分为对照组、脂多糖(LPS)刺激组(LPS处理12 h)、去除LPS刺激组(LPS处理3 h后再用培养基培养9 h),实时定量聚合酶链反应(qRT-PCR)检测骨膜蛋白、转化生长因子β1(TGF-β1)、基质金属蛋白酶2(MMP2)的表达。结果栓丝7 d组可见明显的牙槽骨吸收,栓丝14 d组牙周组织破坏加重,表现为破骨细胞增多、牙周膜间隙增宽、牙槽骨高度降低,而自愈组见一定程度的牙周组织修复。与对照组相比,栓丝4 d组、栓丝7 d组牙周膜内骨膜蛋白表达降低,栓丝14 d组骨膜蛋白表达相较于栓丝4 d组及栓丝7 d组增加,自愈组骨膜蛋白表达与对照组相似。qRT-PCR结果显示,LPS刺激组与对照组相比骨膜蛋白、TGF-β1的表达均下降,而去除LPS刺激组与LPS刺激组相比骨膜蛋白、TGF-β1的表达均升高。结论小鼠牙周膜内骨膜蛋白表达随炎症进展呈先下降后回升的趋势,去除炎症刺激后骨膜蛋白表达的恢复可能与TGF-β1表达上调有关。

香芹酚水凝胶对牙周炎大鼠牙槽骨保护作用研究

目的 本研究旨在探究香芹酚水凝胶对牙周炎大鼠牙槽骨的保护作用及机制。方法 以泊洛沙姆、羟丙基甲基纤维素为基质,制备负载香芹酚的温敏型水凝胶。SD大鼠经结扎线法造模,随机分为空白对照组、牙周炎组、空白水凝胶组及低、中、高剂量香芹酚水凝胶组,观察各组大鼠牙周炎症状及牙槽骨CT结构;观察肝、脾、肾及牙周组织变化;检测血清中骨代谢指标;Western blot检测骨保护素(OPG)及核因子-κB (NF-κB)通路蛋白表达;定量反转录聚合酶链反应(qRT-PCR)检测炎性因子水平。结果 香芹酚水凝胶具有良好缓释性、生物相容性及细胞黏附性;香芹酚水凝胶组大鼠牙周炎症状明显减轻,牙龈组织中OPG蛋白表达显著增加(P<0.01),核因子-κB受体活化因子配体(RANKL)、核因子-κB受体活化因子(RANK)、NF-κB蛋白水平及各炎症因子水平大幅降低(P<0.01)。结论 香芹酚水凝胶可调节OPG、NF-κB通路,减少牙槽骨吸收,改善牙周炎症。

改良Widman翻瓣术治疗对重度慢性牙周炎患者牙槽骨状况的影响

目的探讨改良Widman翻瓣术治疗重度慢性牙周炎的效果及对患者牙槽骨状况的影响。方法选取2020年1月至2022年1月吉安市中心人民医院口腔科收治的96例重度慢性牙周炎患者作为研究对象,根据治疗方案的不同分为对照组与观察组,每组48例。参考组单纯应用牙周基础治疗,观察组在常规应用牙周基础治疗的同时联合应用改良Widman翻瓣术治疗。比较两组临床疗效、牙周指标(牙龈退缩度、龈沟出血指数、牙周袋深度、菌斑指数、附着力丧失)、牙槽骨吸收情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗1、2周后,观察组牙龈退缩度、附着力丧失均少于对照组,龈沟出血指数、菌斑指数均低于对照组,牙周袋深度浅于对照组,差异有统计学意义(P<0.05)。治疗1周后,两组牙槽骨吸收情况比较差异无统计学意义;治疗2周后,观察组牙槽骨吸收低于对照组,差异有统计学意义(P<0.05)。结论在常规进行牙周基础治疗的同时联合应用改良Widman翻瓣术治疗重度慢性牙周炎效果显著,可改善患者牙周指标与牙槽骨吸收情况,值得临床推广应用。

沉默信息调节因子Sirtuins在牙周炎中的作用

背景:牙周炎是以牙菌斑生物膜为主要致病物质的炎症性、破坏性疾病,发生于牙龈、牙周膜、牙槽骨和牙骨质。细菌复合体的抗原及其分泌的毒素、酶等直接导致牙周组织的破坏,并引发宿主的免疫反应,使机体组织受到间接损害。沉默信息调节因子(Sirtuins,SIRTs)在抗衰老、抗氧化应激、调节炎症、介导细胞自噬等方面发挥重要作用,与牙周炎的发生和发展也有着密切的关系。目的:针对Sirtuins在牙周炎中的研究概况做一综述。方法:由第一作者应用计算机在PubMed、Web of Science、中国知网和万方数据库检索涉及Sirtuins在牙周炎中的相关研究,以“Sirtuins,Sirtuin1-7,periodontitis”为英文检索词,“沉默信息调节因子,沉默信息调节因子1-7,牙周炎”为中文检索词,经过筛选后纳入57篇文献进行综述分析。结果与结论:①SIRT1、SIRT2、SIRT3、SIRT6参与调控了牙周炎的发生与发展;②SIRT1:抑制SIRT1表达可能是牙周炎治疗靶点;SIRT1的过表达对牙周炎症有抑制作用,保护牙周组织;SIRT1的激活剂可减轻牙周组织的炎症,并可改善牙周炎引起的全身组织病变;③SIRT2:参与烟酰胺磷酸核糖转移酶介导的牙周炎症,SIRT2在牙周疾病的治疗和转归中发挥一定的作用;④SIRT3:可改善年龄相关的牙周病;天麻素可通过SIRT3的上调促进牙周膜干细胞成骨分化;SIRT3的激活剂通过调节细胞自噬水平,降低牙周炎对牙周和肾脏组织的破坏程度;⑤SIRT6:可抑制牙周组织炎症反应,抑制成牙骨质细胞的分化和矿化;SIRT6对根尖周炎的预后有利;⑥SIRT4、SIRT5、SIRT7与牙周炎的关系鲜有报道。

无机焦磷酸盐及其相关调控因子对牙周支持组织的矿化调控作用

牙周治疗的最终目标是重建功能性的牙骨质-牙周膜-牙槽骨复合体(即牙周复合体)。如何精准调控不同牙周组织的矿化是实现牙周组织再生的关键和难点。无机焦磷酸盐(PPi)及其相关调控因子对牙槽骨、牙骨质和牙周膜的矿化发挥重要调节作用。本文就PPi及其相关调控因子对牙周支持组织的矿化调控作用的研究进展进行分析和总结,以期为牙周组织再生提供理论依据。

木犀草素在牙周炎防治中的研究进展

木犀草素是一种植物来源的天然四羟基黄酮类化合物,近年来已被广泛应用于各种炎症相关疾病的研究中,在牙周炎的防治中具有广阔的应用前景,但目前还缺乏木犀草素治疗牙周炎的相关临床试验,其发展潜能、相关作用机制及安全性仍有待进一步探索。本文就木犀草素对牙周炎相关软组织破坏以及牙槽骨吸收的影响进行综述。

牙周炎患者牙周膜组织miR-106a、miR-34a水平与炎症反应、牙槽骨吸收的相关性

目的:分析牙周炎患者牙周膜组织miR-106a、miR-34a水平与炎症反应、牙槽骨吸收的相关性。方法:选取2021年6月至2023年6月期间在杭州师范大学附属萧山医院接受治疗的81例牙周炎患者为牙周炎组,另选取在本院接受治疗的牙齿正畸患者81例作为对照组。入院后行牙周检查,包括菌斑指数(PLI)、龈沟出血指数(BI)、探诊深度(PD)、附着丧失(AL)。采用RT-PCR法测定牙周膜组织miR-106a、miR-34a的表达水平;采用ELISA测定热休克蛋白60(HSP60)、趋化因子12(CXCL12)、细胞间黏附分子-1(ICAM-1)、IL-17、I型胶原交联C-末端肽(CTX)、I型前胶原氨基末端肽(PINP)、骨保护素(OPG)、Runt相关转录因子2(Runx2)、I型胶原交联氨基末端肽(NTX)表达水平。Pearson法分析牙周膜组织miR-106a、miR-34a表达与炎症反应、牙槽骨吸收指标的相关性;ROC曲线分析牙周膜组织miR-106a、mi R-34a对牙周炎的诊断价值。结果:与对照组相比,牙周炎组患者PLI、BI、PD、AL表达水平显著升高(P<0.05)。与对照组相比,牙周炎组患者牙周膜组织中miR-106a表达水平降低,miR-34a表达水平显著增加(P<0.05)。与对照组相比,牙周炎组患者HSP60、CXCL12、ICAM-1、IL-17表达水平均显著升高(P<0.05),槽骨吸收指标中CTX、NTX表达水平显著升高,PINP、OPG、Runx2表达水平显著降低,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,miR-106a与HSP60、CXCL12、ICAM-1、IL-17、CTX、NTX水平呈负相关(P<0.05),与PINP、OPG、Runx2水平呈正相关(P<0.05)。miR-34a表达水平与HSP60、CXCL12、ICAM-1、IL-17、CTX、NTX水平呈正负相关(P<0.05),与PINP、OPG、Runx2水平呈负正相关(P<0.05)。牙周膜组织miR-106a、miR-34a二者联合诊断牙周炎的AUC最高,优于牙周膜组织miR-106a、miR-34a各自单独诊断(Z_(二者联合-miR-106a)=2.553、P=0.011,Z_(二者联合-miR-34a)=2.834、P=0.005)。结论:牙周炎患者牙周膜组织miR-106a水平显著降低,miR-34a水平显著升高,二者与炎症反应、牙槽骨吸收之间具有相关性,二者联合诊断牙周炎有效性提高。

牙槽嵴保存术在牙周感染位点中的应用:从软硬组织再生到后续种植修复

牙周炎会导致牙周软硬组织破坏,其感染位点在拔牙后往往会存在硬组织缺损及软组织缺陷等问题,影响后续种植修复。牙槽嵴保存术可以在拔牙同期对牙槽窝进行处理,促进牙槽窝的重建并减少牙槽嵴的吸收,实现软硬组织的保存。本文拟对牙周感染位点的牙槽嵴保存术,兼顾其术后软组织改变以及对后续种植影响,从感染对牙槽窝愈合的影响、感染位点行牙槽嵴保存术的疗效以及感染位点牙槽嵴保存术的影响因素三方面进行综述。

牙周炎患者种植牙同期行引导骨组织再生术的美学修复效果及对牙槽骨吸收的影响研究

目的:探究伴牙周炎患者种植牙同期行引导骨组织再生术(Guided bone regeneration,GBR)治疗的美学修复效果及对牙槽骨吸收的影响。方法:病例选取笔者医院2019年6月-2021年6月收治的牙周炎牙种植患者78例作为研究对象,按照随机数字表法分为对照组和观察组,对照组给予患者常规种植修复,观察组在对照组基础上采用GBR治疗,比较两组患者术后6个月、12个月的牙周探查深度(Periodontal exploration depth,PD)、改良龈沟出血指数(Sulcular bleeding index,mSBI)、改良菌斑指数(Plaque index,mPLI)、骨吸收量以及美学修复效果。结果:术后6个月、12个月,观察组患者的mSBI均低于对照组患者(P<0.05)。种植体周围骨吸收量比较,术后12个月两组患者的近中骨吸收量和远中骨吸收量均较术后6个月显著降低(P<0.05),且术后12个月观察组患者的近中骨吸收量和远中骨吸收量均显著低于对照组。美学效果比较,观察组患者术后6个月、12个月红色美学指数评分均显著高于对照组(P<0.05),且术后12个月两组红色美学指数评分均显著高于术后6个月(P<0.05),术后6个月、12个月,两组白色美学指数评分差异无统计学意义(P>0.05),且两组术后12个月与术后6个月白色美学指数评分比较,差异无统计学意义(P>0.05)。结论:牙周炎患者牙种植同期应用GBR能有效改善患者牙周健康指标,防止种植体周围骨吸收,进而提高种植体留存率,满足患者治疗中种植美学的要求。

骨皮质切开术及改良术式加速正畸牙移动的临床研究进展

加速正畸牙移动的辅助干预技术一直是正畸领域关注的热点。较长的正畸治疗周期常伴随多种潜在并发症,例如脱矿、龋坏、牙根吸收和牙龈炎症等。因此,使用加速正畸牙移动的辅助干预技术,缩短正畸治疗周期,可以为患者提供诸多益处,具有重要的临床意义。目前,加速正畸牙移动的辅助干预措施主要可以分为手术干预和非手术干预。其中,手术干预又以骨皮质切开术及其改良术式在临床最为常见,可以显著减少治疗时间,实现牙槽骨增量,扩大牙移动范围,但是会不可避免地造成创伤,存在诸多风险及限制因素,因而未能在临床上得到广泛应用。近年来,多种骨皮质切开术的改良术式不断涌现,如微创骨皮质切开术、压电切开术、骨微穿孔术和盘状切开术等,有效减少了软、硬组织损伤,降低了术后并发症发生率,且临床操作较为简便。皮质切开及改良术式均能在一定程度上缩短正畸治疗的时间,并对牙周健康的恢复有促进作用,且其对牙周、牙体及牙髓组织不会造成不利影响,但是在临床应用时仍需要对牙周组织损伤、牙根吸收、牙髓活力丧失等潜在副作用及不足进行重点关注和长期随访。

A five-in-one novel MOF-modified injectable hydrogel with thermo-sensitive and adhesive properties for promoting alveolar bone repair in periodontitis:Antibacterial,hemostasis,immune reprogramming,pro-osteo-/angiogenesis and recruitment

Periodontitis is a chronic inflammatory disease caused by plaque that destroys the alveolar bone tissues,resulting in tooth loss.Poor eradication of pathogenic microorganisms,persistent malignant inflammation and impaired osteo-/angiogenesis are currently the primary challenges to control disease progression and rebuild damaged alveolar bone.However,existing treatments for periodontitis fail to comprehensively address these issues.Herein,an injectable composite hydrogel(SFD/CS/ZIF-8@QCT)encapsulating quercetin-modified zeolitic imidazolate framework-8(ZIF-8@QCT)is developed.This hydrogel possesses thermo-sensitive and adhesive properties,which can provide excellent flowability and post-injection stability,resist oral fluid washout as well as achieve effective tissue adhesion.Inspirationally,it is observed that SFD/CS/ZIF-8@QCT exhibits a rapid localized hemostatic effect following implantation,and then by virtue of the sustained release of zinc ions and quercetin exerts excellent collective functions including antibacterial,immunomodulation,pro-osteo-/angiogenesis and pro-recruitment,ultimately facilitating excellent alveolar bone regeneration.Notably,our study also demonstrates that the inhibition of osteo-/angiogenesis of PDLSCs under the periodontitis is due to the strong inhibition of energy metabolism as well as the powerful activation of oxidative stress and autophagy,whereas the synergistic effects of quercetin and zinc ions released by SFD/CS/ZIF-8@QCT are effective in reversing these biological processes.Overall,our study presents innovative insights into the advancement of biomaterials to regenerate alveolar bone in periodontitis.