Advanced injectable Ti₃C₂ MXene hydrogel: A multifunctional solution for diabetic alveolar bone defect repair

Diabetes mellitus creates significant challenges for alveolar bone repair due to oxidative stress-induced immune dysregulation, and chronic hyperglycemia induced- increased infection susceptibility. The irregular alveolar bone defects further limits conventional bone repair approaches, as traditional grafts and rigid scaffolds lack adaptability for proper integration in these challenging sites. MXene nanosheets have emerged as promising candidates due to their exceptional reactive oxygen species (ROS) scavenging capabilities and remarkable photothermal conversion efficiency, enabling antibiotic-free antimicrobial therapy. Hydrogel systems offer complementary advantages through injectability, self-healing capacity, and superior tissue adhesion. However, integration of MXene nanosheets within dynamically crosslinked hydrogel networks for diabetic bone repair remains largely unexplored. Therefore, we developed an innovative double-crosslinked, injectable, self-healing hydrogel system incorporating MXene nanosheets, designed to target interconnected pathological processes in diabetic alveolar bone defects. Our multifunctional approach addresses three critical objectives: First, exceptional injectability, self-healing and tissue adhesion properties enable precise adaptation to irregular defect geometries with stable retention and inherent tissue adhesion. Second, incorporated MXene nanosheets function as efficient ROS scavengers, restoring local immune homeostasis and counteracting detrimental effects on osteoblast function. Third, photothermal-responsive antimicrobial activity provides on-demand sterilization without contributing to antibiotic resistance. Comprehensive validation demonstrates this platform successfully orchestrates immune modulation, infection prevention, and osteogenic enhancement through coordinated multilevel pathway regulation, establishing a clinically translatable therapeutic strategy for diabetes-related alveolar bone repair. • Integrated Material Design: The successful incorporation of MXene nanosheets into multifunctional hydrogels. • Coordinated Therapeutic Mechanisms: Our platform provides dual-mode antioxidant activity. • Antibiotic-Free Strategy: The NIR photothermal system provides precise infection control during healing process.