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Herein, we engineer a novel microneedle\u2010nanosheet (MN) composite membrane that enables conformal adhesion to bone surfaces and sequentially targets the bacterial and inflammatory phases in periodontitis (PD). Upon implantation, with the instant degradation of the polyvinyl alcohol (PVA) layer, MN achieves adaptive adhesion to periodontal defect sites via nanoscale properties. Accelerated degradation of gelatin methacryloyl (GelMA) layer enables sustained antimicrobial peptide release to control periodontal pathogens, while slow degradation of microneedle facilitates sustained delivery of mesenchymal stem cell\u2010derived exosomes. In vitro, MN exhibits favorable mechanical stability, potent antibacterial activity against periodontal pathogens, biocompatibility, and promotes osteogenesis\/angiogenesis. In rat and beagle dog periodontal bone defect models, MN enhances immunomodulation, osteogenesis, and angiogenesis, resulting in significant alveolar bone regeneration. 16S rRNA sequencing reveals reduced abundance of PD\u2010associated bacterial communities, while RNA sequencing analysis further demonstrates activation of immune signaling pathways. In summary, MN adapts to critical demands for next\u2010generation GBR membranes that offer a dynamic, bio\u2010integrated microenvironment for tissue healing and regeneration by enabling temporally regulation, from space maintenance to multiplexed biological functions.<\/jats:p>","DOI":"10.1002\/adma.72919","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T11:48:09Z","timestamp":1774525689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Adhesive Microneedle\u2010Nanosheets With Temporally Orchestrated Antimicrobial, Immunomodulatory, and Osteogenic Functions for Periodontal Regeneration"],"prefix":"10.1002","volume":"38","author":[{"given":"Xinfang","family":"Zhang","sequence":"first","affiliation":[{"name":"Hospital of Stomatology, Guanghua School of Stomatology Sun Yat\u2010sen University, Guangdong Provincial Key Laboratory of Stomatology  Guangzhou P. R. 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