Extracellular vesicles derived from dental mesenchymal stem cells for regenerative medicine: a scoping review

Extracellular vesicles (EVs), particularly small EVs (sEVs), are nanoscale particles secreted by cells that mediate intercellular communication and hold promise in tissue regeneration. Dental mesenchymal stem cells (D-MSCs) are an attractive source of sEVs due to their non-invasive collection, ease of expansion, and low immunogenicity. This scoping review aimed to evaluate current evidence on the regenerative potential of sEVs derived from D-MSCs (D-MSC-sEVs) and the methods used for their isolation and application. A search was performed using PubMed/MEDLINE, Scopus, Web of Science, and EMBASE. The inclusion criteria were studies investigating D-MSC-sEVs in all languages ​​and data. Studies not using human MSCs or in vitro models were excluded. The search resulted in 2,285 records and 44 studies were included. D-MSC-sEVs were obtained from the dental pulp of permanent and deciduous teeth, periodontal ligament, apical papilla, dental follicle, and gingiva. The most robust evidence of D-MSC-sEVs has been from craniofacial tissues, with particular emphasis on increasing bone volume and the number of trabeculae in defects, with improved angiogenesis and neurogenesis. They have also been investigated for skin, nervous tissues, joints, tendons, angiogenesis, and inflammation. These results demonstrate the potential of using D-MSC-sEVs for immunomodulation and regeneration for different diseases as an alternative to cellular therapies.