Advantages and potential of cell-derived exosomes in oral tissue regeneration

Li Jiapeng; Zuleina·Abula; Jia Qianqian; Nigare·Yunusijiang; Sun Jiaqi; Zhao Jin; Wu Zeyu

doi:10.12307/2026.219

Abstract：BACKGROUND:Stem cells show a great potential in oral tissue regeneration but face challenges such as immune rejection and tumor formation.Exosomes are nanoscale extracellular vesicles secreted by cells,reducing immunogenicity and tumor risks while maintaining stem cell functions,such as promoting angiogenesis and tissue repair. OBJECTIVE:To summarize the mechanisms and roles of exosomes in oral tissue regeneration,explore exosome engineering strategies and the challenges and future directions in the application of exosomes in oral regenerative medicine. METHODS:The relevant literature published from the WanFang and PubMed databases from their inception to 2025 was searched using Chinese search terms"stem cells,exosomes,dental pulp regeneration,periodontal regeneration"and English search terms"exosomes,stem cells,dentistry,regenerate."Finally,94 articles were included for review and analysis. RESULTS AND CONCLUSION:(1)Exosomes have lower immunogenicity and no tumorigenic risk compared with stem cells.They are more stable and easier to store and transport.Additionally,exosomes can penetrate dense tissues for targeted delivery.They can avoid the ethical and immune rejection issues faced by stem cell therapy,making them a safer and more effective treatment option.(2)Exosomes have shown significant efficacy in the regeneration of oral tissues,including dental pulp,periodontal tissue,craniofacial bone,salivary glands,nerves,and skin.They can promote tissue repair and regeneration through multiple mechanisms,demonstrating broad application prospects.(3)Engineering strategies such as pre-treatment,isolation and purification,and targeted modification can enhance the functions of exosomes,improving their therapeutic potential and clinical feasibility.However,the current technologies still have limitations.Further optimization is needed in the future to promote their widespread application.