Therapeutic potential of dental stem cell–derived exosomes in regenerative dentistry

Dental stem cells (DSCs) are multipotent mesenchymal stem cells capable of differentiating into multiple lineages. Their unique properties have sparked significant interest in the exosomes derived from them. Recent focus has shifted toward cell-free therapeutic approaches, such as exosomes, which carry bioactive molecules that can influence the behavior of recipient cells. This review aims to provide a comprehensive overview of exosomes derived from various types of DSCs, emphasizing their biological properties, therapeutic potential, and clinical applications. We critically analyzed published studies investigating DSC-derived exosomes, with a focus on their role in angiogenesis, inflammation modulation, and differentiation potential. Additionally, we reviewed primary clinical trials of stem cell-derived therapeutic exosomes, categorized by the source of stem cells and stage of clinical development, and explored their industrial applications. Evidence from preclinical studies demonstrates that DSC-derived exosomes promote differentiation into multiple lineages. These properties translate into therapeutic potential for clinical applications. Early-stage clinical trials have begun to explore the safety and efficacy of DSC-exosome-based therapeutics, with growing industrial interest in their development. DSC-derived exosomes represent a promising cell-free therapeutic strategy in regenerative medicine. Continued research, particularly well-designed clinical trials, is essential to fully realize their translational applications. This ongoing early-phase clinical trial primarily investigates exosomes derived from mesenchymal stem cells (MSC-Exo) and neural stem cells (NSC-Exo). The aim is to assess their safety, tolerability, and appropriate dosage criteria. These studies seek to establish comprehensive regulatory and pharmacological guidelines to facilitate the future clinical development of exosomes derived from these stem cells.