Exosomes Derived from Dental Pulp Stem Cells in Tissue Repair and Regeneration

Dental pulp stem cells (DPSCs) are multipotent stem cells with strong differentiation capacity and immunomodulatory properties, making them a promising source for regenerative therapies. Traditional cell-centric approaches such as stem cell transplantation face limitations including high cost, ethical concerns and technical complexity, which has shifted attention toward cell-free strategies. Exosomes, nanosized extracellular vesicles enriched in proteins, RNAs and bioactive molecules, offer advantages such as low immunogenicity, stability and efficient intercellular communication. Exosomes derived from DPSCs (DPSC-Exo) have demonstrated notable regenerative potential. They promote angiogenesis and dentin-pulp complex formation, thereby facilitating pulp regeneration. They also enhance osteogenic differentiation and contribute to bone defect repair, while exerting neuroprotective effects and supporting neural repair through secreting neurotrophic factors and regulating inflammatory responses. Despite these advances, major challenges remain regarding large-scale isolation, precise delivery and long-term safety evaluation. This review aims to summarize current knowledge of DPSC-Exo in pulp regeneration, bone formation and neural repair, highlight their clinical prospects and outline key directions for further studies.