Efficacy of dental pulp stem cell-derived extracellular vesicles and scaffold combination for bone regeneration in pre-clinical animal models

Efektivitas kombinasi vesikel ekstraseluler yang berasal dari stem sel pulpa gigi dan scaffold untuk regenerasi tulang pada model hewan praklinis

Abstract

The regeneration of bone damage is a major challenge in regenerative therapy and requires effective strategies for bone repair and reconstruction. Extracellular vesicle (EV)-based therapy has emerged as a promising cell-free approach due to its role in intercellular communication. This systematic review evaluates the efficacy of dental pulp stem cell-derived extracellular vesicles (DPSC-EVs) combined with scaffolds for bone regeneration, focusing on preclinical evi-dence. An electronic search of PubMed, Scopus, and ScienceDirect was conducted up to October 2025, following PRISMA guidelines, and risk of bias was assessed using SYRCLE. Of the 489 articles identified, 9 met the inclusion criteria. The findings indicate that DPSC-EV combined with a scaffold enhances the osteogenic response and promotes bone repair in preclinical models. It is concluded that DPSC-EV has potential as a novel and effective cell-free therapy for bone regeneration. However, further standardisation in EV preparation, long-term studies in large animals, and early-phase clinical trials are required to support clinical translation.