Muco-Adhesive Hydrogels-Based Exosome Delivery for Periodontal Tissue Regeneration and Inflammation Reduction: A Review.

This review highlights the potential of muco-adhesive hydrogel-based exosome delivery vehicles for the regeneration of periodontal tissue and the reduction of inflammation in periodontitis. Exosomes, mainly produced from mesenchymal stem cells (MSCs), represent nano-sized vesicles loaded with bioactive molecules that can stimulate tissue repair and modulate inflammatory pathways. The review provides a thorough view for the synthesis of the in vitro, in vivo and clinical-pilot studies on exosome-loaded muco-adhesive hydrogels, encompassing the physicochemical characterization, exosome delivery and biological efficacies. In vitro studies highlight the regenerative potential of exosomes on periodontal ligament cells and on alveolar bone cells. In vivo animal models have shown significant improvements in tissue regeneration with effective inflammation control. Preliminary clinical pilot studies similarly show promising results for periodontal tissue healing. The use of exons in combination with muco-adhesive hydrogels provides an effective and non-invasive approach for the targeted, prolonged therapeutic delivery for the treatment of periodontal disease. The main conclusion of this review is that exosome loaded muco-adhesive hydrogels represent a promising strategy for developing strategies to treat periodontitis, setting up as its double aims to enhance the regeneration of tissues and reduce inflammation.