Background Extracellular vesicles (EVs), including exosomes, microvesicles, and apoptotic bodies, are nanoscale membrane-bound structures that mediate intercellular communication through the transfer of proteins, lipids, and nucleic acids. In the oral cavity, EVs are present in saliva and gingival crevicular fluid, where they contribute to immune regulation, epithelial barrier integrity, and host–microbiome interactions.Objective This review aimed to critically summarize current knowledge regarding EV biogenesis, molecular composition, cellular and microbial sources, and their roles in oral homeostasis and disease pathogenesis.Results Current evidence demonstrates that EVs derived from host cells and oral microorganisms actively regulate inflammatory responses, biofilm dynamics, tissue regeneration, and microbial colonization. Dysregulation of EV-mediated communication has been implicated in the development and progression of periodontal disease, oral candidiasis, and oral squamous cell carcinoma (OSCC). In addition, salivary EVs have emerged as promising non-invasive biomarkers and potential therapeutic tools in oral medicine. However, important methodological limitations remain, particularly regarding EV isolation, characterization, and standardization.Conclusions EVs represent central mediators of communication within the oral microenvironment and play dual roles in maintaining oral homeostasis and promoting disease progression. Further standardized and clinically relevant studies are required to better define EV biology and facilitate the translation of EV-based diagnostic and therapeutic strategies into clinical oral medicine.
Semlali et al. (2026) studied this question.