A review from mesenchymal stem-cells and their small extracellular vesicles in tissue engineering

This review aims to offer a vision of the clinical reality of cell therapy today in intensive medicine. For this, it has been carried out a description of the properties, functions, and Mesenchymal Stem Cells (MSCS) sources to subsequently address the evidence in preclinical models and studies clinical trials with whole cells and models attributed to small extracellular vesicles (sEVs), nanoparticles made up of microvesicles secreted by cells with an effect on the extracellular matrix, and their impact as an alternative towards cell-free regenerative medicine. MSCs are cells that enhance the regenerative capacity which can be differentiated typically in different lineages committed as bone, cartilage, and adipose tissue. On the other hand, small extracellular vesicles are structures that participate notoriously and crucially in intercellular communication, which has led to a change in the concept of the functions and the role that these vesicles play in living organisms, in the restoration of damaged tissues and the inflammatory response and immunological. We present the mechanisms that are involved in the applications of MSCS as whole cells and their sEVs in cell therapy and cell-free therapy as an alternative in regenerative medicine. Considering the structural loss that occurs after surgical procedures for cystic and tumoral pathology in periodontitis, as well as the maxillary atrophy that determines the rehabilitation with dental implants, it is imperative to find satisfactory solutions. The opportunity provided by the findings in stem cells is a recent introduction in the field of oral surgery, based on the regenerative potential that these cells possess to restore defects at different levels of the oral cavity. This review aims to discover the real applications that stem cells may have in our treatments shortly.