Mesenchymal stromal cell exosomes enhance dental pulp cell functions and promote pulp-dentin regeneration

•MSC exosomes enhance dental pulp cell functions including migration, proliferation, and odontogenic differentiation.•Exosome-mediated enhancements are mediated through CD73/NT5E adenosine receptor activation of AKT and ERK signaling pathways.•MSC exosomes are amenable for delivery in collagen sponge for implantation and in collagen gel for injection in animal models of dental pulp defect and subcutaneously implanted human premolar.•MSC exosomes can trigger a sustained regenerative process to restore pulp homeostasis and promote pulp-dentin regeneration.