DPSC-EV-loaded hydrogels accelerated bone regeneration in rats with alveolar bone defects. (A) A rat model of alveolar bone defects was established, and the rats were treated with DPSC-EVs. The rats were euthanized after the operation, and new bone regeneration was less intense in the control group and hydrogel group. More new bones were found in the hydrogel + DPSCs-EVs group. (B) Similarly, the BV/TV results showed that the hydrogel + DPSCs-EV group formed more new bones than the other groups. (C) The expression of osteogenesis-related proteins (BSP, ALP and RUNX2) and TGF-β1/Smad signaling were determined via Western blotting. (D) Expressions of TGF-β1 and p-Smad3/Smad3 were significantly greater in the DPSC-EV-loaded hydrogel group than in the DPSC-EV group. (E) Expressions of BSP, ALP and RUNX2 were significantly greater in the DPSC-EV-loaded hydrogel group than in the DPSC-EV group. The data from three independent experiments are presented as the mean ± SD; *P<0.05 and **P<0.01. DPSC, dental pulp stem cell; EV, extracellular vesicle; HERS, Hertwig's epithelial root sheath; p, phosphorylated; RUNX2, runt-related transcription factor 2; ALP, alkaline phosphatase; i, inhibitor; BV/TV, bone volume/total volume; BSP, bone sialoprotein.