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Figure 5. Roles of EVs in periodontitis. EVs play three core roles in periodontitis. Regarding therapeutic applications, EVs promote periodontal bone regeneration, modulate the immune microenvironment, and serve as drug delivery systems. In terms of pathogenesis, bacterial EVs not only contribute to periodontal tissue destruction but are also associated with various systemic diseases. Regarding diagnostic potential, EVs serve as promising diagnostic biomarkers. [Created in BioRender. Yixing, Z. (2026) https://BioRender.com/d17m8vx]. EVs: Extracellular vesicles; IL: interleukin; miRNA: microRNA; mRNA: messenger RNA; MSC: mesenchymal stem cell; TGF-β: transforming growth factor beta; Th17: T helper 17; TNF-α: tumor necrosis factor-alpha; Treg: regulatory T cell.