The oral cavity is a dynamic "open growth system" of microbiome, which contains over 700 species of bacteria. [1][2][3] Typically, periodontal disease status, disease progression, and unsuccessful therapy have long been ascribed to the dysbiosis between host and microbial communities. Periodontitis has a sophisticated microbial ecosystem that colonizes in the periodontal pockets, primarily represented by "the red complex," Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. 4 Emerging evidence has extended the pathogenic microbial spectrums with gram-negative Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum; 5,6 gram-positive Streptococcus spp. and Filifactor alocis; 7,8 and many others. These periodontopathogens possess abundant virulence factors, among which vesicles exfoliated from bacterial membranes are getting increasing attention.Membrane vesicles (MVs) are spherical nanostructures with size ranging between 20-400 nm, and they are secreted by diverse bacterial species, both gram-negative and gram-positive, pathogenic or nonpathogenic. 9,10 MVs enclose sorted cargo molecules and serve essential biological functions, such as toxin transport, immunomodulation, biofilm formation, gene transfer, and intercellular interactions. 9 The recent identification of outer membrane vesicles (OMVs), together with outer-inner membrane vesicles (OIMVs) and