Numerous preclinical studies have investigated bioactive coatings on titanium implant surfaces to enhance antibacterial and osteointegrative performance in oromaxillofacial applications. However, these studies employ heterogeneous experimental methods and biological outcomes, making it difficult to identify which coating strategies hold the greatest translational potential. This systematic review and Bayesian network meta-analysis (NMA) aimed to rank titanium coating strategies published over the last five years according to their biological performance, using a quantitative statistical framework. Nine coating categories of increasing compositional complexity, ranging from single-component (inorganic, organic, peptides/growth factors) to two-component and three-component formulations combining these classes with each other or with antibiotics, were compared across six biological outcomes in preclinical models. Inclusion criteria followed the PICOS framework for studies published between 2020 and 2025. Three databases were searched according to PRISMA 2020 and its NMA extension. Mean difference (MD) was used for outcomes on a common scale; ratio of means (RoM) when measurement units were heterogeneous. Treatment ranking was estimated using the surface under the cumulative ranking curve (SUCRA). Study reporting quality and data completeness were assessed, and studies with insufficient quantitative data were excluded from the quantitative synthesis. Of 143 records identified, 59 met the inclusion criteria and 40 contributed to the quantitative synthesis. SUCRA rankings indicated that three-component hybrid coatings incorporating antibiotics achieved the highest antibacterial performance and osseointegration, while inorganic coatings functionalized with peptides or growth factors demonstrated superior osteogenic differentiation. Organic coatings combined with peptides or growth factors showed the greatest cell proliferation. These findings provide the first evidence-based ranking of bioactive coating strategies for titanium implant surfaces, suggesting a potential advantage of multi-component formulations over single-agent approaches across biological outcomes. The identified compositional complexity gradient may inform the rational design of future multifunctional coatings and help prioritize candidates for further preclinical and translational validation in oromaxillofacial applications.
To describe same-day discharge and recorded postoperative complications after bimaxillary osteotomy in a selected retrospective cohort, without establishing comparative safety. The cohort comprised 80 adults classified as American Society of Anesthesiologists (ASA) I–II who underwent bimaxillary osteotomy, with or without adjunctive procedures, at a day-surgery center in Riyadh between January 2022 and November 2023. Forty were discharged on the same day and 40 were admitted overnight. Discharge planning reflected patient preference and clinical assessment. The primary endpoint was the recorded postoperative-complication indicator in the available clinical dataset. Post Anesthetic Discharge Scoring System (PADSS) readiness was described separately. Complication proportions were compared without adjustment for confounding. PADSS scores ≥ 9 were recorded in 40/40 same-day and 32/40 overnight patients. Recorded complications affected 2/40 (5.0
Oral cancer remains one of the most common malignancies worldwide and is associated with significant morbidity and mortality. Conventional therapies often cause systemic adverse effects and reduced patient compliance. Mucoadhesive buccal drug delivery systems provide localized and sustained drug release, potentially enhancing therapeutic efficacy while minimizing systemic toxicity. This study aimed to develop and optimize a mucoadhesive buccal gel containing Curcumin, Quercetin, and Resveratrol for localized oral cancer therapy using a 32 full factorial design. Nine mucoadhesive buccal gel formulations (F1-F9) were prepared by the dispersion method using Hydroxypropyl Methylcellulose K15M (HPMC K15M Grade) and Carbopol 934P as mucoadhesive polymers. The formulations were evaluated for appearance, pH, viscosity, spreadability, drug content, mucoadhesive strength, and in-vitro drug release. Drug-excipient compatibility was assessed using Fourier Transform Infrared spectroscopy (FTIR) and Differential Scanning Calorimetry (DSC). Drug release kinetics were analyzed using Zero order, First order, Higuchi, Hixson-Crowell, and Korsmeyer-Peppas models. Statistical optimization was performed using Design-Expert® software. All formulations exhibited acceptable physicochemical characteristics, including suitable pH, homogeneity and formulation-dependent differences in viscosity, spreadability and mucoadhesive strength. The optimized formulation F5 demonstrated acceptable stability under accelerated conditions for 6 months. Increasing polymer concentration enhanced viscosity and mucoadhesive strength while reducing spreadability and drug release. The cumulative drug release after 8 h ranged from 71.50
Autogenous bone grafting remains the gold standard for reconstruction of alveolar ridge deficiencies, and the mandibular symphysis is a commonly used intraoral donor site. This study quantitatively and qualitatively evaluated the mandibular symphysis using cone-beam computed tomography (CBCT), with emphasis on harvestable bone volume, and bone quality according to age and sex. In this retrospective cross-sectional study, CBCT scans of 100 adults were analyzed. Linear measurements, harvestable bone volume calculations, cortical and cancellous bone segmentation, and Misch bone classification were performed in the mandibular symphyseal region. Associations with age and sex were evaluated. 58 women and 42 men with a mean age of 44.86 ± 12.16 years were included. Mean total bone volume was 1645.25 ± 481.75 mm³, comprising 813.30 ± 260.12 mm³ of cortical bone and 831.95 ± 285.93 mm³ of cancellous bone. Cortical and cancellous volumes were nearly equivalent, with a cancellous-to-cortical ratio of 1.02. Harvestable bone volume was significantly greater in men than in women (P < 0.001). Sex was significantly associated with most quantitative and qualitative bone parameters, whereas age was associated only with harvestable graft length. Bone quality distribution according to the Misch classification also differed between the sexes. The mandibular symphysis demonstrated a balanced cortical-cancellous composition and measurable radiographic bone volume within the predefined anatomical boundaries. Gender plays a more influential role than age in relation to bone indices. Preoperative three-dimensional assessment with CBCT should be performed to select the appropriate intraoral autograft harvesting site.
To compare the effects of leukocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) on bone healing and postoperative outcomes following impacted third molar extraction (ITME). A randomized, double-blind, split-mouth clinical trial was conducted in patients undergoing bilateral ITME. One extraction socket received L-PRF and the contralateral socket received A-PRF. The primary outcome was bone volume at the extraction socket, assessed by cone-beam computed tomography (CBCT), as a measure of bone healing. Secondary outcomes included trabecular thickness, trabecular spacing, soft tissue healing assessed using the modified Landry healing index, postoperative pain assessed using a visual analog scale (VAS), and facial swelling. Statistical significance was set at p < 0.05. Thirty-five patients were included in the final analysis. No significant differences were observed in bone volume between the L-PRF (21.04 ± 7.46) and A-PRF (21.43 ± 7.65) groups (p = 0.802). Trabecular thickness was significantly greater in the A-PRF group (p = 0.012), whereas trabecular spacing did not differ between groups. An exploratory time-specific comparison showed lower pain scores in the L-PRF group at 8 h postoperatively (p = 0.046), although no significant overall treatment effect was observed for postoperative pain. No significant differences were identified regarding facial swelling or soft tissue healing. Within the limitations of this randomized clinical trial, L-PRF and A-PRF demonstrated comparable effects on bone healing and postoperative clinical outcomes following impacted third molar extraction. Trial registration Brazilian registry of clinical trials [ReBEC] number: RBR-10vc6r63.
