Background: In maxillofacial reconstruction, even small inaccuracies can compromise aesthetics, function, and safety. Surgeons currently rely on preoperative imaging; however, recent advances in intraoperative imaging now provide three-dimensional, real-time guidance, possibly enhancing surgical outcomes. This review evaluates the current application of intraoperative imaging in maxillary and mandibular surgery including its impact on accuracy, efficiency, and outcomes. Methods: Two separate systematic reviews (PROSPERO CRD420251125497, CRD420251124600), analyzing maxillary and mandibular repair were conducted through Cochrane, Medline, Embase, and Web of Science. Both reviews adhered to the PRISMA guidelines. Inclusion criteria encompassed intraoperative digital imaging or navigation in maxillary or mandibular surgery. Studies without human subjects, intraoperative imaging, or the surgery of interest were excluded. Bias was assessed with NIH Quality Assessment. Results: A combined total of 795 publications were screened, with 35 studies ultimately included in this review, encompassing 1643 patients. Techniques included intraoperative computed tomography (CT) (n = 12, 34.3%), stereotactic navigation (n = 16, 45.7%), augmented reality (n = 2, 5.7%), ultrasound, fluoroscopy, infrared stereoscopic and electromagnetic (n = 1, 2.9%, each). The most common indication for surgery was fracture repair. Reporting was heterogeneous, with variable metrics and reporting for accuracy, complications, and revisions. Overall, cone-beam CT (CBCT) and stereotactic navigation both demonstrated significant restoration of normal symmetry, and stereotactic navigation enabled accuracy of <2 mm. CBCT added the shortest amount of time intraoperatively, ranging from 1 to 20 min. Reporting on long-term outcomes was heterogeneous. Conclusions: A variety of intraoperative imaging and navigation techniques are being applied in maxillofacial surgery. However, inconsistent reporting metrics, small study size, and study feasibility-focused study design limit meaningful comparison across technologies. Rigorous prospective studies with standardized outcome measures are needed to further define their clinical value and guide adoption.

Traumatic injuries often result in nerve tissue damage and functional deficits due to limited regeneration. Silk fibroin, a biopolymer with inherent biocompatibility and tunable properties, is a promising material for 3D-bioprinted neural tissue scaffolds. This review highlights recent advancements in silk-derived composite scaffolds, often incorporating additional materials like collagen or conductive polymers to enhance their performance. This review examines how material composition, scaffold architecture, and fabrication strategy influence biological response and functional recovery. This comprehensive review follows PRISMA guidelines and uses comprehensive searches of PubMed, MEDLINE, Embase, Web of Science, Cochrane Central, and ClinicalTrials.gov for studies published through 2025. Studies were screened for eligibility based on substance type, mechanical properties, production methods, and outcomes. Findings were synthesized qualitatively. Twelve studies were included, comprising rat (50%), canine (8.3%), and in vitro (41.7%) models. Analysis reveals that silk fibroin acts as a highly adaptable mechanical backbone. It can consistently integrate with bioactive additives (collagen, dECM) or conductive polymers (Polypyrrole, MXene) to meet specific therapeutic demands. For spinal cord injuries, composites reached a compressive modulus capable of resisting physiological pressures and preventing scaffold collapse. In soft tissue applications, silk–hydrogel blends provided localized release of exosomes and small molecules during the acute injury phase, reducing neuroinflammatory markers. Additionally, adding conductive materials allowed the scaffolds to bridge electrical gaps and promote Schwann cell proliferation and neuronal differentiation. Furthermore, 3D bioprinting enabled the creation of defined microchannels that replicate native fascicular architecture. In vivo outcomes consistently showed superior axonal regeneration, myelination, and synaptic reconnection compared to controls, correlating with significant improvements in electrophysiological and motor function. This review highlights the clinical potential of silk fibroin-based 3D-printed biomaterials for nerve regeneration, including neural repair and neural tissue engineering. More recent studies place greater emphasis on integrating mechanical, architectural, and biological considerations into scaffold design, resulting in increasingly multifunctional scaffold systems. Despite promising efficacy, the heterogeneity of fabrication methods and the predominance of rodent models highlight the need for standardized protocols and evaluations in relevant models to facilitate clinical translation.