The included studies demonstrated a consistent increase in ALP activity across surface-modified implants, particularly at 7 and 14 days postimplantation. The 7-day RR was 2.02 (95% CI: 1.76-2.29), and the 14-day RR was 1.36 (95% CI: 1.18-1.55), indicating enhanced osteogenic potential. Similarly, OCN expression at day 7 showed a significant pooled standardized mean difference (SMD) of 11.01 (95% CI: 3.02-19.00), and OPN expression at day 7 demonstrated a more consistent effect, with a pooled SMD of 3.76 (95% CI: 2.46-5.06), all suggesting a marked upregulation of osteogenic differentiation markers. However, significant heterogeneity was observed, attributed primarily to differences in cell lines and experimental conditions.