While several studies investigated the effects of mechanical or electrical stimulation on osseointegration and bone fracture healing, little is known about the molecular and cellular impact of combined biophysical stimulation on peri-implant osseointegration. Therefore, we established an in vitro system, capable of applying shear stress and electric fields simultaneously. Capacitively coupled electric fields were used for electrical stimulation, while roughened Ti6Al4V bodies conducted harmonically oscillating micromotions on collagen scaffolds seeded with human osteoblasts. Different variations of single and combined stimulation were applied for three days, while samples loaded with Ti6Al4V bodies and untreated samples served as control. Metabolic activity, expression of osteogenic markers and bone remodeling markers were investigated. While combined stimulation showed no substantial benefit compared to sole mechanical stimulation, we observed that 25 µm micromotions applied by roughened Ti6Al4V bodies led to a significant increase in gene expression of osteocalcin and tissue inhibitor of metalloprotease 1. Additionally, we found an increase in metabolic activity and expression of bone remodeling markers with reduced procollagen type 1 synthesis after 100 mV_RMS electrical stimulation. We were able to trigger specific cellular behaviors using different biophysical stimuli. In future studies, different variations of electrical stimulation will be combined with interfacial micromotions.

Objectives: This study aimed to investigate the microbial spectrum and resistance patterns in surgically treated odontogenic infections and to assess the clinical impact of resistance, including systemic complications and hospitalization. Resistance rates were additionally evaluated in relation to reported penicillin hypersensitivity. Methods: A total of 740 inpatient cases with microbiological testing from surgically treated odontogenic infections at the Jena University Hospital from January 1, 2012, to December 31, 2023, were analyzed. Resistance rates were assessed at infection level. Time trends were analyzed using Poisson regression. Associations between resistance rates and clinical variables were evaluated using binary logistic regression. Results: Clindamycin resistance was observed in 38.9% of infections, while amoxicillin/clavulanate (6.9%) and moxifloxacin (4.5%) showed lower resistance rates. No statistically significant trends in resistance rates were observed. Moxifloxacin resistance increased the risk of systemic complications (OR: 10.875; 95%-CI: 2.364–50.017; p = 0.002), while no significant associations were found between antibiotic resistance and prolonged hospitalization. A history of penicillin hypersensitivity was associated with increased clindamycin resistance (OR: 2.156; 95%-CI: 1.038–4.480; p = 0.04). Conclusions: Clindamycin exhibits high resistance rates in odontogenic infections and should be critically re-evaluated as empirical therapy, especially in patients with penicillin hypersensitivity. Given the overall low resistance rates to moxifloxacin, resistance to this agent indicated highly resistant infections and was associated with an increased risk of systemic complications. Clinical relevance: Continuous resistance surveillance and adaptation of empirical therapy are essential for managing severe odontogenic infections and reducing life-threatening infection-related complications, emphasizing the need for antimicrobial stewardship.

Background: Odontogenic infections remain a frequent cause of hospitalization and can progress to systemic complications with substantial resource use. Reliable risk stratification is needed to guide early management. Therefore, this study aimed to identify independent risk factors for systemic complications and prolonged hospitalization in odontogenic infections, and to examine trends in case frequency over a 12-year period. Methods: A retrospective analysis of 997 surgically treated inpatient cases from 2012 to 2023 was conducted. Clinical outcomes of interest were systemic complications and prolonged hospitalization (≥ 10 days). Associations with clinical and demographic variables were evaluated using bivariate and multivariable logistic regressions. Multivariable models were validated by bootstrap resampling and receiver operating characteristic analyses. Case volume trends were analyzed using Poisson and negative binomial regression models. Results: Annual hospitalization rates for odontogenic infections increased significantly over the study period (IRR 1.043; 95% CI: 1.025–1.063; p < 0.001), despite an overall decline in inpatient admissions. Systemic complications occurred in 3.8% of cases and were independently associated with age (aOR: 1.040 per year; 95% CI: 1.019–1.061; p < 0.001), COPD (aOR: 3.707; 95% CI: 1.569–8.761; p = 0.003), chronic alcohol addiction (aOR: 5.625; 95% CI: 2.270–13.937; p < 0.001), and multi-space involvement (aOR: 5.492; 95% CI: 2.379–12.681; p < 0.001). Prolonged hospitalization occurred in 6.7% and was independently predicted by multi-space involvement (aOR: 8.381; 95% CI: 4.390–16.000; p < 0.001). Conclusions: Age, COPD, chronic alcohol addiction, and multi-space involvement independently predict systemic complications in odontogenic infections. Multi-space involvement also identifies patients at risk for prolonged hospitalization. The increasing burden of odontogenic infections highlights the need for a clinical risk score to enable early risk stratification, guide triage, and improve interdisciplinary management while reducing treatment costs.

Objectives: Mandibular condylar process fracture is the most common fracture of the mandible, with great medical relevance. Materials and Methods: In this retrospective exploratory observational study, we describe outcomes in 22 patients after unilateral or bilateral mandibular condylar process fracture. Owing to heterogeneous treatment allocation and the absence of a comparable control group, the findings are descriptive and hypothesis-generating rather than causal. In addition to collecting descriptive data from digital patient records, a survey was conducted using standardized questionnaires on the underrepresented construct of oral health-related quality of life. Results: The patient sample comprised 22 individuals between the ages of 8 and 72 years after functional orthodontic or combined surgical–functional orthodontic treatment 2.5 years after sustaining a unilateral or bilateral mandibular condylar process fracture. In this cohort, children showed more favorable observed functional results than adults. Unilateral fractures were associated with better functional outcomes than bilateral fractures. Furthermore, midline shift was more common in unilateral fractures and was associated with functional limitations such as occlusal disorders. Conclusions: Both treatment approaches were associated with favorable functional and radiographic outcomes, particularly in children and after unilateral fractures, although these findings should be interpreted as descriptive and hypothesis-generating in light of the limited sample size.