Research Spotlight

Adams, J., Mauldin, T., Yates, K., Zumwalt, C., Ashe, T., Cervantes, D. and Tao, M.H. (2022). “Factors related to the accurate application of NHSN surveillance definitions for CAUTI and CLABSI in Texas hospitals: A cross-sectional survey.” Am J Infect Control 50(1): 111-113.

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Previous studies indicate variability in the accurate application of National Healthcare Safety Network surveillance criteria with limited data on possible contributing factors. In this cross-sectional, convenience sampled web-based survey sent to members of Texas infection prevention and control organizations, training, experience, and time spent on surveillance was collected and assessed including 2 case studies. Our results indicate correct identification of catheter-associated urinary tract infection (CAUTI) and central line-associated bloodstream infection (CLABSI) criteria may be associated with 2019 National Healthcare Safety Network training (CAUTI: aOR = 0.17, 95% CI: 0.04, 0.80; CLABSI: aOR = 0.45, 95% CI: 0.045, 4.56) and increased years of infection prevention experience (CAUTI: aOR = 1.35, 95% CI: 0.42, 4.33; CLABSI: aOR = 1.23, 95% CI: 0.24, 6.38). Routinely performing more hours of surveillance may increase accuracy of CLABSI identification, but not CAUTI.

Beyabanaki, E., Eftekhar Ashtiani, R., Feyzi, M. and Zandinejad, A. (2021). “Evaluation of Microshear Bond Strength of Four Different CAD-CAM Polymer-Infiltrated Ceramic Materials after Thermocycling.” J Prosthodont.

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PURPOSE: To evaluate the bond strength of three monolithic hybrid ceramics/resin nanoceramics and a zirconia-reinforced lithium silicate to resin cement after thermocycling. MATERIALS AND METHODS: Using four materials, including Vita Enamic (VITA Zahnfabrik), Lava Ultimate (3M ESPE), Crystal Ultra (Digital Dental), and Vita Suprinity (VITA Zahnfabrik), 64 specimens were prepared with dimensions of 4 mm × 3 mm × 1.5 mm. Vita Suprinity samples were sintered at 840°C for 8 min. After polishing and cleaning all the samples in each group (n = 16), they were subjected to their recommended surface treatment: 10% hydrofluoric acid for Vita Enamic (60s) and Vita Suprinity (20s); air abrasion of Lava Ultimate and Crystal Ultra with 50 u Al(2) O(3) particles. Then, tygon tubes were filled with dual cure resin cement (Panavia F2.0), cured and then subjected to thermal cycling (2000 cycles; 5-55°C). The microshear bond strength was measured using microtensile testing machine. The data were analyzed using Welch and Games-Howell tests (α = 0.05). The mode of failure was also evaluated using a stereomicroscope. RESULTS: The highest and the lowest mean microshear bond strength belonged to the Crystal Ultra (7.71 ± 1.54 MPa) and Vita Suprinity (4.73 ± 1.87 MPa) groups, respectively. The differences between groups were significant and Crystal Ultra had higher bond strength in comparison to all three materials (p < 0.05). CONCLUSION: Hybrid ceramics showed higher bond strength to resin cements in comparison to resin nanoceramics and zirconia-reinforced lithium silicate materials.

Labrador, A.J.P., Marin, N.R.G., Valdez, L.H.M., Sanchez, K.B.T., Zabarburu, W., Ibazetta, K.A.R., Garcia, A.E.R., Cabezas, D.M., Romero, L., Conte, A.M. and Wright, J.M. (2021). “Metastasis to the oral and maxillofacial region. A systematic review.” J Stomatol Oral Maxillofac Surg Dec 20;S2468-7855(21)00276-7. [Epub ahead of print].

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OBJECTIVE: Metastasis to oral and maxillofacial region (MOMFR) is an unusual finding; representing between 1 and 1.5% of all malignancies in the maxillofacial region. A systematic review is presented to determine trends in presentation, diagnostic features, and patient outcome. METHODS: Searches of databases were carried out for papers reporting MOMFR. The variables were demographics, patient symptoms, tumor location, tumor size, histopathology, origin of the tumor, immunohistochemical studies, follow-up and survival. RESULTS: 696 cases were identified; 391 males, and 305 females. The most common race was white. The most common primary tumor for females was from breast 31.1% (n = 95), for males from lung 20.5% (n = 143). The most common location was the mandible 44.9% (n = 313), followed by gingival soft tissue 16.8% (n = 117). A frequent clinical symptom was pain with 17.5% (n = 122). The most common clinical presentation was a mass or tumor 37.4% (n = 260). The mean age was 58.8 years. The average time before diagnosis was 10.3 months, the mean follow-up after diagnosis was 13.1 months, and the average survival was 9.8 months. CONCLUSION: MOMFR shows a strong predilection for the posterior mandible, with a mass or tumor being the most common clinical presentation. They are frequently painful, and demonstrate a poor prognosis.

Pinto, L.P., Wolford, L.M., Franco, J. and Bezerra, T.P. (2022). “Mini-Anchors to Surgically Treat the Chronic Mandibular Dislocation.” J Oral Maxillofac Surg 80(1): 47-54.

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PURPOSE: Evaluate the feasibility of using mini-anchors for the treatment of chronic mandibular dislocation and to identify the variables that affect the success of this approach. PATIENTS AND METHODS: A retrospective cohort study evaluated 9 patients with bilateral recurrent dislocation of the mandible (18 operated joints), treated by a mandibular translation control system using the mini-anchor technique. Data was collected using a Visual Analog Scale (VAS) for subjective parameters and measurements for objective parameters prior to surgery (T1) and at the longest available follow-up (T2) with a minimum of a 12 months interval. Patients subjectively rated their facial pain/headache, jaw function, disability, temporomandibular joint (TMJ) pain and diet. Objective functional changes were determined by measuring the interincisal opening and lateral excursions at T1 and T2. RESULTS: Significant subjective improvements in pain and dysfunction (89 to 94%) were observed (P < .01) from T1 to T2 in all parameters. The comfortable and guarded interincisal opening without mandibular dislocation increased by 41%, the maximum interincisal opening reduced 12 mm, and lateral excursions improved by 43%. CONCLUSIONS: Patients with recurrent mandibular dislocations with or without disc dislocation can be treated effectively by the mini-anchor translation control system.

Wolford, L.M. and Kesterke, M.J. (2022). “Does Combined Temporomandibular Joint Reconstruction With Patient-Fitted Total Joint Prosthesis and Orthognathic Surgery Provide Stable Skeletal and Occlusal Outcomes in Juvenile Idiopathic Arthritis Patients?” J Oral Maxillofac Surg 80(1): 138-150.

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PURPOSE: To determine skeletal and occlusal surgical changes and long-term stability outcomes for patients diagnosed with juvenile idiopathic arthritis (JIA) after TMJ reconstruction with TMJ Concepts patient-fitted total joint prostheses (TJP) and concomitant maxillary orthognathic surgery. MATERIAL/METHODS: A retrospective cohort study was conducted of all patients diagnosed with JIA, receiving TJP, and concomitant maxillary orthognathic surgery between 1991 and 2019, at Baylor University Medical Center treated by 1 surgeon. Patient evaluations presurgery (T1), immediate postsurgery (T2), and at longest follow-up (LFU) (T3) were analyzed using 20 cephalometric landmarks to compute 29 linear and angular measurements to determine surgical changes, long-term skeletal and occlusal stability, as well as oropharyngeal airway changes. Comparative data were tested for significance (α = 0.05) using paired and unpaired t tests. RESULTS: Forty-two patients met the JIA inclusion criteria, with a median age of 17.5 years and median postsurgical follow-up of 26 months. There were significant surgical changes (T1-T2) (P ≤ .05) for all parameters associated with mandibular linear and angular surgical changes, except for the horizontal position of posterior nasal spine and the vertical/horizontal position of gonion, indicating highly stable surgical outcomes. There were significant improvements in the oropharyngeal airway dimensions. CONCLUSIONS: This study suggests that TMJ Concepts patient-fitted TJP for TMJ reconstruction in conjunction with maxillary orthognathic surgery for counterclockwise rotation of the maxillo-mandibular complex for the JIA patients provides long-term skeletal and occlusal stability as well as dimensional improvement in the oropharyngeal airway.