Outcomes of total joint alloplastic reconstruction in TMJ ankylosis.

OBJECTIVE: The purpose of this study was to evaluate subjective and objective outcomes in patients with temporomandibular joint (TMJ) ankylosis treated with TMJ alloplastic reconstruction (TMJR). STUDY DESIGN: All patients diagnosed with TMJ ankylosis that underwent TMJR at our institution between 2010 and 2019 were retrospectively reviewed. Patients were divided into 2 cohorts: bony and fibrous ankylosis. Subjective variables assessed were facial pain and headaches, TMJ pain, jaw function, diet, and disability. Objective variables assessed were maximum interincisal opening and lateral excursions. The Mann-Whitney test was employed to analyze subjective variables and an unpaired t-test was used to analyze the objective variables. P < .05 was considered statistically significant. RESULTS: Twenty-eight patients met the inclusion criteria (21 female, 7 male). The mean age at the time of surgery was 42 years, and the mean number of prior TMJ surgeries was 3. A total of 52 TMJRs were performed in the 28 patients, and the mean follow-up time was 46 months. All subjective variables were significantly improved, and the mean maximum interincisal opening increased from 16.9 mm to 37.25 mm. CONCLUSIONS: The results of the study demonstrate that TMJR is an effective and reliable method for the management of both fibrous and bony TMJ ankylosis.

Alloplastic Temporomandibular Joint Reconstruction for Patients With Juvenile Idiopathic Arthritis.

PURPOSE: The purpose of this study was to assess the efficacy of alloplastic temporomandibular joint (TMJ) total joint replacement (TJR) in patients with juvenile idiopathic arthritis (JIA). MATERIALS AND METHODS: All patients with a formal diagnosis of JIA requiring a TMJ patient-specific TJR between 2010 and 2018 at The University of Texas-Health at San Antonio were retrospectively analyzed. To be included, patients must have had a formal diagnosis of JIA, complete records, and TMJ reconstruction with the TMJ Concepts patient-specific total joint prosthesis (TMJ Concepts, Ventura, CA). Clinical data acquisition was required at a minimum of 12 months after surgery (longest follow-up [LFU]). Subjective and objective analyses were performed using a 10-point visual analog scale at the preoperative and LFU time points. Surgical data at the perioperative and LFU time points were recorded for comparison. RESULTS: Twenty patients with JIA met the inclusion criteria. The mean visual analog scale measurements for facial pain, TMJ pain, jaw function, diet, and disability were all significantly reduced at LFU. The maximal interincisal opening with pain was increased from 33.5 mm preoperatively to 44 mm at LFU, and the mean maximal interincisal opening without pain was increased from 31.1 mm preoperatively to 43 mm at LFU. None of the patients had complications from their TMJ TJR. CONCLUSIONS: Alloplastic TMJ reconstruction is a safe and efficacious treatment option for the surgical management of end-stage TMJ disease in JIA patients.

Barriers to Full Text Journal Publication of Abstracts Presented at Annual AAOMS Meetings.

PURPOSE: The purpose of the present study was to identify the perceived barriers to full-text journal publication (JP) from abstracts presented at the 2010-2013 American Association of Oral and Maxillofacial Surgeons (AAOMS) meetings. METHODS AND MATERIALS: In the present cross-sectional study, all unpublished AAOMS abstracts (n = 473) from the temporal period were procured using a database from a previous publication. An online questionnaire was then distributed to the primary or secondary author for whom an e-mail address was available through the AAOMS Member Directory (n = 260) to assess 1) the current publication status of the abstract; and 2) the perceived barriers to JP. The responses were summarized with descriptive statistics. RESULTS: Of the 260 authors surveyed, 51 responded, for a response rate of 19.6%. At the time of the survey, 66.7% of the authors stated that submission for JP had not been pursued, and 15.7% stated that the abstract had achieved JP. However, no citations were provided. Overall, a low perceived priority (52.9%), insufficient time (50%), methodologic limitations (23.5%), and inadequate institutional support (17.6%) were the 4 primary reasons cited by the authors for the failure to pursue or achieve JP. CONCLUSIONS: JP of abstracts presented at the annual AAOMS meeting is very low, with many barriers to JP of presented abstracts.

Factors Associated With the Journal Publication of Oral Abstracts From the American College of Foot and Ankle Surgeons: 2010 to 2014.

The oral abstract publication incidence (76.9%) of the American College of Foot and Ankle Surgeons (ACFAS) is currently the highest reported for any national foot and ankle society conference to date. However, factors associated with the conversion of an abstract to a journal publication (JP) remain undetermined. The purpose of the present study was to identify the factors associated with the JP and time to publication for oral abstracts from the ACFAS conference from 2010 to 2014. Databases containing information on the abstracts were procured, and predictor variables were categorized as abstract or author specific. Bivariate analysis was conducted using the Mann-Whitney U test, Fisher's exact test, chi-square test of independence, or Spearman's rank correlation. Multivariable logistic regression and generalized linear regression models were utilized to analyze predictor variables. Oral abstracts by authors without a formal research degree were >12 times (95% confidence interval 2.25 to 71.67) more likely to achieve JP compared to abstracts by authors with a research degree. The author-specific variable was the only significant predictor of future JP (p = .002); however, trends with respect to other variables (funding, prior publications, and ACFAS regional division) were also identified. Abstracts originating from academic institutions (p = .042) and those involving fewer centers (p = .03) were associated with a significantly shorter time to publication. Although the present study broadens our understanding on the publication incidence and time to publication for oral abstracts from the ACFAS from 2010 to 2014, it remains unclear why almost a quarter of the abstracts accepted ultimately failed to achieve JP. Identifying the publication barriers of those abstracts remains a necessary first step in helping to form recommendations aimed at improving the future publication incidence for oral abstracts presented at the ACFAS conference.

A Formal Work Hour Analysis of the Resident Foot and Ankle Surgeon.

As new documentation requirements by governments and third-party payees increasingly occupy physicians' time, duty hour restrictions have continued to restrict the work hours of residents, leaving programs tasked to produce proficient foot and ankle surgeons (FASs) in less time. The purpose of the present study was to quantify the workday of resident FASs at our institution to identify areas suited for revision to improve efficiency and training. A resident from each postgraduate year (PGY) was recruited and consented for minute-to-minute observation by 4 independent observers over 5 consecutive workdays. The time recorded was placed into a predefined work model consisting of 9 categories (education, research, operating room, patient care, documentation/administration, communications, transit, basic needs, and standby) within 1 of 3 value groups (positive, neutral, or negative). A fifth independent observer reviewed and recorded all collected data. Over 5 consecutive days, ancillary staff frequently disrupted the PGY-1 resident's workflow. The interruptions fragmented the resident's thoughts, increased inefficiency, and resulted in the largest proportion of the resident's time (16.7%) being occupied by documentation/administration duties. For the PGY-2 and PGY-3 residents, unexpected trends in standby were identified during the preoperative period. Secondary analysis revealed that during unexpected preoperative delays, resident efficiency was poor. To maximize efficiency and improve training, residents must increase their awareness of self-inefficiency while minimizing unnecessary interruptions and the time occupied by duties of lesser value. It is our hope that the present study will aid other institutions in facilitating similar improvements to the education and training of our fellow resident FASs.

Publication Incidence of Abstracts Presented at the American Association of Oral and Maxillofacial Surgeons Meeting: 2010 to 2014.

PURPOSE: The quality of national society conferences is often indirectly assessed by the full-text publication rate of the abstracts presented. The purpose of this study was to assess the full-text journal publication rate of abstracts presented at the American Association of Oral and Maxillofacial Surgeons conferences from 2010 to 2014 and determine the publication plateau best suited for the analysis. MATERIALS AND METHODS: In this retrospective cohort study, all presented abstracts from 2010 to 2014 were compiled using the published educational summaries and outlines from the Journal of Oral and Maxillofacial Surgery website. PubMed and Google Scholar searches were conducted to identify full-text journal publications. The predictor was abstract type (oral vs poster), and the outcome variable was time to publication. Descriptive, bivariate, and regression analyses were calculated; P < .05 was considered significant. RESULTS: A total of 1,053 abstracts were presented at the conferences. The full-text journal publication frequency was 34.6% (119 of 344) for oral abstracts and 26.2% (187 of 709) for posters. The incidence 24 months after presentation was 74% and 81%, respectively. A comparison of the proportions of published abstracts showed significantly higher conversion for oral presentations. The median time to publication was 12.5 months (mean, 15.7 months; range, 0 to 52 months) and 12 months (mean, 14 months; range, 0 to 53.5 months) for oral and poster abstracts, respectively. A Kaplan-Meier analysis showed no significant difference in time to publication between the presentation types (hazard ratio, 1.2; 95% confidence interval, 0.9 to 1.5; P = .14). Within 2 years of the respective conference, only 78.4% of published abstracts (240 of 306) successfully navigated the peer-review process compared with 93.1% (285 of 306) within 3 years of the conference. CONCLUSIONS: The publication incidence of abstracts presented was higher for oral presentations; however, posters had a shorter time to publication. Of those published, a large proportion were published between 2 and 3 years after presentation, suggesting that a minimum 3-year publication plateau should be used for future analyses.