Anatomical characteristics of maxillary sinus antroliths and their influence on sinus membrane thickness: a retrospective cone beam computed tomography analysis.

The purpose of this study was to assess the anatomy of antroliths and its influence on the thickness of the maxillary sinus membrane. Cone beam computed tomography (CBCT) was performed on 239 patients (478 sinuses). The prevalence of antroliths per sinus was 8.4%. Regarding their distribution, antroliths were predominantly unilateral (82.5%), single (67.5%), and in a dentate area (60.0%). The antroliths were mainly located in the molar region (95.0%) and in the sinus floor (77.5%). The measured dimensions of the antroliths were as follows: length 5.6±4.4mm, width 4.1±2.9mm, height 3.5±2.1mm. The relationships between the antroliths and the sinus membrane (type 1, 34.1%; type 2, 52.3%; type 3, 13.6%) indicated that sinus membranes tended to encircle antroliths, which resulted in a gradual increase in membrane thickness. The sinus membrane was found to be significantly thicker in the presence of antrolith(s) (P<0.001). Antroliths which are sufficiently large or are located adjacent to the sinus floor or lateral wall increase the risk of sinus membrane perforation during sinus augmentation procedures. Therefore, a thorough CBCT evaluation is needed to minimize the risk of complications prior to sinus augmentation procedures.

Association between Anxiety and Pain in Dental Treatment: A Systematic Review and Meta-analysis.

Accumulating evidence has revealed that dental anxiety (DA), as a dispositional factor toward the dental situation, is associated with the state anxiety (SA) and pain related to dental procedures. However, conclusions from individual studies may be limited by the treatment procedures that patients received, the tools used to assess DA, or the treatment stages when anxiety or pain was assessed. It is unclear whether DA, at the study level, accounts for the variance in pretreatment SA. The impact of DA and SA on pain at different treatment stages has not been systematically investigated. To address these questions, we present novel meta-analytical evidence from 35 articles (encompassing 47 clinical groups) that investigated DA in a clinical group. Subgroup analyses revealed that the studies of surgical and nonsurgical procedures did not significantly differ in either DA or pretreatment SA. Furthermore, metaregressions revealed DA as a significant predictor that explained the variance in SA assessed before and during treatment but not after treatment. The findings suggest that patient DA has a significant impact on patient SA. Metaregressions revealed DA as a significant predictor that explained the variance in expected pain, pain during treatment and posttreatment pain. In contrast, pretreatment SA was a significant predictor that explained the variance in expected pain. The findings reveal that DA has a consistent impact on pain through the entire period of dental treatment. Altogether, the findings highlight the role of DA as an overall indicator for anxiety and pain, across different types of dental procedures or treatment stages. We conclude that anxiety should be assessed as a critical step not only in anxiety management for high-DA patients, but also in pain control for all dental patients.

The prevalence of bronchiectasis in patients with Marfan syndrome.

An association has been suggested between Marfan syndrome (MFS) and the nodular bronchiectatic form of lung disease caused by non-tuberculous mycobacteria (NTM). We evaluated the prevalence of bronchiectasis in 79 adult patients with MFS using computed tomography (CT) imaging. Airway dilation indicative of bronchiectasis (22/79, 28%) and bronchioloectasis (10/79, 13%) were relatively common, although the extent of dilation was not severe and was frequently confined to a single lobe. However, bronchiolitis was evident in only three patients (4%), and no patient was diagnosed with NTM lung disease.

[Solitary pulmonary nodules: detection, characterization, and guidance for further diagnostic workup and treatment]. / Nódulos pulmonares solitarios: detección, caracterización y guías para su diagnóstico y tratamiento*

OBJECTIVE: The purpose of our study is to improve radiologists' understanding of the clinical issues involved in making a diagnosis and to guide further diagnostic workup and treatment of solitary pulmonary nodules (SPNs). CONCLUSION: Information on the morphologic and hemodynamic characteristics ofSPNs provided by dynamic helical CT, with high specificity and reasonably high accuracy, can be used for initial assessment. PET/CT is more sensitive at detecting malignancy than dynamic helical CT, and all malignant nodules may be potentially diagnosed as malignant by both techniques. Therefore, PET/CT may be selectively performed to characterize SPNs that show in-determinate results at dynamic helical CT.

Pulmonary cavitary mass containing a mural nodule: differential diagnosis between intracavitary aspergilloma and cavitating lung cancer on contrast-enhanced computed tomography.

AIM: The objective of this study was to identify whether there were any significant differences in the computed tomography (CT) findings of an intracavitary aspergilloma and a cavitating lung cancer containing a mural nodule. MATERIALS AND METHODS: The CT and histopathological findings of 12 patients (male:female ratio 3:9; aged 51-76 years) with cavitating lung cancer containing a mural nodule and 26 patients (male:female ratio 14:12; aged 29-72 years) with intracavitary aspergilloma were retrospectively reviewed. RESULTS: The mural nodules within cavitating lung cancer were more enhanced (p<0.001) and showed a nondependent location more frequently (p=0.012) than those of intracavitary aspergillomas. The cavitary walls were thicker in cavitating lung cancer (mean 5.8mm thick) than those in intracavitary aspergillomas (mean 2.6mm thick; p=0.035). Adjacent bronchiectasis and volume decrease of the involved lobe were observed more frequently in intracavitary aspergillomas than in cavitating lung cancers (p<0.001 and p=0.008, respectively). CONCLUSION: Whether a mural nodule within a cavitary lesion is contrast-enhanced or not is one of the most important features in making a differential diagnosis between an intracavitary aspergilloma and a cavitating lung cancer. Assessment of dependent location of a mural nodule within the cavity and wall thickness of the cavity itself can also be helpful for differentiation.