RESUMO
BACKGROUND: Accurate diagnosis of thyroid nodules is crucial for avoiding unnecessary surgeries and enabling timely treatment. Fine needle aspiration cytology (FNAC) and ultrasound are commonly employed diagnostic techniques, but their reliability is debated. This study aimed to compare the diagnostic accuracy of FNAC and ultrasounds using histopathology as the reference standard. METHODS: A retrospective review was conducted on 344 patients who underwent thyroidectomy between January 2017 and May 2022. An ultrasound and FNAC were performed before surgery, and histopathological findings were compared. Statistical analyses were conducted to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), false positive rate, false negative rate, and overall accuracy for each diagnostic method. RESULTS: Among the study population, 38.67% of thyroid tumors were malignant. Ultrasound showed a sensitivity of 68.18%, specificity of 76.55%, PPV of 64.74%, NPV of 79.20%, and overall accuracy of 73.31%. FNAC had a sensitivity of 89.31%, specificity of 48.44%, PPV of 78%, NPV of 68.89%, and accuracy of 75.89%. The correlation coefficient between ultrasound and FNAC was 0.512 (p < 0.0000001). Ultrasound correlated with histopathology with a coefficient of 0.408 (p < 0.0000001), while FNAC with histopathology had a coefficient of 0.304 (p < 0.00001). The correlation coefficient between these three diagnostic methods was 0.423 (p < 0.0001). CONCLUSION: In the diagnosis of thyroid nodules, both FNAC and ultrasound demonstrated moderate diagnostic accuracy. Ultrasound showed a higher specificity, while FNAC exhibited a higher sensitivity. Combining these techniques may improve diagnostic accuracy. Further research and the development of more reliable diagnostic methods are warranted to optimize the management of thyroid nodules and avoid unnecessary surgeries.
RESUMO
BACKGROUND: Contradictory results exist regarding influence of apico-coronal implant placement on crestal bone levels. METHODS: Complete charts of patients ≥18 years old with one or more dental implants were included. Demographic, medical, surgical, and prosthetic information was recorded. Implant bone levels were evaluated at initial placement, implant uncovery, prosthetic delivery, and 3 to 6, 7 to 11, and 12 to 18 months post-implant placement. RESULTS: Charts of 55 patients and 134 implants were included. At baseline, 19.5%, 67.3%, and 13.3% of implants were recorded as equicrestal, subcrestal, and supracrestal, respectively, on their mesial aspect, and 32.1%, 50.0%, and 17.9% on their distal aspect, respectively. At time of prosthetic delivery, mesial aspect implant position was equicrestal in 35.4%, subcrestal in 17.7%, and supracrestal in 46.9% of cases, whereas on their distal aspects, the same categorical positions were found in 28.4%, 21.1%, and 50.5% of implants. For the mesial aspect of the implant, 3- to 6-, 7- to 11-, and 12- to 18-month intervals, and for the distal aspect of the implant, 7- to 11- and 12- to 18-month intervals, along with diabetes (for both mesial and distal), were associated with a statistically more apical position of the bone compared with baseline. Although the odds ratio of a subcrestal implant position at follow-up times was statistically greater for implants located subcrestally at surgery, linear measures of differential crestal bone loss (CBL) as a function of the categorical initial placement of the implant (supracrestal, equicrestal, subcrestal) at 3- to 6-, 7- to 11-, and 12- to 18-month time points generally showed no significant differences among groups. CONCLUSION: A subcrestal position of the implant at time of surgery leads to reduced odds of having implant threads exposed; however, it is associated with similar linear CBL compared with an equicrestal or supracrestal surgical position.
