Childhood trauma is predictive for clinical staging, alcohol consumption, and emotional symptoms in patients with head and neck cancer.

BACKGROUND: Traumatic events in childhood have been associated with the occurrence of anxiety and depression in adulthood. This relation has been investigated in patients with breast cancer; however, it has been little explored in patients with other types of cancer. The objective of this study was to evaluate the occurrence of childhood trauma in patients with head and neck cancer and its association with clinicopathological variables and anxiety and depression levels. METHODS: The study included 110 patients with head and neck squamous cell carcinoma (HNSCC) before they started cancer treatment. Clinicopathological and biobehavioral data were collected from patients' medical records. Anxiety and depression levels were assessed with the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. The Childhood Trauma Questionnaire was used to evaluate the occurrence of traumatic events in childhood. RESULTS: One hundred five patients (95.5%) experienced at least 1 type of childhood trauma. Emotional neglect was the most reported childhood trauma (43.8%), and multiple regression revealed that it was an independent variable for advanced clinical staging (ß = 2.15, P = .048) and higher alcohol consumption (ß = 2.32, P = .031). Patients with HNSCC who experienced more traumatic events in childhood had an almost 12 times greater chance of increased depression levels during the pretreatment period (ß = 11.89; P = .0002). The occurrence of physical child neglect was a predictive factor for increased anxiety levels (ß = 4.17, P = 0.029). CONCLUSIONS: Traumatic events in childhood are predictive for advanced clinical staging, alcohol consumption, and emotional symptoms in patients with HNSCC, and they should be considered in clinical and psychological intervention strategies during cancer treatment. Cancer 2018;000:000-000. © 2018 American Cancer Society.

In vitro-evaluation of secondary caries formation around restoration.

The objective of this in vitro study was to evaluate demineralization around restorations. Class V preparations were made on the buccal and lingual surfaces of each tooth. TPH (Group 1), Fuji II LC (Group 2), Tetric (Group 3), Dyract (Group 4), GS 80 (Group 5) and Chelon Fil (Group 6) were randomly placed in equal numbers of teeth. The teeth were submitted to a pH-cycling model associated with a thermocycling model. Sections were made and the specimens were examined for the presence of demineralization under polarized light microscopy. Demineralization was significantly reduced with Chelon Fil (Group 6). Furthermore, a similar inhibitory effect on the development of demineralization was observed in Groups 2, 4 and 5.

Circulating catecholamines are associated with biobehavioral factors and anxiety symptoms in head and neck cancer patients.

Studies have shown that stress-related catecholamines may affect cancer progression. However, little is known about catecholamine secretion profiles in head and neck cancer patients. The present study investigated plasma norepinephrine and epinephrine levels in head and neck squamous cell carcinoma (HNSCC) patients and patients with oral leukoplakia, as well as their association with clinicopathological and biobehavioral variables and anxiety symptoms. A total of 93 patients with HNSCC and 32 patients with oral leukoplakia were included. Plasma norepinephrine and epinephrine levels were measured by high performance liquid chromatography with electrochemical detection (HPLC-ED), and psychological anxiety levels were measured by the Beck Anxiety Inventory (BAI). Plasma norepinephrine and epinephrine concentrations were significantly higher in patients with oral and oropharyngeal squamous cell carcinoma (SCC) compared to non-cancer patients. Oral SCC patients displayed plasma norepinephrine levels about six times higher than oropharyngeal SCC patients, and nine times higher than oral leukoplakia patients (p < .001). Plasma epinephrine levels in oral SCC patients were higher compared to the oropharyngeal SCC (p = .0097) and leukoplakia (p < .0001) patients. Oropharyngeal SCC patients had higher plasma norepinephrine (p = .0382) and epinephrine levels (p = .045) than patients with oral leukoplakia. Multiple regression analyses showed that a history of high alcohol consumption was predictive for reduced plasma norepinephrine levels in the oral SCC group (p < .001). Anxiety symptom of "hand tremor" measured by the BAI was an independent predictor for higher plasma norepinephrine levels in HNSCC patients (ß = 157.5, p = .0377), while the "heart pounding/racing" symptom was independently associated with higher plasma epinephrine levels in the oropharyngeal SCC group (ß = 15.8, p = .0441). In oral leukoplakia patients, sleep deprivation and worse sleep quality were independent predictors for higher plasma norepinephrine levels, while severe tobacco consumption and higher anxiety levels were factors for higher plasma epinephrine levels. These findings suggest that head and neck cancer patients display sympathetic nervous system hyperactivity, and that changes in circulating catecholamines may be associated with alcohol consumption, as well as withdrawal-related anxiety symptoms.

Dental bleaching with a 10% hydrogen peroxide product: a six-month clinical observation.

CONTEXT: The possibility of bleaching vital teeth with peroxide-based products considerably revolutionized esthetic dentistry. AIM: The aim of this clinical study was to evaluate tooth color change and dental sensitivity after exposure to preloaded film containing a 10% hydrogen peroxide whitening system (Opalescence Trθswhite Supreme). MATERIALS AND METHODS: A total of 13 volunteers, aged 18 to 25 years, participated in this study. The patients used the whitening system once a day for 60 minutes during the 8-day study. For maxillary incisors and canines, the color change was visually evaluated with the Vita color scale before, immediately, and six months after the treatment. Tooth sensitivity was evaluated during the daily gel applications. All whitening applications were done in office and under the supervision of a dental professional. STATISTICAL ANALYSIS USED: The results were analyzed using the Friedman Test (nonparametric repeated measures ANOVA) at a level of 5%, and Dunn's Multiple Comparison Test at the level of 5%. RESULTS: It was verified that the original mean color values observed at the baseline analysis differed significantly from those observed immediately after bleaching, as well as from those seen in the analysis at six months ( P = 0.001). There was no significant difference between the mean color values observed in the immediate time and in the analysis at six months ( P = 0.474). No tooth sensitivity was observed in any patients. CONCLUSION: It was concluded that the bleaching technique using the 10% hydrogen peroxide system was effective in a short period of time without tooth sensitivity during applications.