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Tobacco and alcohol consumption are the main risk factors for head and neck cancer (HNC). However, some individuals do not have a history of addiction and even so they develop the disease. This study evaluated clinicopathological and prognostic features of non-smoking and non-drinking (NSND) HNC patients. A sample of smoking and/or drinking (SD) HNC patients was used to explore the differences with NSND patients. Data were obtained from 667 patients with squamous cell carcinoma in oral cavity, oropharynx or larynx. The group of NSND individuals represented 12.6% of the HNC patients and had higher prevalence of women and elderly compared to SD group. Among NSND patients, most of them displayed tumors in oral cavity, advanced clinical staging and absence of second primary tumor. NSND HNC patients had higher tumor recurrence and increased overall and specific survival rates at 5-years follow-up. The NSND group showed higher prevalence of tumors in lips and alveolar ridge, lower rate of tumors in floor of mouth and no tumor in soft palate. NSND patients show a distinct profile from that found in SD patients. Clinicopathological features from NSND patients should be considered for HNC management.
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Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Femenino , Neoplasias de Cabeza y Cuello/epidemiología , Humanos , Neoplasias de la Boca/epidemiología , Neoplasias de la Boca/patología , Recurrencia Local de Neoplasia , Pronóstico , Factores de RiesgoRESUMEN
BACKGROUND: To describe the clinicopathologic profile of young patients with head and neck squamous cell carcinoma (HNSCC) and compare to middle-aged and elderly adults. MATERIAL AND METHODS: Patients' individual records were reviewed for clinicopathologic data. Eighty-nine patients with age 18-45 years old met the inclusion criteria of the study. Two additional groups of middle-aged (n = 89) and old (n = 89) adults were set to comparative analysis. RESULTS: Young patients represented 11.9% of all patients diagnosed with HNSCC. Women were more affected by HNSCC in the young and elder groups (p= 0.04), and young patients were more prone to be non-smokers (p= 0.01) and have lymph node metastasis at the time of diagnosis (p = 0.04). In the young group, patients diagnosed with the disease in advanced stages were more prone to have a positive familial history of cancer (p= 0.04), a positive status of alcohol consumption (p= 0.03), and to be heavy drinkers (p= 0.01). Survival was not different for the young group in comparison to the other groups. CONCLUSIONS: HNSCC in young patients had a different profile when compared to older patients, especially regarding sex and exposure to the classic risk factors for this disease. The survival of the young group is similar to the older groups and advanced clinical stage is predictor of worse survival
No disponible
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Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/epidemiología , Neoplasias de Cabeza y Cuello/epidemiología , Carcinoma de Células Escamosas/patología , Neoplasias de Cabeza y Cuello/patología , Distribución por Edad y Sexo , Estadificación de Neoplasias , Factores de Tiempo , Factores de Riesgo , Estimación de Kaplan-Meier , Estudios Retrospectivos , Brasil/epidemiologíaRESUMEN
Introduction: Head and neck tumors are in the 9º place among the most frequent cancers in the world, being the incidence of 700,000 new cases per year. To suspect and to diagnose early the cancer implies to know well the subject. The questionnaire is a good instrument for measuring knowledge. Objective: To provide an item bank, calibrated by the Item Response Theory (IRT), to evaluate the "knowledge about head and neck cancer", in any respondent, in order to benefit the studies on this construct, in the area of health education. Methods: To evaluate the "knowledge about head and neck cancer", we started with a scale already calibrated by the IRT, with 24 items for schoolchildren (n = 2,006). A further 29 items of equal difficulty were created (n = 994 schoolchildren). Then, 60 new items, of equal construct and greater difficulty (n = 883 dentistry professionals) were incorporated into this scale. Results: The analysis of 2,847 responses resulted in a bank with 113 items on head and neck cancer calibrated by IRT and arranged on a skill scale. Conclusion: From this collection of items, different questionnaires can be set up according to the skill level of the respondent. The results of the evaluations, in single or distinct moments, can be compared since the items are on the same scale of ability.
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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.
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Consumo de Bebidas Alcohólicas/epidemiología , Ansiedad/epidemiología , Maltrato a los Niños/estadística & datos numéricos , Depresión/epidemiología , Emociones , Neoplasias de Cabeza y Cuello , Carcinoma de Células Escamosas de Cabeza y Cuello , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Alcoholismo/epidemiología , Alcoholismo/psicología , Ansiedad/diagnóstico , Brasil/epidemiología , Niño , Maltrato a los Niños/psicología , Preescolar , Depresión/diagnóstico , Femenino , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/epidemiología , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/psicología , Humanos , Lactante , Recién Nacido , Acontecimientos que Cambian la Vida , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/diagnóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/epidemiología , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Carcinoma de Células Escamosas de Cabeza y Cuello/psicología , Adulto JovenRESUMEN
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.
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Ansiedad/sangre , Catecolaminas/sangre , Leucoplasia Bucal/sangre , Carcinoma de Células Escamosas de Cabeza y Cuello/sangre , Adulto , Anciano , Ansiedad/complicaciones , Ansiedad/patología , Epinefrina/sangre , Femenino , Humanos , Leucoplasia Bucal/patología , Masculino , Persona de Mediana Edad , Norepinefrina/sangre , Carcinoma de Células Escamosas de Cabeza y Cuello/complicaciones , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Sistema Nervioso Simpático/patología , Temblor/sangre , Temblor/fisiopatologíaRESUMEN
Evidence show that stress hormones can influence cancer progression, but its role in carcinogenesis is poorly understood. In this study, we used a new method based on oral carcinogenesis model in rats to test the hypothesis that physiological levels of stress hormones in the normal tissue microenvironment would have significant predictive value for chemically induced cancer occurrence. Male Wistar rats were submitted to a tongue biopsy for measuring not-stress induced levels of norepinephrine, corticosterone, adrenocorticotropic hormone (ACTH) and brain-derived neurotrophic factor (BDNF) in the tissue before carcinogenic induction. Rats were treated with the 4-nitroquinoline-1-oxide (4NQO) chemical carcinogen for twenty weeks and then euthanized for microscopic evaluation of the tongue lesions. Increased pre-carcinogen norepinephrine concentrations and reduced basal corticosterone levels in the normal tissue microenvironment were predictive for oral squamous cell carcinoma (OSCC) occurrence. Likewise, increased pre-carcinogen norepinephrine levels in the normal microenvironment were associated a lower expression of pCDKN2a-p16 in OSCCs. Post-carcinogen levels of corticosterone and BDNF in oral leukoplakia tissues (precursor lesion of OSCC) and post-carcinogen corticosterone concentrations in OSCCs were higher than basal levels in the normal mucosa. Increased norepinephrine concentrations in OSCCs were associated to a greater tumor volume and thickness. Furthermore, higher levels of norepinephrine, ACTH and BDNF in OSCCs were associated to a lesser intensity of the lymphoplasmocytic infiltrate. This study shows that pre-carcinogen stress hormones levels in the normal microenvironment may be predictive for chemically induced cancer in rats. Moreover, chemical carcinogenesis can promote stressor-like effects with hormonal changes in the tissue microenvironment, which may be associated to tumor progression.
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Hormonas/metabolismo , Neoplasias de la Lengua/metabolismo , Lengua/metabolismo , 4-Nitroquinolina-1-Óxido/farmacología , Hormona Adrenocorticotrópica , Animales , Biomarcadores de Tumor , Factor Neurotrófico Derivado del Encéfalo , Carcinogénesis/metabolismo , Carcinógenos , Microambiente Celular/fisiología , Corticosterona , Modelos Animales de Enfermedad , Masculino , Neoplasias/inducido químicamente , Neoplasias/metabolismo , Norepinefrina , Ratas , Ratas Wistar , Factores de Riesgo , Neoplasias de la Lengua/inducido químicamenteRESUMEN
OBJECTIVES: The aim of this clinical study was to evaluate the performance of restorations for non-carious cervical lesions performed with a two-step etch-and-rinse or with a two-step self-etch adhesive. MATERIALS AND METHODS: The teeth to be restored (15 patients, N = 90 restorations) were randomly assigned into 3 groups (n = 30), according to the adhesive system: group 1 (G1): Peak LC Bond; group 2 (G2): Clearfil Protect Bond; and group 3 (G3): prior selective acid etching of the enamel margins before bonding with Clearfil Protect Bond. The NCCLs were restored with Amelogen Plus composite resin. Two calibrated examiners evaluated the restorations using modified US Public Health Service criteria. The data of retention, marginal integrity, and marginal discoloration were analyzed using the Kruskal-Wallis and Wilcoxon tests. RESULTS: There were no significant differences in clinical performance among the groups for the variables: retention, marginal integrity, and marginal discoloration after 1 year and 2 years. The alpha rates after 2 years were: 93.3% for G1 and 96.7% for G2 and G3 for retention; 93.3%, 100%, and 90% for G1, G2, and G3 for marginal discoloration; 86.7%, 96.7%, and 90% for G1, G2, and G3 for marginal integrity, respectively. CONCLUSIONS: The adhesives presented similar clinical performance at the end of 2 years. Also, the prior etching with phosphoric acid did not significantly improve the clinical performance of self-etch adhesive.
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Grabado Ácido Dental/métodos , Preparación de la Cavidad Dental/métodos , Restauración Dental Permanente/métodos , Recubrimientos Dentinarios , Adulto , Resinas Compuestas/química , Recubrimiento Dental Adhesivo , Adaptación Marginal Dental , Materiales Dentales/química , Recubrimientos Dentinarios/química , Femenino , Fluoruros/química , Humanos , Curación por Luz de Adhesivos Dentales , Masculino , Ensayo de Materiales , Persona de Mediana Edad , Compuestos de Piridinio , Propiedades de Superficie , Resultado del TratamientoRESUMEN
This longitudinal study evaluated the clinical performance of 97 direct class I resin composite restorations after 3 years. The restorations were performed using 2 types of adhesive systems: (1) Adper™ Single Bond Plus (SB) (3M ESPE, 3mespe.com), which is a two-step etch-and-rinse system, and (2) Adper Scotchbond™ SE (SE) (3M ESPE), which is a two-step self-etching system. Two calibrated examiners evaluated the restorations using modified US Public Health Service criteria. The materials were applied following the manufacturer's instructions, and 15 patients received at least one of the two adhesive systems. The restorations were evaluated 7 days after placement (baseline) and again after 3 years. Statistical analysis was performed using a proportion t-test at a significance level of 5% (P < .05). At baseline, all restorations received an Alpha score for the variable marginal discoloration and marginal integrity. After 3 years, marginal discoloration received an Alpha score for 53.19% of the restorations performed with SB and 52.08% with SE. Marginal integrity was rated as Alpha for 65.96% and 68.75% of the restorations with SB and SE systems, respectively. The remaining restorations received Bravo scores for all variables. Eight restored teeth presented postoperative sensitivity at baseline (5 SB; 3 SE), but no sensitivity was found after 3 years. No secondary caries was verified. No statistically significant differences were observed between the teeth restored with the SB and SE systems for marginal discoloration (P = .7880) and marginal integrity (P = .8132) after 3 years. Direct class I resin composite restorations performed with a two-step etch-and-rinse and a two-step self-etching adhesive system demonstrated satisfactory clinical performance after 3 years.
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Cementos Dentales/uso terapéutico , Restauración Dental Permanente , Resinas Acrílicas/uso terapéutico , Adolescente , Bisfenol A Glicidil Metacrilato/uso terapéutico , Resinas Compuestas/uso terapéutico , Caries Dental/cirugía , Grabado Dental/métodos , Sensibilidad de la Dentina , Recubrimientos Dentinarios/uso terapéutico , Femenino , Humanos , Estudios Longitudinales , Masculino , Poliuretanos/uso terapéutico , Factores de Tiempo , Adulto JovenRESUMEN
PURPOSE: There are few clinical studies focusing on treatment outcomes of lip cancer. This study investigated the clinicopathologic variables of a large sample of patients with lip squamous cell carcinoma (LSCC) treated in a reference head and neck cancer center for the past 25 years and analyzed the influence of these variables on treatment outcomes. MATERIALS AND METHODS: This retrospective cohort study reviewed the clinical records of patients with LSCC. Epidemiologic data were age, gender, ethnicity, type of occupation, tobacco smoking, alcohol consumption, comorbid conditions, and family cancer history. Clinicopathologic features included the lip location of the tumor, TNM classification, clinical staging, histopathologic grade, surgical margin analysis, and treatment modality. Local recurrence, second primary tumor, and survival were the outcome variables. Statistical analysis was performed by χ(2) test, Fisher exact test, and binary logistic regression analysis. Survival analysis was assessed through the Kaplan-Meier curve. Level of statistical significance was set at a P value less than .05 for all tests. RESULTS: In total, 144 patients with LSCC were studied. There were 117 men (81.25%) and 27 women (18.75%) with a mean age of 60.21 years. One hundred thirty-four patients (93.05%) were considered of white ethnicity, and in 57 cases (39.58%), the patients reported an occupation that was related to long-term solar exposure. Most cancers had initial clinical staging of 1 or 2 (84.02%). Microscopically, lesions were predominantly well (43.05%) and moderately (40.96%) differentiated tumors. Clinical staging was related to a specific higher survival rate (P = .0049). One hundred twelve cases (77.78%) underwent surgical treatment and only 6 patients (4.80%) had local recurrence, which was directly associated with compromised surgical margins (P = .0320). CONCLUSION: A high success rate in LSCC treatment was observed in this study. Compromised surgical margin was associated with tumor recurrence and is a critical event in lip cancer treatment.
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Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Neoplasias de los Labios/patología , Neoplasias de los Labios/cirugía , Carcinoma de Células Escamosas/epidemiología , Femenino , Humanos , Neoplasias de los Labios/epidemiología , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Clasificación del Tumor , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Objetivo: O objetivo deste estudo foi avaliar o desempenho clínico de restaurações classe V realizadas por alunos de graduação e determinar os fatores que podem influenciar a retenção destas restaurações. Material e Métodos: Prontuários clínicos criados entre 2007 e 2009 foram utilizados para coletar dados sobre os pacientes e suas restaurações cervicais. Os critérios USPHS (United States Public Health Service) foram usados para realização de avaliações observacionais clínicas diretas. As análises estatísticas foram realizadas utilizando o teste exato de Fisher, teste qui-quadrado e análise de regressão logística. Resultados: Os prontuários clínicos foram analisados, dos quais 282 (21,3%) apresentaramrestaurações classe V realizadas em um total de 781 dentes. Esses pacientes foram contatados, e 67 (23,76%) compareceram a clínica para avaliação.Dos 221 (28,3%) dentes avaliados, 37 restaurações foram substituídas e 184 puderam ser analisadas. A análise de regressão logística mostrou que o índice de sangramento gengival (ISG), índice de ocorrência de cárie dentária (CPOD), e proteção pulpar influenciou a retenção das restaurações. Os testes de associação demonstrou superioridade da resina composta sobre o cimento de ionômero de vidro no que diz respeito à retenção, desgaste, e forma anatômica. Conclusão: Neste estudo, a retenção de restaurações cervicais de resina composta foi maior do que a das restaurações de cimento de ionômero de vidro quando executados por estudantes da graduação.
Objective: The aim of this study was to evaluate the clinical performance of class V restorations made by undergraduate students and determine the factors that might influence retention of restorations. Material and Methods: A survey of the clinical records created between 2007 and 2009 was used to collect data on patients with dental restorations. The USPHS (United States Public Health Service) criteria were used to perform evaluations by direct clinical observation. Statistical analyses were performed using Fishers exact test, Chi-square test, and Logistic regression analysis. Results: Clinical records were analyzed, of which 282 (21.3%) described class V restorations performed on a total of 781 teeth. These patients were contacted, and 67 (23.76%) attended the clinic for assessment. Out of the 221 (28.3%) evaluated teeth, 37 restorations were replaced and 184 were analyzed. Thelogistic regression analysis showed that gingival bleeding index (GBI), decay-missing-filled teeth (DMFT) index, and pulpal protection influenced the retention of the restorations. The association tests demonstrated superiority of the composite resin over the glass ionomer cement with regard to retention, wear, and anatomical form. Conclusion: In this study, retention of cervical composite resin restorations was higher than that of the glass ionomer cement restorations when performed by undergraduate students.
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Resinas Compuestas , Cementos de Ionómero VítreoRESUMEN
The aim of this study was to apply the Health Belief Model to explain the adherence to the recommendation not to recap needles by dentists and dental assistants of the public health system in a municipality in the State of São Paulo. A questionnaire validated and adapted for the oral health area was used, which included variables related to the frequency of recapping and health beliefs using Likert-type scales. The relationship between beliefs and adherence to the recommendation not to recap needles was obtained by regression analysis. Of all the professionals in this study (n=79), the majority (83.5%) reported recapping needles at least once in the last month. Through regression analysis, it was observed that the relationship between the beliefs described by the model and the attitude whether or not to follow the recommendation not to recap needles was explained by a lower perception of psychological barriers and a greater perception of stimuli not to recap needles. The conclusion reached is that the acceptance of recommendations to prevent working accidents with biological material was explained by some dimensions of the Health Belief Model, enabling discussion about reformulation of training offered to professionals of the public health system.
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Asistentes Dentales , Odontólogos , Adhesión a Directriz/estadística & datos numéricos , Control de Infecciones , Agujas , Enfermedades Profesionales/prevención & control , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Adulto JovenRESUMEN
The aim of this study was to applythe Health Belief Model to explain the adherence to the recommendation not to recap needles by dentists and dental assistants of the public health system in a municipality in the State of São Paulo. A questionnaire validated and adapted for the oral health area was used, which included variables related to the frequency of recapping and health beliefs using Likert-type scales. The relationship between beliefs and adherence to the recommendation not to recap needles was obtained by regression analysis. Of all the professionals in this study (n=79), the majority (83.5%) reported recapping needles at least once in the last month. Through regression analysis, it was observed that the relationship between the beliefs described by the model and the attitude whether or not to follow the recommendation not to recap needles was explained by a lower perception of psychological barriers and a greater perception of stimuli not to recap needles. The conclusion reached is that the acceptance of recommendations to prevent working accidents with biological material was explained by some dimensions of the Health Belief Model, enabling discussion about reformulation of training offered to professionals of the public health system.
Objetivou-se neste estudo aplicar o Modelo de Crenças em Saúde a fim de explicar a adesão à recomendação de não reencapar agulhas por cirurgiões-dentistas e auxiliares de saúde bucal da rede pública de um município paulista. Utilizou-se um questionário validado e adaptado para a área de saúde bucal, que contemplava variáveis relativas à frequência do reencape e crenças em saúde, por meio de escalas tipo Likert. A relação entre as crenças e a adesão à recomendação de não reencapar agulhas foi obtida por meio da análise de regressão. Da amostra de profissionais obtida por adesão ao estudo (n = 79), a maioria (83,5%) relatou ter reencapado agulhas pelo menos alguma vez no último mês. Por meio da análise de regressão, foi observado que a relação entre as crenças descritas pelo modelo e a atitude de aderir ou não à recomendação de não reencapar agulhas foi explicada por uma menor percepção de barreiras psicológicas e por uma maior percepção de estímulos para não reencapar agulhas. Conclui-se que a aceitação das recomendações para prevenir acidentes do trabalho com material biológico foi explicado por algumas dimensões do Modelo de Crenças em Saúde, possibilitando a discussão sobre a reformulação de capacitações oferecidas para profissionais do sistema público de saúde.
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Animales , Bovinos , Complejo I de Transporte de Electrón/metabolismo , Células Endoteliales/enzimología , Hiperoxia/metabolismo , Mitocondrias/enzimología , Arteria Pulmonar/citología , Arteria Pulmonar/enzimología , Ubiquinona/metabolismo , Aerobiosis/efectos de los fármacos , Benzoquinonas/farmacología , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Cromatografía Líquida de Alta Presión , Medios de Cultivo , Complejo I de Transporte de Electrón/antagonistas & inhibidores , Células Endoteliales/efectos de los fármacos , Inhibidores Enzimáticos/farmacología , Ferricianuros/farmacología , L-Lactato Deshidrogenasa/metabolismo , Mitocondrias/efectos de los fármacos , Mitocondrias/metabolismo , Oxidación-Reducción/efectos de los fármacos , Consumo de Oxígeno/efectos de los fármacos , Arteria Pulmonar/efectos de los fármacos , Espectrofotometría , Cloruro de Tolonio/farmacología , Ubiquinona/análisis , Ubiquinona/farmacologíaRESUMEN
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.
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Peróxido de Hidrógeno/administración & dosificación , Blanqueamiento de Dientes , Adolescente , Adulto , Color , Humanos , Adulto JovenRESUMEN
INTRODUCTION: Recently, case reports have shown that immature teeth diagnosed with necrotic pulp and periapical periodontitis can be repaired through a regenerative endodontic procedure. True regeneration depends on the presence of stem cells in the remaining vital tissues. The aim of this study was to evaluate the histologic condition of the pulp tissue, root apical papilla, and periapical tissues after inducing endodontic infection in immature rat teeth for different periods. METHODS: This study evaluated 18 first upper rat molars (36 roots). Periapical lesions were induced and were confirmed radiographically, and the animals were divided into 3 groups according to the days of pulp exposure for endodontic infection induction: 30, 60, and 90 days. Histologic analysis was performed in 5 different areas (ie, cervical, middle, and apical root canal thirds; the apical papilla; and the periapex surrounding the apical papilla). RESULTS: At 30 days, one third of the specimens still showed vital but intensely inflamed pulp tissue in the apical third and vital apical papilla with varying degrees of inflammation. After 60 days, the results were similar with respect to the apical pulp tissue and apical papilla. Completely necrotic pulp tissue in the space canal and vital apical papilla were observed in about 67% of the cases after 90 days. CONCLUSIONS: Vital pulp tissue was observed in the apical third until 60 days and in the vital apical papilla until 90 days of infection in a rat model.
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Cavidad Pulpar/patología , Enfermedades de la Pulpa Dental/patología , Pulpa Dental/patología , Diente Molar/patología , Tejido Periapical/patología , Ápice del Diente/patología , Animales , Exposición de la Pulpa Dental/patología , Necrosis de la Pulpa Dental/patología , Leucocitos Mononucleares/patología , Masculino , Neutrófilos/patología , Enfermedades Periapicales/patología , Pulpitis/patología , Radiografía de Mordida Lateral , Ratas , Ratas Wistar , Factores de TiempoRESUMEN
The aim of this study was to assess the color alteration and sensitivity of teeth throughout and following in-office bleaching. Twenty-two volunteers participated in this clinical trial of bleaching treatment (35% hydrogen peroxide bleaching gel and placebo) applied on maxillary incisors and canines. According to a split-mouth design, the volunteers' maxillary hemi-arches received either the bleaching or placebo agent, applied four times, at 1-week intervals. Color alteration and tooth sensitivity were assessed throughout and following bleaching. Statistical calculations were performed using gamma distribution and repeated-measures ANOVA. There was a statistically significant difference between teeth submitted to a bleaching agent and placebo (P < .001). At the end of the first, second, third, and fourth sessions, the bleached teeth presented color scores statistically lower than those observed immediately before bleaching. There was no difference in the color scale scores of the bleached teeth between bleaching sessions. The sensitivity data test showed a significant difference among treatments (P < .0001). Color alteration and dental sensitivity were altered by the bleaching agent.
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Diente Canino/efectos de los fármacos , Sensibilidad de la Dentina/etiología , Incisivo/efectos de los fármacos , Blanqueadores Dentales/uso terapéutico , Blanqueamiento de Dientes/métodos , Adolescente , Adulto , Color , Diente Canino/patología , Estudios de Seguimiento , Humanos , Peróxido de Hidrógeno/administración & dosificación , Peróxido de Hidrógeno/uso terapéutico , Incisivo/patología , Placebos , Factores de Tiempo , Blanqueadores Dentales/administración & dosificación , Adulto JovenRESUMEN
A fitoterapia é uma prática usada desde a antiguidade e, no âmbito odontológico, observa-se grande número de dentifrícios com extratos de plantas e produtos naturais incorporados em suas formulações, como Aloe vera e própolis, devido as suas propriedades anti-inflamatórias e antimicrobianas. Proposição: comparar a eficácia de um dentifrício com Aloe vera e própolis em sua formulação no controle da placa dental supragengival em relação a outro de uso difundido e sem esses componentes. Material a Métodos: foram analisados os índices de placa (IHOS índice de higiene oral simplificado) em 30 pacientes divididos em três grupos, sendo o grupo I (apenas água e escova dental para higienização bucal), o grupo II (Colgate Ação Total) e o grupo III (Forever Bright Tooth Gel) nos dias zero e após 15 dias, tendo-se submetidos os dados a análise estatística comparativa, Teste de Fiedman (p < 0,0001) e Teste de Comparação Múltipla de Dunns (p < 0,05). Resultados: encontrou-se significância quando comparados os grupos I e II (p < 0,05) e os grupos I e III (p < 0,01), sendo que não houve diferença estatisticamente significante quando comparados os grupos II e III (p > 0,05). Conclusão: não houve desvantagem do dentifrício com Aloe vera e própolis em sua formulação em relação a outro dentifrício de uso difundido no controle de placa dental supragengival e o uso de dentifrícios pela população em geral é importante para suprir deficiências nas técnicas de higiene bucal através da ação de substâncias com ação efetiva no controle da placa dental e no intuito de evitar a desmotivação dos pacientes.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Aloe , Placa Dental , Dentífricos/análisis , Salud Bucal , Periodoncia , Fitoterapia , PrópolisRESUMEN
The purpose of this study was to evaluate the correlation between the hybrid layer thickness, resin tag length and resin bond strength of a self-etching adhesive system to sound dentin tissue "in vivo". After performing restorative procedures and tooth extractions, ten specimens were sectioned in a mesiodistal direction. One dental section was used for light microscope analysis, in which both the resin tag length and hybrid layer thickness were measured, while the other section was analyzed using a microtensile test (0.5 mm/min). The fractured surface of the latter section was characterized using a stereoscopic magnifying glass (40x magnifcation). The results were subject to statistical analysis using the Pearson Correlation Test (a = 0.05). The hybrid layer thickness, resin tag length and resin bond strength mean values were 2.19 microm (0.34), 4.34 microm (0.28) and 9.73 MPa (5,55), respectively. In addition, correlation tests between the resin tag length and the resin bond strength (r=0.014) and also between the hybrid layer thickness and bond strength (r=0.43), showed no statistically significant correlation. The microtensile bond strength of Adper Prompt L Pop self-etching adhesive system does not depend on hybrid layer thickness or resin tag length.
Asunto(s)
Recubrimiento Dental Adhesivo , Cementos Dentales , Grabado Dental , Resinas Sintéticas , Resistencia a la Tracción , Humanos , Técnicas In Vitro , Ensayo de Materiales , Propiedades de SuperficieRESUMEN
Objective: The aim of this study was to evaluate the level of 6th grade of elementary schoolchildren's knowledge at an elementary school in the municipality of Araçatuba, São Paulo, Brazil, using a validated instrument for Item Response Theory. Methods: A questionnaire was developed based on a literature search of articles in computerized databases such as Pubmed, Bireme and SciELO. We selected questions that had a greater range of adjustments and by applying the Technical Focus Group, these questions were reformulated using language appropriate for the study population. Subsequently the questionnaire was subjected to application of Item Response Theory that was standardized with 19 items. For data processing for correction of the questionnaire, we used the software for analysis and EPI2000 of TRI, BILOG software. A total of 979 questionnaires were applied to adolescents aged 12-14 years who attended the 22 state schools in the city. Results: The percentage of questionnaires completed was 84.4%. All questionnaire items were discriminatory, yet most needed below average skill of knowledge to be answered correctly. Sixteen percent of correct items received over 75%. Only items 2, 3 and 15 obtained indices close to 50%. Sixteen items had hit percentage above 75%. Only items 2, 3 and 15 had percentages close to 50%. Conclusion: From the results of this study, we could conclude that the students have a good level of oral health knowledge, however further research is required to spread the use of Item Response Theory in analysis of assessment tools, especially in dentistry.
Objetivo: Avaliar o nível de conhecimento dos escolares da 6ª série do ensino fundamental do município de Araçatuba, São Paulo, por meio de um instrumento validado pela Teoria de Resposta ao Item. Métodos: Foi elaborado um questionário baseado em uma pesquisa bibliográfica de artigos em bancos de dados informatizados como Pubmed, Bireme e SciELO. Foram selecionadas as perguntas que possuíam uma maior variação de acertos e por meio da aplicação da Técnica do Grupo Focal, foram reformuladas com uma linguagem adequada à população de estudo. Posteriormente o questionário foi submetido a aplicação da Teoria de Resposta ao Item em que foi padronizado com 19 itens. Para o processamento dos dados para correção do questionário, utilizou-se o software EPI2000 e para as análises da Teoria de Resposta ao Item, o software BILOG. Foram aplicados 979 questionários em adolescentes com idade entre 12 a 14 anos que frequentavam as 22 escolas da rede estadual de ensino do município. Resultados: A porcentagem de questionários respondidos foi de 84,4%. Todos os itens do questionário foram discriminatórios, no entanto a maioria necessitava de habilidade abaixo da média do conhecimento para serem respondidos corretamente. Dezesseis itens obtiveram porcentagem de acerto acima de 75%. Somente os itens 2, 3 e 15 obtiveram índices próximos de 50%.Conclusão: Frente aos resultados deste trabalho, pôde-se concluir que os escolares possuem um bom nível de conhecimento sobre saúde bucal. No entanto, pesquisas adicionais são necessárias para disseminar o uso da Teoria de Resposta ao Item em análises de instrumentos de avaliação, especialmente na Odontologia.
Asunto(s)
Adolescente , Adolescente , Conocimiento , Salud Bucal , Salud PúblicaRESUMEN
OBJECTIVES: Dysregulation of the hypothalamus-pituitary-adrenal axis has been observed in patients with cancer. This cross-sectional study investigated whether patients with oral and oropharyngeal squamous cell carcinoma (SCC) show changes in cortisol levels in saliva and plasma compared with three control groups, and evaluated its correlation with clinicopathological data. METHODS: Salivary and plasma cortisol levels of 34 patients with oral SCC were compared with hormonal levels of 17 oropharyngeal SCC patients, 17 oral leukoplakia patients, 27 smokers and/or drinkers and 25 healthy volunteers. Multivariate analysis was used to evaluate the impact of clinical variables on the cortisol levels. RESULTS: The plasma (p<0.05) and salivary (p<0.01) cortisol levels were significantly higher in patients with oral SCC compared with all groups. Patients with oropharyngeal SCC had higher levels of salivary cortisol compared with smokers and/or drinkers (p<0.05) and patients with leukoplakia (p<0.01). Patients with advanced-stage oral SCC showed significantly higher levels of cortisol than those in an initial clinical stage. Men with oral SCC had higher salivary cortisol levels than women (p<0.05). Age, smoking, alcohol consumption, presence of teeth and awareness of cancer diagnosis had no significant effect on cortisol levels. CONCLUSIONS: These results indicate a dysregulation of cortisol secretion in patients with oral cancer and suggest that this hormone can be a biomarker associated with the disease's clinical status.