Endocrine Disorders Short Essays

Endocrine Disorders Important Notes

1. Addison’s disease

  • Occurs due to insufficiency of adrenal cortex hormone
  • Manifested as pale brown to deep chocolate pigmentation of oral mucosa spreading to the buccal mucosa, gingiva, tongue, and lips
  • Bronzing of skin
  • Hypotension
  • GIT disturbances occur
  • Other features include lethargy, fatigue, muscular weakness, severe anaemia
  • Biopsy shows acanthosis with silver-positive granules in the cells of stratum germinativum

2. Gigantism and acromegaly

  • Occurs due excessive secretion of growth hormone
  • There is an increase in the number of granules in the acidophilic cells
  • If the increase in granules occurs before the closure of the epiphysis of long bones, gigantism results
  • If the increase occurs after epiphyseal closure acromegaly develops
  • Gigantism occurs in children and acromegaly occurs in adults
  • Acromegaly
    • Lips become thick
    • The tongue becomes enlarged and shows indentations on side
    • Mandible becomes large and macrognathic
    • Mandibular teeth are buccally tipped

3. Hypophosphatemia

  • Occurs due to deficiency of alkaline phosphatase enzyme in serum
  • Oral manifestations are
    • Formation of globular, hypocalcified dentin in region of pulp horns
    • Pulp horns are elongated
    • Abnormal cementum
    • Lamina dura is absent

Endocrine Disorders Short Essays

Question 1. Precautions to be taken during dental treatment of cardiac patients
(or)
Dental considerations for Ischaemic Patients.

Answer:

Dental considerations for Ischaemic Patients

  • Ischaemic heart diseases patients should be taken up for early appointments in the morning and not made to wait
  • Patient with known diseases should be asked to carry their rescue medication
  • In patients with moderate to severe angina, prophylactic nitroglycerine may be used 5 minutes before starting dental procedure
  • If patient gets an acute episode of angina during dental procedure
    • Stop the dental procedure for a few minutes
    • Administer tab nitroglycerine 0.5 mg sublingually
    • Monitor pulse and BP
    • If pain is not relieved in 8-10 minutes, nitroglycerine dose may be repeated

Question 2. Hyperparathyroidism/Brown’s tumor.

Answer:

Hyperparathyroidism

  • It is an endocrine disorder occurring due to an excess of circulating parathyroid hormone

Brown’s Tumor Types:

  1. Primary Hyperparathyroidism: Occurring due to tumor of glands
  2. Secondary Hyperparathyroidism: Occurs to response to hypocalcemia
  3. Tertiary Hyperparathyroidism: Occurs after long-standing secondary hyperparathyroidism

Brown’s Tumor  Clinical Features:

  • Age and Sex – Common in middle-aged women

Brown’s Tumor  Classic Triad:

  • Kidney stones
  • Bone resorption
  • Duodenal ulcers

Brown’s Tumor  Renal Symptoms:

  • Renal calculi
  • Hematuria
  • Back pain

Read And Learn More: Oral Medicine Question and Answers

  • Psychological symptoms – Emotionally unstable
  • GIT symptoms – Anorexia, nausea, vomiting

Skeletal:

  • Bone pain
  • Pathologic fractures
  • Bone deformities
  • Hypercalcemia

Generalized Symptoms:

  • Muscle weakness
  • Fatigue
  • Weight loss
  • Insomnia
  • Headache
  • Polydipsia and polyuria

Oral Manifestations:

  • Brown tumor – Intraoral/Extraoral swelling appears

Brown’s Tumor  Teeth:

  • Gradual loosening
  • Drifting and loss of teeth
  • Malocclusion

Brown’s Tumor  Radiographic Features:

  • Radiodensity-Radiolucentlesion
  • There may be the normal, granular, or ground-glass appearance
  • Moth-eaten appearance with varying density
  • Osteitis fibrosa generalisata – Localised bone destruction
  • Brown tumor – represents ill-defined radiolucency
  • Thinning of cortical tables
  • Pepper pot skull
  • Demineralization of the inferior border of the mandibular canal
  • Thinning of outlines of the maxillary sinus
  • Loss of lamina dura

 Brown’s Tumor Management:

  • Surgical – Hyperplastic tissue is removed
  • Vitamin D – Oral administration of vitamin D
  • Parathyroidectomy
  • Restriction of dietary phosphate, phosphate binding agent, and aluminum salts

Question 3. Oral manifestations of diabetes mellitus.
(Or)
Diabetes Oral manifestations and dental management.

Answer:

Periodontium:

  • Alters response of the periodontal lesion to local irritants
  • Retards healing of tissues
  • GCF contains more glucose
  • Periodontal abscess formation
  • Tooth mobility
  • Severe and rapid bone resorption

Diabetes Oral manifestations Tongue:

  • Altered taste sensation
  • Median rhomboid glossitis
  • Impaired local immune response
  • Decreased Langerhans cell

Oral Candidiasis:

  • Alveolar bone
  • Localized osteitis

Diabetes Oral manifestations Mouth:

  • Burning mouth sensation
  • Dysgeusia
  • Dysesthesia
  • Xerostomia
  • Increased caries activity

  Diabetic Sialadenosis:

  • Nerve: Diabetes neuropathy involving the trigeminal nerve
  • Angular cheilosis
  • Oral lichen planus

Dental Management:

  • Acute musculoskeletal pain, painful dental lesions
    • Patients with diabetes need to maintain very good oral hygiene as they are prone for odontogenic, periodontal, and other infections
    • In well-controlled diabetics, dental procedures generally do not require any special precautions
    • Antibiotic coverage may be required
    • In uncontrolled diabetics, infections and wound healing may be a problem even after minor procedures
    • If major dental procedures or surgery is to be undertaken, prior control of diabetes by the physician is needed
    • If the patient is on only oral antihyperglycemic drugs, he should start insulin
    • Dental procedures may often reduce food intake and diabetics may go to hypoglycemia
    • Dose adjustments may be required

Question 4. Serum Sickness.

Answer:

Serum Sickness Causes:

  • After the administration of foreign serum
  • Tetanus antitoxin
  • Rabies antiserum

Serum Sickness Mechanism:

  • Antibodies form immune complexes in blood vessels with administered antigens
  • These complexes fix complement which attracts the leukocytes to the area causing direct tissue injury

Serum Sickness Features:

  • Fever
  • Swelling
  • Lymphadenopathy
  • Joint and muscle pain
  • Rash
  • Peripheral neuritis,
  • Kidney disease
  • Myocardial ischemia

Question 5. Name 2 conditions with increased serum alkaline phosphate.

Answer:

2 conditions with increased serum alkaline phosphate.

  • Malignancy
  • Abscess of liver
  • Amyloidosis
  • Leukemia
  • Sarcoidosis

Endocrine Disorders Viva Voce

  1. Rapid weight loss with salt and water depletion is found in type 1 diabetes
  2. Chronic fatigue and malaise is found in type 2 diabetes
  3. Median rhomboid glossitis is pathognomonic oral manifestation

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