This presentation discusses thyroid, parathyroid, and adrenal disorders. It covers hypothyroidism and hyperthyroidism, their clinical presentations, treatments, and dental considerations. Hypo- and hyperparathyroidism are also discussed, along with pseudo-hypoparathyroidism and Albright hereditary osteodystrophy. Hyperparathyroidism can cause oral manifestations like brown tumors. Cushing syndrome and its dental risks are reviewed. Hypoadrenocorticism/Addison's disease and the need to increase corticosteroid dosing for dental treatment are summarized.

1. Title of presentation: THYROID, PARATHYROID, ADRENAL DISORDERS
Presenter name: DIVYA B
Department of Oral Pathology
& Microbiology
SRM Dental College,
Ramapuram, Chennai, India

2. THYROID GLAND

3. HYPOTHYROIDISM

4. CRETINISM, MYXEDEMA

5. CLINICAL PRESENTATION

6. RADIOGRAPHIC FEATURES

7. HYPOTHYROIDISM
• Treatment: Levothyroxine
• Differential diagnosis:
Iron deficiency anemia,
Depression
• Dental considerations:
Hemostasis,
Delayed wound healing

8. HYPERTHYROIDISM

9. CLINICAL PRESENTATION

10. HISTOPATHOLOGIC FEATURES

11. PARATHYROID GLAND

12. HYPERTHYROIDISM
Treatment:
• Radioactive iodine therapy,
• Drug therapy (propylthiouracil, methimazole), and
• Subtotal thyroidectomy
Dental considerations:
• Hyperthyoidism- congestive heart failure, angina
• Thyroid storm - fainting and hyperventilation after dental treatment

13. HYPOPARATHYROIDISM

14. Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy
syndrome

15. ORAL MANIFESTATION
• delayed eruption
• paresthesia of the tongue or lips,
• facial twitching
• Dental caries
• serum calcium levels < 8 mg/100 ml –
cardiac arrhythmias, seizures

16. HYPOPARATHYROIDISM
Diagnosis:
• Serum calcium and PTH are low,
• Serum phosphate level is high
Treatment:
• Vitamin D precursor (ergocalciferol, Vitamin D2),
• dietary calcium,
• Teriparatide ( recombinant PTH)

17. PSEUDOHYPOPARATHYROIDISM
• Kidneys fail to respond to parathormone due to deficient receptor
• Serum calcium is low, serum phosphate level is high, PTH is high
• Mutation in GNAS gene

18. Albright hereditary osteodystrophy

19. RADIOGRAPHIC FEATURES

20. HYPERPARATHYROIDISM

21. CLINICAL PRESENTATION

22. ORAL MANIFESTATIONS

23. BROWN TUMOR OF HYPERPARATHYROIDISM

24. RADIOGRAPHIC FEATURES

25. RADIOGRAPHIC FEATURES

26. HYPERPARATHYROIDISM
Treatment:
• Primary hyperparathyroidism- surgical removal
• Secondary hyperparathyroidism- Phosphate binders, vitamin
D(calcitriol), and calcimimetics(Cinacalcet), parathyroidectomy

27. CORTISOL

28. HYPERCORTISOLISM: CUSHING SYNDROME

29. CLINICAL PRESENTATION

30. CUSHING SYNDROME

31. Dental considerations
• Prevention of infections,
• pathological fractures during surgical treatments
• complications such as hypertension, hyperglycemia, depression and
delayed healing

32. HYPOADRENOCORTICISM

33. • CLINICAL PRESENTATION

34. • ADDISONS DISEASE

35. Dental consideration
• Corticosteroid dose must be increased
• Addisonian crisis