INTRODUCTION HORMONES PITUITARY GLAND AND HORMONES THYROID GLAND AND HORMONES PARATHYROID GLAND AND HORMONES PANCREAS ADRENAL GLAND AND HORMONES PINEAL GLAND THYMUS GLAND

1. DINESH DEEP KUNDU
MDS 1st
YEAR
DEPT. OF PROSTHO

2.  INTRODUCTION
 HORMONES
 PITUITARY GLAND AND HORMONES
 THYROID GLAND AND HORMONES
 PARATHYROID GLAND AND HORMONES
 PANCREAS
 ADRENAL GLAND AND HORMONES
 PINEAL GLAND
 THYMUS GLAND
2

3.  Two types of glands in body
 Exocrine glands and Endocrine glands
 Exocrine glands
 Release secretions into duct that carries them to
outside of body
 Example: sweat glands
 Endocrine glands
 Release hormones directly into bloodstream
 Have no ducts, referred to as ductless glands
 Example: thyroid gland
3

4.  Pituitary gland
 Pineal gland
 Thyroid gland
 Parathyroid glands
 Adrenal: 2 glands
 Ovaries and testis
 Pancreas
 Thymus gland
4

5. • The word hormone is derived from the Greek
“hormao” meaning “I excite or arouse”, was
given by Starling in 1905.
• Hormones are secretory products of
ductless(endocrine) glands released directly
into the circulation in small amounts in
response to a specific stimulus and on delivery
in circulation produces response on the target
cells or organs.
5

6. • Small marble-shaped gland. It lies in the
sella turcica of sphenoid bone.
• Located underneath brain
• Divided into anterior and posterior lobes
• Regulated by hypothalamus

7. 7

8. 8
Endocrine System | Medical Terminology for Health Professionals

9.  Referred to as “master gland”
 Secretes hormones that regulate other
endocrine glands
 Thyroid-stimulating hormone (TSH)
 Regulates function of thyroid gland
 Adrenocorticotropin hormone (ACTH)
 Regulates function of adrenal cortex
9

10. • Gonadotropins
– Follicle-stimulating hormone (FSH)
– Luteinizing hormone (LH)
• FSH
– Responsible for development of ova and sperm
– Also stimulates ovary to secrete estrogen
• LH
– Stimulates secretion of sex hormones
– Plays a role in releasing ova in females
10

11.  Growth hormone (GH)
 Also called somatotropin
 Stimulates cells to grow and divide
 Prolactin (PRL)
 Stimulates milk production in breast
 Melanocyte-stimulating hormone (MSH)
 Stimulates melanocytes to produce more melanin
11

12.  Antidiuretic hormone (ADH)
 Also called vasopressin
 Promotes water re-absorption by the kidney tubules
 Oxytocin (OXT)
 Stimulates uterine contractions during labour and
delivery
 After birth stimulates release of milk from breast
12

13. ACROMEGAL
Y
chronic hypersecretion of growth hormone
in adults; causes enlargement of bones of
head and extremities.
GIGANTISM
Hypersecretion of growth hormone in child;
results in very tall adult.
DWARFISM
hyposecretion of growth hormone in
children; causes short stature.

14.  CHARACTERISTIC
FEATURES
 Tall stature
 Bilateral gynaecomastia.
 Large hand and feet.
 Coarse facial features.
 Loss of libido/impotence.
 Increase in size of
calvarium.

15.  CHARACTERSTICS FEATURES
 Elongation and widening of
the mandible.
 Enlargement of frontal,
mastoid and maxillary sinus.
 Thickening of the skin and
coarsening of the facial
features.
 Periosteal growth of vertebrae
causes bowing of spine.
 Hypertrophy of the body soft
tissues such as heart, liver,
kidney and spleen. 15

16.  CHARACTERSTICS FEATURES
 Immature facies.
 Small genitalia.
 Delicate extremities, body
proportion according to the
chronological age.
 Delayed skeletal and dental
development
 Low circulating growth hormone
level.
16

17.  GIGANTISM
 Teeth size are proportional to
generalized body size.
 Interdental spacing.
 Dental malocclusion.
 Hypercementosis of roots.

18. • ACROMEGALY
– Thick and negroid lips.
– Enlarged tongue with indentation on lateral
borders.
– Enlarged prognathic mandible.
– Spacing in teeth.
– Enlarged nasal sinus.
– Anterior open bite.
– Thickening and enlargement of the alveolar
bone.
18

19.  HYPOPITUITARISM
 Delayed eruption rate as well as delayed
shedding of deciduous teeth.
 Crowding and malocclusion.
 Retarded growth of mandible.
 Smaller clinical crown of teeth.
 Smaller dental arches.
19

20. MACROGLOSSIA
IMPRESSION MAKING
 In case of patients with large
sluggish tongue, proper designing
of the lingual flange at the wax up
stage helps increase the stability of
mandibular denture providing
adequate room for the tongue to
perform its function of distributing
the food during mastication and to
relax when the mouth is at rest
without disturbing the mandibular
denture.
20

21.  This can be achieved by adding as little as wax
possible, behind the incisors in the anterior
region while behind the premolars, a flat or
slightly concave surface should be established.
 In the molar and retromolar region, the
polished surface is designed to be slightly
concave facing inwards, upwards and
forwards.
 Narrow posterior teeth should be selected for
patients with macroglossia.
21

22. Class 3 dentures should be given in case of
mandibular prognathism.
Frequent examination to evaluate fit and function
of removable prosthesis.
22

23. 23
 It is the largest
endocrine gland .
 Located on roof of the
neck at either side of
trachea.
 Resembles a butterfly
in shape.
 Divided into right and
left lobes which are
connected in the
middle by an isthmus.

24. 24
 Thyroid hormones
 Thyroxine (T4)
 Triiodothyronine (T3)
 Calcitonin
 Thyroxine and
Triidothyronine are
secreted by follicular
cells.
 Calcitonin is secreted by
parafollicular cells.

25.  Facilitate growth and development.
 Facilitate carbohydrate and fat metabolism.
 Increase oxygen consumption by the tissue,
basal metabolic rate, heat production.
 Necessary for normal development and activity
of the CNS.
 Increase the protein synthesis.
25

26. 1) TRAPPING of
inorganic iodide from
blood.
2) OXIDATION of
iodide to iodine.
3) BINDING of iodine
with tyrosine to form
iodotyrosine.
4) COUPLING of one
monoiodotyrosine and
1 diiodotyrosine to
form T3 or two
diiodotyrosine join to
form T4. 26

27.  Release of
Thyrotrophin-
Releasing
Hormone(TRH) from
hypothalamus.
 Stimulation of
anterior pituitary to
release Thyroid
Ttimulating
Hormone(TSH).
27

28.  Then TSH stimulates
thyroid to release T3
and T4.
 The rising levels of T3
and T4 have negative
feedback effect on
anterior pituitary as
well as hypothalamus.
28

29. Cretinism
congenital hyposecretion of thyroid;
results in poor physical and mental
development
Goiter enlarged thyroid gland
Graves’ disease
hypersecretion of thyroid; symptoms
include exophthalmos and goiter

30. Hashimoto’s
disease
autoimmune destruction of thyroid;
results in hyposecretion disorder
Myxedema
hyposecretion disorder in adult;
symptoms include anemia, edema,
and mental lethargy
Thyrotoxicosis
marked hypersecretion; symptoms
include rapid heart rate, tremors,
thyromegaly, and weight loss

31. HYPERTHYROIDISM HYPOTHYROIDISM
 1. Nervousness
 2. Anxiety
 3. Hand tremors
 4. Goiter
 5. Weight loss, despite
increased appetite
 6. Heart palpitations
 7. Heat intolerance
 8. Increased perspiration
 1. Fatigue
 2. Cold intolerance
 3. Thin brittle hair or
fingernails
 4. Weight gain, easily
with normal diet
 5. Weakness
 6. Goiter

32.  Maxillary or mandibular osteoporosis
 Increased susceptibility to caries.
 Periodontal disease.
 Burning mouth syndrome
 Sjogren’s syndrome
 Enlargement of extraglandular thyroid tissue .
32

33.  It has been described by the International
Headache Society as “an intra oral burning or‑
dysesthetic sensation, recurring daily for more
than 2 h/day for more than 3 months, without
clinically evident causative lesions.”
 Symptoms- glossopyrosis, glossodynia, burning
sensation in mouth, generalized soreness.
33

34. 34

35.  Sjögren's syndrome(S.S) is a systemic, chronic,
autoimmune, inflammatory disorder
Characterized by lymphocytic infiltrates in
exocrine organs.
 Xerophthalmia (dry eyes) and xerostomia (dry
mouth) are the main clinical presentations in
adults. Bilateral parotid swelling is the most
common sign of onset in children.
35

36.  DRY EYES
 Artificial tears
 Avoidance of drugs that decrease lacrimal &
salivary secretion such as diuretics, antihypertensive
drugs,anticholinergics & antidepressants.
 Systemic stimulation with oral pilocarpine 5 mg
TID,oral cevimeline 30 mg TID
 XEROSTOMIA
 Lubrication – water( the best replacement)
 Local stimulation- flavoured lozenges or gum
 Topical application of fluoride
 Oral candidiasis – topical nystatin or clotrimazole
lozenges
36

37. 37
1. Delayed eruption
2. Enamel hypoplasia in both dentitions,
(being less intense in the permanent
dentition)
3. Macroglossia
4. Micrognathia
5. Thick lips
6. Dysgeusia
7. Mouth breathing

38. • OSTEOPOROSIS
• Mucostatic or open mouth impression
techniques, selective pressure impression
technique, should be employed to reduce
mechanical forces while impression making.
• Use semi anatomic or non anatomic teeth with
narrow buccolingual width.
• Optimal use of soft liners, extended tissue
intervals by keeping the dentures out of mouth
for 10 hours a day can be advised.
38

39. • While fabricating fixed partial denture in
periodontally compromised abutments it may
accelerate the bone loss in osteoporotic patients.
So, the fabrication of FPD should follow treatment
of osteoporosis rather than preceding it.
• In osteoporotic patients, the dentist should
perform a proper treatment planning, modifying
the implant geometry, and use larger implant
diameter and with surface treatment.
• Daily calcium uptake should be up to 1500
mg/day pre and post surgically.
39

40.  ANTITHYROID DRUGS
Carbimazole – 40mg/day
Propranolol - 10mg/2-3 times day
Propyl thiouracil - 600mg/day
Lugol’s iodine – 15mg/day
40

41.  Surgery
 Toxic adenoma –lobectomy
 Multinodular goiter –subtotal thyroidectomy
 Radioiodine
 Sodium iodide -150 microcurie/gm
41

42.  BEFORE TREATMENT: ASSESSMENT OF
THYROID FUNCTION
 Establish type of thyroid condition.
 Is there a presence of cardiovascular disease? If yes,
assess cardiovascular status.
 Are there symptoms of thyroid disease? If yes, defer
elective treatment and consult a physician.
 Obtain baseline thyroid-stimulating hormone.
42

43.  Obtain baseline complete blood count.
 Assess medication and interactions with
thyroxine and TSH.Make proper treatment
modifications if the patient is receiving
anticoagulation therapy.
 Take blood pressure and heart rate. If blood
pressure is elevated in three different readings
or there are signs of tachycardia/bradycardia,
defer elective treatment and consult a
physician.
43

44. • Oral examination should include salivary glands.
Give attention to oral manifestations.
• Monitor vital signs during procedure:
– Is the patient euthyroid? If yes, there is no
contraindication to local anesthetic with epinephrine.
– Use caution with epinephrine if the patient taking
nonselective β-blockers.
– If the patient’s hyperthyroidism is not controlled, avoid
epinephrine; only emergent procedures should be
performed.
44

45.  Minimize stress–appointments should be brief.
 Discontinue treatment if there are symptoms of
thyroid disease.
 Make pertinent modifications if end-organ
disease is present (diabetes, cardiovascular
disease, asthma).
45

46.  Patients who have hypothyroidism are
sensitive to central nervous system depressants
and barbiturates.
 Use precaution with nonsteroidal anti-
inflammatory drugs for patients who have
hyperthyroidism, avoid aspirin.
 Continue hormone replacement therapy or
antithyroid drugs as prescribed.
46

47.  LOW RISK PATIENT
 patients without any symptoms.
 DENTAL CONSIDERATION -normal protocol can be
followed for implant surgery and prosthodontics
appointments.
 MODERATE RISK PATIENT
 Patient has no symptoms but had recently thyroid
function test.
47

48.  DENTAL CONSIDERATION - These patients may
follow a normal protocol in addition with stress reduction,
and redaction for simple surgical procedures.
 The use of epinephrine and CNS depressant drugs should
be limited.
 HIGH RISK PATIENT
 Patients with symptoms.
 DENTAL CONSIDERATION-Such patients should have
only examination procedures formed and all other
treatment is defaced until the medical and laboratory
evaluation confirms controls of disorder.
48

49. 49
 Four tiny glands that
measures about 6mm
long, 3mm wide and
2mm thick with dark
brown colour.
 Located on posterior
surface of thyroid
gland.
 Secretes parathormone
(PTH).

50. • Secreted by chief cells of parathyroid gland.
• The primary action of parathormone is to
maintain the blood calcium level by following
actions.
1. By increasing the resorption of calcium from the
bones.
2. By decreasing the excretion of calcium through the
kidneys.
3. By increasing the absorption of calcium from the
gastrointestinal tract.
50

51.  HYPOPARATHYROIDISM
 Decreased secretion of parathormone.
 Results in hypocalcemia.
 Usually due to parathyroid gland damage
occurring during thyroidectomy, para-
throidectomy.
51

52. • Hyperexcitability of peripheral nerves.
SIGN AND SYMPTOMS
Carpopedal spasm- spasmodic contraction of the
muscles of the hands.
Laryngeal stridor- spasm of muscles of
respiration.
52

53. • Hyperexcitability before the onset of
tetany.
SIGN AND SYMPTOMS
Trousseau’s sign- carpopedal spasm of hand on
applying blood pressure cuff to the arm and
inflating above systolic blood pressure.
Chvostek’s sign- twitching of facial muscle on
tapping the angle of jaw.
53

54. 1. Dental abnormalities
 Enamel hypoplasia
 Poorly calcified dentine
 Widened pulp chambers
 Dental pulp calcifications
 Shortened roots
 Hypodontia
 Delay or cessation of dental development
54

55. • 2. Mandibular tori
• 3. Chronic candidiasis
• 4.Parasthesia of the tongue or lips
55

56. • Increased secretion of parathormone.
• Results in hypercalcemia.
SIGN AND SYMPTOMS
Muscle weakness
Weight loss
Depression
Abdominal pain
Bone disease
Constipation
Renal stones
56

57. • Widened pulp chambers
• Development defects
• Alterations in dental eruption
• Weak teeth
• Malocclusions
• Loss of lamina dura on radiographs
• Giant cell lesions
57

58.  A triangular gland, which has both exocrine
and endocrine cells, located behind the
stomach.
 Acinar cells produce an enzyme-rich juice used
for digestion (exocrine product)
 Pancreatic islets (islets of Langerhans) produce
hormones involved in regulating fuel storage
and use.
58

59. Paul Langerhans – German medical student, 1st
discovered in dogs in 1869.
•Islets of Langerhans consist of four types of cells:
1. A cells or α-cells, which secrete glucagon.
2. B cells or β-cells, which secrete insulin.
3. D cells or δ-cells, which secrete somatostatin.
4. F cells or PP cells, which secrete pancreatic
polypeptide.
59

60.  Frederick G. Banting and John Macleod were
awarded the Nobel Prize in Physiology or
Medicine in 1923 "for the discovery of insulin.
 In January 1922, Leonard Thompson, a 14-year-
old boy dying from diabetes in a Toronto
hospital, became the first person to receive an
injection of insulin.
60

61. Liver
 Stimulates glucose oxidation
 Promotes glucose storage as glycogen
 Inhibits glycogenolysis
 Inhibits gluconeogenesis
Muscle
 Stimulates glucose uptake (GLUT4)
 Promotes glucose storage as glycogen
61

62.  Facilitates amino acids entry into muscle
cells
 Facilitates protein synthesis in ribosomes
by induction of gene transcription
 Inhibits proteolysis by decreasing
lysosomal activity
62

63. Adipose tissue
 Promotes storage of fat
 Inhibits lipolysis by inhibiting Hormone
sensitive lipase
 Promotes lipogenesis by stimulating
lipoprotein lipase
63

64. 64

65.  Glucagon is secreted from A cells or α-cells in
the islets of Langerhans of pancreas.
 It is also secreted from A cells of stomach and L
cells of intestine.
65

66.  Stimulates glycogenolysis, gluconeogenesis &
inhibits glycogenesis.
 Promotes lipolysis & ketogenesis.
 Increases calorigenesis.
Other Actions
 i. Inhibits the secretion of gastric juice.
 ii. Increases the secretion of bile from liver.
66

67.  Secreted from D cells of pancreas.
 Also secreted in hypothalamus & GIT.
Functions:
 Inhibits secretion of insulin & glucagon
 Inhibits GI motility & GI secretions
 Regulates feedback control of gastric emptying
67

68.  The name ‘diabetes mellitus’ was coined by
Thomas Willis, who discovered sweetness of
urine from diabetics in 1675.
 A serious disorder of carbohydrate
metabolism.
 Most common endocrine disorder.
 Results from hyposecretion or hypoactivity of
insulin
 The three cardinal signs of DM are:
 Polyuria – huge urine output
 Polydipsia – excessive thirst
 Polyphagia – excessive hunger and food
consumption 68

69.  Type 1 or IDDM Insulin Dependent Diabetes‑
Mellitus
 Type 2 or NIDDM Non Insulin Dependent‑ ‑
Diabetes Mellitus
69

70. 70

71. 71

72.  Cardiovascular complications like:
i. Hypertension
ii. Myocardial infarction
 Diabetic retinopathy.
 Diabetic nephropathy
 Diabetic neuropathy.
 Periodontitis.
72

73.  Periodontitis
 Oral candiasis
 Localized osteitis
 Burning mouth
 Xerostomia
 Delayed healing
 Increased caries activity
 Median rhomboidal glossitis
73

74.  Fasting blood glucose(>126mg/dl)
 Random blood sugar(>200mg/dl
 Glucose tolerance test (>200mg/dl)
 Glycosylated (glycated) hemoglobin(>6.5%)
74

75. • Insulin therapyInsulin therapy
• Oral hypoglycemic agentsOral hypoglycemic agents
• Life style modificationsLife style modifications
75

76.  Medical history :
 ·Take history and assess glycemic control at initial
appointment.
 Glucose levels
 Frequency of hypoglycemic episodes
 Medication, dosage and times.
 Establishing the levels of glycemic control
early in the treatment Process.
 Patients recent glycated Hb values
76

77.  Stress Reduction.
 Oral hygiene instructions, frequent prophylaxis
& monitoring of periodontal health, as there is
increased risk of periodontal disease.
 The use of antibiotics in case of infection and
Diet modifications.
77

78.  Diabetic patients can receive dental treatment
in the morning.
 But, it is generally best to plan dental treatment
to occur either before or after periods of peak
insulin activity.
 Greatest risk of hypoglycemia will occur about
 30-90 min after injecting Lispro Insulin.
 2 – 3 Hours after injecting regular insulin
 4-10 hours after injecting Lente Insulin
78

79.  The most common diabetic emergency in the
dental office is hypoglycemia.
 Signs and symptoms of hypoglycemia include;-
Confusion ,sweating, tremors, agitation,
anxiety,dizziness, tingling or numbness, and
tachycardia. Severe hypoglycemia may result
in seizures or loss of consciousness.
 Blood glucose with a glucometer should be
checked.
79

80.  If glucometer is not available, condition is
treated as hypoglycemic episode and the
patient should be given approximately 15g of
oral carbohydrate.
 If patient is unable to take food by mouth i.v
line is in place, 25-50 ml of 50% dextrose
solution (D50) or 1mg of glucagon can be given
intravenously.
80

81.  Abutment Failure.
 Tissue abrasions are more likely in denture
wearers.
 Erythematous candidosis is associated to the use
of upper total denture or prosthesis (denture
stomatitis).
 Oral carrier rate and density of C. albicans in
denture wearers of diabetic group were higher.
 Increased residual ridge resorption.
 Mucostatic impressions should be made.
81

82. Diabetes-induced changes in
bone formation:
Inhibition of collagen matrix
formation
Alterations in protein synthesis
Increased time for
mineralization of osteoid
Reduced bone turnover
Decreased number of
osteoblasts and osteoclasts
Altered bone metabolism
Reduction in osteocalcin
production
82

83.  Implant dentistry is not contraindicated in most
diabetics.
 Diabetics patients with blood glucose levels of around
100 Mg/dl.
 Sedative procedures and antibiotics.
 Need for a stress reduction protocol and diet
evaluation before and after surgery.
 Corticosteroids, often used to decrease edema,
swelling and pain may not be used in the diabetic’s
patient.
 Detrimental effects of diabetes on osseointegration
can be modified using aminoguanidine systemically.
83

84.  Mucostatic impressions should be made.
 Monoplane teeth should be used.
 Relining and rebasing.
 Tissue conditioners.
 Liquid supported dentures.
 Frequent recalls.
84

85.  Also called life-saving glands or essential
endocrine glands.
PARTS OF ADRENAL GLAND
1. Adrenal cortex
2. Adrenal medulla
85

86. 1. Mineralocorticoids
a) Aldosterone
b) 11-deoxycorticosterone
2. Glucocorticoids
a) Cortisol
b) Corticosterone
c) Cortisone.
3. Sex hormones
86

87.  1. Reabsorption of sodium from renal tubules.
 2. Excretion of potassium through renal
tubules.
 3. Secretion of hydrogen into renal tubules.
87

88. 88

89.  It stimulates the release of amino acids from
the body.
 It stimulates lipolysis, the breakdown of fat.
 It stimulates gluconeogenesis, the production
of glucose from newly-released amino acids
and lipids.
89

90.  It increases blood glucose levels in response to
stress, by inhibiting glucose uptake
into muscle and fat cells.
 It strengthens cardiac muscle contractions.
 It increases water retention.
 It has anti-inflammatory and anti-allergic
effects.
90

91. Androgens or androgenic steroids are produced
by the zona reticularis layer of the adrenal cortex.
 Androgens, including testosterone are male sex
hormones.
It’s assist the development of male
characteristics, and proper development of male
sex organs during embryonic development.
91

92. CUSHING SYNDROME
Due to the hypersecretion
of glucocorticoids,
particularly cortisol.
It may be either due to
pituitary origin or adrenal
origin.
92

93. 93
 Also called chronic
adrenal insufficiency of
adrenal cortex.
 It was first described by
addison in 1855.
 it is the failure of
adrenal cortex to secrete
corticosteroids.

94.  Medulla is the inner part of adrenal gland and
it forms 20% of the mass of adrenal gland.
 It is made up of interlacing cords of cells
known as chromaffin cells (pheochrome cells or
chromophil cells.
HORMONES OF ADRENAL MEDULLA
 Adrenaline or epinephrine
 Noradrenaline or norepinephrine
 Dopamine.
94

95. On Metabolism (via Alpha and Beta Receptors)
 Adrenaline increases the blood glucose level.
 Adrenaline causes mobilization of free fatty acids
from adipose tissues.
On Blood (via Beta Receptors)
 Adrenaline decreases blood coagulation time.
 It increases RBC count in blood by contracting
smooth muscles of splenic capsule.
On Heart (via Beta Receptors)
 It increases overall activity of the heart.
95

96.  Heart rate
 Force of contraction
 Excitability of heart muscle
 Conductivity in heart muscle
 On Blood Vessels (via Alpha and Beta-2
Receptors)
 Noradrenaline has strong effects on blood vessels. It
causes constriction of blood vessels throughout the
body via alpha receptors.
 Adrenaline also causes constriction of blood vessels.
However, it causes dilatation of blood vessels in
skeletal muscle, liver and heart through beta-2
receptors.
96

97.  On Blood Pressure (via Alpha and Beta
Receptors)
 Adrenaline increases systolic blood pressure by
increasing the force of contraction of the heart and
cardiac output And it decreases diastolic blood
pressure by reducing the total peripheral resistance.
 Noradrenaline increases diastolic pressure due to
general vasoconstrictor effect by increasing the total
peripheral resistance. It also increases the systolic
blood pressure to a slight extent by its actions on
heart.
97

98. PHEOCHROMOCYTOMA
Pheochromocytoma is a condition characterized by
hypersecretion of catecholamines.
Signs and Symptoms
3 most common symptoms are- palpitation,
headache and episodic sweating.
Other features- Anxiety, Chest pain, Fever,
Hyperglycemia, Nausea and vomiting,
Polyuria, Tachycardia,Weight loss.
98

99.  Pineal gland or
epiphysis is located in
the diencephalic area of
brain above the
hypothalamus.
Pineal gland has two types
of cells:
 1. Large epithelial cells
called parenchymal
cells
 2. Neuroglial cells. 99

100.  It controls the sexual activities in animals by
regulating the seasonal fertility. However, the
pineal gland plays little role in regulating the
sexual functions in human being.
 It secretes the hormonal substance called
melatonin.
100

101.  Thymus is situated in front of trachea, below
the thyroid gland.
 Thymus is small in newborn infants and
gradually enlarges till puberty and then
decreases in size.
FUNCTIONS
 Processing the T lymphocytes
 Endocrine function
101

102.  Kansal G, Goyal D. Prosthodontic
Management Of Patients With Diabetes
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JADA July 2002;133;849-858.
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103.  Bandela V, Mungapati B, Karnati R et al.
Osteoporosis: Its Prosthodontic Considerations
- A Review. Journal of Clinical and Diagnostic
Research. 2015 Dec, Vol-9(12): ZE01-ZE04.
 Nasri-Heir C, Zagury JG, Thomas D, Ananthan
S. Burning mouth syndrome: Current concepts.
J Indian Prosthodont Soc 2015;15:300-7.
 KC S, Shantaraj S. Etiology, Diagnosis and
Management of Burning Mouth Syndrome: An
update.Journal of Advanced Oral Research, Vol
3; Issue 3: Sept - Dec 2012.
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104.  Kaur M, Shailaja S, Chandra S, Mamatha B.
Acromegaly – A case report with dentist’s
perspectives and review of literature.Journal of
Advanced Oral Research, Vol 3; Issue 2: May-
Aug 2012.
 Mody et al. Management of flabby ridges.
Contemporary clinical dentistry, vol 3;Issue
3:Jul-Sep 2012.
104

105. THANK
YOU
105