dental

1. ENDOCRINE SYSTEM
Under the able guidance of,
Dr. Ram Autar (HOD, & Prof.)
Dr. Rakesh koul (Prof.)
Dr. Shantanu Khattri (Prof.)
Dr. Madhavi Bharadwaj (Prof.)
Dr. Vijayta Yadav (Reader)
Presented by-
Farhanaz Jamil JR1

2. INTRODUCTION:
overview
• The endocrine system constitutes endocrine
glands which are situated in different parts of
body.
• The functions of these glands are mediated by
chemical substances which are called chemical
messengers or chemical mediators or first
messengers or hormones.
• Most of the functions of nervous system are
executed by these hormonal substances.
• Hormones therefore affect growth between birth
and adulthood and their secretions play an
important role in homeostasis in vivo.

3. Orthodontic Tooth Movement
• It is a unique process where a solid object
(tooth) is made to move through a solid
medium (bone).
• Orthodontic tooth movement results from
the response of the periodontal tissue to
the orthodontic force, which leads to
modeling and remodeling of the
surrounding alveolar bone.
• The response is considered to occur
through the activation of specific signaling
pathways, many of which are known, all
acting to ultimately result in tooth
movement.

4. MECHANISM OF ACTION:
• On the target cell, the hormone in combination with the receptor acts by any
of the following mechanism:
• By altering the permeability of the cell membrane
Neurotransmitter substance
• By activating the intracellular enzyme
Protein hormones and catecholamine’s
• By activating the gene
Thyroid hormones

5. GROWTH HORMONE (GH):
• GH is a protein hormone, secreted by the
acidophil cells of the anterior pituitary gland.
• GH has no specific target organ.
• It is an anabolic hormone.
• GH secretion is pulsatile, secretory bursts
occurring especially at early hours of sleep and
throughout the night.
• GH pulse amplitude is increased in growth spurt.

6. GROWTH HORMONE EFFECT ON CARTILAGE AND BONE
• (1) Increased deposition of protein by the chondrocytic and
osteogenic cells that cause bone growth.
• (2) Increased rate of reproduction of these cells.
• (3) A specific effect of converting chondrocytes into osteogenic cells,
thus causing deposition of new bone

7. PROSTAGLANDINS (PGs):
• Belong to group of chemical messenger family of
hormones called eicosanoids.
• These are paracrine hormones, i.e. they act only
on cells near the point of hormone synthesis.
• Prostaglandins act in many tissues by regulating
the synthesis of Cyclic AMP.
• Cyclic AMP mediates the actions of diverse
hormones, so prostaglandins affect a wide range
of cellular and tissue functions.

8. Prostaglandins and orthodontics
• A direct action of prostaglandins on osteoclasts
occurs, thereby increasing their numbers and
their capacity to form a ruffled border and effect
bone resorption.
• Chumbley et al reported that Indomethacin, an
inhibitor of prostaglandin synthesis, inhibited
orthodontic tooth movement.
• Lee et al reported that systemic administration of
PG was more effective and produced more bone
resorption than local injection.

9. GH Effect on Dentition:
• GH influence on growth starts after 9 months of
age, so that the effect on the growth of primary
teeth is very little known.
• Dental delay is less pronounced than height or
bone delay.
• Dentition seems to be harmoniously delayed, so
that all studied components of dental development
(primary root resorption, secondary tooth
formation and eruptive movement) display the
same degree of retardation.

10. THYROID HORMONE (TH):
• Thyroid is an endocrine gland situated at the
root of the neck on either side of trachea.
• It is larger in females than in males.
• TH lacks in a specific target organ and may
affect every organ system and every biologic
process.
Functions:
• To increase the overall metabolic rate in the
body.
• To stimulate growth in children.

11. Hypothyroidism:
• Failure of thyrotropic function on the part of
pituitary or an atrophy or destruction of the thyroid
gland, leading to :
• Cretinism
• Myxedema
Clinical features:
• Stunting of growth.
• Infantile skeletal proportions and nasoorbital
configurations.
• Delayed and defective tooth development.
• Epiphyseal dysgenesis.

12. Hyperthyroidism:
• Produces increase in rate of maturation by increase in BMR.
• Premature eruption of permanent teeth.
• Disturbed resorption of the roots of the deciduous teeth.
• Hyperthyroidism is rare in children but when it does occur
eruption of teeth is accelerated; occasionally some of teeth
may be present at birth.
• Acceleration of eruption of teeth by as much as 2 years or
more ahead of their normal time.
• Teeth may show bluish white coloring.
• Acceleration of skeletal ossification.

13. CALCITONIN:
• It is a peptide hormone secreted by the
interfollicular or C-cells in the thyroid
gland, also called Thyrocalcitonin.
• These cells constitute only about 0.1 per
cent of the human thyroid gland.
• Thyrocalcitonin flows into the
bloodstream and attracts calcium to the
bone, thus reducing serum calcium.

14. Effects of Calcitonin on bone and tooth movement:
• Has effects opposite to those of PTH. However, the
quantitative role of calcitonin is far less than that of
PTH in regulating calcium ion concentration.
• Calcitonin inhibits bone resorption by direct action on
osteoclasts, decreasing their ruffled surface which
forms contact with resorptive pit.
• It also stimulates the activity of osteoblasts.
• Because of its physiological role, it is considered to
inhibit the tooth movement, consequently delay in
orthodontic treatment can be expected

15. PARATHYROID HORMONE (PTH):
• Produced by parathyroid glands to regulate
serum calcium concentration.
• In kidneys, PTH increases renal calcium
resorption and stimulates the excretion of urinary
phosphate.
• In bone, PTH can induce a rapid release of
calcium, but also mediates longer term changes
by acting directly on osteoblasts & indirectly on
osteoclasts.
• Its effects on osteoclasts occur through the
production of RANK-L, a protein that plays a
crucial role in osteoclast formation and activity.

16. Effects of PTH on tooth movement:
• PTH could stimulate both osteoclast-mediated bone resorption and
osteoblast-mediated bone formation, therefore accelerating the bone
turnover rate.
• Continuous infusion of PTH results in a catabolic effect, whereas intermittent
injection leads to an anabolic effect.
• Systemic continuous infusion or local chronic application of PTH could
accelerate tooth movement through enhancement of alveolar bone
resorption.
• Whereas long-term intermittent injection of PTH facilitats periodontal
repair of bone after orthodontic tooth movement through activation of
osteoblastic cells.

18. INSULIN:
• Insulin is a polypeptide hormone secreted by beta cells
of the Islets of Langerhans of Pancreas.
• Its main function is to maintain the blood glucose level.
• Deficiency of Insulin causes Diabetes mellitus is
diagnosed in 3-4% of the population and it is very
common to find such patients in our day-to-day
orthodontic practice.
• Patients show the symptoms of polyuria, polydipsia,
weight loss, and susceptibility to infections.
• Long-term complications include retinopathy,
cardiovascular disease and increased tendency for
periodontal diseases.

19. Orthodontic considerations:
• Orthodontic treatment should not be performed
in a patient with uncontrolled diabetes.
• Appliances might give rise to increased plaque
retention, which could more easily cause tooth
decay and periodontal breakdown in these
patients.
• Maintaining good oral hygiene, proper use of
toothbrush, interdental toothbrush and daily
rinses of chlorhexidine mouthwash can provide
preventive benefits.

20. VITAMIN D:
• Vitamin D itself is not the active, Instead, vitamin D must first be converted
through a succession of reactions in the liver and the kidneys to the final
active product, 1, 25-dihydroxycholecalciferol.
• Vitamin-D and its most active metabolite, vitamin-D3, together with
parathyroid hormone and Calcitonin, regulate the amount of calcium and
phosphorus in the human organism.
• It promotes intestinal Calcium ion absorption and reduces renal excretion.
• Vitamin- D3 increases bone mass and thus reduce fractures in osteoporosis
patients.
• Considering its beneficial effects on bone tissue, it may be assumed that it
inhibits tooth movement.

22. ESTROGENS:
• Estrogen secreted by ovaries, is considered to be
the most important hormone to affect bone
metabolism in women.
• Estrogen decreases the rate of bone resorption.
• It inhibits the production of various cytokines,
mainly interleukin-1 (IL-1), (TNF-a) tumor
necrosis factor-alpha, and interleukin-6(IL-6),
which are involved in bone resorption by
stimulating osteoclast formation and osteoclastic
bone resorption.
• Oral contraceptives taken for long periods of
time can therefore influence the rate of tooth
movement.

23. CONCLUSION:
• Hormones have an important influence on the rate of tooth
movement, and information on their normal functioning and
consumption is essential to adequately discuss treatment planning
with patients.

24. REFERENCES:
1. Graber TM, Vanarsdall RL, Vig KWL. Orthodontics: current principles and techniques. 4th edition. Elsevier, St Louis, Missouri,
USA. 2005; 145.
2. Diravidamani K, Sivalingam S, Agarwal V. Drugs influencing orthodontic tooth movement: An overall review. J Pharm Bioallied
Sci. 2012;4(suppl 2): S299-S303.
3. Effects of Growth Hormone on Craniofacial Growth Duration of Replacement Therapy. Minayo Funatsua; Koshi Satob; Hideo
Mitanic
4. Thilander B. Basic mechanisms in craniofacial growth. Acta Odontol Scand.1995; 53:144–151.
5. Pirinen S. Endocrine regulation of craniofacial growth. Acta Odontol Scand.1995; 53:179–18.
6. Bevis RR, Hayles AB, Isaacson RJ, Sa AH. Facial growth response to human growth hormone in hypopituitary dwarfs. Angle
Orthod. 1977; 47:193– 205.
7. George Litsas*.Growth Hormone and Craniofacial Tissues. An update. The Open Dentistry Journal, 2015, 9, 1-8 .
8. Thilander B. Basic mechanisms in craniofacial growth. Acta Odontol Scand.1995; 53:144–151.
9. Shirazi M, Dehpour AR, Jafari F. The effect of thyroid hormone on orthodontic tooth movement in rats. J Clinical Pediatric
Dent 1999; 23:259-264.
10. Kim S, Oh Kim S, Hee Kim C, Lee JH, Son HK. The effect of hyperthyroidism on the rate of orthodontic tooth movement. J
Korean Acad Pediatr Dent 2010; 37(2):202-05.