The document discusses the influence of the endocrine system on periodontium. It describes how hormones from various endocrine glands like the hypothalamus, pituitary gland, pancreas, adrenal gland, sex glands, thyroid gland, and parathyroid gland can impact periodontal health and disease. Specific hormones are noted to increase or decrease inflammation, alter collagen production, affect bone metabolism, and influence the host response to bacterial pathogens in the mouth. Understanding these endocrine influences may provide insights into periodontal disease pathogenesis and ways to modify risk.
immune system is the body’s tool for preventing or limiting infection. Its complex network of cells, organs, proteins, and tissues enable the immune system to defend the body from pathogens.
A fully functional immune system can distinguish healthy tissue from unwanted substances. If it detects an unwanted substance, it will mount an immune response — a complex attack to protect the body from invaders like bacteria, viruses, and parasites. It also recognizes and removes dead and faulty cells.
The immune system does not always get it right, however. Sometimes, for instance, it is unable to fight effectively because a person has a health condition or needs certain medications that affect how the system works.
In autoimmune diseases and allergies, the immune system mistakenly perceives healthy tissue as unhealthy and launches an unnecessary attack, leading to uncomfortable and sometimes dangerous symptoms.
This article will look at some of the main features of the immune system and how they defend the body from pathogens and other invaders. It will also look at problems that can arise with the immune system.
immune system is the body’s tool for preventing or limiting infection. Its complex network of cells, organs, proteins, and tissues enable the immune system to defend the body from pathogens.
A fully functional immune system can distinguish healthy tissue from unwanted substances. If it detects an unwanted substance, it will mount an immune response — a complex attack to protect the body from invaders like bacteria, viruses, and parasites. It also recognizes and removes dead and faulty cells.
The immune system does not always get it right, however. Sometimes, for instance, it is unable to fight effectively because a person has a health condition or needs certain medications that affect how the system works.
In autoimmune diseases and allergies, the immune system mistakenly perceives healthy tissue as unhealthy and launches an unnecessary attack, leading to uncomfortable and sometimes dangerous symptoms.
This article will look at some of the main features of the immune system and how they defend the body from pathogens and other invaders. It will also look at problems that can arise with the immune system.
Bone Morphogenetic Proteins - Role in Periodontal RegenerationDr.Shraddha Kode
BMP's are the multifunctional growth factors extensively studied throughout the years. It has recently gained a lot of interest as therapeutic agents in periodontal regeneration.
There are many benefits to integrating orthodontics and periodontics in the management of adult patients with underlying periodontal defects. The key to treating these patients is communication and proper diagnosis before orthodontic therapy. Not all periodontal problems are treated in the same way. It should be remembered that overall success of orthodontic treatment depends on the combined effort and close monitoring of the case, by an orthodontist and a periodontist.
this ppt depicts pattern of bone destruction. its a very good slide show showing the process of bone formation, bone destruction and their patterns in periodontal diseases.
Bone Morphogenetic Proteins - Role in Periodontal RegenerationDr.Shraddha Kode
BMP's are the multifunctional growth factors extensively studied throughout the years. It has recently gained a lot of interest as therapeutic agents in periodontal regeneration.
There are many benefits to integrating orthodontics and periodontics in the management of adult patients with underlying periodontal defects. The key to treating these patients is communication and proper diagnosis before orthodontic therapy. Not all periodontal problems are treated in the same way. It should be remembered that overall success of orthodontic treatment depends on the combined effort and close monitoring of the case, by an orthodontist and a periodontist.
this ppt depicts pattern of bone destruction. its a very good slide show showing the process of bone formation, bone destruction and their patterns in periodontal diseases.
The study of how genes and gene products interact with dietary chemicals to alter phenotype and, conversely, how genes and their products metabolize nutrients is called nutritional genomics or “Nutrigenomics”.
DOI:10.21276/ijlssr.2016.2.4.11
ABSTRACT- Every year more than 13 million deaths worldwide are due to environmental pollutants, and
approximately 24% of diseases are caused by environmental exposures that might be averted through preventive
measures. Out of all these environmental chemicals, effects of air pollution is responsible for death of 3.3 million people
prematurely worldwide - a figure that could double by 2050 if emissions continue to rise at the current rate. Increasing
number of evidences has linked environmental pollutants with epigenetic variations, including changes in DNA
methylation status, histone modifications and other factors like incorporation of miRNAs, nucleosome remodeling, etc.
These entire mechanisms are likely to play important roles in disease aetiology, and their modifications, thus providing
further understanding of disease aetiology, as well as biomarkers for these exposures to environmental chemicals and/or
prediction of the risk for the disease. In this, we had tried to summarize the different epigenetic alterations related to
environmental chemical exposures, and propose the probable mechanisms of action behind such epigenetic changes. We
will also focus onopportunities, challenges and further directions for future epidemiology research in environmental
epigenomics. Further studies are needed in this regard to solve methodological and practical challenges, including
uncertainties about stability over time of epigenomic changes induced by the environment, tissue specificity of epigenetic
alterations, validation of laboratory methods, and adaptation of bioinformatic and biostatistical methods to
high-throughput epigenomics. Moreover, there are several reports of epigenetic modifications arising from environmental
chemical exposures, but most have not been directly linked to disease endpoints. Key-words- Environmental chemicals, Epigenetics, Disease susceptibility
Oral Submucous fibrosis and the role of curcumin in its treatment: A reviewinventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
PERIODONTAL MEDICINE 1.pptx DIABETES DIABENitika588942
The term periodontal medicine, as first suggested by Offenbacher, that defines a rapidly emerging branch of periodontology focusing on the wealth of new data establishing a strong relationship between periodontal health or disease and systemic health or disease.
This means a two-way relationship in which periodontal disease in an individual may be a powerful influence on an individual’s systemic health or disease as well as the more customarily understood role that systemic disease may have in influencing an individual’s periodontal health or disease.It would be new diagnostic and treatment strategies that recognize the relationship between periodontal disease and systemic disease.
William Hunter, attesting to the influence of oral sepsis on systemic health and disease.
Recently scientists and clinicians have begun to provide an increasing body of scientific evidence suggesting that moderate untreated periodontitis may affect an individual systemically, and may contribute to cardiovascular disease, diabetes and pre-term low birth weight.This is important new information indeed. It appears that not just teeth are at stake in maintaining good oral health.
Rather, oral health is an important component of general health, and individuals with periodontitis may be at risk for other diseases as well.
Evidence has also shed light on the converse side of the relationship between systemic health and oral health: the potential effects of inflammatory periodontal diseases on a wide range of organ systems.Pathogenesis of periodontitis has changed remarkably over last 30 years.
The non-specific accumulation of bacterial plaque was once thought to be the cause of periodontal destruction, but it is now recognized that periodontitis is an infectious disease associated with a small number of predominantly gram-negative microorganisms that exist in a subgingival biofilm.
Furthermore, the importance of the host in disease initiation and progression is clearly recognized.
Although pathogenic bacteria are necessary for periodontal disease, they are not sufficient alone to cause the disease.
A susceptible host is also imperative. In a host who has relatively low susceptibility to disease, bacterial pathogens may have no clinical effect.
This may be due to a particularly effective host immunoinflammatory response that eliminates pathogenic organisms while minimizing destruction of native tissues.
Conversely, in a host with relatively high disease susceptibility, marked destruction of periodontal tissues may result.Acc. To William Hunter in 1900,
Oral microorganism- responsible for systemic conditions
Restoration instead of extraction, trapping of infectious agents
Gingivitis & periodontitis- foci of infection .Acc. To William Hunter in 1900,
Oral microorganism- responsible for systemic conditions
Restoration instead of extraction, trapping of infectious agents
Gingivitis & periodontitis- foci of infection
Acc. To William Hunter in 1900,
Oral microorganism
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay
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3. Bacterial plaque has been established as the primary etiologic factor for
the initiation of periodontal disease (Loe et al. 1965).
However, it has also been shown that without a susceptible host the
periodontal pathogens are necessary but not sufficient for disease to
occur.
Apart from the microbial etiology for periodontal diseases, a number of
factors, namely, environmental and genetic factors, have been proposed,
to modulate host microbial interactions, which ultimately decide the clinical
picture of periodontal disease.
INTRODUCTION:
4. Hormones are specific regulatory molecules that modulate reproduction,
growth and development, maintenance of the internal environment, as well
as energy production, utilization, and storage (Mariotti 1994).
Hormonal effects reflect physiological/pathological changes in almost all
types of tissues of the body.
Consequently, systemic endocrine imbalances may have an important
impact in periodontal pathogenesis.
10. In a study by Britto et al, the aim was to investigate the
possible associations between isolated growth hormone
deficiency (IGHD) and periodontal attachment loss (PAL) in
adults affected by congenital IGHD and ….
16. In the US National Health and Nutrition Examination Survey (NHANES) III,
adults with an HbA1c level of >9% had a significantly higher prevalence of
severe periodontitis than those without diabetes after controlling for age,
ethnicity, education, sex and smoking
21. SEX HORMONES AND PERIODONTIUM:
Sexual hormones have been suggested as important modifying factors that
may influence the pathogenesis of periodontal diseases (Mariotti 1994,
Parkar et al. 1998b, Hofbauer & Heufelder 2001).
22.
23. Gingival changes during puberty
Microbial changes have been reported during puberty and can be attributed to changes in the
microenvironment seen in the gingival tissue response to the sex hormones, as well as the
ability of some species of bacteria to capitalize on the higher concentration of hormones
present.
Clinically, during puberty there may be a nodular hyper plastic reaction of the gingival in areas
where food debris, material alba, plaque, and calculus are deposited.
The inflamed tissues are deep red and may be lobulated, with ballooning distortion of the
interdentally papillae.
Bleeding may occur when patients masticate or brush their teeth.
Histologically, the appearance is consistent with inflammatory hyperplasia.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33. Hormone Fibroblasts
Androgens (testosterone &
hydrotestosterone)
Decrease proliferation
Decrease IL-6 production
Progesterone Decrease proliferation
Decrease protein synthesis
Decrease cytokine production
Estradiol Increase proliferation
Increase cytokine production
34.
35.
36. stimulate matrix synthesis by osteoblasts and periodontal ligament fibroblasts (Ojanotko et al.
1980, Kasperk et al. 1989, Sooriyamoorthy & Gower 1989c)
stimulate osteoblast proliferation and differentiation (Kasperk et al. 1997, Morley 2000)
reduce IL-6 production during inflammation (Parkar et al. 1998b, Gornstein et al. 1999)
inhibit prostaglandin secretion (ElAttar et al. 1982)
Enhance OPG concentration (Szulc et al. 2001)
Effects of androgens in the periodontium
37. Effects of estrogen in the Periodontium
increased amount of plaque with no increase of gingival inflammation
(Reinhardt et al. 1999)
inhibit proinflammatory cytokines release by human marrow cells
(Gordon et al. 2001)
reduce T-cell-mediated inflammation (Josefsson et al. 1992)
suppress leukocyte production from the bone marrow (Josefsson et al.
1992,Cheleuitte et al. 1998)
inhibit PMN chemotaxis (Ito et al. 1995)
stimulate PMN phagocytosis (Hofmann et al. 1986
38. Effects of progesterone in the periodontium
increase production of prostaglandins (self-limiting process) (ElAttar 1976b, Smith et
al. 1986)
increase polymorphonuclear leukocytes and PGE2 in the GCF
reduce glucocorticoid anti-inflammatory effect (Feldman et al. 1975, Chen et al. 1977)
altered collagen and noncollageneous protein synthesis (Willershausen et al. 1991)
alter PDL fibroblast metabolism (Nanba et al. 1989b, Sooriyamoorthy & Gower 1989b,
Tilakaratne & Soory 1999a, b)
increase vascular permeability (Abraham-Inpijn et al. 1996)
39.
40. areas of increasing interest over the past two
decades. Early detection of these diseases plays a crucial role
Negative emotion
Hypothalamus releases CTRH
Releases adrenocorticotropic hormone
from pituitary
Cortisol released
41.
42. The higher cortisol and β endorphin concentrations
significantly up regulates expression of MMP-
1,2,7,11 and TIMP-1 in human gingival fibroblasts
Increased periodontal breakdown
Periodontitis
Hence, the systemic factors/conditions of the host must be understood since they may affect disease prevalence, progression, and severity
Bacteria alone cannot cause disease – host immune system impairment or function plays role – systemic dis / conditions influence the host defense mechanism
Endo – directy affect tissue, modify their response to local factors and prduce anatomic changes in gingiva
Targets for a number of hormones such as androgens, estrogen, and progesterone have also been localized in periodontal tissues (Gornstein et al. 1999).
Hyothalamus is located on the undersurface of brain. It lies just below thalamus and above the pituitary gland to which it is attached by a stalk. Major function is to maintain homeostasis. To keep the human body in stable condition.
Pituitary gland / hypophysis lies at the base of brain in sella turcica. Physiologically the pituitary gland is divided into 2 portions namely, the anterior pituitary or adenohyphysisand posterior pituitary or neurohypophysis.
Pituitary hormones are essential for growth, reproduction, blood volume regulation, response to stressors. The secretion of both anterior and posterior pituitar is controlled by hypothalamus.
Local mitogenic effect In this study, the direct effect of L-dopa was investi- gated on human periodontal ligament fibroblast (HPLF) cells. These results suggest that L-dopa can also have a direct local effect on the growth of HPLF cells.
l-DOPA is the precursor to the neurotransmitters dopamine, norepinephrine (noradrenaline), and epinephrine (adrenaline), which are collectively known as catecholamines.
to compare the periodontal status of the acromegalic patients to the healthy subjects selected from a population-based cohort. And they conclded that periodontal disease severity did not differ between acromegalic patients and healthy SHIP-1 controls.
The endocrine function of pancreas is performed by islet of langerhans. Four types of cells are present in islets namely: alpha – glucagon, beta- insulin, delta- somatostatin, pp cells- pancreatic polypeptide. Insulin and glucagon are the important panceatic hormones, which regulate the various metabolic processes of carbohydrates , proteins and fats.
-induced degradation, synthesis and ⁄ or transformation of protein, carbohydrate and fat from nutrients occurs between the blood and cells.
The action of insulin on carbohydrate metabolism are: transport and uptake of glucose, peripheral utilization of glucose, storage of glucose and inhibition of glycogenolyis, inhbition of gluconeogenesis.
Transport of aminoa cid into the cell from blood is facilitated by insulin. It inhibits protein catabolism and prevents formation of glucose from proteins. Insulin facilitates the transport of fatty acid into the adipose tissue. And storage of fat in adipose tissue by inhibiting the enzymes. Along with growth hormone insulin promotes growth of body.
Glucagon increases the blood glucose by brek down of glycogen into glucose. It increases release of free fatty acids from adipose tissue and available for peripheral utilization. It also increases glucose from proteins.
Also known as GH inhibiting hormone and somatotropin Release Inhibiting H
Action is negative feedback – prevents excess plasma nutrient by –products
It inhibits secretion of both glucagon and insulin. Decreases motility of stomach , duodenum amd gall bladder. Reduces the secretion of gastrc inhibitory polypeptide and vasoactive intestinal plypeptide.
Advanced glycation end products (AGEs) are proteins or lipids that become glycated as a result of exposure to sugars
There are two adrenal glands siuated on the upper pole of each kidney. It is madeup of 2 distinct parts, adrenal cortex and adrenal medulla. It has 3 different layers
Zona glomerulosa, zona fasiculata, zona reticularis.
Hormonal influences associated with reproductive process alter periodontal and oral tissue responses to local factors.
A number of studies have shown that periodontium is a target tissue for female sex hormones.
The effect of hormones may be amplified by the inflammatory response to bacteria.
Gingival tissues and the subgingival microflora respond with a variety of changes to the increasing hormone level at the onset of puberty.
If local factors are absent then there are no changes seen
Pronounced ease of bleeding is the most striking clinical feature
Studies have shown a high prevalence of P. intermedia and P. gingivalis at the 2nd trimester of pregnancy due to progesterone and/or estradiol being present in high concentrations, which contribute to bacterial growth
gingival tissues that are shiny and dry, bleed readily, and may range from pale to erythematous in color
Directly and indirectly exert influence on cellular proliferation, differentiation, and growth in target tissues, including keratinocytes and fibroblasts in the gingiva. (Mariotti A, 1999).
Estrogens stimulate epithelial proliferation and increase keratinization ….
TIMP TISSUE INHIBITOR OF METALLOPROTEINASE
May be found on the gingiva , palate , tongue and lips
Stress has been implicated in reducing gingival blood flow which in turn, could increase the possibility of necrosis of tissues, with subsequent reduced resistance to plaque.
THYROID gland is situated at the root of the neck on either side of the trachea. It has two lobes which are connected in the middle by an isthumus. It is larger in females than in males. The structure and the function of the thyroid gland change in different stages of the sexual cycle in females. It function is slightly increased during pregnancy and lactation and is decreased during menopause. It secretes 3 hormones namely, tetraiodothyonine, triiodothyronine, calcitonin.
thyroid hormones affect many physiological processes, and optimal functioning of body systems requires the circulating thyroxine and triiodothyronine levels to be maintained within a relatively narrow range
The effects of thyroid hormones on the basal metabolic rate reflect their actions on catabolic and anabolic metabolic pathways affecting lipids, carbohydrates and proteins
MYXOEDEMA- SEVERE HYPOTHYROIDISM
4 parathyroid glands which are located immediately behind thyroid gland at upper and lower poles. Each parathyroid gland is madeup of chief cells and oxyphil cells. The chief cells have secretory function and secrete parathormone.
In an effort to elucidate the relationship of parathyroid hormone with destructive periodontal disease, recent clinical studies have examined the effects of parathyroid hormone on the periodontium.
The influence of hormones from the endocrine system on health or disease is colossal. even as our understanding expands regarding how the disruption of hormone production and ⁄ or function affects different organs, the current understanding of the effects of these powerful chemical messengers remain largely unknown in the
periodontium. For example, diabetes mellitus has been identified as one of the few known risk factors for destructive periodontal diseases, yet the direct
effects of insulin on periodontal tissues, at any time in the life cycle, continues to be obscure. Thus a thorough understanding of the hormones and their influence is essential for carrying out a successful treatment protocol for patients.