Endocrine System: Diseases and Oral Manifestations

Posted on Feb 10, 2025 in Human Biology

Endocrine System

The pituitary gland is an organ located in the sella turcica of the skull that governs the entire endocrine system. It has two distinct anatomical and physiological regions:

  • Anterior lobe (adenohypophysis): Secretes FSH (follicle-stimulating hormone), LH (luteinizing hormone), TSH (thyrotropin or thyroid-stimulating hormone), ACTH (adrenocorticotropic hormone that controls the adrenal glands), GH (growth hormone), and prolactin (stimulates mammary glands and promotes milk production).
  • Posterior lobe (neurohypophysis): Secretes ADH (antidiuretic hormone) and oxytocin (stimulates the uterus during childbirth).

Pathologies of the Pituitary

  • Hypopituitarism
  • Hyperpituitarism: Hyperfunction of the pituitary gland, normally caused by tumors.
    • When it occurs before puberty and affects growth hormone, it causes gigantism.
    • When it occurs in adulthood, it widens the limb bones, mainly characterized by coarse facial features, increased prognathism (mandible with the lower incisors in front of the superiors), false microdontia (teeth are normal size but inserted in excessively developed bone), malar bone hypertrophy, macroglossia, and thickening of the lips.

Thyroid Gland

Located in the neck on the laryngeal cartilages and trachea, it is highly vascularized and is responsible for activating general metabolism. It secretes thyroid hormones (T4 and T3), stimulated by TSH in the adenohypophysis and inhibited by circulating levels of the thyroid hormones themselves. These hormones are responsible for the control of basal metabolism and the growth and maturation of nerve tissue, among others.

Thyroid Gland Pathologies

  • Hypothyroidism: An underactive thyroid gland.
    • Congenital hypothyroidism: Begins during fetal development. Characterized by disturbances in psycho-physical development, mental deficiency, and dwarfism.
    • Infant-juvenile hypothyroidism: Begins around age 5. Presents with symptoms similar to adult hypothyroidism, along with growth, development, skeletal maturation, and mental health disorders.
    • Adult hypothyroidism: Characterized by decreased psycho-physical ability (apathy, mental dullness), menstrual disorders, headaches, and joint pains. It also presents with swollen lips, a large tongue, and a hypotonic, hoarse voice due to vocal cord edema. Oral manifestations include delayed tooth eruption, enamel hypoplasia, and malocclusion.

Pathologies of the Adrenal Glands

  • Hypofunction: Addison’s disease. Characterized by pigmentation in skin folds, palms, and mucous membranes. Irregular brownish spots appear on the lips, buccal mucosa, gums, and, less frequently, on the tongue. It also presents with fatigue, weight loss, fainting, and a desire to eat salt to compensate for losses due to vomiting.
  • Hyperfunction: Cushing’s syndrome. Characterized by obesity, increased facial hair, stretch marks on the skin, and psychiatric disorders. A characteristic feature is a tendency to form fatty deposits in the face (moon face).

Disorders of the Gonads

  • Hypofunction or hypogonadism:
    • Testicles: Malocclusion, prognathism, morphological changes of the palate, and macrodontia.
    • Ovaries: Micrognathia and abnormal tooth development (small teeth).

Stomatological Manifestations of Diabetes Mellitus (DM)

There are no manifestations unique to DM, but certain signs may lead us to suspect that a patient has it.