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AGGRESSIVE PERIODONTITIS ASSOCIATED

WITH PITUITARY ADENOMA

Dr.Kamalpreet Chhina(HOD & Vice Principal)

Department of Periodontology & implantologyBRS DENTAL COLLEGEPanchkula

Presented by:

Puneet Sekhon

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Introduction

PITUTARY GLAND

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WHAT IS ADENOMA ?

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Pituitary Adenoma

Are tumors that occur in thepituitary gl

and& account for about

15%of intracranialneoplasms.

Small pituitary tumors often remain undiagnosed.

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Symptoms of pituitary adenoma

Affect the body metabolism in 3 different ways-

Hypersecretion,

Hyposecretion

Tumor mass effects.

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PERIODONTITIS ASSOCIATED WITH PITUITARY

ADENOMA

Adenoma causes increase inthe level of growth hormone

that causes acromegaly

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Exhibit various oral characteristic most commonly

Prognathism

Macroglossia

Everted & edematous lips

Tooth mobility

Interdental spaces( diastema) & tooth loss

Rarely gingival overgrowth.

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EXTRAORAL FEATURES

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ENLARGEMENT OF HAND

`

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ENLARGEMENT OF FEET

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INTRAORAL EXAMINATION

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ENLARGED AND

DEEP MAXILLA

AND MANDIBLE

MACROGLOSSIA

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GENERALIZED AGGRESSIVE

PERIODONTITIS

Provisional diagnosis

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RADIOGRAPHICINVESTIGATION

Completeevaluation of OPG

of the patientrevealedgeneralized boneloss along all the

teeth.

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Hematological investigations of hormone reveals:-

Increase in level of GH 59.50 ng/ml (normal is

50ng/ml)Thyroid hormones mark shows increase in level of

T4 that is 109.4 ng/ml (normal is 10 27 ng/ml)

Cortisol level was also increased that is 235nmol/lit (normal is

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DIAGNOSIS AND TREATMENT

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FINAL DIAGNOSIS

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DISCUSSION

Pituitary adenomas secretes growth hormone causingacromegaly in adults and gigantism in pre-pubescentchildren.

Most growth hormone effects are mediated through insulin-

like growth factor-1 (IGF-1), which is produced by the liver.

Keisuke M, Chu S, Toshiyuki N et al in year 2007 presenteda case of pituitary adenoma with gingivitis. They

recommended extraction of loosen teeth and scaling, patientwas given brushing instruction. In the medicine departmentpatient was administrated bromocriptine mesylate, a GHsecretion inhibitor, was initiated. The results was gingivalswelling was rapidly diminished and gingival pocket was

reduced suggested that abnormal growth hormone secretionshould be the cause of intractable gingivitis.

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Danilo Lopez Ferreira Lima et al in year 2007

investigated the status of 16 acromegalypatients observed that acromegaly patient had

tooth mobility of grade I, mainly in anterior

region, malocclusion and diastema.

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CONCLUSION

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