Endocrinopathies have a variety of orofacial presentations which span from dental malocclusion to facial disfigurement. These characteristics depend on the nature and severity of the condition. An orthodontist should understand the body’s physiological processes to be able to timely determine the optimum intervention and plan treatment stages accordingly in compromised individuals. Communication between the two specialties should be well coordinated and should help facilitate quality health care to the patient. This review was aimed to impart the basic knowledge and the pivotal guidelines for orthodontic management in these conditions. Systemic conditions require multidisciplinary management and the dental team should aim to provide quality oral health care to enhance the overall quality of life and the orthodontist plays a vital role in helping patients achieve physical and psychological health.
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1. Graber LW, Vanarsdall RL, Vig KW, Huang GJ. Orthodontics: Current Principles and Techniques. 5 th ed. Elsevier Health Sciences; 2016.
2. Patel A, Burden DJ, Sandler J. Medical disorders and orthodontics. J Orthod, 2009;36:1-21.
3. Kovacs K, Horvath E, Vidal S. Classification of pituitary adenomas. J Neurooncol, 2001;54:121-127.
4. Vilar L, Vilar CF, Lyra R, Naves LA. Acromegaly: clinical features at diagnosis. Pituitary, 2017;20:22-32.
5. Melmed S, Kleinberg D. Anterior pituitary. In: Reed Larsen P, Kronemberg HM, Melmed S, Polonsky KS, editors. Williams textbook of Endocrinology. 10th ed. Philadelphia: Saunders; 2003.
6. Choi SH, Fan D, Hwand MS, Lee HK, Hwang CJ. Effect of growth hormone treatment on craniofacial growth in children: idiopathic short stature versus growth hormone deficiency. J Formos Med Assoc, 2017;116:313-321.
7. Miranda-Rius J, Brunet-Lobet L, Lahor-Soler E, de Dios-Miranda D, Gimenez-Rubio A. GH-secreting pituitary macroadenoma (acromegaly) associated with progressive dental malocclusion and refractory CPAP treatment. Head Face Med, 2017;13:7.
8. Naves LA, Mercado M, Duarte FG, Vilar BF, Vilar L. Acromegaly – an overview. In: Vilar L, editor. Endocrinologia Clínica (Clinical Endocrinology). 6th ed. Rio de Janeiro: Guanabara Koogan; 2016. p. 56-70.
9. Davidopoulou S, Chatzigianni A. Craniofacial morphology and dental maturity in children with reduced somatic growth of different aetiology and the effect of growth hormone treatment. Prog Orthod, 2017;18:10.
10. MacGillivray MH. Disorders of growth and development. In: Felig P, Baxter JD, Broodu E, Frohman LA, editors. Endocrinology and Metabolism. 2nd Edition. New York: McGraw-Hill Book Co; 1987.
11. Herrmann BL, Mortsch F, Berg C, Weischer T, Mohr C, Mann K. Acromegaly: a cross-sectional analysis of the oral and maxillofacial pathologies. Exp Clin Endocrinol Diabetes, 2011;119:9-14.
12. Vitral RWF, Tanaka OM, Fraga MR, Rosa EAR. Acromegaly in an orthodontic patient. Am J Orthod Dentofacial Orthop, 2006;130:388-390.
13. Bevis RR, Hayles AB, Isaacson RJ, Sather AH. Facial growth response to human growth hormone in hypopituitary dwarfs. Angle Orthod, 1977;47:193-205.
14. Salas-Flores R, González-Pérez B, Barajas-Campos RL, Gonzalez-Cruz B. Changes on craniofacial structures in children with growth-hormone deficiency. Rev Med Inst Mex Seguro Soc, 2010;48:591-595.
15. Keller EE, Sather AH, Hayles AB. Dental and skeletal development in various endocrine and metabolic diseases. J Am Dent Assoc, 1970;81:415-419.
16. Konfino R, Pertzelan A, Laron Z. Cephalometric measurements of familial dwarfism and high plasma immunoreactive growth hormone. Am J Orthod, 1975;68:196-201.
17. Pirinen S, Majurin A, Lenko HL, Koski K. Craniofacial features in patients with deficient and excessive growth hormone. J Craniofac Genet Dev Biol, 1994;14:144-152.
18. Poole AE, Greene IM, Buschang PH. The effect of growth hormone therapy on longitudinal growth of the oral facial structures in children. Prog Clin Biol Res, 1982;101:499-516.
19. Cantu G, Buschang PH, Gonzalez JL. Differential growth and maturation in idiopathic growth-hormone-deficient children. Eur J Orthod, 1997;19:131-139.
20. Oliveira-Neto LA, Melo Mde F, Franco AA, Oliveira AH, Souza AH, Valença EH, et al. Cephalometric features in isolated growth hormone deficiency. Angle Orthod, 2011;81:578-583.
21. Van Erum R, Mulier M, Carels C, Verbeke G, de Zegher F. Craniofacial growth in short children born small for gestational age: effect of growth hormone treatment. J Dent Res, 1997;76:1579-1586.
22. Kjellberg H, Wikland KA. A longitudinal study of craniofacial growth in idiopathic short stature and growth hormone-deficient boys treated with growth hormone. Eur J Orthod, 2007;29:243-250.
23. Sonwane S, Shweta RK, Kumar SB, Shett RGK. Chronic congenital systemic disorder- a hurdle in orthodontic treatment plans: meta-analysis. Int J Med Res Health Sci, 2016;5:239-247.
24. Giannini C, Mohn A, Chiarelli F. Growth abnormalities in children with type 1 diabetes, juvenile chronic arthritis and asthma. Int J Endocrinol, 2014;14:1-10.
25. De la Monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes – evidence reviewed. J Diabetes Sci Technol, 2008;2:1101-1113.
26. Vucic S, Korevaar TIM, Dhamo B, Jaddoe VWV, Peters RP, Wolvius EB et al. Thyroid function during early life and dental development. J Dent Res, 2017;96:1020-1026.
27. Abuabara A. Biomechanical aspects of external root resorption in orthodontic therapy. Med Ora Patol Oral Cir Bucal, 2007;12:610-613.
28. Fiscaletti M, Stewart P, Munns CF. The importance of vitamin D in maternal and child health: a global perspective. Public Health Rev, 2017;38:19.
29. Hanna AE, Sanjad S, Andrary R, Nemer G, Ghafari JG. Tooth development associated with mutations in hereditary vitamin D-resistant rickets. JDR Clin Trans Res, 2018;3:28-34.
30. Burke AB, Collins MT, Boyce AM. Fibrous dysplasia of bone: craniofacial and dental implications. Oral Dis, 2017;23:697-708.
32. Akintoye SO, Boyce AM, Collins MT. Dental perspectives in fibrous dysplasia and McCune Albright syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol, 2013;116:1-12.
33. Reddy K, Anitha E. Orthodontic management of medically compromised patients. Ann Essences Dent, 2009;1:1-11.
34. Erichsen MM, Lovas K, Skinningsrud B, Wolff AB, Undlien DE, Svartberg J, et al. Clinical, immunological, and genetic features of autoimmune primary adrenal insufficiency: observations from a Norwegian registry. J Clin Endocrinol Metab, 2009:94:4882-4890.
35. Bensing S, Hulting AL, Husebye ES, Kampe O, Lovas K. Epidemiology, quality of life and complications of primary adrenal insufficiency: a review. Eur J Endocrinol, 2016;175:107-116.
36. Maheshwari S, Verma SK, Ansar J, Prabhat KC. Orthodontic care of medically compromised patients. Indian J Oral Sci, 2012;3:129-137.
37. Hernandez CJ, Guss JD, Luna M, Goldring SR. Links between the microbiome and bone. J Bone Miner Res, 2016;31:1638-1646.
38. Weaver CM. Diet, gut microbiome, and bone health. Curr Osteoporos Rep, 2015;13:125-130.
39. Weaver C, Gordon C, Janz K, Kalkwarf H, Lappe J, Lewis R, et al. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporosis Int, 2016;27:1281-1386.
40. Takaishi Y, Arita S, HondaM, Sugishita T, Kamada A, Ikeo T, et al. Assessment of alveolar bone mineral density as a predictor of lumbar fracture probability. Adv Ther, 2013;30:487-502.
41. Miyajima K, Nagahara K, Iizuka T. Orthodontic treatment for a patient after menopause. Angle Orthod, 1996;66:173-178.
42. Bartzela T, Türp JC, Motschall E, Maltha JC. Medication effects on the rate of orthodontic tooth movement: a systematic literature review. Am J Orthod Dentofacial Orthop, 2009;135:16-26.
43. Igarashi K, Mitani H, Adachi H, Shinoda H. Anchorage and retentive effects of a bisphosphonate (AHBuBP) on tooth movements in rats. Am J Orthod Dentofacial Orthop, 1994;106:279-289.
44. Graham JW. Bisphosphonates and orthodontics: Clinical implications. J Clin Orthod, 2006;40:425-428.