Dinh X. Bui, D.D.S., M.S.
Tori is a common exostosis that develops either in maxilla
or mandible. When occurred in the palatal region, it is referred
to as torus palatinus. When occured in the mandible, it is
called torus mandibularis. They are localized bony protuberances
that originates from the cortical plates.
Torri are sometimes classified
according to their shape:
- Flat torus has a broad base
and slightly convex smooth surface and usually is symmetrical
on to both sides of the mouth
- Spindle torus presents as a
midline ridge in the maxilla
- Nodular arises as multiple protuberances,
with individual base.
- Lobular torus presents as a
lobulated mass, but it arises from the single base.
Histologically, exostosis is a
mass of dense, lamellar, cortical bone with a small amount
of fibrofatty marrow and in some case a small amount of trabecular
bone at the inner zone. The pathogenesis of the torus is multifactorial,
including both genetic and environmental influences such as
local irritation, bruxism, and malocclusion or functional
stresses. Palatal tori is more common than mandibular tori,
and the occurence of tori is more common in the Asian population.
Do we need to remove the tori?
Most of the time no treatment is necessary unless in the case
of edentulous patient where surgical removal of the torus
is required to accommodate a lower or upper denture. The exostosis
prevents the seating of denture or partial and also may cause
gingival irritation due to functional stress upon denture
or partial insertion. In the partial edentulous patient, tori
may be removed upon fabrication of the partial denture. In
patient with teeth, tori may be removed to aid in improvement
of food deflection from the dentogingival junction and eliminated
food impaction into the areas. Bony exostosis also removed
to aid in improving clinical crown height in crown fabrication.
Finally, tori is also removed to improve oral hygiene by allowing
better angulation of tooth brush head into the dentogingival
Does the tori grow back in time?
The recurrence of tori is rare and also if occured is very
slow. In edentulous patient recurrence will not occured. Functional
stresses can be reduced or treated with full mouth reconstruction.
We offer payment plan with a low
monthly payment and if paid in full in the time specified,
you will not have to pay any interest. For any question,
please do not hesitate to call our office at 281-579-6066.
Below is the case of maxillary exostosis preventing
the insertion of a complete denture due to undercut. After
a thorough examination, Dr. Bui decided to perform the osseous
surgery to remove the exostosis prior to denture construction.
We began to construct the complete denture approximately four
to six weeks after the healing of the surgery.
Notes: Initial view; flap reflected (right and
left sides) showing exostosis; bone recontour (right and left
sides) to remove exostosis; suture with continuous interrupted
Notes: before (right) and after (left); final
smile with complete upper and lower dentures
For full presentation of this case
done in Flash, please browse our porfolio section, under "OMFS
Surgery, Exostosis/Tori Removal"