Tori excision

Mandibular tori are bony exophytic growths that are present on the lingual aspect of the mandible, opposite to the bicuspids. They present in early midlife and tend to grow with age. Mandibular tori occur in 6-7% of the population. The etiology of exostosis is multi factorial including genetic and functional influences. Larger versions may require removal because of their interfere with tongue positioning, speech interference, prosthodontic reconstruction, as well as with poor oral hygiene around the lower posterior teeth. One more indication for considering tori removal is cancer phobia.

Rotatory and reciprocating devices are most frequently used but have disadvantages, such as noise, vibration, and the potential for inducing thermal damage. Many patients are reluctant to be subjected to the use of an osteotome and mallet while awake, especially if repeated blows are required to separate the torus or exostosis from the bone. As a result of these factors, most patients who present with mandibular tori postpone and even avoid clinical treatment. Interest is growing in using alternatives to rotatory and manual instruments for osteotomies in oral and maxillofacial surgical procedures. Laser excision has better patient acceptance compared to conventional technique in removal of mandibular tori. Currently, there are few reports regarding the use of lasers in bone surgery and little is known about the effectiveness for bone ablation or the healing characteristics of the laser-irradiated bone tissue compared with conventional rotary instrumentation. The intention of this case report is to demonstrate the Er,Cr:YSGG laser use in a clinical setting for the atraumatic and effective excision of the mandibular lingual tori.

Currently, there are few reports regarding the use of lasers in bone surgery. The intention of this case report is to demonstrate the Er,Cr:YSGG laser use in a clinical setting for the atraumatic and effective excision of the mandibular lingual tori. The removal of the tori with the Er,Cr:YSGG laser device was done with the settings of 3.5 W, 40% water, 20% air and 20 Hz. Lasers have clinical advantages such as bacterial reduction at the surgical sites and increased comfort levels. The surgical field is cleaner, with less blood to obscure the surgeon’s field of vision. Laser technology has certain advantages, such as accuracy of the incision and absence of vibration and manual pressure during use.