Torus palatinus is a sessile nodule of bone occuring commonly in midline of hard palate. It can also occur over the lingual surface of the maxilla (torus mandibularis). Torus mandibularis is a bony protruberance located on the lingual aspect of the mandible (commonly between the canine and premolar areas). These are bony masses, begining their development during early teens and gradually progresses to adult hood. These masses are slow growing and painless.
These masses are usually self limiting, rarely they may cause periodontal diseases. Periodontal disease is usually caused by the mass forcing food towards the teeth while being chewed instead of away from it. Too large torus may interfere with dentures.
Etiology:
1.
Masticatory hyperfunction
2.
Genetic factors (common in females)
3.
Environmental factors
4.
Multifactorial
Age of occurrence:
It is very rare during the first decade of life. Its increase in size occur during the second and third decades of life. According to Bruce etal the average age of presentation of tori is 34. Since there is very little literature available on this subject very little knowledge regarding age of occurrence is available.
Rate of growth:
The rate of growth of these bony masses is very slow and gradual. Studies have shown that maximum increase in size occurs during the second and third decades of life.
Role of imaging:
CT scan is virtually diagnostic
Classification:
Oral exostosis was first classified by Haugen. He classified oral cavity exostosis according to their sizes as small, medium and large.
1.
Less than 2 mm in their largest diameter – small
2.
2 – 4 mm in their largest diameter – medium
3.
More than 4 mm in their largest diameter
According to Haugen majority of oral cavity exostosis belonged to the small and medium categories.
Reichart in his modification of Haugen’s classification suggested few changes:
Grade I – Tori up to 3 mm in their largest dimension
Grade II – Tori up to 6 mm in their largest dimension
Grade III – Tori above 6 mm belong to this group
Shapes:
Torus palatinus occur in varying shapes. It can be flat, nodular, lobular or spindle shaped. Small tori are invariable nodular and they are the most common variety encountered. Lobular shapes are pretty rare.
Indications for surgical removal:
1.
The mucosa over torus is ulcerated
2.
When it interferes with placement of dentures
3.
When there is associated periodontal disorder
4.
Where torus can be used as graft material
5.
Phonatory disturbances
6.
Sensitivity of the overlying mucosal layer
7.
Disturbances involving masticatory apparatus
8.
Esthetic reasons
.
