Oral Buccal Maxillary Bony Exostosis And Mandibular Tori Done By: Moh’d Khaled Jarboua U00020398 Ala Omar AL-Aqqad U00020080 Oral Buccal Maxillary Bony Exostosis And Mandibular Tori 1st of May 2014

Introduction: The word “tori” is derived from the latin word torus which means “to stand out” / “lump”. Synonyms: Exostosis of oral cavity, Buccal exostosis. Definition: -Torus maxillaris externus is a sessile nodule of bone signifies one or multiple unilateral or bilateral hyperostoses arising from the alveolar portion of the maxilla, usually in the molar region. -Torus mandibularis is a bony protruberance located on the lingual aspect of the mandible (commonly between the canine and premolar areas).

Bony Exostosis: Localized bony protuberance that arises from normal cortical plate. The most common oral exostosis is Torus Palatinus &Torus mandibularis. Torus Palatinus: Common & occur in the midline of the vault of hard palate. Torus palatinus is a benign thickening of normal cortical and medullary bone on the oral surface of the hard palate. It is covered by a thin, pale mucosa.Prevalence of palataltori ranges from 9% - 60%. Torus Mandibularis: Appears as bony protuberance along the lingual aspect of the mandible above the myelohyoid line in the region of the premolars. The prevalence of mandibular tori ranges from 5% - 40%.

Multifactorial in origin & classified according to their morphology into: Flat torus. Spindle torus Nodular torus Lobular torus

Etiology: Masticatory hyperfunction Genetic factors (common in females) Environmental factors Multifactorial Classification: Reichart in his modification of Haugen's classification: 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 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. 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.

Indications for surgical removal: The mucosa over torus is ulcerated When it interferes with placement of dentures When there is associated periodontal disorder Where torus can be used as graft material Phonatory disturbances Sensitivity of the overlying mucosal layer Disturbances involving masticatory apparatus Esthetic reasons

References: Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial pathology. Philadelphia, W. B. Saunders; 1995. Indignities DZ, Bailees M, Papanayiotou P. Concurrence of torus palatinus with palatal and buccal exostoses: case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85:552-557. Jainkittivong A, Langlais RP. Buccal and palatal exostoses: Prevalence and concurrence with tori. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:48–53. Garcia-Garcia AS, Martinez-Gonzalez JM, Gomez-Font R, et al. Current status of the torus palatines and torus mandibularis. Medicina Oral, Patologia Oral, y Cirugia Oral. 2010 Mar 1;15(2):353–60. Durrani MA, Barwise JA. Difficult Endotracheal Intubation Associated with Torus Mandibularis. Anesth and Analg. 2000 Mar;90(3):757–9.]

References: Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial pathology. Philadelphia, W. B. Saunders; 1995. Indignities DZ, Bailees M, Papanayiotou P. Concurrence of torus palatinus with palatal and buccal exostoses: case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85:552-557. Jainkittivong A, Langlais RP. Buccal and palatal exostoses: Prevalence and concurrence with tori. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:48–53. Garcia-Garcia AS, Martinez-Gonzalez JM, Gomez-Font R, et al. Current status of the torus palatines and torus mandibularis. Medicina Oral, Patologia Oral, y Cirugia Oral. 2010 Mar 1;15(2):353–60. Durrani MA, Barwise JA. Difficult Endotracheal Intubation Associated with Torus Mandibularis. Anesth and Analg. 2000 Mar;90(3):757–9.]