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 Table of Contents  
LETTER TO EDITOR
Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 264-265

Cone beam computed tomography for mandibular tori


1 Department of Oral and Maxillofacial Pathology and Microbiology, Dr. Dnyandeo Yashwantrao Patil Dental College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
2 Private Practise, Belapur, Navi Mumbai, Maharashtra, India

Date of Web Publication11-Nov-2014

Correspondence Address:
Treville Pereira
Department of Oral and Maxillofacial Pathology and Microbiology, Dr. Dnyandeo Yashwantrao Patil Dental College and Hospital, Sector 7, Nerul, Navi Mumbai - 400 706, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-4848.144370

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How to cite this article:
Pereira T, Shetty S, Pereira S. Cone beam computed tomography for mandibular tori . Arch Med Health Sci 2014;2:264-5

How to cite this URL:
Pereira T, Shetty S, Pereira S. Cone beam computed tomography for mandibular tori . Arch Med Health Sci [serial online] 2014 [cited 2019 Oct 19];2:264-5. Available from: http://www.amhsjournal.org/text.asp?2014/2/2/264/144370

Sir,

A 23-year-old male patient reported to our clinic at Airoli, Navi Mumbai, India, with the chief complaint of pain in relation to upper left posterior region. On intraoral examination, maxillary second molar tooth was decayed. Root canal treatment was performed for the decayed tooth followed by a crown. However, impression making was difficult because of the presence of bilateral bony exostoses on the lingual aspect of the mandible [Figure 1]. Hence, a custom-made special tray was fabricated after relieving the bony exostoses.
Figure 1: Clinical photograph of the patient showing bilateral mandibular tori

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We advised a cone beam computed tomography (CBCT) in relation to the exostoses for academic purposes. CBCT showed bilateral well-defined hyperdense exostoses attached to lingual cortical plate of mandible extending from canine to premolar on either side [Figure 2] and [Figure 3]. The interior of the lesion appeared to be uniformly hyperdense.
Figure 2: Axial section passing through the mid root level of mandibular teeth

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Figure 3: The 3D image view of the mandible

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CBCT is used in dentistry for a variety of applications such as to evaluate pathosis in the jaws and to evaluate bone for implants, along with orthodontic, temporo-mandibular joint, and endodontic assessment. CBCT may be helpful in diagnosing incidental findings in the maxillofacial region. [1]

Torus mandibularis is exostosis or outgrowths of bone found on the lingual surface above the mylohyoid line in the region of the premolars of the mandible. [2] Bilateral involvement occurs in 90% of cases. Most mandibular tori occur as single nodules. Patients are unaware of their presence unless the overlying mucosa becomes ulcerated secondary to trauma. A study on the apparent hereditary nature showed that when one or both parents have either type (maxillary or mandibular) of torus, the frequency of occurrence of a torus in the children ranged between 40 and 64%. When neither parents had a torus, the incidence was only 5-8%. [3] In the present case, no hereditary pattern was observed.

Studies indicate that torus mandibularis is not as common as the torus palatinus; the prevalence ranges from 5-40%. [2] It has been suggested that the torus mandibularis will develop as a reinforcement of bone in the bicuspid area in response to the tortional stress created by heavy mastication. The age of onset of mandibular tori is usually by 30 years. [4]

Most mandibular tori do not require any treatment. However, surgical removal may be required to accommodate a lower full or partial denture. Occasionally tori may recur if teeth are still present in the area. [2]

Tori may interfere with film placement in intraoral radiography. However, it should be noted that tori may be used for harvesting bone for alveolar ridge augmentation and as a source of autogenous cortical bone in periodontal surgery. [5]

 
  References Top

1.Allareddy V, Vincent SD, Hellstein JW, Qian F, Smoker WR, Ruprecht A. Incidental findings on cone beam computed tomography images. Int J Dent 2012;2012:871532.  Back to cited text no. 1
    
2.Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology. 3 rd ed. Developmental Defect of Oral and Maxillofacial Region. New Delhi: Elsevier; 2009. p. 21-2.  Back to cited text no. 2
    
3.Suzuki M, Sakai T. A familial study of torus palatines and torus mandibularis. Am J Phys Anthropol 1960;18:263.  Back to cited text no. 3
    
4.Rajendran R, Sivapathasundharam B. Shafer's Textbook of Oral Pathology. In: editors. Benign and Malignant Tumors of the Oral Cavity. 6 th ed. New Delhi: Elsevier; 2009. p. 154-5.  Back to cited text no. 4
    
5.Ongole R, Praveen BN. Textbook of Oral Medicine, Oral Diagnosis and Oral Radiology. 2 nd ed. New Delhi: Elsevier; 2013. p. 20-1.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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