What Is Torus Mandibularis?

INTRODUCTION Tori means “to stand out” in Latin. Torus mandibularis is a benign localised, peripheral outgrowth of bone of unknown etiology which is asymptomatic in nature. When multiple, small nodular protuberances appear on the alveolar bone, they are called exostosis. When a bony protuberance occurs it is called a torus and when it occurs on the lingual surface of mandible opposite to mental foramen it is called torus mandibularis.These bony growths enlarge slowly usually above the mylohyoid line at the premolar and canine area and has a tendency for recurrence.1,2Tori are usually removed when they interfere with speech, tongue positioning, prosthetic reasons, poor oral hygiene and traumatic ulceration of mucosal surface.
CASE REPORT A
A written informed consent was obtained from the patient. To achieve profound local anaesthesia, inferior alveolar, mental and lingual nerve blocks using 2% Lignocaine with 1:2,00,000 adrenaline was administered. A crevicular incision was made along the necks of teeth with BP no 15 blade extending from canine to second molar. A full thickness mucoperiosteal flap was reflected carefully without tearing thin mucosa over the growth to expose the bone surface, which was flat and smooth, and had the appearance of cortical bone. Excision of the mass was done using fissure bur with copious saline irrigation. A guide groove was made on the base of the torus using a fissure bur and the final enbloc resection was done using a bone chisel and
In 1879 Kupser and Besselhegen put forward the word torus and it was used to designate exostosis arising in the midline of palate and lingual side of lower jaw4. Hyperostosis is defined as benign neoformation of bone tissue which is diffuse or localized5. Genetic factors, environmental factors, masticatory hyperfunction and continued growth are the current postulated etiologic factors for this entity 6,7,8. Genetic predisposition to mandibular torus may be inherited in a dominant manner7. A mechanism of proposed buttressing bone formation is stated because flexon causes release of bone morphogenic proteins which then stimulates bone growth expression as thickening, lipping or exostosis at a point of stress9. Genetic origin of torus mandibularis was estimated in 29.5% of the cases while approximately 70% of the origin was attributed to environmental factors like occlusal stress by Eggen10. Consumption of fish which contains omega 3 unsaturated fatty acid and Vitamin D encouraging bone growth was found to be etiologic reason as done by the study of Al-Bayaty et al.11 A relationship between hyperparathyroidism and development of tori was observed in haemodialysis patient by Pey Jung