Tori are harmless bony outgrowths in the oral cavity, but when they interfere with daily activities like talking, chewing, and wearing dentures, then dental management is strictly indicated. To know more, have a look at this article.
Oral Tori, analogous to maxillary (upper jaw tori) and mandibular tori (lower jaw tori), are bony outgrowths that usually project inward (into the inner surface of the alveolar jaw bone) or outwards (into the outer surface of the alveolar bone). Most patients with dental tori report bilateral or two-sided distribution or presence of these outgrowths, but it would be unilateral too.
Tori are frequently misunderstood and associated with cancerous growths, but that is not true. They are, in fact, benign growths or, in other words, merely a bony exostosis found in the jaw (upper or lower).
To elaborate about an exostosis or an osteoma - it is basically a benign outgrowth of new bone on top of the existing bone. It can occur in other parts of the body like the ear, the heel of the foot, sometimes even under nail beds and in sinuses as well. Research shows children and young adults are more likely to experience exostosis.
Tori are asymptomatic but may frequently be associated with eating and drinking issues for the patient due to the hardness or the uneven growths they feel with the tongue or the teeth in the jaw, depending on the location. Tori are composed of compact bone and are quite dense and mineralized. The cause of tori are not exactly traced or established, but research indicates that a genetic component may be likely. The possibility of tori existing in people with parafunctional habits like night grinding and clenching is also observed.
In the maxilla or the upper jaw, the tori are usually seen arising from the midline of the hard palate (often termed torus palatinus). In the mandible, the origin of tori is from the inner aspect of the alveolar bone of the mandible above the origin of the mylohyoid muscle. Bony exostosis also may rarely occur on the buccal aspect of the maxilla or mandible (Buccal Exostosis) but is less reported than the dental tori.
Pathologically, whether it is maxillary or mandibular tori, they are considered slow-growing, harmless and non-invasive. Studies also indicate that the mandibular tori are not as prevalent compared to the maxillary palatal tori. The mandibular tori are further known to grow due to torsional stress (more in the area of the canine tooth) created by heavy mastication (chewing). When the maxillary or mandibular tori are covered by fibrous tissue or cartilage, or soft tissue, they are further prone to tissue irritation. For example -when the tori in the mouth are covered by soft tissue due to long-standing presence in the jaw with constant friction, then the overlying oral mucosa tends to get ulcerated.
The tori remain harmless and do not require dental management only so long as they do not cause these below explained issues. Tori most often do not require any form of surgical management, usually owing to the fact that it goes unnoticed in patients. They, however, do tend to create these issues in such cases:
Despite the multiple disadvantages of having this dental exostosis or tori, they are an important asset for being used as autogenous bone grafts for dental procedures. For either dental implants or post-extraction of teeth-in order to fill certain bony defects and traumatic bone -it requires autografts (harvesting graft from the patient’s own body wherein the donor site is from the jaw or ileac crest or symphysis of jaw). In such cases, as these tori are quite firm and dense in origin, this extra tissue is hence useful as being an ideal autogenous bone graft material.
Clinical diagnosis of these mineralized outgrowths is fairly straightforward by your dentist upon oral examination. But when the tori cause pain or loss of sensation in the affected area (paresthesia), then investigations should be further attempted by the dental surgeon.
The differential diagnosis of a slow-growing unilateral lesion would not be tori at all but rather serious conditions like osteochondroma, osteoblastoma or sarcoma, especially if it is invasive or causing pain and paresthesia.
Surgical resection of dental tori are seldom recommended, but when they cause the above-enlisted problems or bleeding due to soft tissue outgrowths over the tori or oral health issues, then it needs to be removed by your dentist.
To conclude, though developing tori may seem alarming and create anxiety in the patient, they are harmless to the maximum extent. New growths in the mouth, whether observed suddenly or for a long time, always hence needs to be investigated by the dental surgeon. It is important not to self-diagnose and visit your dentist to confirm that the outgrowths are tori and to make sure you have no potential serious issues associated with tori in the future.
Last reviewed at:
27 Apr 2021 - 4 min read
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