Clinical, tomographic aspects and relevance of torus palatinus: case report of two sisters

Abstract

Despite the nomenclature suggested to be a tumor, torus palatinus (TP) is an overgrowth of the bone in the palatal region and represents an anatomic variation. Its prevalence varies among the population studied and its etiology is still unclear; however, it seems to be a multifactorial disorder with genetics and environmental involvement. Surgical removal of the TP is indicated in the following circumstances: (1) deglutition and speech impairment, (2) cancer phobia, (3) traumatized mucosa over the torus, and (4) prosthetic reasons. The aim of this case report is describe cases that occurred in two sisters, emphasizing the genetic etiology of this anatomic variation. In addition, intra-oral exam and computed tomography scan (axial, coronal and sagittal view) provided a detailed assessment of the TP and elimination of other possible diagnoses, furthermore allowed a better analyzes of the anatomic relation with adjacentes structures. No surgical removal was indicated for both cases.

Study of the frequency and location of incidental findings of the maxillofacial region in different fields of view in CBCT scans

“…Torus and exostosis are anatomical variations characterized by hard bony prominences located on the hard palate (palatal torus), the lingual plate of the mandible (mandibular torus) or the buccal plate of the maxilla and mandible (exostosis). 19 Because they are asymptomatic, they usually do not require treatment, but they may be removed for prosthetic reasons and for use as biomaterials in periodontics and implantology. 1 …”

Imaging Aspects of Palatal Torus in Cone Beam Computed Tomography and Magnetic Resonance: Case Report

“…U jednom istraživanju uočena je visoka incidencija torusa unutar obitelji te se sugerira da se nasljeđuje dominantno autosomno (12). Pechenkina i suradnici (13) proučavali su egzostozne formacije lubanje neolitičkoga Kineza i smatraju da je njihov nastanak složen proces čija etiologija može potjecati od bilo kakve traume ili upale gingivnoga tkiva.…”

“…to što omogućuje trodimenzionalni pogled i razne presjeke te vizualizaciju detalja u usporedbi s periapikalnim i panoramskim radiogramima (10). Tomografski prikazi omoguću-ju bolju procjenu anatomskih varijacija i točnije prikazivanje njihova odnosa s okolnim strukturama te sastav medularne ili kortikalne kosti (12). Premda je u većini slučajeva TP slučajan nalaz na CT-u, Ruprecht i suradnici (18) istraživali su mandibularne toruse i uspoređivali njihov radiografski izgled s njihovim izgledom na diseciranim lubanjama te su pronašli da su oni manji od tri milimetra vrlo teško uočljivi i gotovo ih je nemoguće pronaći radiološki.…”

“…Computed tomography is widely used for the diagnosis of specific pathological conditions or observation of anatomical structures, since it provides a three-dimensional view and transverse images and permits to visualize details when compared to panoramic or periapical radiography (10). Tomography scans permit better evaluation of these anatomical variations and demonstrate their relationship with adjacent structures and the composition of medullary and cortical bone (12). However, in most cases, TP is also an incidental finding on CT. Ruprecht et al (18) investigated mandibular tori by relating their intraoral radiographic appearance to their corresponding appearance in dissected skulls and found that tori smaller than 3 mm are very difficult or impossible to detect radiographically.…”

Origin of torus palatinus and torus mandibularis: basis for clinical interpretation

“…It varies significantly in shape from one patient to another, as it can be flat, fusiform, nodular or lobulated. 16 The oral mucosa covering the torus palatinus is normal; however, it is usually extremely thin and reveals the whitish color of the bone underneath, which renders the torus a protuberance of whitish or yellowish color (Fig 1). Due to being delicate, the oral mucosa becomes ulcerous with ease whenever prostheses or appliances of any kind (metal bars, expanding screws or acrylic plates) are placed (Fig 2).…”