Mandibular Tori: A source of autogenous bone graft

Abstract

Restoration of lost alveolar bone support remains as one of the main objectives of periodontal surgery. Amongst the various types of bone grafts available for grafting procedures, autogenous bone grafts are considered to be the gold standard in alveolar defect reconstruction. Although there are various sources for autogenous grafts including the mandibular symphysis and ramus, they are almost invariably not contiguous with the area to be augmented. An alternative mandibular donor site that is continuous with the recipient area and would eliminate the need for an extra surgical site is the tori/exostoses. Bone grafting was planned for this patient as there were angular bone loss present between 35-36 and 36-37. As the volume of bone required was less and bilateral tori were present on the lingual side above the mylohyoid line, the tori was removed and used as a source of autogenous bone graft, which were unnecessary bony extensions present on the mandible and continuous with the recipient area. Post-operative radiographs taken at 6 and 12 month intervals showed good bone fill and also areas of previous pockets, which did not probe after treatment indicates the success of the treatment. The use of mandibular tori as a source of autogenous bone graft should be considered whenever a patient requires bone grafting procedure to be done and presents with a tori.

Mandibular Torus Harvesting for Sinus Augmentation: Two-Year Follow-Up

“…In a recent study by Santhanakrishnan and Rangarao, torus grafts were used for alveolar defect reconstruction. One-year follow-up revealed good bone fill in the defects [11]. However, to our knowledge not many studies demonstrate long follow-up periods and long-term outcomes of such treatment.…”

Utilização de tórus mandibular para reconstrução parcial de rebordo atrófico em mandíbula - relato de caso clínico

“…Neiva, Neiva & Wang (2016) Rastogi, Verma & Bhushan (2013) em relato de caso afirmaram que comumente o tórus é removido devido a razões protéticas, porém, este também pode ser utilizado como biomaterial na implantodontia. Santhanakrishnan & Rangarao (2014), afirmam que a Development, v. 9, n. 7, e537974412, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i7.4412 recuperação do suporte ósseo alveolar perdido ainda é um dos principais objetivos da cirurgia periodontal, sendo o tórus mandibular uma alternativa de região doadora uma vez que não se faz necessário um local cirúrgico extra e deve ser considerado como fonte de enxerto ósseo autógeno sempre que um paciente portador desta exostose necessitar de procedimento de enxertia óssea.…”

Three-dimensional evaluation of the mandibular symphyseal region in block graft harvesting for dental implants using cone-beam computed tomography

“…4 The quantity of bone required at the recipient site and the biological qualities of the donor bone are 2 of the most important factors to consider before determining the autogenous donor site. 5 Intraoral donor sites are the most highly preferred bone harvesting locations, not only for the repair of maxillofacial bony defects but also for ridge augmentation and jaw reconstruction procedures. The apparent advantages of local bone grafts are their convenient surgical access and reduced operative and anesthe-Three-dimensional evaluation of the mandibular symphyseal region in block graft harvesting for dental implants using cone-beam computed tomography sia time, making them ideal for most outpatient implant procedures.…”

“…8 Evidence shows that autogenous bone blocks within the retromandibular region only offer 80% of the bone volume available in the chin region. 5 Furthermore, neurosensory dysfunction, mandibular fractures, and extensive bleeding are all acknowledged risks associated with retromolar grafting sites. 12,13 One drawback to autogenous bone blocks in the chin region is the high rate of morbidity due to nerve bundle and blood vessel damage.…”