What is Mandibular Tori, its Types, Reason of Occurrence, Problem, Diagnosis and Treatment

Now you might be wondering that what is mandibular tori, don’t worry I will explain this in detail in some time but for introduction, let me give you a glance about this, have you ever seen somebody complaining of some bony outgrowth in jaw, mostly seen in lower jaw bone at inner surface near the premolar region. This bony outgrowth is painless and hard. Basically it is asymptomatic but still, it can cause irritation to the patient. If it increases in size then it can cause irritation and restriction in movement of the tongue.

But however, most of the people do not notice this and the reason for this is that it is very small and unnoticeable in the beginning and gradually increases in size. But this gradual increase in size can also be rapid and can cause an interruption in the normal anatomy of the oral region. In most of the cases, the problem which arises due to the torus mandibularis is the placement of the denture, which might also need the removal of the tori surgically.

So today we will give you detailed information about the tori, it’s types, reasons for its occurrence, problems due to this, treatment plans.

What is Mandibular Tori

These are the bony outgrowth along the inner surface of the mandible, these are completely benign in nature ie, do not convert into cancer of any type. These are mostly present near the premolar region. In 90 percent cases, the torus mandibularis is present at both the sides of the mandible (near both right and left premolar). Other names of mandibular tori are torus mandibularis, mandibular torus, exostoses.

Torus mandibularis

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Types of Torus Mandibularis

There are various types of tori present such as:

Lingual Tori

These are the tori which are also called mandibular tori, present at the inner border of the lower jaw, near the premolars and above the mylohyoid muscle present at that region.

Singularly it is known as a torus and If more then one bony outgrowth present then it is called Tori. These exostoses are smooth, hard and non-movable, also these are asymptomatic outgrowth.

The removal of the lingual torus is not necessary until it is disturbing speech or oral hygiene or else is becoming bruised with sharp foods. Also, if the patient’s denture placement is getting misfit due to tori, then the tori must be removed.

This lingual tori can be further divided as the unilateral tori which means only one side of the jaw or bilateral tori which means present at both sides of the jaw near premolar region.

Submandibular Tori

These are the tori which are present below the level of the jawline. These type of exostoses are almost similar to the mandibular tori in every aspect, apart from the fact that they are positioned slightly below the level of the mandibular tori.

Tori Palatine

These are the tori which are present at the palate region of the mouth (roof of the mouth) as a bump on roof of mouth.

The palatal tori or lump on roof mouth causes increased pressure over the tongue and also gets irritated and bruised by the food. As the increasing size decreases the area of the oral cavity.

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What is the Reason for Occurrence

Mandibular overgrowth

Increased or Irregular Chewing Force

Due to the increased pressure over the premolars can cause trauma to the teeth, if this increased pressure continues due to some habit of bruxism then the force start to get transferred to the bone and occurrence of the exostoses is seen.

Genetics

Chances of a genetic link are not that common, but the patterns of occurrence in a patient who has a family history related to this is seen. So, if the family members have this problem then chances of its occurrence increases

Diet

Researchers have seen that the occurrence of exostoses in patients in the region of Japan and nearby where consumption of saltwater fish is common, this fish is high in vitamin D and polyunsaturated fat which are two important nutrients for the bone growth.

Salivary Gland Obstruction

Due to the obstruction of the salivary gland, formation of the bluish lump occurs, slowly with time, it can also be a factor to initiate the tori.

Injury or Trauma

Due to some sudden injury and trauma, the initiation of the tori can occur, as while the healing period the excessive bony formation can occur and can cause exostoses

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Problems due to Tori

Mandibular Tori

Ulcers

This is the problem which is very common if the size of the tori is large enough to cause an interruption in the process of chewing food. Due to the increased size, hard food might causes bruises over its surface and which will cause the formation of the ulcer. Also, these ulcers can occur due to the denture causing bruises and denture sores over the tori surface and are painful.

Denture Placement

It is another commonly seen in the patients, in this due to the presence of the tori the placement of denture is not done properly. The presence of torus palatine can still be managed by altering the denture design but it becomes difficult in mandibular tori case.

Poor Oral Hygiene

The overgrowth blocks the toothbrushes from reaching certain areas of the oral cavity which causes increased problems in teeth and related tissues.

Speech Deviation

Due to the increased size of the tori, the movement of the tongue is affected and this caused slurring of speech.

Throat Pain

If the tori are more in number or are present more posterior side then it can irritate the tonsils and this will cause the throat pain and irritation. The patient will feel a bump on the back of the tongue and increases gagging and throat pain.

Neural Involvement

When the bony growth extends into the nearby soft tissues then it can cause pressure over the nerves and this can cause paresthesia or tingling sensation in nerves.

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Diagnosis

The tori can be differentiated from any other similar looking problems like tumors by the help of following tests

Diagnosis of mandibular tori

  • Oral examination of the individual: Checking if the area is hard and smooth and asymptomatic. Also, check the position of the tori, this can give indications.
  • Then take a proper family history about the occurrence of tori in any of parents or other members of the family.
  • CT scan
  • MRI
  • DENTAL X-RAYS
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Treatment of Tori

Usually, the torus mandibularis is asymptomatic and hence they are not needed any treatment if are not interfering with the normal routine of the patient and is small in size.

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But if the size is big enough to interfere with the normal anatomy and causing problems in speaking or chewing food or any other problem like interfering in the placement of dentures, then the surgical procedure is done to remove and smooth the bone.

This procedure is normal and is of fewer complications. The surgery is done under local anesthesia and done by the oral surgeon.

So this was all about the topic mandibular Tori, hope you got most of your doubts clarified.

If you have any queries or suggestions then you can write to us in the comment section below.

 

Dr Deepak Kansal is a dentist, who is currently working in Sri Ganganagar. He did his Bachelor of Dental Surgery from Rajasthan University of Health Science.

  1. Valuable information provided.Thanks

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