4.3 Clinical presentations and management
The majority of tori are asymptomatic and incidental finding during oral
or dental examination. As they enlarge and become more prominent,
however, they may cause a wide spectrum of problems. These include
difficulty with placement and function of dentures, interference with
mastication and speech, compression and displacement of the tongue
causing snoring or sleep apnea.14 Furthermore, the
tori can promote plaque formation and periodontal disease because of
food retention hindering proper dental hygiene.3, 8
Patients with large tori often experience recurrent mucosal ulceration
and inflammation resulting from trauma by hard food items (Figure 5).
Prominent tori may also interfere with endotracheal intubation during
general anesthesia.15 There have been several reports
concerning painful ulceration and osteonecrosis of torus in patients
receiving biphosphonate for treatment of
osteoporosis.16 In some instances, the larger
symptomatic tori may necessitate surgical removal.3,17This procedure was performed in 4 of our patients (Figures 2 and 4). The
cited indications for the torus resection include interference with
phonation or mastication, traumatic inflammation and ulceration,
prosthetic instability, and in patients with
cancerophobia.10 It may be of interest to note that a
potential use of an excised torus has been its application as an
autogenous bone graft in periodontal surgery and implants
elsewhere.10, 18