Tori are common lesions of the maxillofacial regions. They are part of a clinical spectrum of bony osteomas that can be found throughout the bony parts of the mouth.

Tori (taken from the Latin to describe a bull or bull horn) are bony lesions that occur around the jaws. Their sites of origin include the alveoli, palate, & cortival bone.

They occur commonly, & may present at any age, though usually from early adulthood. As they grow, they develop cauliflower like heads, arising from broad based stems, with thin overlying oral mucosa. By growing into a space such as the cheek vestibule, roof of mouth, of tongue space, they can affect normal chewing function & comfort.

By developing slowly over many years, & sometimes decades, they arise innocuously, & often without any knowledge by the individual concerned. It is often only with overlying trauma that the patient may first present seeking an opinion.

Trauma may arise simply & innocently, such as from a chicken bone stabbing the lesion; and which over the years has become slowly more prominent & subtly more susceptible to chewing injury. The stretched overlying mucosa is friable & prone to spontaneous break down or ulceration, & may cause underlying bone osteoma to squester or die.

Surgery to remove the lesion often dramatically causes an increase in available tongue space; something that was never noticed as having reduced over the years whilst the lesion is slowly expanding.

Surgery may be prophylactic or symptomatic, but in many cases is necessary to exclude a more sinister reason for abnormal bone growth; such as neoplasm, sarcoma or local ondontogenic lesions.

For edentulous, or partially edentulous patients, tori can interfere with the proper fitting and function of full or partial dentures, & in these cases removal is very much indicated.

Operations to remove osteomas, particularly those lining the inside of the lower jaw (torus mandibularis), are used as free bone grafts to other areas of the jaws for pre-implant surgery.

Garner's syndrome is particularly associated with multiple maxillary & bowel polyps, & a higher than usual occurrence of bowel neoplasm. People with multiple alveolar osteomas should also present to their Gastro-intestinal physician or surgeon for routine & regular bowel colonoscopies.

Only Oral & Maxillofacial Surgeons are trained in all aspects of mouth & jaw surgery, & they should be consulted if you are concerned about a lump or appearance alone, & surgery is a near painless & quick procedure, conducted in a day-stay or office based surgical clinic.

Routine investigations for tori include CT scans, which aim to detect adjacent structures of the mouth & jaws which may become compromised if surgery is not conducted by expert trained Oral & Maxillofacial Surgeons.

Patients who are on biphosphonates are potentially prone to spontaneous sequester of tori, and removal also is cautiously provided due to risk of jaw osteo-necrosis. The writer has seen at least one case of posterior lingual tori osteo-necrosis (non-healing) in an 83 year old on long term Fosamax use following a wisdom tooth removal by a general dentist.

Palatal Tori (Torus Palatinus)

Torus Palatinus is a bony growth in the palate. Palatal Tori are usually present on the midline of the hard palate... Read more

Alveolar Tori

Alveolar Tori is a bony growth which occurs in the bone ridge area of your teeth... Read more

Anterior Lingual Tori (Torus Mandibularis)

Torus Mandibularis is a bony growth in the mandible along the surface nearest to the tongue. Mandibular Tori are usually present near the premolars... Read more

Lingual Osteoma

Osteomas are a new piece of bone growing on another piece of bone. It is a benign tumour... Read more