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Torus palatinus

Torus palatinus (TP) is a developmental malformation of the hard palate with an unknown etiology. Read on to find out all about the condition as well as its symptoms, causes, diagnosis and treatment programs.

Torus palatinus Definition

This condition is characterized by a slow-growing, tumor-like bony enlargement that occurs in the midline of the hard palate- the roof of the mouth separating the oral cavity from the nasal cavity.

The disorder is also referred to as “Palatinus torus”. In plural form, the disorder is called tori palatinus or palatal tori. In Latin, the word “tori” means “to stand out or lump”. This is one form of exostosis of the oral cavity.

Torus palatinus Incidence

The prevalence of the condition normally ranges from 9%-60%. It involves specific racial groups such as the Asians, Native Americans, and Inuit Eskimos. In the United States, the disorder occurs in about a fourth to a third of the population. The bony growth usually occurs in the early years of adulthood. Females are twice as likely to suffer from the disorder compared to males.

Torus palatinus Symptoms

The bony protrusion normally has a diameter of less than 2 cm but can gradually grow big with time. The condition is either marked by one large bump or a cluster of smaller growths. The variantion in size can be seen in terms of diameter and elevation. The bony growth exhibits a variety of shapes that has led medical researchers to classify it into several types. In appearance, some of these lumps are smooth and can be knob-shaped or flat with a broad base. The latter, which is usually known as flat tori, extends symmetrically to either side of the midline of the palate. The former, denoted as “lobular tori,” has multiple growths with a common base. In some instances, the protrusion may appear as a tiny nodule with innumerable bony growths in which each lump has an individual base. Such a type of growth is known as “nodular tori”.

Picture of Torus palatinus

Picture 1 - Torus palatinus

Spindle-shaped lumps, called spindle tori, possess a ridge situated at their midline. Tiny nodular bumps in the process of growth may often fuse to give rise to a single massive tumor-like mass. The condition becomes more apparent when patients grind their teeth. The presence of the bony lumps on the roof of the mouth does not cause any pain or discomfort unless scratched or pushed while eating. In fact, it is hardly noticeable to patients if not large enough. Patients with lobular tori may have difficultly eating and drinking.

Torus palatinus Causes

While there are many causes of different types of non-cancerous growths in the mouth, the causation of a bony protuberance on the palate is yet to be ascertained. The existence of a genetic component could play a role in causing the abnormal formation of such oral benign lumps. The disorder follows a pattern of autosomal dominant inheritance in which the mutated gene is located on one of the autosomes. This explains the occurrence of the condition in certain racial groups. Affected parents have a 50% chance of passing the mutant gene to their children. However, the influence of other potential factors can also lead to eruption of a bony lump. Some of these include:

  • Excessive chewing
  • Environmental agents
  • Superficial injuries
  • Tooth abrasion
  • Vitamin and calcium deficiency
  • Use of phenytoin

Torus palatinus Diagnosis

The diagnosis of TP is based on the clinical findings and normally does not warrant any exclusive diagnostic test. An X-ray of the benign growth can be conducted to rule the presence of neoplasia. The possibility of torus mandibularis- a bony growth in the lower jaw can be excluded, owing to the appearance of the tori in the midline of the palate. By the use of a CT scan, the site-specific entities of the condition can be precisely examined to evaluate the characteristic shape and size of the bony prominence.

Torus palatinus Treatment

In geriatric patients, the bony mass may shrink through a process called bone resorption that naturally releases the mineral from the bones. Asymptomatic hard lumps do not require treatment. However, the surgical excision of the benign growth is crucial for those who are going to have an upper partial or complete denture. This procedure of using prosthetic devices to replace missing teeth can be greatly hindered due to the presence of a bony protrusion on the palate. Patients who are already suffering from periodontal disorders as well as having speech difficulties opt for removal of the lump for palatal relief. Correction of the palate is also done by many for aesthetic reasons.

Image of Torus palatinus

Picture 2 - Torus palatinus Image

The surgical treatment of TP aims at removing a certain amount of bone from the palate. Most patients recuperate well after the operation with no major complications. However, in some cases, palatine artery hemorrhage and fracture of the palatine bone might occur depending on the severity of the condition.

Torus palatinus Complications

The presence of a bony prominence can cause oral hygiene problems in many individuals. Accumulation of food debris around the bony mass leads to bacterial growth. Although the condition poses no major risks, the presence of bigger lump/lumps can turn painful upon injury. The subsequent ulceration of the hard palate worsens the condition by causing excruciating pain while eating or swallowing. Less number of blood vessels on the palate delays wound healing. The overlying mucosal layer becomes quite sensitive and gives rise to a number of oral disorders. Some patients may even find it difficult to open the mouth and tend to develop a sore throat. This is one of prime reasons for the ailing patients to undergo prompt surgery.

Torus palatinus rarely causes any periodontal disorders, and is self-limiting in most cases. However, one has to cautious while eating or brushing in order to prevent the palate from getting injured. If you come across a strange lesion, growth or bump on the roof of your mouth, visit an orthodontic specialist as early as possible for proper evaluation.

References:

http://en.wikipedia.org/wiki/Torus_palatinus

http://www.drtbalu.co.in/torus.html

http://www.maxillofacialcenter.com/BondBook/bone/torus.html

http://www.wisegeek.com/what-is-torus-palatinus.htm

By   Last updated November 24th, 2012

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