Mandibular tori and exostoses are benign bony growths in the oral cavity, corresponding to localized overgrowths of cortical bone. Although they are generally asymptomatic, they have clinical significance in restorative dentistry, prosthodontics, and oral surgery.
Anatomical and clinical characteristics
Mandibular tori typically present as bilateral nodular elevations located on the lingual surface of the mandible, most often in the premolar region, above the mylohyoid line. They consist of dense, compact bone and are covered by a thin mucosa, which is susceptible to easy trauma.
Exostoses, on the other hand, are similar bony protrusions that can appear on the vestibular surfaces of the maxilla or mandible, often in response to occlusal stress or chronic irritation.
Aetiology and predisposing factors
The aetiology of these growths is multifactorial, involving:
- a genetic predisposition,
- increased masticatory stress,
- functional adaptation phenomena.
Parafunctional habits such as bruxism and teeth clenching are frequently associated. Epidemiological data show a higher prevalence in adults and in certain ethnic groups, with no clear gender preference.
Clinical implications
Although mandibular tori and exostoses are benign and generally do not require treatment, they can:
- complicate oral hygiene,
- hinder the creation of dental prostheses,
- interfere with certain periodontal or surgical procedures.
In cases of repeated trauma, ulcerations, or functional discomfort, surgical excision by osteoplasty may be indicated.
It is essential to distinguish them from bone pathologies such as osteomas, fibrous dysplasia, or osteoblastic metastases.
Radiographic and diagnostic considerations
Radiographically, mandibular tori appear as well-defined radiopaque masses.
Three-dimensional imaging (CBCT) allows for an accurate assessment of their volume and location, particularly during the planning of prosthetic or surgical treatments.
The recognition of mandibular tori and exostoses is essential for reliable diagnosis, adequate therapeutic planning, and clear patient information. Although benign, these anatomical variants must be rigorously integrated into clinical management to avoid any prosthetic or surgical complications.
