Surgical management of palatine Torus - case series
Tratamento cirúrgico de Tórus palatino - série de casos
Imada, Thais Sumie N.; Tijoe, Kellen Cristine; Sampieri, Marcelo Bonifácio da Silva; Tinoco-Araujo, José Endrico; Rubira-Bullen, I.R.F.; Santos, P. S. S.; Gonçales, Eduardo Sanches
Abstract
Introduction: Torus palatinus is a specific name to identify exostoses developed in the hard palate along the median palatine suture. Despite of not being a pathological condition, its presence requires attention and knowledge regarding its management. Surgical removal of exostoses is indicated when the patient frequently traumatizes the area of palatine torus during mastication and speech or when it is necessary for the rehabilitation of the upper arcade with complete dentures. Objective: The aim of this article is to present three cases of Torus palatinus and to discuss the management of them. Case report: In the first case, a 57-year-old Caucasian man sought oral rehabilitation of his edentulous maxilla but presented a hard nodules in the hard palate; in the second case, a 40-year-old Caucasian woman was referred for frequent trauma of palatal mucosa during mastication, aesthetic complaint, and discomfort caused by the trauma of her tongue in this area; and in the third case, a 45-year-old Caucasian woman presented with a lesion on the palate that caused difficulty swallowing. When the Torus palatinus was impairing the basic physiological functions of the patients, all cases were surgically treated, improving the patients’ quality of life. Final consideration: The dentist should be properly prepared to choose the best from among the existing surgical approaches for each individual lesion in order to improve the results and avoid possible complications.
Keywords
Resumo
Introdução: Torus palatinus é um nome específico usado para identificar exostoses no palato duro ao longo da sutura palatina mediana. Apesar de não ser considerado uma condição patológica, sua presença requer atenção e conhecimento no que diz respeito ao seu tratamento. A remoção cirúrgica de exostoses é indicada quando o paciente traumatiza frequentemente a área do Torus palatinus durante a mastigação e a fala, ou quando for necessária a reabilitação da arcada dentária superior com próteses totais. Objetivo: O objetivo deste trabalho é apresentar três casos de Torus palatinus e discutir os seus respectivos tratamentos. Caso clínico: O primeiro caso era de um homem leucoderma e com maxila edêntula que procurou reabilitação dentária, porém apresentou um nódulo no palato duro. O segundo caso era de uma mulher, leucoderma e de 40 anos que foi encaminhada devido ao trauma frequente na mucosa do palato durante a mastigação, insatisfação com a estética e desconforto causado pelo trauma na língua. O terceiro caso era de uma mulher de 45 anos de idade, leucoderma com uma lesão no palato e dificuldade pra engolir. Uma vez que o Torus palatinus estava prejudicando as funções fisiológicas básicas dos pacientes, todos os casos foram cirurgicamente tratados, melhorando a qualidade de vida dos mesmos. Consideração final: O dentista deve estar preparado para selecionar a técnica cirúrgica mais indicada para cada caso buscando o melhor resultado e evitando possíveis complicações.
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References
1. Vidic B. Incidence of torus palatinus in Yugoslav skulls. J Dent Res. 1966;45:1511–5. http://dx.doi.org/10.1177/00220345660450054101
2. García-García AS, Martínez-González JM, Gómez-Font R, Soto-Rivadeneira A, Oviedo-Roldán L. Current status of the torus palatinus and torus mandibularis. Med Oral Patol Oral Cir Bucal. 2010;15(2):e353-60. PMid:19767716. http://dx.doi.org/10.4317/medoral.15.e353
3. Raldi FV, Nascimento RD, Sá-Lima JR, Tsuda CA, Moraes MB. Excision of an atypical case of palatal bone exostosis: a case report. J Oral Sci. 2008;50:229-31. PMid:18587217. http://dx.doi.org/10.2334/josnusd.50.229
4. Fox J. Natural history and diseases of human teeth. E. Cox: London; 1814.
5. Kupffer C, Bessel-Hagen F. Verhandlungen der berliner gesellschaft fur anthropologie, ethonologie und urgeschichte. Zeitschrift fur Ethnologie. 1879;11:70–1.
6. Sirirungrojying S, Kerdpon D. Relationship between oral tori and temporomandibular disorders. Int Dent J. 1999;49:101-4. http://dx.doi. org/10.1111/j.1875-595X.1999.tb00516.x
7. Sonnier KE, Horning GM, Cohen ME. Palatal tubercles, palatal tori, and mandibular tori: prevalence and anatomical features in a U.S. population. J Periodontol. 1999;70:329-36. PMid:10225550. http://dx.doi.org/10.1902/jop.1999.70.3.329
8. Cagirankaya LB, Kansu O, Hatipoglu MG. Is torus palatinus a feature of a well-developed maxilla? Clin Anat. 2004;17:623-5. PMid:15494968. http://dx.doi.org/10.1002/ca.20032
9. Belsky JL, Hamer JS, Hubert JE, Insogna K, Johns W. Torus palatinus: a new anatomical correlation with bone density in postmenopausal women. J Clin Endocrinol Metab. 2003;88:2081-6. PMid:12727958. http://dx.doi.org/10.1210/jc.2002-021726
10. Sisman Y, Gokce C, Tarim Ertas E, Sipahioglu M, Akgunlu F. Investigation of elongated styloid process prevalence in patients with torus palatinus. Clin Oral Investig. 2009;13:269-72. PMid:18972141. http://dx.doi.org/10.1007/s00784-008-0232-6
11. Kerdpon D, Sirirungrojying S. A clinical study of oral tori in southern Thailand: prevalence and the relation to parafunctional activity. Eur J Oral Sci. 1999;107:9-13. http://dx.doi.org/10.1046/j.0909-8836.1999.eos107103.x
12. Gorsky M, Bukai A, Shohat M. Genetic influence on the prevalence of torus palatinus. Am J Med Genet. 1998;75:138-40. http://dx.doi. org/10.1002/(SICI)1096-8628(19980113)75:2%3C138::AID-AJMG3%3E3.0.CO;2-P
13. Jainkittivong A, Langlais RP. Buccal and palatal exostoses: prevalence and concurrence with tori. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:48-53. PMid:10884635. http://dx.doi.org/10.1067/moe.2000.105905
14. Al-Bayaty HF, Murti PR, Matthews R, Gupta PC. An epidemiological study of tori among 667 dental outpatients in Trinidad & Tobago, West Indies. Int Dent J. 2001;51:300-4. PMid:11570546. http://dx.doi.org/10.1002/j.1875-595X.2001.tb00842.x
15. Bruce I, Ndanu TA, Addo ME. Epidemiological aspects of oral tori in a Ghanaian community. Int Dent J. 2004;54:78-82. PMid:15119797. http://dx.doi.org/10.1111/j.1875-595X.2004.tb00259.x
16. Halffman CM, Scott GR, Pedersen PO. Palatine torus in the Greenlandic Norse. Am J Phys Anthropol. 1992;88:145-61. PMid:1605314. http://dx.doi.org/10.1002/ajpa.1330880204
17. Gorsky M, Raviv M, Kfir E, Moskona D. Prevalence of torus palatinus in a population of young and adult Israelis. Arch Oral Biol. 1996;41:623-5. http://dx.doi.org/10.1016/0003-9969(96)00149-5
18. MacInnis EL, Hardie J, Baig M, al-Sanea RA. Gigantiform torus palatinus: review of the literature and report of a case. Int Dent J. 1998;48:40-3. PMid:9779082. http://dx.doi.org/10.1111/j.1875-595X.1998.tb00692.x
19. Antoniades DZ, Belazi M, Papanayiotou P. Concurrence of torus palatinus with palatal and buccal exostoses: case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:552-7. http://dx.doi.org/10.1016/S1079-2104(98)90290-6
20. Eggen S, Natvig B, Gasemyr J. Variation in torus palatinus prevalence in Norway. Scand J Dent Res. 1994;102:54-9. PMid:8153581.
21. Jainkittivong A, Apinhasmit W, Swasdison S. Prevalence and clinical characteristics of oral tori in 1,520 Chulalongkorn University Dental School patients. Surg Radiol Anat. 2007;29:125-31. PMid:17340055. http://dx.doi.org/10.1007/s00276-007-0184-6
22. Haugen LK. Palatine and mandibular tori. A morphologic study in the current Norwegian population. Acta Odontol Scand. 1992;50:65-
77. http://dx.doi.org/10.3109/00016359209012748
23. Reichart PA, Neuhaus F, Sookasem M. Prevalence of torus palatinus and torus mandibularis in Germans and Thai. Community Dent Oral Epidemiol. 1988;16:61-4. PMid:3422622. http://dx.doi.org/10.1111/j.1600-0528.1988.tb00557.x
24. Abrams S. Complete denture covering mandibular tori using three base materials: a case report. J Can Dent Assoc. 2000;66:494-6. PMid:11070628.
25. Blakemore JR, Eller DJ, Tomaro AJ. Maxillary exostoses. Surgical management of an unusual case. Oral Surg Oral Med Oral Pathol. 1975;40:200-4. http://dx.doi.org/10.1016/0030-4220(75)90152-8
26. Topazian DS, Mullen FR.Continued growth of a torus palatinus. J Oral Surg. 1977;35:845-6. PMid:269237.
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