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Dx:Torus Palatinus
KEY FACTS
Terminology
Synonym: Palatal torusDefinition: Exophytic proliferation of
normal cortical & cancellous bone in midline of hard palate
Imaging
Size varies from very small nodule to large multilobed
protuberances
Flat, nodular, multilobed, or spindle-shaped
Intraoral Imaging: Well-defined radiopacities, which may
superimpose on maxillary sinus in posterior periapicalviews
CBCT:Exophytic high-density areas in middle of hard palate
Top Differential Diagnoses
Exostoses
Osteoma
Pathology
Genetic with overlay of environmental influences: Parafunctional
activity
Possibly X-linked, accounting for higher incidence in women
Associated with buccal and palatal exostoses& mandibular
tori
Clinical IssuesFemales > males
More common in ethnic groups: Mongols and Eskimos
Prognosis excellent; no malignant potential
Tori are removed when consistently traumatized or interfere with
function
Diagnostic ChecklistConsider: Osteoma/Gardner syndromeif not in
expected location for tori
TERMINOLOGY
Abbreviations
Torus palatinus (TP)
Synonyms
Palatal torus
Definitions
Exophytic proliferation of normal cortical and cancellous bone
in midline of hard palate
IMAGING
General Features
Location: Midline of hard palate
Size: Varies from very small nodule to large multilobed
protuberances
Morphology: Flat, nodular, multilobed, or spindle-shaped
Radiographic Findings
Intraoral plain film: Well-defined radiopacities, which may
superimpose on maxillary sinus in posterior periapical
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views
CT Findings
CBCT: Exophytic high-density areas in middle of hard palate
DIFFERENTIAL DIAGNOSIS
ExostosesPlain film: Well-defined radiopacity usually more
cervical than torus palatinus
CBCT: Exophytic bony protuberances on buccal or palatal alveolar
processes
Osteoma
Exophytic nodules more common on ramus and inferior border of
mandible
May be multiple: Gardner syndrome
PATHOLOGY
General Features
Etiology: Genetic with overlay of environmental influences:
Parafunctional activity
Genetics: Possibly X-linked, accounting for higher incidence in
women
Associated abnormalitiesBuccal and palatal exostosesMandibular
tori
Microscopic Features
Dense cancellous bone with rim of cortical bone of various
thickness
CLINICAL ISSUES
Presentation
Most common signs/symptoms: Asymptomatic unless traumatized
Other signs/symptomsLarge tori may cause difficulty eating and
speakingLarge tori may be chronically traumatized during
mastication
Demographics
Age: Usually develops before age 30
Gender: Females > males
EpidemiologyMore common in ethnic groups: Mongols and
EskimosStudies have shown that postmenopausal women with large TP
have higher mean bone density than theirpeers and much younger
women
Natural History & Prognosis
May slowly increase in size
Prognosis excellent; no malignant potential
Treatment
No treatment required
Tori are removed when consistently traumatized or interfere with
function or fabrication of prostheses to replacemissing teeth
DIAGNOSTIC CHECKLIST
Consider
