Journal of Medicine, Radiology, Pathology & Surgery (2019), 6, 14–15

CASE REPORT

Torus mandibularis: A case report

Tejavathi Nagaraj, Soniya Kongbrailatpam, Ijum Doye, Devu Krishnan
Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Science and Hospital, Bangalore, Karnataka, India

Keywords:
Bony exostosis, tori, torus mandibularis
Correspondence:
Dr. Soniya Kongbrailatpam, Department of
Oral Medicine and Radiology, Sri Rajiv Gandhi
College of Dental Science and Hospital,
Bangalore - 560032, Karnataka, Indai.
E-mail: soniya.kongbrailatpam00@gmail.com
Abstract
Torus mandibularis is an extra growth of bone mostly detected on the lingual aspect of
the mandible which could be single or many. It is asymptomatic and sometimes result in
complications include speech disturbance, position of tongue, prosthodontic treatment,
poor oral care, and traumatic ulceration. It is roughly calculated that 10% of the people of
United States shows mandibular tori. This case report is to present bilateral mandibular
tori and its clinical features.

Received: 22 July 2019;

Accepted: 28 August 2019

Doi: 10.15713/ins.jmrps.170

Introduction the midline extended from the distal of 36 to mesial of 46,

Osteoma or hyperostosis is a non-pathologic, benign new bony
growth. They are developmental anomalies and usually seen in
adult and increase in size. They are asymptomatic, slow-growing,
resolve without treatment and painless growth, but sometimes,
may grow over several centimeters and create problem in the
fabrication and wearing of removable dentures or prosthesis.[1,2]
It is roughly calculated that the incidence rate of tori is roughly
40 in each 1500 populations and found mostly in Eskimos,
American Indians and Asians, and Koreans. Torus is derived
from Latin word, which means lump. Etiology is unclear but
a genetic condition is expected. Tori which are located in the
midline of the hard palate are called a palatal torus, or torus
palatinus, and on the lingual aspect of the mandible are called a
mandibular torus, or torus mandibularis.
Case Report
A male patient of 47 years old came to the oral medicine and
radiology department with a chief complaint of crown placement
in the lower right back tooth. The patient had a history of root
canal treatment done 3 months back and also underwent removal
of teeth in the upper and lower right and left back teeth region
when he was 20 years old for orthodontic treatment. No relevant
medical history was revealed. On clinical examination intraorally
[Figure 1], there was nodular growth seen bilaterally crossing
measuring approximately 4*1 cm in size bilaterally and mucosa
appears normal as compared to adjacent mucosal surface. On
palpation, it was non-tender and bony hard in consistency,
suggested of mandibular tori. The patient was explained about
the incidental pathological finding. The patient reported that it
was asymptomatic and started around 5–6 years back. He did
not have any interference in speech or chewing food. The patient
was sent to the department of conservative and endodontics for
crown placement.
Discussion
The tori mean “bulge” or “lump” in Latin word which is
defined as a benign new bone growth which leads exostoses,
mostly observed on the hard palate, called palatal tori or torus
mandibularis, upper buccal aspect, called buccal exostoses,
and lingual surface of mandible, called mandibular tori or
torus mandibularis.[3] Although etiology is unclear, hereditary
condition is suspected. The exostoses are organized by thick
corticated bone enveloped by a thin and poorly vascularized
mucosa which forms a hard mass in the oral cavity.[4] The
prevalence of torus palatinus among the people of United States
has been described as elevated as 25–40% and it is accepted
that palatal tori are 2 times as prevalent in females than males.
It is roughly calculated that 10% of the people of United States
shows mandibular tori. However, there is no particular male

14 Journal of Medicine, Radiology, Pathology & Surgery  ●  Vol. 6:4  ●  Jul-Aug 2019
Mandibular tori
Figure 1: Mandibular tori
or female preference which is reported in torus mandibularis.
Torus mandibularis mostly happens bilaterally near the canine
and premolar region of the mandibular lingual aspect above
the mylohyoid ridge. Sometimes, bilateral tori extend and
encounter at the midline and it is termed as “kissing tori.” The
peak prevalence of torus palatinus and torus mandibularis is in
third decades of life.[5] The incidence rate ranges from 9% to 70%
for palatal torus and 1% to 60% for mandibular torus.[6] They
started developing after puberty and increased in size steadily
over the years. Classification of tori clinically based on their
morphology:[7-9] (i) Flat tori – It is slight rounded bony lump
with a rolled surface for mandibular tori and it extends uniformly
on both sides of the palate. (ii) Lobular tori: It arises from a
single base which is pedunculated or sessile lobular lump seen on
the mandible or palate. (iii) Nodular tori: They are many bony
prominences each arising from individual bases and coalesce
when they extend and form grooves between them. (iv) Spindle
tori: It is elongated and seen next to the line of the mid-palatine
region for palatal tori and bilaterally in the mandibular lingual
surface.
Although there are no clear criteria for classification by size,
but two group of sizes are given (1) 2 mm, 2–4 mm, and above
4 mm or (2) 3 mm, 3–6 mm, and above 6 mm. 2 mm and 3 mm
have been found to be common sizes.[4]
Usually, tori are 1.5 mm-4 cm in diameter and can be single
growth or grouped together in a cluster, that is, nodular. Buccal
exostosis occurs less frequently than tori.[10] Buccal exostosis
and tori are benign lesions and do not possess malignant
potential.[3,4] The etiology is unclear and the most believed
theory of torus mandibularis at present is of genetic origin
in 29.5% of cases and 70% of cases are related to increased
masticatory forces to the teeth, that is, occlusal stress.[4,11]
No surgical management is generally needed for tori as it is
symptomless and however it becomes so large that (1) it mess
with function or denture placement, (2) suffers from recurrent
Journal of Medicine, Radiology, Pathology & Surgery  ● 6:4 ●  Jul-Aug 201915
Nagaraj, et al.
traumatic surface ulcerations because of hard food, such as fish
bones, and (3) contributing to a periodontal condition.[10] In this
case, we did not do the treatment as the patient came for other
reason but we counseled him about the growth. Moreover, this
case we suggested that the growth was lobular and nodular and
also kissing tori as the growth meets in the midline of the lingual
aspect of mandible.
Conclusion
Mandibular tori are an asymptomatic, non-neoplastic, slow-
growing, self-limiting, and painless growth. Surgical treatment is
not necessary but verbal counseling is required unless it is large
size, interference in speech, and mastication.
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How to cite this article: Nagaraj T, Kongbrailatpam S, Doye I,
Krishnan D. Torus mandibularis: A case report. J Med Radiol
Pathol Surg 2019;6(4):14-15.