Mandibular tori are bony protuberances on the lingual spect of the andible that usually occur in the premolar area. The orlgtns of this bony exostosis are uncertain, and the growths may slowly increase in size. Occasionally,
extremely large tori interfere with normal speech or tongue function during eating, but, these tori rarely require removal when teeth are present: Afterthe removal, of Iower teeth and before the construction of partial or
complete dentures, it may be necessary to remove mandibular tori.to facilitate denture construction. , Bilateral lingual and inferior alveolar injections provide adequate anesthesia tor tori removal. A-cr~ the
ridge incision should be made, extending 1 & 1.., f.~.beyond each end of the ori to be reduced. When bilateral t ori are to be removed simultaneously, it is best to leave a small band of tissue attached at the midline between
the anterior extent of the two incisions. Leaving this tiss.sue attached helps eliminate potential hematoma formation. In the anterior floor of the mouth and wilkmalntaln as much of the lingual vestibule a\ possible in the anterior
mandibular area. As with maxillary tori, the mucosa over the lmgua! tori is generally very thin and should be reflected carefully to expose the entire area of bone to be recontoured (Pig. 13-16) When the torus ha s a small pedunculated base, a mallet and osteotome may be used tocleave the tori from the medial aspect of the mandible. The line of cleavage can . be directed by creating a small trough with a bur and a handpiece before using an osteotome. It is extremely . important to ensure that the direction of the initial burtrough (or the osteo ome if it is used alone) is parallel with the medial aspect of the mandible ‘to avoid an unfavorable fracture of the lingual or inferior cortex. The bur can alsobe used to deepen the trough so that. a small instrument can be levered against the mandible to fracture
the lingual tori to allow its removal, A bone bur or file can then be used to smooth the lingual cortex. The tissue should be readapted and palpated to evaluate contour and elimination of undercuts. An interrupted or continuous suture technique is used to close the incisions. Gauze .packs placed in the floor of the mouth and retained for 12 hours are generally helpful in reducing postoperative edema and hematoma formation. In the
event of wound dehiscence or exposed bone in the area of a mucosal perforation, treatment with local care, including frequent vigorous saltne irrigation, is usually sufficient. . AFIG. ’13-15 .Removal of palatal torus. A, Typical appearance of maxillary torus. B, Midline. incision will. nteroposterior oblique releasing incisions. C, Mucpperiosteal laps retracted with silk sutures to improve access to all areas of torus.