You know, Doctor, it’s pretty common for patients to come into our clinic, and purely by chance, we discover these bony protrusions on the inside of their lower jaw, right near the tongue. A patient might have lived with them their entire life, completely unaware they were even there, or they might suddenly notice them and ask, a bit worried, “What’s this bony lump, Doctor?”
Most of the time, these structures are something very simple and benign called mandibular tori. Let’s delve into what they are and how we typically spot them on our radiographs.
What Exactly Are Mandibular Tori?
Simply put, Doctor, mandibular tori are a form of hyperostosis—a benign bony growth—that appears on the lingual aspect of the mandible, which is the inner surface of the lower jaw. In essence, they’re just extra bony outgrowths that some people are naturally born with.
How They Appear on X-rays: Radiographic Features
When you’re looking at radiographs, you’ll easily recognize them by these specific signs:
Location
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They are very clearly visible on mandibular periapical radiographs, particularly those of the lower jaw.
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Sometimes, we can even catch a glimpse of them on bitewing radiographs.
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The clearest views are often found on periapical X-rays of the lower anterior teeth.
Edge
Their borders are always well-defined, and their position is distinctively well-localized.
Shape
They typically present as either round or ovoid in shape.
Internal Composition
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Internally, they appear radiopaque, meaning they block X-rays effectively.
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Their radiopacity will match the density of the surrounding bone.
Number
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You might find just a single one, appearing unilaterally (on one side).
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However, it’s far more common to see them bilaterally, meaning multiple tori on both sides.
Why They Matter: Clinical Significance
In the vast majority of cases, mandibular tori are entirely asymptomatic, meaning they don’t cause any symptoms at all. However, they can become an issue if a patient requires a denture, as their presence can significantly impede the stability and fit of the prosthetic. Occasionally, patients might also find it challenging to maintain proper oral hygiene in the area around these growths. Rarely do we need to remove them, only if they’re genuinely causing functional problems for the patient.
An Important Diagnostic Point
Despite their visibility on radiographs, remember, Doctor, that a thorough clinical examination is truly the definitive step in making a final diagnosis. Additionally, their often bilateral nature—appearing on both sides—is a very common characteristic that significantly aids in their diagnosis.
