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Flangeless horseshoe maxillary complete denture: a prosthodontic solution to maxillary tori Sandeep Pai Wouter Leyssen Dental Update 2024 49:8, 707-709.
Authors
SandeepPai
BDS, MFDS RCPSG
Dental Core Trainee Year 3, Birmingham Dental Hospital
Tori may present difficulties in achieving a retentive prosthesis with full palatal coverage. Management of tori in such cases may involve attempting to avoid coverage of the torus, providing relief over the torus, or surgical reduction/removal. This article presents a case where a patient who presented with a large maxillary torus was managed with a non-surgical approach, which enabled provision of a successful prosthesis. Dental practitioners could consider this approach for selected cases.
CPD/Clinical Relevance: Thorough prior planning and a modified denture design can be used to provide an effective clinical solution for maxillary and mandibular tori.
Article
Tori present in the maxilla (torus palatinus) or mandible (torus mandibularis). Their incidence varies depending on the surveyed population, varying between differing ethnicities and sexes, with an incidence of up to 66% reported, equal between males and females.1,2 The aetiology of tori are unclear;3 however, novel hypotheses state they occur more frequently in bruxists due to the effect of excessive loading on surrounding hard tissues.4 They are also reported to undergo dimensional changes over time, which may manifest as discomfort.5 Tori are benign bony exostosis that generally do not interfere with dental treatment unless a removable prosthesis is indicated, which would encroach onto or around the torus.
Tori may be circumvented by means of accepting the edentulous gaps, or providing an appropriate fixed restorative option depending on the patient's specific circumstances. Anatomical challenges cannot be dismissed entirely, however, in cases where a removable prosthesis requiring palatal or lingual connector coverage is required, because tori will require specific consideration when designing the connector. Thorough assessment of what can be achieved by conservative measures alone may allow the practitioner to provide a satisfactory solution for the patient, prior to considering a surgical approach outright.
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