The

n e w e ng l a n d j o u r na l

of

m e dic i n e

images in clinical medicine

Torus Mandibularis

62-year-old woman presented for a routine dental examination. Plinio Arcuri, D.D.S.
During the examination, she was asked about the increased tissue on the Hospital Regional de Osasco
lingual surface of her lower jaw. The patient reported that the mass had So Paulo, Brazil
been growing slowly for years and that several family members had similar growths. plinio_miguel@hotmail.com
She reported no pain, pruritus, or other symptoms. On examination, four hard,
sessile nodules were noted on the lingual surface, with normal overlying mucosa. Luana Campos, D.D.S.
No notable abnormalities were identified on panoramic radiographs. Exostoses are University of So Paulo
localized, benign bony protrusions. The most common oral exostoses are torus So Paulo, Brazil
palatinus and torus mandibularis, which do not have cartilage involvement, owing to
their anatomical location. There are many reasons for the development of exostoses,
including genetic and environmental causes. They are generally asymptomatic.
Removal of oral exostoses may be indicated before prosthetic rehabilitation or if
complications from chronic trauma develop. Since this patient was asymptomatic,
no intervention was required.

DOI: 10.1056/NEJMicm1207099
Copyright 2013 Massachusetts Medical Society.

n engl j med 368;9

nejm.org

february 28, 2013

The New England Journal of Medicine

Downloaded from nejm.org on October 9, 2014. For personal use only. No other uses without permission.
Copyright 2013 Massachusetts Medical Society. All rights reserved.

e11