Tori, Torus, Exostoses. Brian Palmer, D.D.S. Leawood, Kansas USA December 2004
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1 Tori, Torus, Exostoses Brian Palmer, D.D.S. Leawood, Kansas USA December
2 Tori: Non-pathologic outgrowth of bone. I believe this is one way bone responds to stresses applied to it. Is it due to ionization? 2
3 Hypothesis Tori are very common in today s population (2004). I believe they are a result of stresses on the bone and are mainly found on nervous, anxious and driver-type personalities. The significant increase in the number and size of tori seen today as compared to prehistoric times are the result of society stresses. Tori, I believe, will not be found in prehistoric skulls in the frequency or size of today s tori. Prehistoric man had stresses, but their stresses were the result of survival, not of society stresses. Difference will be in frequency (can be seen on a daily basis in dental offices today) and size (massive today not as massive in prehistoric times). 3
4 Tori May be genetically linked % of people have them. Females more affected. Mendelian Dominate. Evidence of what causes them is lacking % of children of parents who had them, will have them. (Source unknown) 4
5 Frequency of Occurrence of Toru Palatinus Origin Frequency Investigator (Year) Koreans 90% Osima (1939) Japanese 73% Sakaguchi (1939) Eskimos/Laplanders 60% Schreiner (1935) Venezuelans 24% Luzardo (1958) Americans White 21% Kolas (1953) Black 19% Austin (1965) Chileans.37% Witkop (1963) 5 Compendium of Continuing Education, Year and issue unknown.
6 6 Enlarged mandibular angle usually associated with powerful masseters.
7 7 Panoramic radiograph demonstrating over developed mandibular angles in a strong bruxer / clencher. (See next 2 slides)
8 8 Enlargement of one side.
9 9 Enlargement of other side.
10 10 Square jaw. Typical of clencher / bruxer.
11 11 Large mandibular angle of square jawed individual.
12 Skulls from era evaluated at the Smithsonian Natural History Museum in
13 13 Smithsonian skull ( ). Note bony tori.
14 14 Note bony lingual torus on this mandible. ( )
15 15 Maxillary bony torus. ( ).
16 16 Same skull has tori on lingual as well.
17 17 Bony tori on the lingual of this mandible. ( )
18 Eskimo skulls from Smithsonian that have exostoses and tori. 18
19 19 Eskimo mandible #1. Exostoses and tori.
20 20 Eskimo mandible #2. Tori.
21 21 Eskimo mandible #3. Exostoses and tori.
22 Tori growth cases. Case 1 22
23 23 Mandibular tori. 1994
24 24 Same tori in 1998.
25 1994 Same individual
26 1994 Same individual, different pictures
27 27 Case 2
28 28 Mandibular lingual tori. 1995
29 29 Same individual in (Post whitening.)
30 1995 Same individual (Post whitening.)
31 Mandibular right torus. (Mirror used)
32 Same mandibular right torus. (Direct view)
33 1995 (Mirror used) Same torus in different years (Direct view) (Post whitening.)
34 Mandibular left torus. (Mirror used)
35 Same mandibular left torus. (Direct view)
36 Mandibular left torus (Mirror used) Same torus in different years (Direct view) (Post whitening.)
37 Maxillary left torus. (Mirror used)
38 38 Same maxillary left torus in (Direct view)
39 1995 (Mirror used) 2004 (Direct view) (Post whitening.) 39
40 Individual mandibular / maxillary tori cases. 40
41 41 Mandibular tori.
42 42 Mandibular tori.
43 43 Mandibular tori.
44 44 Massive tori take up tongue space. Lady had OSA.
45 45 Mandibular tori.
46 46 Mandibular tori.
47 47 Mandibular tori. Note heavy wear marks.
48 48 Mandibular tori.
49 49 Mandibular tori. Note multiple gold crowns.
50 50 Mandibular tori.
51 51 Mandibular tori. Bonded retainer.
52 52 Mandibular tori.
53 53 Mandibular lingual tori.
54 54 Mandibular lingual tori.
55 55 Mandibular tori.
56 56 Maxillary buccal tori. (Mirror used)
57 57 Maxillary lingual tori.
58 58 Maxillary lingual tori.
59 Multiple Slide Cases Case 1 59
60 60 Mandibular anterior tori. Lady is 92.
61 61 Maxillary tori. Same lady. Age 92.
62 62 Case 2
63 63 Massive maxillary tori.
64 64 Massive buccal and lingual tori. Note multiple crowns.
65 65 Massive buccal and lingual tori.
66 66 Left side. Massive buccal and lingual tori.
67 67 Left and right sides.
68 68 Occlusal view of tori and gold crowns.
69 69 Another view of tori and crowns. (25 years old crowns)
70 70 Massive maxillary left buccal tori.
71 71 Massive maxillary right buccal tori.
72 72 Person also has a palatal torus.
73 73 Case 3
74 74 Maxillary and mandibular tori.
75 75 Close up of maxillary buccal tori.
76 76 Maxillary left tori.
77 77 Case 4
78 78 Maxillary right torus..
79 79 Maxillary left tori.
80 Models of case. Tori marked in red. 80
81 81 Case 5
82 82 Mandibular lingual tori.
83 83 Measuring space between tori.
84 84 Daughter of previous person developing tori also.
85 85 Case 6
86 86 Typical powerful square jaw of bruxer / clencher.
87 87 Mandibular tori.
88 88 Models of case. Tori marked in red.
89 89 Palatal Tori
90 90 Youngest torus I have seen. Age 7.
91 91 Different palatal torus. Age 9.
92 92 Palatal torus.
93 93 Palatal torus
94 94 Palatal torus.
95 95 Palatal torus.
96 96 Palatal torus.
97 Individual thought her torus was a tongue scratcher. 97 Massive palatal torus. (See next 2 slides.)
98 98 Same palatal torus - different view. (See next slide.)
99 99 Same torus on model.
100 100 Another massive palatal torus. (See next 2 slides.)
101 101 Same torus - different view. (See next slide.)
102 102 Another view of same torus.
103 103 Treatment Options
104 104 Maxillary hard occlusal splint.
105 Lips together - teeth apart. Only time your teeth should be squeezed together and touching is when you swallow. Even when you are eating there are usually food particles keeping your teeth apart. 105
106 Presentation developed by: Brian Palmer, D.D.S. Leawood, Kansas, USA December 2004
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