Developmental Disorders
A bilateral a symptomatic benign bony lump or lumps, lingual to the mandibular premolars
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		    Developmental Disorders
 
 Torus Mandibularis Definition
 
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 A bilateral asymptomatic benign bony lump or lumps, lingual to the mandibular premolars
 
 Etiology
 
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 Developmental Seen especially in Asian and Black races May be associated with parafunction Seen mainly in males, and rarely in Turner's syndrome (4S,X)
 
 Gingival Involvement
 
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 Common
 
 Other Sites of Involvement
 
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 Often associated with torus palatinus; a slow-growing, asymptomatic, benign bony lump in midline of palate
 
 Main Clinical Features
 
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 Bony lumps, which grow slowly, appear in adolescence and usually cease growth in late teens (Fig. 32). Bony hard with normal overlying mucosa, asymptomatic, benign and of no consequence.
 
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 Diagnosis
 
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 Diagnosis is from history and clinical features, supplemented by: • Radiographic examination.
 
 Differential Diagnosis
 
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 Torus mandibularis - exclude unerupted teeth Torus palatinus - exclude neoplasms
 
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 Excise or reduce only if causing severe difficulties with dentures.
 
 Treatment
 
 FIGURE 32
 
 Torus mandibularis
 
 G. Laskaris et al., Periodontal Manifestations of Local and Systemic Diseases © Springer-Verlag Berlin Heidelberg 2003
 
 Chapter 3 • Developmental Disorders
 
 Multiple Exostoses ofthe Maxillary Alveolar Process Definition
 
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 Multiple exostoses of the maxillary alveolar process
 
 Etiology
 
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 Genetic
 
 Gingival Involvement
 
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 Rare
 
 Other Sites of Involvement
 
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 Occasionally arise beneath a bridge pontic (sub-pontic osseous hyperplasia)
 
 Main Clinical Features
 
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 Exostoses typically buccal to maxillary premolars and molars (Figs. 33, 34). Appear in adolescence. Grow slowly and usually cease growth in late teens. Most are asymptomatic, benign and of no consequence.
 
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 Diagnosis
 
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 Diagnosis is from history and clinical features, supplemented by: • Radiography.
 
 Differential Diagnosis
 
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 Osteoma
 
 Treatment
 
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 Leave alone
 
 Fibrous Tuberosity Definition
 
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 A fibrous tuberosity
 
 Etiology
 
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 Idiopathic
 
 Gingival Involvement
 
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 Uncommon
 
 Other Sites of Involvement
 
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 None
 
 Main Clinical Features
 
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 Enlarged tuberosities, mainly palatally (Figs. 35-37)
 
 Diagnosis
 
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 Diagnosis is from history and clinical features.
 
 Differential Diagnosis
 
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 Hereditary gingival fibromatosis Drugs Neoplasms Pregnancy gingivitis Sarcoidosis Crohn's disease Leukaemia
 
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 Occasionally surgery
 
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 Treatment
 
 Chapter 3 • Developmental Disorders FIGURE 33
 
 Multiple exostoses
 
 FIGURE 34
 
 Multiple exostoses
 
 FIGURE 35
 
 Fibrous tuberosity
 
 Chapter 3 • Developmental Disorders FIGURE 36
 
 Fibrous tuberosity
 
 FIGURE 37
 
 Fibrous tuberosity
 
 Reading List Alvesalo L, Mayhall JT, Varrela J (1996) Torus mandibularis in 45,X females (Turner syndrome). Am J Phys Anthropoll0l:145-149 Antoniades DZ, Belazi M, Papanayiotou P (1998) Concurrence of torus palatinus with palatal and buccal exostoses: case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:552-557 Jainkittivong A, Langlais RP (2000) Buccal and palatal exostoses: prevalence and concurrence with tori. Oral Surg O		
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