Mandibular Tori Used as Bone Graft Source For Dental Implants

Mandibular tori (bone bumps next to your tongue) can sometimes be used as bone graft source for dental implants. The images in this post are of a patient I recently treated in Burbank.

She is missing one of her first molar teeth and the bone has shrunk because it has been a long time since she lost the tooth. She came to me for a dental implant, but was also interested in removing the bumpy nodules next to her tongue.  The plan was do have one surgery where the tori on each side would be removed and that same bone used to rebuild the area that is going to have the implant!

Burbank Dental implant tori (1) 
Burbank Dental implant tori (2) 
Burbank Ramsey Amin bone graft (2) 

After removal and healing bone graft:
Burbank Dental bone graft (1) 
Mandibular tori are a bony growth (bumps) in the lower jaw  along the surface nearest to the tongue. Mandibular tori are usually present near the premolars (middle teeth) and above the location of the mylohyoid muscle's attachment to the mandible. In 90% of cases, there is a torus on both the left and right sides.

Tori are slow-growing and vary in size. Most of them do not interfere with

eating or speech. Many people have tori without knowing it. Look in the mirror; you might notice them in your own mouth!

Many people who notice tori are concerned about oral cancer. Tori are not cancerous. They also do not turn into cancer. A torus is normal bone covered with normal tissue. However, other types of growths in the mouth can turn out to be oral cancer.

The prevalence of mandibular tori ranges from 5% – 40% and are less common than bony growths occurring on the palate, known as torus palatinus. They will not disappear unless surgically removed. Tori cannot be prevented.

It is believed that mandibular tori are caused by several factors. They are more common in early adult life and are simetimes associated with grinding. The size of the tori may fluctuate throughout life, and in some cases the tori can be large enough to touch each other in the midline of mouth!

Mandibular tori are usually a clinical finding with no treatment necessary. It is possible for ulcers to form on the area of the tori due to trauma. The tori may also complicate the fabrication of dental implant or regular dentures. If removal of the tori is needed, surgery can be done to reduce the amount of bone.

Because they are on the roof of your mouth, tori palatini can be irritated by some foods. Hard foods, such as crusty bread, or hot foods, such as pizza, are most likely to cause problems. Large upper and lower tori can interfere with speech. Tori on the roof of the mouth can also be used for dental implant grafting, but there are other, easier areas to obtain your own bone if needed

Surgery  can be done under IV sedation in the office.

So…do you have tori?

Feel free to comment below or join the conversation on my Facebook page.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California

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9 Responses to Mandibular Tori Used as Bone Graft Source For Dental Implants

  1. RJ says:

    Wow –awesome –I didnt even know those could be removed!

  2. Josh says:

    Yeah so…it DOES hurt. i can’t even feel my jaw without being in pain…or move my tongue without hurting them…or even place my tongue properly inside my mouth…do you have any idea how annoying and tiring that is to deal with everyday? How much does it cost to have them removed? i heard it’s $1000+ for each tori removed. is this correct?

  3. Hi Josh,
    You must have some really large tori! They should only hurt when you cut them with crunchy, sharp foods.
    If they hurt on their own, you should be looked at asap!
    The cost depends on size and how they are attached.
    Ramsey A. Amin, D.D.S.
    Diplomate of the American Board of Oral Implantology /Implant Dentistry
    Fellow of the American Academy of Implant Dentistry
    Burbank, California

  4. Andrea says:

    I live in Hawaii and I have both mandibular & palatial tori, which are all quite large. I had a problem last year when I was anesthetized for spinal surgery. The palatial one was nicked, and developed a very slow healing, painful chancre sore which later had some bone-like protrusion. I saw 3 dentists, and was told I needed oral surgery done for removal. Unfortunately, my dental doesn’t cover it, and I am financially strapped, so surgery was not done. Then about 2 weeks ago, I had gallbladder surgery, and my mandibular tori was nicked on both sides of my mouth. Now I am suffering again with painful chancres. I would like to have them all removed, but since my dental doesn’t cover that, and I don’t have the money, I guess am stuck with these tori.

    • RamseyAminDDS says:

      Hi Andrea,

      Based on what you wrote there is a chance your medical insurance might pay for the removal. There would be no guarantee, but speak to a dental surgeon that commonly bills medical. That might help.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  5. Dana says:

    I have large madibular tori 2-3cm (1 inch) that are scheduled for removal in a few weeks because they’ve gotten large enough that they are becoming problems. I first noticed them about 15-20 years ago as bumps, now there’s only about a half centimeter (1/4 – 3/8 inch) between them. They don’t hurt at all unluss I eat sharp foods.

    However, they are interfering with my speech. More importantly, since my tongue can’t nest properly in my jaw, I bite my tongue badly about once a week, usually in my sleep. Some of the tongue lacerations were quite severe, and after the most recent chomp, I’ve had enough.

    There will be an incision made along the top of my gums, the tissue will be peeled back, the tori shaved down, and some extra tissue excised. Then I’ll be stitched back up. Conceptually a little gruesome, but probably on par with diffucult wisdome teeth removal as far as post-operative discomfort and recovery time. I’m a little grossed out by the procedure, but not worried about it. I can’t wait to have my mouth back!

    • Judy Voorhees says:

      Im 63 and mine are now so close that the tissue under my tongue that hangs down is straining, they were always big but this is ridiculous. Probably 20 yrs ago the dentist I have now saw them and was alarmed but they werent in the way then so I blew it off. I guess Im going to have to have them removed. Did you go for your surgery, was it painful afterwards, did they put you out, how long before you can swallow without pain. Im so scared.

      • Ramsey Amin DDS says:

        Hi Judy,

        If you are going to have them removed, I suggest you have IV sedation. Most of my patients that have this done recover within a day with minimal pain or interruption of their life. If the surgical technique and your healing capability are good, this shouldn’t be so bad.

        I would definitely be sedated though. It is a bit scary.

        Ramsey A. Amin, D.D.S.
        Diplomate of the American Board of Oral Implantology /Implant Dentistry
        Fellow-American Academy of Implant Dentistry

  6. Verneal Maze says:

    I have three children, one daughter, two sons, and 2 grandchildren that have the mandibular tori and they’ve gotten very large in each of them, but I don’t know how many more of my family has them. I don’t have them, nor did my parents and neither did their father and none of the children showed any signs when they were younger. My eldest son has them and they’ve given him quite a bit of trouble, such as tooth extractions. My two grandchildren’s mandibular tori has grown much faster than their mother’s. Hers started in her late twenties and her two children in their late teens, they are now in their thirties. and they’re mother is in her fifties.

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