Palatal mass with an overlying white lesion

TORUS PALATINUS

Torus palatinus presents as a median, symmetrical bony protuberance along the midline ridge of the hard palate. It is typically asymptomatic, often goes unnoticed, and is usually discovered by the patient or incidentally during routine dental examination.¹

Torus palatinus is present in up to 25% of the general population and is more common in women.^1,2 It has a higher prevalence in East Asian populations than in West African populations; individuals between 20 and 50 years of age are most commonly affected.³ A study that included 448 women from different ethnic groups living in the United States found torus palatinus was present in 25.6% (11 of 43) of Hispanic participants, 22.5% (68 of 302) of Black participants, 16.7% (6 of 36) of Asian participants, 16.1% (10 of 62) of White participants, and 0% (0 of 5) of Native American participants.⁴ A study conducted in Malaysia reported a torus palatinus prevalence of 32.9% in Malaysian women.⁵

About 30% of palatal tori are hereditary, while the remaining 70% are thought to result from environmental factors such as masticatory hyperfunction (excessive chewing) and parafunctional habits such as bruxism and jaw clenching.^1,3

Torus palatinus should be differentiated from other intraoral lesions, including fibromas, mucoceles, osteomas, osteochondromas, osteoid osteomas, and, most important, malignant tumors such as squamous cell carcinoma and chondrosarcoma (Table 1).^1,2 The diagnosis of torus palatinus is primarily clinical, but radiographic and pathologic examinations may occasionally be helpful.¹

Treatment is generally not required for asymptomatic patients³; however, surgical removal may be considered when there are concerns related to trauma, hygiene, psychological distress, or functional impairment.¹ The mucosa covering palatal tori is often thin and prone to trauma, which may lead to ulceration or inflammation.¹ Additionally, white, nonscrapable lesions such as frictional keratosis, lichen planus, or leukoplakia can develop on the surface.⁶ These lesions are commonly encountered by dental surgeons, dermatologists, and otolaryngologists; they require careful monitoring because of the potential for malignant transformation into, for example, squamous cell carcinoma.^2,6

DISCLOSURES

The author reports no relevant financial relationships which, in the context of their contribution, could be perceived as a potential conflict of interest.