Download Citation on ResearchGate | Extirpación de torus palatino / | Tesis audiovisual (Cirujano Dentista) UAN. Bibliografía: p. }. Exposición espontánea de un torus palatino de la línea media La evolución clínica fue satisfactoria, con resolución completa un mes después de la cirugía. ly during middle age of life; the torus palatinus is more commonly torus and the presence of abraded teeth in Thais, but Cirugía Bucal.
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Cirrugia aim of this study was to assess the ability of Er: YAG laser to remove by excision torus mandibularis and to smooth torus palatinus exostosis. YAG laser using the following parameters: Once peeling was considered to be accomplished, the use of a surgical rasp was necessary to eliminate bone spicules that could delay the wound to heal in good conditions.
YAG peeling TP are safe clinical techniques easy to practice even if the time required for excision or surface smoothing is more than the time required with bony burs and high speed instruments.
Tori may be considered as specific exostosis, formed by a highly dense and strictly limited amount of bone marrow, covered with a thin mucosa, easy to flap and poorly vascularised.
Their growth is very slow and do not produce any symptoms except in edentulous patients where constructing and wearing partial dentures seems palatio to impossible.
Rodete mandibular – Wikipedia, la enciclopedia libre
The aetiology of tori is not clear at all [ 1 ] even if genetics is supposed to be the most widely accepted factor [ 23 ]. Other causes such as functional responses to superficial injuries, temporomandibular disorders, eating habits and diet, vitamin deficiency, and drugs causing an increase in calcium homeostasis have been evoked. Clinically, discovering of tori is frequently diagnosed in occasional way because those pathologies are asymptomatic.
The request for clinical examination depends mainly on the size: Conventional surgical treatment, in exception of chisel and hammers that involve possible risks of traumatic injuries, request to perform excision via bony burs once the flap has been anchored by different methodologies or simply elevated and maintained via suture needle or any other conventional means. The aim of this paper is to demonstrate that Er: YAG laser may be an effective help in the surgical treatment of bony protuberances arising from cortical plate torus palatinus, torus mandibularisand that it may conducted rapidly and safely without potential damages to the surrounding tissues.
The patient was concerned about an oral rehabilitation partial denture and the Department of Prosthetics asked for the removal of a large, round, lobular osseous protuberance Figure 1 located in front of the buccal side of the mandibular premolars teeth 44, This bony exostosis was covered with normal thin mucosa and the patient did not mention any identified symptoms.
All the missing teeth 46, 47, 35, 36, 37 had to be replaced by a partial denture after carious decays plus root canal treatments and ceramic-metallic crowns aiming to serve the stability and the retention of the future prosthesis. General and oral health of the patient was satisfactory. Being clearly informed on the protocol to be engaged, the surgical procedure was performed. Incision of the mucosa was performed with the lowest fluence Figure 2 and rapidly obtained pulses number i.
The flap was then removed and maintained via a metallic surgical spacer. In those conditions, the mouth floor was protected form laser hazards, being Er: YAG light totally reflected on metallic surfaces. Due to its gradual growth and its highly compact structure, high output power was used.
Spontaneous exposition of a midline palatal torus
The torus was completely sectioned Figure 3 after pulses corresponding to a 1. YAG laser being poorly absorbed in haemoglobin, the operative field is bleeding but at the same time washed with the air-water spray: Suturing was performed with 4.
Sutures were removed one week later and complete healing observed after 12 days after surgery. Neither postoperative ppalatino nor discomfort were observed. The examination of hematoxylin and eosin staining specimen revealed Figure 4 dense, mature bony tissue, organized in wide lamellar pattern with scattered osteocytes and small marrow spaces. Photomicrograph of histological appearance of TM shows dense bony tissue, presence of lacunae and normal osteocytes hematoxylin-eosin, original magnification x.
A years-old woman was referred to the Clinic for palatal bone exostosis removal Figure 5. This exostosis covered the anterior region of the palatal vault without extension to the alveolar process. With this TP being poorly raised and in the same way large, excision by slicing or cutting was impossible whatever the technique used bur or laser. It was possible to choose between two techniques: It was decided to use Er: YAG laser the following parameters: Half thickness flap was easily tipped over Figure 6 and the left side smoothed by firing.
Same protocol was used for the right side. At the end of the surface treatment, a rasp was used to eliminate the possible remaining bony spicules. The suture was then made by simple points not too tight.
Analgesic was immediately delivered and prescribed as previously described and the patient was informed that the signs and possible symptoms during the postoperative period might be those that are common with this type of surgical procedure. Moreover, she was informed and recommended to continue with appropriate hygiene. After one week, sutures were removed and the wound healed cidugia good conditions Figure 7.
Due to the mechanism of tissue elimination with Citugia YAG laser explosive vaporizationit was impossible to take a sample for histopathological examination.
Tori are bony swellings that develop slowly in the mouth. They are considered to be a developmental anomaly and they are classified according to their shape [ 6 ]:.
However, in exception of suffering from recurring traumatic surface ulceration or mucosal problems or when contributing to a periodontal problem, removal of the tori is unnecessary.
There is no report on possible malignant potential transformation [ 78 ]. A lot of speculations have been reported on possible etiopathogenic processes even if the most widely accepted hypothesis is genetics [ 9 — 11 ]. However, it has not always been possible to demonstrate the autosomal dominant nature of its appearance. Prevalence of palwtino TP versus TM is controversial too [ 12 ] as well crugia possible dominant sex group and ethnic groups [ 1314 ].
Tori are easily diagnosed by clinical examination. Usually the finding is incidental probably because they are asymptomatic for the patient even if some rare complains are se. While histopathological examination of TM shows a compact structure, TP microscopic structure is impossible to examine because they are neither nodular nor spindle but generally flat. Subsequently, surgery is conducted by remodelling the surface via bone-burr plus air-water spray.
YAG laser also remodels the surface via the so-called explosive vaporization of the target tissue. Each shot pulse takes of a small amount of bone and the repetition rate as well as the pulse duration, the spot size diameter, and the fluence are related to the efficiency of laser remodelling. As a consequence of a larger spot dr, the energy delivered on the target tissue is reduced, fluence being expressed in Joules per centimetre toeus.
YAG laser tori removal, specifically for TP, takes more time than conventional methods. A little problem encountered in peeling the surface with this device regards the irregular surface observed once the TP has been Er: For this reason, the use of a surgical rasp in order to prevent possible soft tissue damages is necessary before suturing the flap.
Postoperative prescription and recommendations were identical to those previously described TM. YAG laser is an optimal instrument to excise TM or smooth TP these lesions even if the time required for the intervention is more than the time needed by bony burs and high speed instruments. Good clinical healing process dr with this wavelength could be related to the reduction of target tissue heating, the decontamination, the absence of smear layer production that could disrupt the healing process, plus totus biostimulation of the irradiated tissues.
National Center for Biotechnology InformationU. Journal List Case Rep Dent v. Published online Jun tofus Rocca1 H.
Raybaud1 E. Merigo2 P. Pxlatino2 and C. Author information Article notes Copyright and License information Disclaimer.
dr Received May 1; Ttorus May This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Introduction Tori may be considered as specific exostosis, formed by a highly dense and strictly limited amount of bone marrow, covered with a thin mucosa, easy to flap and poorly vascularised.
Open in a separate window. Discussion Tori are bony swellings that develop slowly in the mouth. They are considered to be a developmental anomaly and they are classified according to their shape [ 6 ]: Torus palatinus, an exostosis of unknown etiology: The Compendium of Continuing Education in Dentistry.
Current status of the torus palatinus and torus mandibularis. Concurrence of torus palatinus with palatal and buccal exostoses: Palatine and mandibular tori. A morphologic study in the current Norwegian population. Torus palatinus and torus mandibularis: Epidemiological aspects of oral tori in a Ghanaian community. Cirugiq S, Kerdpon D. Relationship between oral tori and temporomandibular disorders. Jainkittivong A, Palarino RP. Buccal and palatal exostoses: Kerdpon D, Sirirungrojying S.
A clinical study of oral tori in southern Thailand: European Journal of Oral Sciences. Palatal tubercles, palatal tori, and mandibular tori: Prevalence of oral lesions in a selected Vietnamese population. Variation in torus palatinus prevalence in Norway.