When a “Simple” Lingual Tori Isn’t Simple: CBCT Insights Every Dentist Should Know

Описание: Explore more dental CBCT cases and specialist insights at mfiradiology.com.au
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What appears clinically as a routine lingual tori can sometimes conceal a far more complex and clinically significant condition.

In this case, a low-dose dental CBCT of the maxilla and mandible revealed an atypical pedunculated bony protuberance arising from the lingual cortex of the mandible. While exostoses are common findings, this lesion showed erosion and sequestration, features that immediately raise concern beyond normal anatomical variation.

The scan also demonstrated generalised periodontal bone loss, TMJ remodelling, and additional exostoses elsewhere in the jaws. Crucially, the focal erosion and sequestration suggested an active pathological process. In the appropriate clinical context, this raises the possibility of medication-related osteonecrosis of the jaw (MRONJ), inflammatory change, or, less likely, an underlying neoplastic process.

Why this matters for dentists

Without CBCT and specialist interpretation, this finding could easily be dismissed as a benign tori. Missed or delayed diagnosis may lead to:

Progression of bone necrosis

Chronic infection and ongoing pain

Increased risk of pathological fracture

Delayed referral for surgical management or biopsy

Serious complications if extractions or surgery are performed unknowingly

This case highlights why full-volume CBCT review, beyond the teeth alone, is critical for safe treatment planning and confident clinical decision-making.

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