Torus

A torus is a benign, slow-growing bony exostosis that develops on specific anatomical surfaces within the oral cavity. The two most common types are torus palatinus, forming along the midline of the hard palate, and torus mandibularis, developing on the lingual surface of the mandible, typically in the premolar region bilaterally. Tori are composed of dense cortical bone covered by thin oral mucosa and vary from small, barely palpable nodules to large lobulated masses. The etiology is considered multifactorial, involving genetic predisposition, masticatory stress, and environmental factors. Prevalence varies by population, with some ethnic groups exhibiting rates as high as 60 to 80 percent.

In most cases, tori are asymptomatic and require no treatment. They are typically discovered during routine examinations and should be documented as benign incidental findings. However, tori become clinically significant when they interfere with prosthetic rehabilitation. A large torus palatinus can prevent fabrication and seating of a maxillary denture by occupying the palatal area needed for the denture base. Torus mandibularis can obstruct the design and insertion path of a mandibular removable prosthesis. When indicated, surgical removal is performed as a preprosthetic procedure, involving mucosal reflection, removal of the bony growth with rotary instruments or osteotomes, smoothing of the site, and suture closure.

On the billing side, torus removal is coded under the preprosthetic surgery CDT code series and is separately billable from the subsequent prosthetic appliance. Coverage is generally available when the procedure supports necessary dental treatment, but claims must document the functional impairment created by the torus. A narrative describing the size and location, the planned prosthetic treatment, and why removal is necessary is standard practice. Some medical plans may cover torus removal under musculoskeletal or oral surgery benefits, and practices should evaluate whether cross-coding provides better reimbursement. The healing period between removal and prosthetic impression taking should be communicated to the patient during treatment planning.