Uncommon bilateral maxillary exostosis: case report

ABSTRACT Exostoses or hyperostoses are benign bony outgrowths originating from the cortical bone and depend on their location for a more precise designation. The most common types found in the oral cavity are the torus palatinus and the torus mandibularis. Buccal and palatal exostoses are located along the buccal aspect of the maxilla and/or the mandible (commonly in the premolar and molar areas) and on the palatal aspect of the maxilla (usually in the tuberosity area), respectively. The etiology of exostoses still hasn’t been enlightened but an interaction between environmental and genetic factors is accredited. They are usually asymptomatic, unless the mucosa becomes ulcerated. The frequency of exostoses increases with age, having their biggest prevalence from 60 years old, being more common in men and suffering ethnic influences. A thorough evaluation is important for the correct diagnosis since other lesions have similar clinical characteristics to the exostoses such as osteomas. The majority of exostoses are diagnosed clinically along with radiographic interpretations, making the biopsy dispensable and the treatment is usually unnecessary. The aim of this article was to describe a case report of bilateral maxillary exostosis, unusual, in a female patient. If an excessive amount of bone is present the exostoses may exhibit a relative radiopacity on dental radiographs. Initially, periapical and panoramic radiographs were performed to evaluate the alterations. Due to the size of the exostoses a concomitant Cone Beam Computed Tomography was performed to confirm the diagnosis. The patient is in follow-up.

摘要：外生骨疣（Exostoses）或骨质增生（Hyperostoses）是起源于皮质骨的良性骨性赘生物，其精准命名需依据发病部位确定。口腔内最常见的类型为腭隆突（torus palatinus）与下颌隆突（torus mandibularis）。颊部外生骨疣与腭部外生骨疣分别位于上颌骨和/或下颌骨的颊侧（多见于前磨牙与磨牙区），以及上颌骨的腭侧（通常位于结节区）。目前外生骨疣的病因尚未阐明，但普遍认为与环境及遗传因素的相互作用相关。此类病变通常无明显症状，仅当黏膜发生溃疡时可出现临床表现。外生骨疣的患病率随年龄增长而升高，60岁年龄段为高发阶段，且男性发病率更高，同时受种族因素影响。由于部分其他病变（如骨瘤（Osteomas））的临床特征与外生骨疣相似，因此全面评估对明确诊断至关重要。多数外生骨疣可通过临床检查结合影像学检查确诊，无需活检，通常也无需治疗。本文旨在报告1例罕见的双侧上颌外生骨疣病例，患者为女性。当骨组织过度增生时，外生骨疣在牙科X线片上可呈现相对阻射影。本病例最初通过根尖片与全景片评估病变情况，鉴于病变体积较大，进一步辅以锥形束计算机断层扫描（Cone Beam Computed Tomography）以明确诊断。目前患者仍在随访中。