PACT Spry Menu Pages
Congenital or Developmental, continued
Bony Tori (“Torus Palatinus or Mandibularis”)
 
Benign bony overgrowth (exostosis) in the midline of the hard palate (palatinus) or the lingual aspect of the mandible (mandibularis) where they are often bilateral and symmetric.
 
Torus palatinus is quite common and often not present or noticeable until adulthood, often in the third decade. Approximately 20% to 30% of the adult population develops a torus palatinus. Torus mandibularis is less common.
 
Do not require intervention unless the lesion becomes painful, ulcerates, or interferes with speech or eating.

Diastema
This is the term for the space between the central incisors associated with a prominent maxillary frenum. It is normal in childhood, but a diastema greater than 3 mm after eruption of the permanent upper canines (ages 10 to 13) should be evaluated for treatment (eg, orthodontic treatment or a
Frenectomy: Excision of a frenulum.
frenectomy).

Macroglossia
 
Enlargement of the tongue has a wide differential that includes Down syndrome, Beckwith-Wiedemann, Hurler’s syndrome, hypothyroidism, Rubenstein-Taybi, and local factors (eg, lymphangioma, hemangioma).
 
Airway maintenance and feeding are paramount, with involvement of appropriate specialists to ensure timely evaluation and management (eg, ENT, genetics).

Micrognathia
 
Denotes a small jaw, commonly from
Hypoplasia: A condition of arrested development in which an organ or part of an organ remains below the normal size or in an immature state.
hypoplasia of the mandible.
 
Can be an isolated finding or associated with a syndrome such as Pierre Robin sequence, Treacher Collins syndrome, Goldenhar’s syndrome or Cri-du-chat (5p-syndrome).

 
 
Bony tori can develop on the hard palate or the floor of the mouth.
 
Diastema that persist after eruption of the permanent maxillary canines should be evaluated.
 
The differential diagnosis of macroglossia is broad.



View the Chapter 11 Photo Gallery.