An asymptomatic, hard, bony lesion is present in the midline of the hard palate in a patient presenting for a removable prosthesis. She reports no difficulty eating or speaking. What is the diagnosis, and what is the next step?

Correct answer: A. Torus palatinus — proceed with the prosthesis, relieving or surgically reducing the torus only if it interferes with the denture

• A. CORRECT. TORUS PALATINUS is a benign, hard, bony exostosis in the MIDLINE of the hard palate covered by normal, thin mucosa. It is a developmental variant of normal requiring NO treatment. In denture patients, the torus is a relief area — it is non-resilient and will cause a rocking, unstable denture and ulceration if loaded. Manage it by relieving the denture base, or surgically reduce it only if it is large, undercut, or lobulated enough to prevent an adequate seal.
• B. Nicotinic stomatitis is a diffuse WHITE change of the palatal mucosa with red dots, not a bony hard midline mass.
• C. There is no clinical feature suggesting neoplasm: no ulceration, no growth, no pain, no fixation, and the location and consistency are typical.
• D. Biopsy is unnecessary for a classic torus — the clinical presentation (midline, bony hard, asymptomatic, normal mucosa, long-standing) is diagnostic.

Note: Torus mucosa is thin and easily ulcerated — always relieve it in the denture. Removed tori are also a convenient source of autogenous bone graft.