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Radiographs with large touching lingual tori

I have a patient that has very large touching lingual tori that I need to take bitewings on. We have Schick in our office. Any advice on how to take diagnostic bitewings especially of the mandibular premolars/molars?



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3 Answers

Wow, this is a tough one. The digital sensors are thicker and probably won’t fit. Could you “rest” the sensor on the tori with cotton rolls between the teeth to stabilize? You would only get the crowns on the film and not bone levels but this might be better than nothing.
It may be time for this patient to consider reduction of the tori and a good night guard to help prevent regrowth.

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I agree with Sue. I have a similar patient who had her tori removed, and every time I take xrays (we also use digital) I say a silent prayer of thanks that they’re gone!

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The surgery to remove the tori is not a painful process. I’ve been told it’s painless except for the healing where the sutures hold the gingiva between the teeth… The sutures poke the lip. That was the only discomfort most experience.
You might have to use the technique bisecting the angle since the sensor is wide and only take PA of each quad. The teeth will be distorted and over angled etc… Large tori make roots hard to see, but usually the crowns of the teeth are fine on the radiograph.
I think tori or exostosis is hereditary………but also think it can be bruxism related. The jury is still out.

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