Torus Removal Surgery — ORE Part 1 MCQ

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HardOral SurgeryTorus Removal SurgeryORE Part 1

A 50-year-old patient has a mandibular torus that needs to be removed because it interferes with the design of a lower partial denture. What is the most appropriate surgical approach?

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Correct answer: D — Raise a mucoperiosteal flap, section the torus with a bur, and remove with chisel and mallet; suture the flap

Option D describes the standard surgical approach to mandibular torus removal. Raising a full-thickness mucoperiosteal flap provides complete visualisation and allows safe sectioning of the dense bony exostosis using a high-speed bur, followed by careful removal with chisel and mallet, and watertight primary closure. This technique is faster and more controlled than alternatives. Option B (punch biopsy) is inappropriate for complete lesion removal and is used only for diagnosis. Option A (laser ablation) is technically feasible but requires significantly longer operative time and additional rasp finishing compared to conventional burs, making it not the most appropriate first choice. Option C (cryotherapy) is not an established technique for bony exostoses. Option E (acid dissolution) has no clinical basis—bone does not dissolve under clinically relevant conditions.

Reference: Royal College of Surgeons Faculty Dental Journal. Surgical removal of torus palatinus in a patient with a history of bisphosphonates. 2022. https://publishing.rcseng.ac.uk/doi/10.1308/rcsfdj.2022.14. Supported by: Surgical removal of mandibular tori and its use as an autogenous graft (PubMed 2013). https://pubmed.ncbi.nlm.nih.gov/23605821/