What is jaw exostosis, how to remove this bone growth

Under exostosis (osteophyte) in dentistry, it is customary to understand a benign neoplasm in the form of a bone, sometimes osteochondral outgrowth on the alveolar process or in the jaw area.

They can take the form of bumps, spines, projections, or ridges.

How osteophytes appear

If we talk about the mechanism of osteophyte formation, then we can express ourselves as follows - first on bone tissue, a cartilaginous outgrowth is formed, which hardens over time and degenerates into cancellous bone. The surface of such a bone is again covered with cartilage, which in turn then hardens again. And so it can be repeated indefinitely. The tumor grows in size quite slowly and painlessly and can reach 10 centimeters or more.

If the osteophyte forms on the upper jaw, then it is located on the side of the buccal surface.

On the lower jaw, exostoses are manifested from the side of the tongue in the area of ​​the premolars, somewhat less often - near the incisors or canines. In the zone of small lower molar osteophytes are formed only in 5-15% of the examined patients.

Sometimes osteophytes (palatine torus) can be found in infants in the region of the median palatine suture.

It should be noted that, as a rule, jaw exostoses do not cause discomfort. It is for this reason that they are detected randomly during a medical examination or in preparation for prosthetics. But over time, neoplasms increase in volume and begin to cause inconvenience. For example, it becomes difficult to eat, diction is distorted, the growth interferes with prosthetics.

If you do not take any measures to remove them, then neophytes can begin to put pressure on the teeth, which in turn entails their displacement and a change in bite. That is why it is so important not to run this pathology, but to take timely measures to remove it.

Causes and symptoms of appearance

It should be noted that no obvious reasons for the formation of neophytes have yet been identified. But among the factors that contribute to the appearance of this pathology, the following can be listed:

• trauma and other types of mechanical stress;
• bone inflammation;
• hormonal imbalance;
• loss of bone strength;
• infectious inflammatory processes (flux, fistula, syphilis in the chronic stage);
• the wrong angle of inclination or growth of individual segments of the upper or lower dentition;
• congenital jaw pathology;
• a consequence of insufficient work of the organs of the endocrine system;
• damaged jaw fragments;
• old fractures;
• heredity;
• osteophytes of osteogenic dysplastic origin may occur.

The symptomatology of neophytes is mainly complicated by the fact that, as noted above, the patient often does not experience any symptoms: there are no painful sensations, the mouth opens quite freely, and the mucous membrane in the area of ​​the neoplasm does not have any changes.

For this reason, the disease is most often detected by the dentist.

But over time, with the progression of the disease, the symptoms of osteophyte become more pronounced:

• a small tubercle can be seen on the gums;
• over time, a neoplasm can reach the size of a large bump from a pea, which is clearly felt by the tongue and interferes with its correct location;
• painful sensations of varying degrees of intensity may occur;
• the mucous membrane of the mouth may acquire a bright reddish-pink hue;
• the patency of the blood vessels of the oral cavity is disturbed;
• the mobility of the lower jaw may be impaired.

Why does it sometimes grow after tooth extraction

Sometimes, extraction (extraction) of the tooth acts as the cause of the formation of jaw exostosis. This can be caused by violation of recommendations a dentist during the rehabilitation period or excessive trauma to the periosteum.

In addition, tooth extraction sometimes leads to various complications directly related to bone and soft tissue lesions.

If, during the extraction, the stage of smoothing the edges of the well was skipped during traumatic extirpation, then bony protrusions-thorns may also appear.

Diagnosis of the disease

Since developed exostosis can only be felt, the initial examination can only reveal a suspicion of bony exostosis. This is due to the fact that it is impossible to determine a clear picture visually. A very important role in the diagnosis of a neophyte is given to the symptoms of the disease and anamnesis.

Accurate diagnosis is carried out by X-ray examination. It is this that gives an accurate idea of ​​the number of neophytes, their size. It should be borne in mind that even this diagnostic method cannot give a complete picture. This is due to the fact that the cap of the neophyte, consisting of cartilage, is not reflected on the X-ray. And its size, especially in a child, can reach 7-10 mm.

In some cases, the doctor may order additional tests. Especially if a rapid increase in the size of the neoplasm is clearly traced.

Although the disease is benign, there is some risk of becoming a malignant neophyte. Then the doctor, to confirm or refute such a diagnosis, prescribes a biopsy for tissue sampling and their subsequent laboratory and cytological analysis.

Neophyte treatment methods

There is only one effective way to treat jaw exostosis - surgical intervention. However, it should be borne in mind that some patients may not need such an operation. Children do not undergo surgery until the age of majority. This is due to the fact that during the period of maturation, the neophyte may decrease or even completely dissolve.

Indications for removal

The indications for surgical intervention to remove exostoses are the following indicators:

• its considerable size;
• a fairly rapid increase in jaw exostosis;
• the risk of transformation into a malignant neoplasm;
• painful sensations;
• planned prosthetics;
• other reasons.

The procedure for removing the build-up

Immediately before the operation, a thorough examination of the patient's oral cavity is performed.

The surgery itself is usually performed under local anesthesia. There are two methods of surgery used in modern dentistry. Their choice directly depends on the location of the build-up.

When removing the palatine torus, the doctor makes a small linear incision and two laxatives - in front and behind. Then the dentist makes exfoliation of the mucous membrane at the location of the palatine torus.

After that, the neophyte himself is removed using a laser or chisel. Moreover, both the whole neophyte and its fragments can be removed. Then the bone tissue is smoothed out with a drill, and interrupted sutures are applied.

When surgical removal of alveolar jaw exostosis, the procedure is similar to the procedure for removal of the palatine torus. The only difference is that the configuration of the sections changes. They are produced in the shape of a trapezoid.

The rehabilitation period lasts from 2 to 5 days, depending on the patient's well-being and individual indicators. If, after surgical removal of the neophyte, swelling appears and pain is felt, then the doctor prescribes anesthetics and wound healing drugs.

Contraindications to removal

The following factors act as contraindications to surgical intervention:

• diabetes of any form, other diseases of the endocrine system;
• low blood clotting;
• poor work of the adrenal glands;
• diseases of the thyroid gland.

Complications and postoperative period

After the operation to remove the jaw exostosis, an exacerbation of chronic diseases can be observed. This is especially true for patients suffering from chronic diseases of the cardiovascular system.

As for the complications arising after the operation, then, as a rule, the patient himself is to blame. Divergence of sutures due to active chewing of solid food almost always leads to an unsatisfactory outcome of the operation.

In the postoperative period, alcoholic beverages should not be consumed. Chewing gum, toffee candy, smoking are not recommended. Do not have oral sex.

The healing process itself, even with low immunity, rarely lasts more than a month.

Prevention: how to prevent development

The only effective prophylactic agent for jaw exostosis is regular (at least 2 times a year) passing a high-quality examination by a dentist. At the slightest suspicion of a neophyte, you can conduct independent checks for any changes.

Jaw exostosis is not a death sentence. If all the recommendations of the dentist are followed, it is curable and not dangerous to human life.