Bilateral buccal exostosis evaluated by CBCT: rare accidenta
Buccal exostoses are broad-based, non-malignant surface growth occurring on the outer or facial surface of the maxilla and/or mandible, found usually in the premolar and molar region. Etiology is still not established, but it has been suggested that the bony overgrowth can be because of abnormally increased masticatory forces to the teeth. The present case has been published in the Indian Journal of Dental Sciences.

A male patient who was aged 54 years reported for a routine checkup and oral prophylaxis. On clinical examination, it was found that his oral hygiene status was poor, and multiple bony nodules were found in the lower and upper anterior region of his maxilla and mandible.

The patient had not previously noticed the “nodules” and he was otherwise healthy. He had a medical history of hypertension since 3 years, for which he was taking medicine regularly, and there was also no history of any other family illness or any tissue tumors which were suggestive of any syndrome.

On examination, the patient was found to be apyrexic, and there was no lymphadenopathy intraorally, an intact dentition was present, and all the mucosal surfaces appeared to be healthy. Multiple bony protuberances were evident along the labial aspect of the maxilla and mandible. The approximate diameter of the bony swellings varied from 5 to 6 mm.

On palpation, 10 round, firm, raised, nontender protuberances were diagnosed in the maxillary arch and six-rounded protuberances in the mandibular arch. An orthopantomogram was taken to confirm the presence of multiple radiopaque masses along the middle thirds of roots of maxillary central incisors to second premolars on both the right and left side, and mandibular anterior region, which extended from canine to canine, that demonstrated a buccolingual growth of the alveolar bone in the region of the bony swellings.

Radiolucencies were seen in between these teeth, and clinically, no mobility in the teeth was present. To reach a confirmed diagnosis, a cone-beam computed tomography (CBCT) was taken.

Multiple radiopaque masses seen on the labial aspect of maxillary anterior, measuring approximately 5 mm with loss of labial cortical plate 7 mm approximately below the cementoenamel junction giving a beaded appearance over the anterior maxilla and mandible suggestive of bony exostoses as depicted.

In the CBCT, it was apparent that buccal cortical plate was missing in the areas of exostoses. Maybe compensatory response to periodontal disease can be proposed to explain this case of exostoses.

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