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Excision of maxillary torus palatinus

CPT4 code

Name of the Procedure:

Excision of Maxillary Torus Palatinus
Common Name: Removal of Palatal Torus
Medical Term: Torus Palatinus Excision

Summary

Excision of the maxillary torus palatinus involves surgically removing an overgrowth of bone from the roof of the mouth. This procedure is generally performed by oral surgeons to alleviate discomfort or to prepare for dental appliances like dentures.

Purpose

The purpose of this procedure is to remove the bony growth (torus palatinus) that can interfere with oral functions, dental appliances, and cause discomfort or other complications. The goal is to improve the patient's oral health and comfort.

Indications

  • Presence of a bony growth on the roof of the mouth (torus palatinus)
  • Difficulty in fitting dental appliances like dentures
  • Discomfort or pain from the bony overgrowth
  • Recurrent trauma or ulceration due to the bony prominence
  • Interference with speech or eating

Preparation

  • Patients may be advised to fast for a few hours prior to the procedure if general anesthesia is to be used.
  • Preoperative diagnostic imaging like X-rays or CT scans to assess the size and location of the torus.
  • Review of medical history and any medications taken by the patient.
  • Adjustments in certain medications (e.g., blood thinners) as instructed by the healthcare provider.

Procedure Description

  1. Local anesthesia or general anesthesia is administered to numb the area or sedate the patient.
  2. An incision is made in the mucosa covering the torus.
  3. Specialized surgical tools, such as chisels and bone files, are used to carefully remove the bony overgrowth.
  4. The surgical site is smoothed, and any bone fragments are removed.
  5. The incision in the mucosa is closed using sutures.
  6. The patient is monitored until the effects of anesthesia wear off.

Duration

The procedure typically takes between 30 minutes to 1 hour, depending on the size and complexity of the torus.

Setting

The procedure is usually performed in a hospital's outpatient surgical center, a specialized dental clinic, or an oral surgeon's office.

Personnel

  • Oral Surgeon
  • Surgical Assistants
  • Nursing Staff
  • Anesthesiologist (if general anesthesia is used)

Risks and Complications

  • Infection
  • Swelling and bruising
  • Pain and discomfort
  • Nerve damage (rare)
  • Bleeding
  • Delayed healing
  • Injury to adjacent structures

Benefits

  • Alleviation of discomfort or pain
  • Improved fitting of dental appliances like dentures
  • Reduction in trauma or ulceration caused by the bony growth
  • Improved oral function, including speech and eating

Recovery

  • Patients are typically prescribed pain relievers and antibiotics to manage pain and prevent infection.
  • Soft diet recommended to avoid irritation to the surgical site.
  • Instructions on oral hygiene practices to promote healing.
  • Sutures may be removed in a follow-up appointment.
  • Recovery generally takes about 1-2 weeks.

Alternatives

  • Monitoring and regular check-ups if the torus is not causing significant issues.
  • Use of dental appliances adjusted to accommodate the bony overgrowth.
  • Conservative approaches to manage symptoms.

Patient Experience

  • Patients are likely to feel numbness during the procedure due to anesthesia.
  • Mild to moderate pain and swelling post-procedure, manageable with medication.
  • Possible discomfort while eating or speaking during the recovery period.
  • Follow-up care will involve monitoring the healing process and ensuring satisfactory results.

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