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I can't afford a root canal, what do I do? Fell free to contact me direct if you have further question ggoldsm590@aol.com make sure to place oral surgery in the subject line. Journal of the American Dental Association. Concurrence of torus palatinus with palatal and buccal exostoses: case report and review of the literature. I am investigating having in implant which will necessitate a bone graft to replace the bone that was lost during and after the extraction. I have it on my entire upper, on the buccal (outer) side. Before I noticed when some patients were really nervous, the anesthesia took longer to take effect, which some will argue is not completely true. see full revision history and disclosures, bizarre parosteal osteochondromatous proliferation (Nora lesion), conventional intramedullary chondrosarcoma, dysplasia epiphysealis hemimelica (Trevor disease), solitary bone plasmacytoma with minimal bone marrow involvement, mixed lytic and sclerotic bone metastases, Lodwick classification of lytic bone lesions, Modified Lodwick-Madewell classification of lytic bone lesions. Morphological and Molecular Characterization of Human Gingival Tissue Overlying Multiple Oral Exostoses. 1985;86(4):230-3. 8-10 Radiographically, these growths appear as well-defined round or oval calcified structures over the dental roots. Most people manage fine with both conditions. There are a number of examples of exostoses that occur due to local irritant stimuli: Where exostoses are capped with cartilage, they are termed osteochondromas, which can be solitary or multiple, sessile or pedunculated: The differential diagnosis for bone tumors is dependent on the age of the patient, with a very different set of differentials for the pediatric patient. and transmitted securely. They begin to develop in early adulthood and may very slowly enlarge over years. This question is in the General Section. 2007 Mar 1;8(3):72-80. Torus mandibularis is a bony overgrowth located on the lingual aspect of the mandible ( Figure 1 ), while buccal exostoses are multiple bony nodules along the buccal aspect of the maxilla or mandible ( Figures 2 and 3 ). Buccal exostoses, the rarest of the three and seen on the upper molars on the outside of the upper arch (touching the cheek) All of these grow very slowly. FOIA The exostosis presents as a hard bony mass on palpation, but the overlying mucosa will be intact and show normal color when stretched. They begin to develop in early adulthood and may very slowly enlarge over the years. Tooth wear and dental pathology of the Bronze-Iron Age people in Xinjiang, Northwest China: Implications for their diet and lifestyle. Before buccal fat removal surgery, you'll meet with your healthcare provider. Unable to load your collection due to an error, Unable to load your delegates due to an error. The utilization of exostosis as a source of autogenous bone for the treatment of osseous defects and bone formed in the grafted areas showed comparable clinical features to those of native bone. Brad W. Neville. The site is secure. An 86-year-old woman had soft-tissue irritation caused by abrasion from food in the buccal posterior right quadrant. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. How do you find a good dentist/periodontist? Exostosesare defined as benign growths of bone extending outwards from the surface of a bone. Rev Stomatol Chir Maxillofac. Description, therapeutic approach. As noted above I have extostoses and have had some of it removed which was less than a pleasant experience. HHS Vulnerability Disclosure, Help To join, you must be at least After he got going I was glad of that decision. Patients are given oral hygiene advice and are advised to cleanse above and below the growth with a mouthwash once a day to remove any food debris. Buccal exostoses have no malignant potential. I2) ncision from the mid-line where the tooth was and up over the outer gun to create a flap of gum that is lifted up to get to the bone. 2016 Sep;11(3):225-230. doi: 10.1016/j.jds.2015.10.004. I have a single exostosis on my upper gum. In this case your lower jaw will be more prone than your upper jaw. He said he worked like a dog to grind it all down and the gum tissue was paper thin. 1, 2 Though the . Unauthorized use of these marks is strictly prohibited. He said in his 30 year career, my exostosis was in the top 3 worst hes seen. It is not a big deal, just make sure you follow all post-operative instructions, such as proper rinsing especially after meals, avoiding spicy foods and keeping the incision area clean while the gums heal. I2) ncision from the mid-line where the tooth was and up over the outer gun to create a flap of gum that is lifted up to get to the bone. Buccal exostosis. Some on the lower, but not nearly as prominent. Buccal maxillary exostosis was unusually common on the Neolithic skulls from China, which thus resemble the Sinantropus crania described by Weidenreich (1943). The findings lend support to the hypothesis that the etiology of exostoses involves an interplay of multifactorial genetic and environmental factors and are related to increasing age. PMC Aug 12, 2021. Princ G, Brassard S, Perrin A, Naman N, Vaillant JM. Its a pretty cool procedure. The aim of this article was to describe a case report of bilateral maxillary exostosis, unusual, in a female patient, with a concomitant Cone Beam Computed Tomography performed to confirm the diagnosis. Was the person uncomfortable during the surgery? Buccal exostosis is benign, broad-based surface masses of the outer or facial aspect of the maxilla and less commonly, the mandible. Again, its been years since I worked as a dental assistant, so Im a bit rusty on my dental terminology. Oops. The type of exostosis you have depends on its location in your mouth. There is no known cause (etiology) of bone growing out of gums, the mouth's roof, or under . The large one that gets irritated is easily dealt with I simply dont eat the things that irritate it. Imaging Aspects of Palatal Torus in Cone Beam Computed Tomography and Magnetic Resonance: Case Report. This case was managed by a combination of osseous resection surgery to treat exostosis and crown lengthening to remove alveolar bone and excessive gingival, resulting in poor esthetics. Bone felt like it was coming out of gum and went back to dentist was very nervous with all that i read but grateful for (joni1977 dental assistant) He was right dentist filed it down with in 5 minutes and was smooth to touch with tongue and feel the difference! 1 Although theories regarding a possible role of a chronic periosteal inflammation have been suggested, the true etiology of OE remains still unclear. Exostoses are defined as benign growths of bone extending outwards from the surface of a bone. So thats what that thing is. [14] 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. Concurrence of Torus Palatinus, Torus Mandibularis and Buccal Exostosis. They can, however, be . A 24-year-old female presented with gingival enlargement on the buccal aspect of both the quadrants of the maxillary arch. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. =o). Then finish by smoothing away any jagged bone and suturing up the gums. Well, Im 46 years old male I had my first Boney Exotosis remove when I was 35, it was both lower outer gums, Suregy took about 35 min and post surgery was pretty easy, Just follow the instructions they give you, Ice on 20 min then off 20 min, we used frozen bags of peas. This site needs JavaScript to work properly. The aim of this study is to analyse environmental factors that may stimulate the formation of exostoses on different regions of the maxilla and mandible. 4) The flap is stitched down and you eat baby food for a week while it heals and the stitches dissolve After surgery you can put weight on the foot but can take approximately four to six weeks before you can return to normal activities. Buccal mandibular exostoses occur very rarely, may have large dimensions and change the feature of the face. Here is the procedure: Check for errors and try again. An exostosis is an extra growth of bone that extends outward from an existing bone. I have a lot of extostoses on the buccal (cheek) side of both my mandible and maxilla and to a lesser extent on the lingual side of the maxilla. 2000 Jun;71(6):1032-42. doi: 10.1902/jop.2000.71.6.1032. J Can Dent Assoc. How interesting. I sometimes wonder if the First Lady has this problem on the lower jaw. and transmitted securely. :). [Giant mandibular exostosis. The removal of the exostosis is illustrated through the use of a device that serves as an alternative to a . Huck, Bayard R. and Goodstal, Samantha M. and Gimmi-mckim, Claude. I have one of those and I do grind my teeth, but I wouldnt say I am a type A personality. The aim of this article was to describe a case report of bilateral maxillary exostosis, unusual, in a female patient and due to the size of the exostoses a concomitant Cone Beam Computed Tomography was performed to confirm the diagnosis. Etiology If the diagnosis is in question, a biopsy should be performed to rule out other bony lesions. Both types of exostoses tended to increase in frequency with age, although a significant trend was observed only for BE. Gender: Tori show gender preference, with men more affected by mandibular tori, and palatal tori more common in women. Would you like email updates of new search results? 8600 Rockville Pike C.M. official website and that any information you provide is encrypted I never had the privilege to work with kids (Pedodontics) so I never saw them in the younger generation. National Library of Medicine At the time the article was last revised Daniel J Bell had no recorded disclosures. What kind of doctor would be best suited to address this undiagnosed, bizarre issue. lol. Please enable it to take advantage of the complete set of features! I might forget to check back on this site as often as I should. Become a Gold Supporter and see no third-party ads. 2020 Apr 15;13:373-379. doi: 10.2147/JMDH.S252013. We conclude that formation of exostoses is a complex process that can be invoked by any agent causing damage and inflammation of gingival tissue. This site needs JavaScript to work properly. We report a significant Spearman correlation between BE and LME (rho = 0.54, P < 0.00001), suggesting a partially shared aetiology of these two types of exostoses. I asked about using some of my extostoses for the donor bone and it seems that it is likely. official website and that any information you provide is encrypted Anat Cell Biol. Copy and paste a set citation format, or use one of the links to import into the document management software. Well, I can not give a direct answer, sorry. 3) The bone was ground down with what felt like a rasp. 13 years old and agree to the Accessibility Chang PC, Hsu CL, Tai SY, Tsai AI, Wang IK, Weng CH, Huang WH, Hsu CW, Yen TH. My dentist informs me that if we can do it that way it will bean buying less bottled bone and reduce my bill for the graft procedure. Alveolar bone exostoses are benign localized outgrowths of buccal or lingual bone, consisting of mature cortical and trabecular bone. government site. Francetti L, Dellavia C, Corbella S, Cavalli N, Moscheni C, Canciani E, Gagliano N. Case Rep Dent. Douglas D Damm. The removal of the exostosis is illustrated through the use of a device that serves as an alternative to a scalpel, offering a safe, predictable outcome. Responses must be helpful and on-topic. There are a number of examples of exostoses that occur due to local irritant stimuli: ivory exostosis. Oral exostoses (OEs) are bony protuberances arising from the buccal or lingual cortical plates of the maxilla and/or the mandible, with a variable prevalence ranging from 8% to 51% in the maxilla and 6%-32% in the mandible. El Achkar VN, Lopes SL, Pinto AS, do Prado RF, Kaminagakura E. Acta Stomatol Croat. Especially if they were missing several teeth. :-( Ill have to find a new doc to do it the next time. Unable to load your collection due to an error, Unable to load your delegates due to an error. Torus palatinus is often a singular growth, whereas torus mandibularus and buccal exostoses tend to be bilateral, meaning they happen on both sides of the mouth. The present invention provides methods of treating cancer using pyrimidine and pyridine compounds which are inhibitors of Bruton's tyrosine kinase (BTK). Smaller but significant correlations were observed between LME and the age adjusted wear rate on lower molars, as well as between BE and indicators of oral/dental pathology, e.g. A power grinder might have been a little less bothersome. The DAPs improved retention in flared root canals, and RXU was the most effective luting agent in the push-out bond strength evaluation. I also have really large mandibular tori inside my lower jaw. While they were in there getting that they took care of the extostosis over that area. @tinyfaery: Haha, glad I helped you figure out what it was! 1 Torus palatinus is another frequently observed bony overgrowth of the oral cavity, is located in the middle of the hard . I dont know whether to find that funny or depressing. They are painless and self-limiting, but occasionally may become several centimet The results support greater frequency of torus/exostosis among mongoloid ethnicities such as the Maya in comparison to other ethnicities. J Contemp Dent Pract. caries, calculus, periodontoses, and antemortem tooth loss. 4.6 (92.57%) 35 votes . Buccal exostosis resection is performed with a local anesthetic. An official website of the United States government. Buccal exostosis: a rare entity Authors Sonali V Medsinge 1 , Ramesh Kohad 2 , Harmeeta Budhiraja 3 , Atamjeet Singh 4 , Shradha Gurha 4 , Akash Sharma 1 Affiliations 1 PG Student, Department of Periodontology, Maharana Pratap College of Dentistry and Research Centre, Gwalior, Madhya Pradesh, India. 11 The lesions do not have malignant transformation potential. Torus and exostosis are bone growth anomalies commonly found on the palate (known as palatine torus), inside of the lower jaw bone ( mandibular torus ), and outside of either the upper and lower jaw bones ( exostosis ). Exostosis can cause chronic pain or irritation, depending on its size. MeSH They are both actually fairly common. Torus (tori) is genetic and is usually located on the roof and the floor of the mouth. FOIA Had all teeth removed bottoms first then tops 3 weeks ago.. I could probably get on fine without having it removed, but it happens to be positioned in an uncomfortable place, so Im thinking I might as well just get it taken out. They begin to develop in early adulthood and may very slowly enlarge over the years. Allen. It is a small, bony growth under the gum that occurs in approximately 3% of people. I am so thankful for joni1977 comment, after reading all the horror stories I was sure my problem was going to be disastrous But Thankful I had one positive feed back to look at that said it was basically a simple procedure and guess what ( It Was! ) 2021. Disclaimer. Now it seems that the extostoses might benefit me. I do get easily stressed, hence the teeth grinding, and im a busy bee all the time, if im not i get worried, hence why im worrying about this!! I was told they were wanting me to come back so to charge my ins. Treatment Typically, no treatment for buccal exostoses is indicated. administering a therapeutically effective amount of a compound of the formula 1-(4-(((6-amino-5-(4-phenoxyphenyl)pyrimidin-4-yl)amino)methyl)-4-fluoropiperidin-1-yl)prop-2-en-1-one or a pharmaceutically acceptable salt thereof to the human subject. I have buccal exostoses all the way along all of my upper and lower molars, with one particular one being really a problem. You have made me feel a lot better. I have a bony lump on the tongue facing part of my lower jaw, i think ive had it a while, i have always grinded my teeth, since i was little i used to wake my mum up, its been really worrying me, doesnt hurt, and when i look in my mouth its not that visable but i can feel it with my tounge!! View. It was in TLCs My Shocking Story before. Again, you should be fine! The surgeon will make sure you are good and numbed before he begins and the only thing you will feel is the vibration from the surgical handpiece is he even has to use it. 2016 Nov;26(11):111-113. Is it a big deal? doi: 10.1002/ajhb.23446. They are painless and self-limiting but may contribute to periodontal disease (gum disease / pyorrhoea) if they become too large. Now, they are growing back, much much faster than the 40 years or took to get them big the first time. Looks like in another 4 or 5 years, Ill have to do it all over again. . In any case, I am glad it isnt. They begin to develop in early adulthood and may very slowly. Patent No.17232383. US Patent 17232383. @Darwin: yes, they are called tori (tor-eye). Hematoma following periodontal surgery with a torus reduction: a case report. Huck, Bayard R. and Goodstal, Samantha M. and Gimmi-mckim, Claude. Have you had it removed? Most Oral Surgeons like using the dissolvable sutures. The diagnosis of a buccal exostosis is made based on the clinical and radiographic findings. On Dec 1,09 just 3 days ago I had the surgery again, this time upper and lower, both outer. I have heard of holes on the top of gums. Mine is somewhat uncomfortable, so I will likely have it removed by an oral surgeon. The diagnosis is established by a combination of medical history and clinical and radiographic features of the affected region. Exostosis. I myself once had a pain on my lower gum, which lasted for a month and it hurt very badly, especially when touched. Careers. Full text data coming soon. We had trouble talking to the server. However, I did have one removed accidentally I was having surgery for another problem when I developed asthma and had to be intubated. THANK YOU girlofscience!!! exostosis of the external auditory canal (surfer's ear) Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Has anyone else got a phobia of medications? government site. 1) Linocane injections in the palate and outer gum. Hours of grinding, 29 stitches and over a week recovery. Ivory Exostosis of the Skull. National Library of Medicine PMC I was told by one dentist that it was a form of Elephant Man Disease. However, whether he meant neurofibromatosis or the current diagnosis of Proteus syndrome, I do not know. The journal of contemporary dental practice. Lets hope I never need dentures! right bne is sticking through my gum and let it heal. I had no choice, I didnt want to look like I was growing tusks. The https:// ensures that you are connecting to the Good luck with yours. The worst part will only be the sore gums during the healing process. Buccal alveolar exostoses: prevalence, characteristics, and evidence for buttressing bone formation. Gingival fibromatosis, fibroma formation secondary to irritation, granulomas, abscesses, and oral neurofibromatosis located on the palate . Accessibility Prognosis after Buccal Exostosis Resection . It can occur in any bone and be triggered by a number of factors. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Torus Palatinus in Taiwan Patients Receiving Peritoneal Dialysis and Hemodialysis: A Prospective Observational Study. Leave a Reply. Methods for Treating Cancer Using Pyrimidine and Pyridine Compounds with BTK Inhibitory Activity. Tori mandibularis: a case report and review of the literature. Before Please try again. Bethesda, MD 20894, Web Policies They work great. Reset. I do know and understand that others have had awful experience with dentist, when i was young they tied me to a dentist chair and trust me I have a lot issues going to one even tho i am old nowHope this helps, Guess Ill be going for round 3 removal soon. Homo. Buccal exostosis is benign, broad-based surface masses of the outer or facial aspect of the maxilla and less commonly, the mandible. Association between masticatory muscle activity and oral conditions in young female college students. 2021 Dec 31;54(4):479-488. doi: 10.5115/acb.21.107. From what Im reading, they usually emerge in early adulthood, but they most commonly become a problem when people need dentures, which could explain why people needed to have them removed if they were missing several teeth. But to make sure we are all on the same boat, I just want to say: Pynn BR, Kurys-Kos NS, Walker DA, Mayhall JT. Journal of the Belgian Society of Radiology, Teaching point: Multiple buccal exostosis are rare but asymptomatic, unequivocal, and always benign conditions of the jaws. Common types of exostoses include bone spurs, which are bony growths also known as osteophytes. eCollection 2020. ahhhh! Jan 1995. If there is neither pain nor sensitivity, the buccal exostosis simply needs to be monitored with routine dental check-ups. @joni1977: Thank you so much; great insight! If you remove , they wont be able to see future changes to this shared folder. more money. But they did vary from young to old adults. US Patent US20210244736A1, filed Apr 16, 2021, and issued Aug 12, 2021. . 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. Lurve. They can be removed with surgery. In their rush to keep me breathing the surgical team actually cracked an exostosis. The prevalence of antral exostoses in the maxillary sinuses, evaluated by cone-beam computed tomography. J Periodontol. Postgrad Med J. Concurrence of Torus Palatinus, Torus Mandibularis and Buccal Exostosis. Three cases of an otherwise healthy patients from the age group of 45-65 years with Mandibular Tori, which were correlated both clinically and radiographically, are reported. An official website of the United States government. Development is influenced by four main risk factors. Would you like email updates of new search results? Exostosis. The fractured bits of bone eventually worked their way out, but in the meantime the pain from that was so great I never even noticed the pain from my surgical site. Based on what it felt like to heal from the accidental removal I would think long and hard before I had any others removed. Journal of International Oral Health : JIOH, 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. There are a variety of oral conditions that may be confused with exostoses. A torus (plural: tori) is an exostosis that occurs in one of two locations intraorally. (2021). This type of exostosis involves your jawbone. sharing sensitive information, make sure youre on a federal 2016 Dec;50(4):359-364. doi: 10.15644/asc50/4/10. 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. 2021 Mar;33(2):e23446. Well when I was in the dental field, I found it to be more common in middle aged men and women. Contents . J Coll Physicians Surg Pak. It is also possible for the area to heal poorly. But thats not to say youre wrong. [0002] The invention relates to a series of pyrimidine and pyridine compounds that are useful as therapeutics in the treatment of cancer in mammals. During your initial visit, your provider will examine you and likely take photographs of your face. It's usually painless, but it might affect the way your mouth. More particularly, embodiments Exostosis is usually asymptomatic and can pose a problem when any prosthetic is being fabricated. From what I remember (thats if I remember correctly), the surgeon will expose the bony area and gently shave the excess bone away with the surgical handpiece. This article describes a surgical technique for excision of exostosis through a case presentation. Federal government websites often end in .gov or .mil. I cant imagine what it would be like if they had used a chisel. 1. Federal government websites often end in .gov or .mil. J Multidiscip Healthc. Potential Complications from Buccal Exostosis Resection: Possible risks following buccal exostosis resection include infection, bleeding, swelling and a negative reaction to the anesthesia. @girlofscience Maybe the way her lower face is shaped? 1965;41 (475): 277-81. Bethesda, MD 20894, Web Policies Epub 2010 Feb 18. One that the authors will refer to break the boredom in reading is choosing oral and maxillofacial pathology as the reading material. Etiology is. @joni1977: I am not middle aged, and I am certainly not missing any teeth! Clipboard, Search History, and several other advanced features are temporarily unavailable. The reason why I have heard of them at all is because I have had them most of my life in several parts of my mouth. Buccal exostoses are hard bony protrusions on the outside of your gums and are less common. Methods for Treating Cancer Using Pyrimidine and Pyridine Compounds with BTK Inhibitory Activity. It is believed to be tied to teeth-grinding. 2010 Apr;61(2):102-16. doi: 10.1016/j.jchb.2010.02.002. I had this done Friday-10th-December. Then I had a tooth pulled and had some broken bone sticking up and irritating my gum. Etiology. It may be uncomfortable during x-rays and when the occasional chip pokes the gum tissue! Hope this helps! ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The oral surgeon had offered to take more of them off but I told him that since they didnt bother me unless they were poked and that didnt happen too often I would leave well enough alone. {"url":"/signup-modal-props.json?lang=us"}, Jones J, Bell D, Gaillard F, et al. US. Concurrence of torus palatinus with palatal and buccal exostoses: Case report and review of the literature . But dont worry. I do not, however, have a Type A personality, although I do sometimes grind my teeth. HHS Vulnerability Disclosure, Help terms and conditions. A lack of anatomic evidence for the theory of buttressing bone formation is indicated and other factors may be of greater importance in the etiology of buccal bone enlargements, which casts doubt on the currently popular concept of abfraction. This case report describes the surgical treatment of bilateral bone projections on the buccal surface . Buccal exostoses are typically found on the buccal surface of the maxillary or mandibular alveolar ridge adjacent to premolar teeth. Reference article, Radiopaedia.org (Accessed on 05 Mar 2023) https://doi.org/10.53347/rID-17041. The https:// ensures that you are connecting to the SO far it hasnt been to bad I used the pain med for the first 2 day and have been able to control the post pain with OTC drugs. Apropos of a case. Do you go by referral or use the internet? Buccal exostoses are benign, broad-based surface masses of the outer or facial aspect of the maxilla and less commonly, the mandible. By clicking accept or continuing to use the site, you agree to the terms outlined in our. Exostosis, a slow-growing, benign bony outgrowth, is a common clinical finding and not usually a concern for patients. The .gov means its official. They can also use a power grinder or a chisel. The cause is actually neoplastic (abnormal growth of cells) and not predetermined by personality type nor parafunctional habits, such as grinding. It emerges in early adulthood and is more common in females, especially those who are stressed and have Type-A personalities. The largest bumps are over my canines. Lucky me. Unauthorized use of these marks is strictly prohibited. eCollection 2019. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. Jerry Elmer Bouquot. The .gov means its official. 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. I was so happy!! All the way around way from the back left to the back right. Buccal exostoses are hard bony protrusions on the outside of your gums and are less common. Clipboard, Search History, and several other advanced features are temporarily unavailable. Other oral health indicators, such as occlusal wear on molars, pathology of temporomandibular joint (TMJ), carious lesions, calculus accretion, periodontal disease, and antemortem tooth loss were recorded. They'll discuss with you what you'd like to achieve from surgery, as well as what to expect during and after your procedure. But the point is, the excess bone can create problems in people of all ages on the buccal/facial and lingual sides. I called the Office and told them the bone was edging my tongue and they said let it heal! They can also use a power grinder or a chisel.