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The Journal of Clinical Endocrinology & Metabolism Vol. 88, No. 5 2081-2086
Copyright © 2003 by The Endocrine Society

Torus Palatinus: A New Anatomical Correlation with Bone Density in Postmenopausal Women

Joseph L. Belsky, Josephine S. Hamer, Janet E. Hubert, Karl Insogna and William Johns

Departments of Medicine (J.L.B.) and Nuclear Medicine (J.E.H., W.J.), Danbury Hospital, Danbury, Connecticut 06810; Department of Mathematics, Western Connecticut State University (J.S.H.); and Department of Medicine, Yale University School of Medicine (K.L.), New Haven, Connecticut 06520

Address all correspondence and requests for reprints to: Joseph L. Belsky, M.D., 235 Main Street, Danbury, Connecticut 06810. E-mail: Joseph.Belsky{at}Danhosp.org.

The observation that subjects who have a striking oral exostosis, called torus palatinus, also tended to have normal or high bone densities prompted us to examine an unselected population referred for bone density assessment for a possible correlation with torus palatinus. Subjects referred from community physicians had a visual examination of the open mouth to estimate the size of any torus palatinus (0 for none/trace to 5 for very large) before undergoing a bone density measurement by dual energy x-ray absortiometry. Bone density T- and z-scores were correlated with the size of each subject’s torus palatinus. Torus size groups were also correlated with other variables affecting bone density. About 20% of 370 postmenopausal female subjects, >90% Caucasian, had a moderate to large torus palatinus. Regression correlations for torus size were modest, but significantly related to T- and z-scores of lumbar vertebrae and left hip (P < 0.01 for each). Differences due to medication, body mass index, smoking, parity, and several other factors that affect bone density did not diminish the relation to torus size. This study shows a small, but significant, positive relation for postmenopausal, Caucasian women between bone mineral density and torus size after controlling for several variables known to affect bone density were examined. Torus prominence, in association with other factors, can be considered in decisions for testing bone density in otherwise normal postmenopausal women.

Abbreviations: BMD, Bone mineral density; DEXA, dual energy x-ray absortiometry; HRT, hormone replacement therapy.




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