Torus palatinus osteonecrosis: A hitherto unreported complication of long-term Denosumab use

Torus palatinus is an osseus exostosis found in the midline of the hard palate. It is a relatively common condition and is benign in nearly all cases. However, complications such as airway obstruction, sleep apnea, and swallowing difficulties do exist. One of the more serious complications is osteonecrosis. Osteonecrosis of tori has scantly been reported in the literature. Reported risk factors include bisphosphonate use, trauma, and anticoagulation. Here, we present a case of torus palatinus osteonecrosis in the setting of Denosumab use, a monoclonal antibody for the treatment of osteoporosis. This case brings awareness to a rare, but important, potential complication of long-term use of that medication.