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Exostoses are defined as benign bone growth projections outward from the surface of a bone.¹ Palatal exostoses are bony protuberances that can cause surface irregularities, leading to periodontal pockets in the area of maxillary molars. Larato proposed a classification based on their anatomical appearance as Type A (small nodule), Type B (large nodule), Type C (sharp ridge), Type D (spike-like projections), and Type E (combinations of types A to D).¹⁹¹

Several studies using human skull specimens have reported a diverse prevalence of palatal exostosis ranging between 30% and 56% (Table 5-11).^191–193 These subtle differences might be influenced by ethnic background and/or age.^192,193 Most of the palatal exostoses (62%) are commonly found in the maxillary third molar area and directly lateral to and at a mean of 11.4 mm from the greater palatine foramen.¹⁹² The removal of these bony protuberances is often indicated to ensure proper flap adaptation during resective procedures. These can also serve as a potential source of autogenous bone for regenerative procedures.¹⁹²

TABLE 5-11 Prevalence of palatal exostosis

Authors	Prevalence
Larato191	Overall: 30%Population: Mexican
Nery et al193	Overall: 40.5%Population: European, Oceanic-Asiatic, African, and Mexican-Peruvian
Sonnier et al192	Overall: 56%Population: Caucasian and African American