Osteonecrosis of Jawbone FAQ
What is a Focal Infection?
The theory assumes that an infection in one part of the body can cause symptoms in another part of the body. The way this was supposed to work was that the organisms from the infection site would break away into the blood stream and be carried around in the blood vessels. This theory has been extended in recent years to include the release of toxins from organisms which they give off as waste products.
When was the theory of Focal Infection first introduced?
Focal infection was a widely respected theory during the first half of the 20th century. Already mentioned in Dr. Thomas Bond’s Book “Dental Treaties” in 1848.
What are common dental sources of focal infections?
There are four main sources:
- Cavitation, Fatty degenerative osteolysis of the jawbone
- Root fillings
- Dead and infected teeth
- Gum disease
What is a Dental Cavitation?
Simply said, a dental cavitation is a hole in the jawbone.
Where do Cavitations develop?
- Most likely they develop in the area where a tooth has previously been extracted and the bone hasn’t healed properly.
- Around root treated or dead teeth.
Why do antibiotics not work to cure a cavitation?
Because the cavitation forms a slimy mucilaginous membrane to protect themselves from the immune system.
How do cavitations develop?
Cavitations develop when the blood supply to the bone is disrupted.
Can cavitations develop in other parts of the body?
Yes, they can develop in other bones too. E.g the leg.
How can a dental cavitation be diagnosed?
- They can sometimes be detected on x-rays but are not easily seen and are often overlooked.
- They can sometimes be detected by their smell (like stale smoke or a strong sour smell). This can happen if a fistula has formed from the cavitation into the mouth.
- The most reliable diagnostic is by means of a Cavitat / CaviTAU Scan.
- The CaviTAU scan shows the extent of a cavitation infection in 3D.
What is the most common reason for developing a cavitation?
- The most common causes of cavitation infection are extractions that didn’t heal properly.
- Injuries such as whiplash, falling off a bike or horse are also common reasons for a cavitation infection to develop.
How can the blood supply in the bone be disrupted?
- The blood supply can be interrupted by the trauma causing the bone to die which lets bacteria become established in the dead area.
- Dental injections, overenthusiastic orthodontic treatment, impacted teeth, infected or dead teeth and root fillings are other causes.
How long does it take for a cavitation to develop?
This can take years or only a few months, it usually develops painless, no markers of an acute infection such as inflammation, redness or swelling.
Are there any blood markers that indicate a cavitation?
An increased inflammation marker RANTES/CCL5 are indicative for a cavitation.
Does it smell once a cavitation is opened for cleaning out?
Not all the times do we find a smell involved
If there is smell, there are two characteristic smells.
- The most frequently encountered is the smell similar to stale smoke
- The other smell is a pungent sour smell.
These smells are sometimes also present when a tooth is extracted or when cleaning out gum infections
What is a NICO?
- This name was introduced by Prof Jerry Bouqout.
- NICO is the abbreviation for Neuralgia-Inducing Cavitational Osteonecrosis).
- A NICO is a neuralgic pain causing osteonecrosis of the jawbone.
- This pain is often mistaken for toothache.
What is the most common therapy?
The most common therapy at present is to surgically remove the osteonecrosis.
How is this therapy, also called surgical clean, carried out?
- The most important part is the opening up of the bone and to manually remove the diseased bone completely leaving only hard bone behind.
- Afterwards rinse with ozonated water and ozone gas.
- Then place a PRF (Plasma Rich growth Factor) membrane, made from your own blood, into the cleaned area.
- Placing stitches on top of the surgery site.
What other therapies are offered?
What is the Stabident method?
- With this method a hole is drilled into the affected bone with a special drill.
- One part of the drill stays in the bone and a remedy can be injected into the bone.
How successful is the Stabident method?
It might be possible to halt the defective bone from spreading but cannot cure the problem.
How does Ozone work in the necrotic bone?
Similar to the Stabident method it doesn’t cure the problem.