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NICO lesions (neuralgia indicing cavitational osteonecrosis) or “cavitations” are areas in the bone or bone marrow that have been nutrient starved (currently diagnosed as ‘ischemic bone disease’). With the lack of proper blood flow, these areas die and produce toxins. Cavitations in the jaw are particularly susceptible to infection from tooth and gum bacteria. This chronic infection causes a multitude of symptoms from pain, chronic fatigue, fibromyalgia, and trijeminal neuralgia to related symptoms in diseased organs. Remember each tooth or area of the mouth relates to a specific organ by the identified meridian connecting the two. Any communication from these areas, whether healthy or toxic travel between the identified organ and the infected oral site. It is very important to maintain a healthy mouth in order to maintain a healthy communication.

The current treatment for nico lesions is to open up the infected site and remove as much of the diseased area as possible. This gives the patient’s own immune system a chance to take over and deal with only the microscopic bacteria left. The patient is then supported by antibiotics, herbal products, and homeopathics to aid in recovery and healing. Most patients respond favorably to cavitation surgery with almost immediate relief from their symptoms. A few, however, need repeat surgeries to eliminate their condition.

The cause of nico lesions is not known, however it can be related to certain inherited blood conditions. Other disease and conditions relating to cavitation are as listed:

In order for proper diagnosis of cavitational areas, a full set of x-rays would be needed (including a full mouth series and a panorex). Along with the x-rays, a cavitat (ultrasound diagnosis for bone density of the jaw) would be necessary to determine the proper blood flow in the area and to help determine if teeth are involved. All full cavitation surgery done at our practice is accompanied by a biopsy sent to pathological analysis.

Biopsies are obtained by careful hand curettage debridement of the infected area. The histopathologic examination of the biopsy shows both idiopathic trigeminal and atypical facial neuralgias. This is a typical pattern characterized by a highly vascular abnormal healing response from the bone. The microscopic pathology of the material from the walls of the cavitations show the existence of a complex mix of polymicrobial aerobic and anaerobic flora. In some cases this surgery may need to be repeated, along with the administration of antibiotics to help induce healing and filling in of the cavities by new bone. In our practice we try to administer all the technology available to us to achieve maximum healing. This may include placement of Emdogain into the surgical site with an injection of ozone to facilitate healing.