What is cavitation or N.I.C.O (neuralgia inducing cavitational osteonecrosis)?

A cavitation (or by the formal name, Ischemic Osteonecrosis) is the process when there is a lack of blood supply to an area of bone thus resulted in “dead” bone. We usually see this occurring in the jawbone. It will be seen as a hole in the jawbone which can occure after a tooth extraction that did not heal correctly.

What goes on after a tooth extraction?

Traditionally, it is assumed that after a tooth has been extracted, your system will act to heal the hole that has been left by a missing tooth. Often in cases, this is true. However, many tooth extractions can lead to a pathological defect that is known as cavitation.

There exists a periodontal ligament that consists of several very thin fibers that act to attach the tooth to the jawbone. When a tooth is extracted, these fibers are broken and some are often left in the socket.

Osteoblasts are specialized cells in a bone that function to repair and grow new bone material. When a tooth is removed, the osteoblasts are prevented from filling the socket of the tooth with new bone by the periodontal ligaments, as these ligaments act as a barrier to prevent osteoblasts from growing bone when a tooth is in place. The ligament fibers need to be removed very effectively and precisely in order for the bone to grow in the socket properly.

Why does cavitation occur?

After a tooth extraction, there may be a number of events and environmental factors that are risk factors:

  1. Trauma – an infection or dry socket can occur. (Especially by wisdom teeth extraction which are usually removed at a young age, between the years 14 to 20 years. Young people suffer from several mineral deficiencies due to a strong growth spurt. In many cases, all four wisdom teeth are removed at once under general anesthesia, focusing on the shortest surgery possible. It is difficult to keep all 4 wounds clear of debris. Usually, it is the case that the wound is not fully cleaned and sterilised.At DR. ROZE BIOHEALTH, we have found that the most effective ways to sterilize is with laser or ozone therapy We also try to avoid massive use antibiotics and cortisone which tend to block the immune system’s natural healing process.
  2. Toxic trauma – periodontal disease, abscess, root canal bacteria or remaining dental materials after extraction can lead to bacteria causing a disruption in the healing process. Again, at DR. ROZE BIOHEALTH, we have found laser or ozone therapy to be of great value with treating bacterial infections.
  3. Risk factors – such as smoking, stress, alcoholism, blood-clotting disorders, age (arteries in the jaw tend to decrease in size with age), chemotherapy or radiation treatment for cancer, rheumatoid arthritis, bone dysplasia, changes in atmospheric pressures, osteoporosis, thyroid dysfunction, bisphosphonates (medication for osteoporosis), can all be factors that increase the risk of cavitation.

What are the symptoms of cavitation?

Patients may find they suffer chronic neuralgic pain in the head, face or neck. But in many cases, patients may be unaware of the condition for many years before symptoms show up.

Cavitations can also cause blockages on the body’s energy meridians and can stress far-reaching organs of the body. Most frequently we can observe unexplained chronicand unexplained fatigue and low immune system conditions which make the body subject to frequent infections.

What is inside the cavitation that we cannot see?

Inside a cavitation, bacteria flourish and deviant cells multiply. Cavitations act as a breeding ground for bacteria and their toxins. Research has shown these bacterial waste products to be extremely potent.

Story of the bacteria causing cavitation:

  • Due to the large number of bacteria inside the mouth, they get into the open socket of the tooth easily. When the bone does not have the ability to fill in the socket’s defect, the cavitation that is newly formed becomes infected.
  • Once bacteria are trapped in a cavity after surgery, they can incubate for several years, leak toxic residue within the blood stream and lead to numerous health challenges that are localized to the jaw as well as other parts of the body. Along with bacteria, this area may host additional harmful elements that include parasites, fungi and viruses.
  • Research shows that these toxins can combine with heavy metals like mercury and chemicals to form highly potent toxins.
  • The lack of blood supply to a cavitation results in tissue death or necrosis.
  • The defect causes a disruption field on the acupuncture meridian that can impair the health and function of other structures, organs and tissues on the meridian.
  • Cavitations are also known as a hole in the bone, osteonecrosis or osteomyelitis. These are hollowed out holes or areas that consist of a cavern occurring when active bacteria successfully departs from the original surgical site and beings to form within the actual jawbone.
  • Each extra hole that is created by this process fills up with decaying tissue and bone that leaves more potential for bacteria and neurotoxins to grow and thrive. This caustic mixture of poison eventually leaks into a person’s bloodstream and can amplify or cause other health problems in the body.

How common are cavitations?

Recent studies involving patients aged from 19 to 83 years found cavitations in approximately 75% of all extraction sites examined. The most commonly extracted teeth, the wisdom teeth, showed cavitations in 88% extraction sites. Not all the cavitations found were related to pain or chronic known conditions.

How can cavitations be diagnosed?

At DR. ROZE BIOHEALTH CLINICS, we use our CT-scan to diagnose the cavitations (or NICO) mostly present in the wisdom teeth area.

A systematic biopsy to confirm the diagnosis of NICO follows the treatment (surgical debridement, ozone, PRF (Platelet-rich-fibrin)).

Diagnosis is difficult due to the fact that some cavitations are almost invisible on standard radiographic films commonly used in dentistry. .

While cavitations can remain undetected for a long time in a healthy individual, jaw pain occasionally occurs in people who suffer from bone lesions. Also, after a sinus infection, jaw pain may manifest and lead to a cavitation being discovered. It seems that most people who seek to find out whether they have cavitations also suffer from other major or persistent health issues.

An important step towards diagnosing cavitations involves using various diagnostic tools that may include an ultrasound device that is specially developed for this purpose, MRIs and Ct-scans. Muscle testing or applied kinesiology is considered to be the most effective method for detecting cavitations.

How can cavitations be treated?

Treatment of cavitations involves surgically cleaning the area remove all unhealthy bone (chronic fatty degenerative inflammation) and other problem areas such as abscesses, cysts, etc. After removing the unhealthy bone, the goal then is bone regeneration.
Ozone and/or Laser therapy is then used as a sterilising agent, sealed with absorbable sutures, to prevent later contamination.

Prior to surgery, it is important to enhance the patient’s immune system and bone regeneration capacity. We will create dietary recommendations and food supplement lists with probiotics to help prepare as well as reduce inflammation and stress on the body.

Click here if you want to see an example of cavitation therapy: (performed by Dr Nitschwitz, Germany )


We at DR. ROZE BIOHEALTH don’t just focus on fixing teeth, but on your overall health as well. We work to help you create a balance between your oral health and your overall health.

We believe that many tooth extractions are not necessary and opt to save the tooth and reduce your body’s trauma whenever possible. Our core belief is that health should never be compromised.

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