Cavitation

(Other Names: cavitational osteonecrosis or ischemic osteonecrosis) A dental cavitation is an area of infection, inflammation, or necrosis within the jawbone. This type of lesion may be a hollow space surrounded by dead bone, or it may be filled with various inflammatory, toxic, or infectious elements.  One of the problems with a dental cavitation is that most of these lesions are painless. However, if there is pain, they are usually called Neuralgia-Inducing Cavitational Osteonecrosis (NICO).

Causes

• Some type of trauma to the bone causing a blockage of blood flow could cause bone cells to die, thereby creating a hollow space within the bone.
• Following an improperly performed procedure to extract a tooth could leave infection or debris in the bone socket, which could result in a dry socket and eventually a dental cavitation.
• Overheating the bone during a dental procedure using cutting drills could cause the bone to die, leading to cavitational osteonecrosis.
• A tooth abscess penetrating into the bone and becoming isolated within the bone could form a bone lesion.
• Continuing infection at the base of a tooth root, which has a failing root canal, could be the culprit.

Diagnosis

• OPG x-ray
• CBCT (3d x-ray)

Treatment

• Treatment of cavitational osteonecrosis consists of entering the lesion and cleaning it out thoroughly. The fluid and tissues removed from the lesion should be sent to pathology to be identified.
• The dental surgeon may use a laser to decontaminate and debride the lesion. S/he may place a biologically active material into the bone space to enhance its healing.
• In addition to surgically treating the bone lesion, it is important to support the patient’s immune system. There should be an integrative approach including a non-inflammatory nutrient-dense diet and various spore-based probiotics to support a diverse and abundant garden of healthy microbes in the gut.
• Sometimes, it will be necessary to determine if any toxic substances already exist in the body like heavy metals, which may need to be reduced or eliminated.

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