Cavitation surgery is a specialized dental procedure targeting areas of poorly healed or necrotic bone tissue within the jaw. This operation is most often performed by biological or holistic dentists who focus on the connection between oral health and overall systemic wellness. The goal is to remove the diseased tissue to eliminate a suspected source of chronic infection or inflammation that may be affecting the body. This treatment is typically sought by patients experiencing chronic facial pain or systemic health issues linked to these jawbone defects.
Defining Jawbone Cavitations
Jawbone cavitations are areas of osteonecrosis, or dead bone, that have failed to heal properly, usually following a tooth extraction, especially wisdom teeth. The technical term for symptomatic lesions is Neuralgia-Inducing Cavitational Osteonecrosis (NICO). These defects are theorized to form when remnants, such as the periodontal ligament, are left behind after an extraction, causing the bone to heal incompletely and leave a hollow or spongy area.
Proposed causes include poor blood circulation, localized trauma, clotting disorders, and the use of certain dental anesthetics containing epinephrine. Within this ischemic, fatty, and poorly vascularized bone tissue, anaerobic bacteria are thought to flourish, producing potent toxins and inflammatory messengers. Histopathological examination often reveals fat necrosis, marrow fibrosis, and chronic inflammation.
Patients with cavitations report symptoms including chronic facial pain, jaw discomfort, and unexplained fatigue. Practitioners attribute these symptoms to the blockage of energy meridians and the spread of low-grade infection. Diagnosing these lesions is challenging because they are not easily visible on standard two-dimensional X-rays. Instead, specialized tools like cone-beam computed tomography (CBCT) scans or other densitometry devices are utilized to identify subtle abnormalities in the bone texture.
The Surgical Procedure
The surgical process focuses on the complete removal of unhealthy tissue to stimulate healthy bone regeneration. The procedure begins with local anesthesia, followed by a small incision to create a gingival flap, allowing direct access to the underlying jawbone. Once the bone is exposed, the surgeon locates the suspected cavitation site.
The diseased, necrotic, and fatty bone tissue is meticulously removed from the jawbone using specialized instruments, such as surgical hand tools or ultrasonic devices. This mechanical debridement, or scraping, continues until the surgeon reaches solid, healthy bone and observes clean, free-flowing blood at the margins of the surgical site. This flow of fresh blood is considered important as it signals restored circulation and the body’s natural capacity for healing.
The site is then thoroughly disinfected to eliminate residual bacteria. Common sterilization techniques involve irrigating the area with ozonated water or applying ozone gas. A laser may also be used for further disinfection of the bone cavity.
The final stage promotes optimal healing and bone growth. The cleaned cavity is often treated with a biocompatible material, such as a mineral graft, to encourage new bone formation. Platelet-Rich Fibrin (PRF), derived from a small sample of the patient’s own blood, is frequently used alone or mixed with the graft material. PRF contains concentrated growth factors and healing cells that accelerate tissue regeneration. Finally, the gingival flap is positioned back over the site and secured with sutures to close the surgical wound.
Scientific Status and Clinical Perspectives
While cavitation surgery is a common treatment within biological and holistic dentistry, its acceptance by the mainstream medical and dental community remains highly controversial. Organizations like the American Association of Endodontists have expressed growing doubt regarding whether NICO is a distinct disease entity with clear, scientifically validated characteristics. Critics argue that the concept of NICO lacks sufficient scientific validation, pointing to a lack of large-scale clinical trials and standardized diagnostic criteria.
The diagnosis and treatment of NICO are subject to debate, and some conventional dentists and maxillofacial surgeons reject the concept altogether. Evidence supporting the link between these lesions and systemic diseases often comes from retrospective case series or studies considered to have a high risk of bias. Despite this, many practitioners who perform the surgery report that patients experience relief from chronic, unexplained facial pain and inflammatory conditions.
Patients should be fully aware of the differing professional opinions and the potential risks associated with any surgical intervention. Risks include possible nerve damage, infection, delayed healing, and the chance that the procedure may not alleviate symptoms. Consulting with both a biological dentist and a conventional orofacial pain specialist can provide a balanced perspective on diagnosis and treatment options.