Pain

The pain in this disease can be produced by a variety of factors, such as ischemia of the nerves, fluid or gasseous pressures on the nerves, distended blood vessels, inflammatory mediators, damage to the nerves from chronic exposure to the toxins of dead or inflamed tissues. It should not be surprising, then that a variety of types of pain occur. Most patients feel a deep ache or sharp pain deep in the bone. This is often difficult to localize and may, in fact, move about from day to day or week to week (remember, the disease is a fluid/pressure phenomenon with small infarctions occurring over time). Pain episodes may be separated by days or weeks with out pain. Another common pain type is a very sharp, lacerating pain shooting up to the eye or along the edge of the nose or back to the ear, Perhaps with temporary secondary pain in those sites. This pain may not may not be triggered by touching a certain part of the alveolar bone or overlying facial skin. Some patients describe their deep pain as "annoying" or "uncomfortable" rather than true pain, but these generally will go on to more severe pain over time. 

Treatment

The recommended treatment for cavitational lesions is surgical removal. The surgery itself consists of making an incision into the suspect area, exposing the bony defects, and debriding (scraping) the lesion to remove all the unhealthy bone. Sometimes it is necessary to remove a non vital ( dead) or root canal tooth to gain access to the lesion. If, after the surgical debridement, excessive bone had been removed, bone regeneration techniques are implemented to help the body rebuild the bony matrix of the jaw. The area is then sutured with special sutures to help prevent bacterial growth. 

Following surgery, vitamin and mineral therapy can assist with the healing and removal of toxic materials and bacteria that may accompany these lesions. Antibiotics are commonly prescribed as well as continuation of appropriate supplements that were begun prior to surgery. 

Patients usually experience some tenderness or soreness in the area of surgery , but most often do not experience intense pain. There may be some swelling along with occasional black and blue markings (blood leaking into the surrounding tissues). Sometimes, general achiness is reported but most patients, after surgery, do fairly well. 

As one might expect disease that could be a sign of an underlying systemic disorder, cavitations or NICO lesions have a tendency to recur or develop in additional jawbone sites, and may require a repetition of the surgical procedure. 

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