NICO (Neuralgia-Inducing Cavitational Osteonecrosis) is a condition that typically develops after improperly performed or previously infected tooth extractions—especially wisdom tooth removals. In this condition, the bone tissue in the extraction area fails to heal completely, its blood supply becomes compromised, and the bone gradually deteriorates internally, forming hollow, fatty, necrotic cavities.
NICO lesions usually do not cause visible swelling or abscesses and are often overlooked on conventional two-dimensional panoramic X-rays. However, patients may experience unexplained chronic pain in the face and jaw, including neuralgia-like symptoms triggered by these hidden lesions.
For a comprehensive diagnosis, three-dimensional dental computed tomography (CBCT) is used to evaluate bone density in detail, while specialized cavitation-detection ultrasound devices such as Cavitat® may also be utilized. Treatment involves surgically opening the affected bone area, thoroughly removing the necrotic fatty tissue within the cavity, and then applying ozone therapy and PRP (Platelet-Rich Plasma)—derived from the patient’s own blood—to promote healthy revascularization and bone regeneration.
