What a cavitation actually is

A jawbone cavitation is bone that has broken down or died within the jaw, sometimes called NICO or FDOJ depending on the term used. These areas often cause no pain (Dominiak et al.) and rarely show up on standard dental x-rays (IAOMT). Some patients have symptoms like facial pain, while others have no symptoms at all. Diagnosis usually requires more than a routine checkup.

What the research says

  • In 1992, Dr. Bouquot and colleagues introduced the NICO label after reviewing 224 bone samples taken from 135 people who had facial nerve pain, though they cautioned the preliminary findings could not confirm a cause (Bouquot et al.).
  • A 2025 scoping review characterizes FDOJ as a long-term, non-infectious inflammation within the jawbone that frequently produces no visible symptoms (Dominiak et al.).
  • Lechner and von Baehr’s 2015 research measured the signaling protein RANTES/CCL5 at nearly 30-fold higher concentrations in FDOJ tissue versus healthy bone (Lechner and von Baehr).
  • A 2026 scoping review covering 41 studies cautioned that suggested biological mechanisms, including RANTES/CCL5, still lack independent confirmation (Scoping review of FDOJ evidence (2026)).
  • Researchers who reviewed 1,000 CBCT scans in a 2026 study found that 60 percent of low-density jaw findings never appeared on panoramic x-rays, and concluded that CBCT scans alone cannot diagnose FDOJ (CBCT and panoramic imaging study (2026)).
  • The IAOMT’s 2023 position paper notes that these lesions typically do not show up on standard 2D dental x-ray images (IAOMT).
  • Researchers conducting a 2022 systematic review of 29 published studies judged the overall evidence on NICO’s causes, diagnosis, and treatment to be poor (Sekundo et al.).

Where experts disagree

Some researchers point to findings like elevated RANTES/CCL5 levels as evidence of an underlying biological process (Lechner and von Baehr), but a broader review found these proposed mechanisms have not been independently confirmed (Scoping review of FDOJ evidence (2026)). Professional opinions on treatment differ, too: the American Association of Endodontists has said it does not support surgery meant to address suspected NICO lesions (AAE), while the IAOMT, a dental group focused on biocompatible care, treats cavitations as a real condition that can be evaluated and treated (IAOMT).

How we evaluate and treat it

Dr. Carlo Litano, DMD, evaluates suspected jawbone cavitations by combining CBCT 3D imaging with a full review of your health history and symptoms. This approach helps build a clearer picture than a standard x-ray alone can provide. If you and Dr. Litano decide that surgery is the right path, the procedure removes diseased bone tissue, disinfects the area using medical-grade ozone, and places LPRF derived from your own blood into the treated site. This protocol follows Dr. Litano’s training through the Swiss BioHealth program. After treatment, we use follow-up imaging to check how the bone is healing. You will receive a written plan outlining the recommended approach and associated costs before making any decision. Out-of-town patients are welcome to stay in our private apartment, located one floor above our downtown St. Petersburg office.

Sources

  1. Dominiak et al., scoping review on FDOJ (2025)
  2. IAOMT, Jawbone Cavitations position paper (2023)
  3. Bouquot et al., Oral Surg Oral Med Oral Pathol (1992)
  4. Lechner and von Baehr, RANTES study (2015)
  5. Scoping review of FDOJ evidence (2026)
  6. CBCT and panoramic imaging study (2026)
  7. Sekundo et al., systematic review (2022)
  8. AAE, NICO lesions position statement (2012)

Last updated October 1, 2026.