Ischemic bone disease, also called osteonecrosis or cavitations, are areas of dead or necrotic bone. Osteonecrosis can occur in any bone in the body. In dentistry, it is most common when the bone doesn’t heal properly after a tooth is removed, but can also be caused by injury, poor circulation or clotting disorders. These cavitations can harbor bacteria and other pathogens and their toxins, which have been shown in research to be related to such symptoms as chronic fatigue, digestive issues, and other chronic health problems.
Cavitations can be difficult to diagnose as they may not be visible on typical x-rays. They appear on CBCT or cone beam x-rays as subtle areas of decreased bone density. Diagnosis of ischemic bone disease is confirmed with a bone biopsy at the time of treatment.
DNA testing is also available to help determine what specific pathogens are present in the cavitation areas treated. A small amount of blood and fluid is collected from the area and sent to DNA ConneXions, where it is processed and analyzed. A full report detailing the pathogens found and the conditions and symptoms associated with them and their toxins is provided, which we recommend you take to your primary care provider for review. They can help you determine what, if any, further treatment is necessary.
Treatment of cavitations usually involves surgical debridement of the area with a thorough curettage of all soft ischemic/necrotic bone utilizing photoacoustics with the Fotona Lightwalker laser, followed by thorough disinfection with ozone. PRF or platelet rich fibrin – known for its regenerative function – is placed back into the bone to aid healing. In certain cases bone grafting may also be recommended.
