Definition and Background
- Neuralgia-inducing cavitational osteonecrosis (NICO) is a diagnosis associated with chronic facial neuralgia caused by a jawbone cavitation.
- NICO is different from osteonecrosis of the jaw.
- The pain in NICO is believed to result from the degenerating nerve.
- The condition is considered rare, and its existence is still debated.
- NICO was first described in dental literature by G V Black in 1920 and gained attention from oral pathologist Jerry E Bouquot.
Diagnostic Criteria and Controversies
- The diagnostic criteria for NICO are imprecise, and there are flaws in the research supporting it.
- Some holistic dentists popularize the diagnosis and treat NICO by surgically removing the dead bone believed to cause the pain.
- However, some dentists and maxillofacial surgeons reject NICO as quackery.
- The American Association of Endodontists stated that NICO occurrence and treatment at endodontically treated teeth is generally implausible.
- Routine extraction of endodontically treated teeth is considered misguided according to the association.
Related Conditions
- NICO is sometimes referred to as Ratners bone cavity.
- Atypical trigeminal neuralgia and trigeminal neuralgia are related conditions.
- These conditions may share similarities in terms of facial neuralgia.
- NICO has been studied in relation to jawbone cavities and neuralgias.
- Idiopathic trigeminal and atypical facial neuralgias are also associated with NICO.
Research and Evidence
- Bouquot et al. conducted a study on NICO, examining jawbone samples from patients with facial neuralgia.
- Other studies have explored the etiology, treatment, and long-term effects of NICO.
- Some researchers challenge the concept of NICO and its association with facial neuralgia.
- The status of NICO as a condition is still a topic of debate.
- Further research is needed to establish the validity and prevalence of NICO.
Criticisms and Ethical Considerations
- NICO has been criticized as a form of health fraud and quackery in dentistry.
- The ethical implications of NICO diagnosis and treatment have been discussed.
- Charlatans in dentistry have been associated with the NICO controversy.
- The American Association of Endodontists issued a position statement on NICO lesions.
- The controversy surrounding NICO highlights the need for critical evaluation and evidence-based dentistry.
Neuralgia-inducing cavitational osteonecrosis (NICO) is a diagnosis whereby a putative jawbone cavitation causes chronic facial neuralgia; this is different from osteonecrosis of the jaw. In NICO the pain is said to result from the degenerating nerve ("neuralagia"). The condition is probably rare, if it does exist.
Also called Ratner's bone cavity, a neuralgia-inducing cavitational osteonecrosis was first described in dental literature by G V Black in 1920. Several decades later, oral pathologist Jerry E Bouquot took especial interest in NICO.
The diagnostic criteria for NICO are imprecise, and the research offered to support it is flawed. The diagnosis is popular among holistic dentists who attempt to treat NICO by surgically removing the dead bone they say is causing the pain.
It has been rejected as quackery by some dentists and maxillofacial surgeons. In its position statement, dated 1996, the American Association of Endodontists asserted that although NICO occur and are treatable in toothless areas, NICO occurrence and treatment at endodontically treated teeth is generally implausible, that the diagnosis ought to be a last resort, and that routine extraction of endodontically treated teeth is misguided.
