Neuralgia‐inducing cavitational osteonecrosis – A systematic review

Abstract

Objective To assess the aetiologic factors, proposed diagnostic means and treatment strategies for neuralgia‐inducing cavitational osteonecrosis. Methods A search of the literature published up to June 2020 was conducted using Medline, the Cochrane Library, PsycINFO, CINAHL and Web of Science. The scientific quality of the evidence was rated according to NIH Quality Assessment Tools. Results 4,051 articles were found, 59 were reviewed in full text, and 29 studies were included. With the exception of hereditary coagulopathies, which were identified as potential risk factors in five studies, suggestions concerning the aetiology varied widely. No gold standard diagnostic mean could be identified. Treatment was most often performed by surgical curettage of the affected bone. Surgical treatment outcomes were equally varied: significant facial pain remission was reported in 66%–100% for periods varying between 2 months to 18 years, whereas no or little relief and recurrences were reported in up to ⅓ of cases. All studies were observational in their design. All investigations were rated as poor quality because of high risk of bias and non‐transparent reporting. Conclusions Evidence concerning the aetiology, diagnosis and treatment of NICO is poor. Prospective diagnostic and therapeutic studies are needed before the usefulness of invasive therapeutic procedures can be evaluated.

In defense of open scientific discussion. Reply to Dr. McMahon

“…For instance, by rendering it more transparent, as we did among the firsts, we made available on the web all exchanges between the authors and the editorial team (reviewers, associated editors, and editors). Thus, contrarily from Dr. McMahon, we see no irony whatsoever in having published the systematic review by Sekundo et al (2022).…”

Comparison of Cytokine RANTES/CCL5 Inflammation in Apical Periodontitis and in Jawbone Cavitations – Retrospective Clinical Study

“… 20 Their existence has therefore been under discussion for decades. 21 The possible pathogenetic effects of an R/C signalling cascade chronically expressed from local BMDJ/FDOJ areas in its scientifically proven systemic inflammatory induction are ignored or misjudged in medical and dental diagnoses. The comparison of AP diagnosis and pathology and BMDJ/FDOJ diagnosis and pathology shows a clear imbalance to the disadvantage of the BMDJ/FDOJ processes, although the systemically-immunologically relevant R/C expression in the BMDJ/FDOJ areas is considerably higher in the data we collected, by a factor of 3, than in the AP processes.…”

Linking Dentistry and Chronic Inflammatory Autoimmune Diseases – Can Oral and Jawbone Stressors Affect Systemic Symptoms of Atopic Dermatitis? A Case Report

“…This case report gives additional space and clinical significance to the demand for large-scale studies for better evidence support. 59 The authors agree that there is a need for further studies with significant study designs to provide evidence for this controversially discussed issue. New examination methods, based on technologically advanced ultrasound TAU sonography, are available and increasingly validated.…”