Gentle and holistic NICO removal

NICO (Neuralgia Inducing Cavitational Osteonecrosis) is an inflammation of the jawbone which leads to destruction of the jawbone and usually manifests itself as nerve or non-specific facial pain. However, NICO is not visible from the outside and even with conventional X-ray procedures the chronic inflammation usually goes unnoticed.

In our practice, we use state-of-the-art diagnostic procedures to reliably determine and precisely localise NICOs – and then gently remove the affected area. In doing so, Dr. med. Thomas Franke draws on many years of experience in the removal of NICOs and can make a comprehensive and lasting contribution to the well-being of his patients thanks to his holistic therapy concept.

What exactly is NICO and how does it manifest itself?

The abbreviation NICO stands for Neuralgia Inducing Cavitational Osteonecrosis, which means neuralgia inducing cavity-forming osteonecrosis. This is a chronic inflammation of the jaw bone, also known as jaw osteitis, which leads to the dissolution of the bone substance or to sponge-like changes in the bone.
Chronic jaw osteitis NICO is a special form of inflammatory interference fields in the jaw bone. It describes an inflammatory and greasy degenerative process in the jawbone that breaks down bone cells, causing the bony structures to dissolve and cavities to form in the jawbone.

Interference fields are local changes that send out constant stimuli to the body and can affect the entire body as well as the immune system. Especially interference fields in the mouth area have a long-distance effect on the body organs and their systems. More than 60% of all chronic illnesses are caused by interference fields in the oral cavity, such as chronic centres of inflammation or metal.

The tricky thing about NICO is that it cannot be detected from the outside. Typical signs of inflammation on the mucous membrane, a noticeable swelling in the jaw area or the formation of pus, do not occur here and even with conventional X-ray procedures the inflammation remains invisible in most cases.

When opened during a surgical procedure, large areas of soft and greasy substance appear in the inflamed jawbone. These consist of decomposed tissue with fat cells, which in turn form inflammatory messengers. These spread quickly throughout the body and have a considerable influence on general health. Especially in sensitive, immunocompromised and stressed people, they can promote the development of various disease patterns in the body.

These conditions include autoimmune diseases such as multiple sclerosis or Hashimoto’s disease, but also migraines, joint, back and limb pain and the development of cancer and other tumours.

Many patients also suffer for years from radiating, unclear pain in the facial area, as the decomposition of the jawbone increasingly irritates the facial nerves. This constant irritation of the facial nerves can eventually lead to trigeminal neuralgia.

Trigeminal neuralgia is a sudden and violent attack of pain in the face. The pain usually lasts for only a few seconds, but returns at short intervals. The starting point of the pain is the trigeminal nerve, which supplies the face, forehead, eyes, chin, upper and lower jaw via three branches.

How is a NICO created?

NICO typically develops after the removal of teeth, such as wisdom teeth. A cavity develops in the jawbone at the affected area. After the removal of the teeth, the wound in the gums is closed and observed for a few days – unfortunately, healing in the jawbone is usually no longer taken into account.
As soon as there is a threat of inflammation at the wound, caused for example by a not quite adequate surgery, antibiotics are prescribed to treat the inflamed wound. However, antibiotics usually only reach the acutely inflamed part of the wound – and not the jawbone itself.
In the following years, the inflammation of the jawbone can persist and cause NICO.
This happens especially when there is also a deficiency of micronutrients such as vitamin D and other minerals, and thus insufficient cell growth, which is important for the healing process of bones.

In the case of NICO, the permanent and unhealed inflammation of the jawbone produces toxins, i.e. certain poisons, which block the body’s vital enzyme systems.
The toxins disturb the energy metabolism of the cells and increase the harmful effect of heavy metals with which they form chemical compounds. From a region contaminated with NICO, increased amounts of pro-inflammatory messenger substances (so-called cytokines) are released into the blood, which place a heavy burden on the entire organism and can weaken the immune system – and thus promote the development of diseases that affect the entire body.

How can NICOs be diagnosed?

There are ways to detect NICOs safely so that a reliable and safe diagnosis can be made.
Using digital volume tomography (DVT), we can quickly, easily and safely create a three-dimensional, high-resolution image of the jaw bones in our practice, which can be used to reliably identify and precisely localise inflammations such as NICOs.

DVT is an ultra-modern, 3D-based, imaging X-ray procedure that provides us with very precise, high-resolution and three-dimensional images of the head and face, including the jaws and sinuses. This diagnostic procedure enables us to accurately assess bone structures and the surrounding soft structures, such as the exact course of nerves, with only low radiation exposure. DVT is an absolute prerequisite for the exact planning of dental implants as well as for many oral surgery procedures, so that these can be carried out as safely and minimally invasively as possible.

In addition, the RANTES value is also checked in advance during a blood test. Due to the scattering of the inflammation-promoting messenger substances cytokines, these can be detected in high concentrations in the blood as so-called RANTES value.

If the affected area is subsequently opened during a surgical procedure, NICOs can also be identified from the significantly altered bone structure: The bone is yellowish to brownish on the outside and has a shiny, fatty mass on the inside.
After surgical removal, the material obtained is then examined by several special laboratories for diseases and heavy metal poisoning, which then provide further solid evidence.

How can NICOs be treated and how does the therapy work?

In the case of NICOs, the interference field created must be surgically removed. Dr. med. Thomas Franke has many years of experience with the gentle, minimally invasive and thorough removal of NICOs and can support his patients in the best possible way in healing and regeneration thanks to his biological and holistic approach.

Diagnosis and immunological preparation

Before an operation, a comprehensive diagnosis is first made by blood screening and DVT. The analysis of the blood is also used to determine whether there are any deficiencies in necessary vitamins or minerals as well as other accompanying diseases. This enables us to prepare our patients for the upcoming operation in the best possible way and to ensure that the body’s own regeneration processes are stimulated, so that both wound and bone healing proceeds in the best possible way and the immune system is strengthened for rapid regeneration.

The intervention and removal of NICO

The procedure takes place on an outpatient basis in our practice in Berlin Charlottenburg after a detailed personal consultation with Dr. med. Thomas Franke, in which the exact procedure, but also existing fears and wishes are discussed.
Immediately before the procedure, the pain is completely eliminated. As a rule, we use a local anaesthetic, but other methods such as deep sleep or general anaesthesia are also possible.
If the pain elimination works reliably, the operation begins.
To do this, the mucous membrane flap at the affected area of the interference field is first opened and unfolded so that the covering jawbone underneath is exposed. This is then removed so that the NICO is exposed. The changed bone tissue can be precisely identified in its composition and colour. The fat-degenerated tissue is removed thoroughly and completely using piezo devices.

We use piezo devices for the removal of the interfering area. These are particularly gentle and safe ultrasound instruments which are gentle on the surrounding soft tissue by working without pressure, selectively and precisely, thus preserving the bone substance in the best possible way, which is important for bone healing. In addition, working with piezo devices is very safe, as the ultrasound devices lose their cutting power in soft structures such as nerves or blood vessels, which means that soft tissue is not damaged.

After the gentle but thorough and complete removal of the degenerated tissue in the jawbone, the entire area is sterilised with ozone.

Ozone is a high-energy form of oxygen and is used in medicine for disinfection. A special treatment device is used for ozone therapy, which generates ozone at the required point, which then rapidly decays when it is released. This process eliminates micro-organisms in the immediate vicinity, killing bacteria, viruses and fungi completely within a few seconds. Ozone therapy can be used to disinfect wounds quickly, gently and comprehensively, as well as to stop bleeding and accelerate the healing process.

After the wound has been thoroughly disinfected, it is inserted and covered with PRP membranes, which ensure accelerated and optimal osseous wound healing.

Platelet rich plasma (also known as PRP) is a proven and state-of-the-art method for enhancing wound healing. The PRP is obtained from the patient’s own blood and the concentrate obtained by centrifugation is introduced locally into the tissue in question, where it supports and accelerates wound healing.

Finally, the wound is sutured with the finest suture material. We ensure that the wound and the bone tissue are prepared in such a way that they can heal optimally without new centres of inflammation and that new, healthy bone can form.

After the operation

After the procedure, we place great emphasis on close monitoring to ensure the best possible bone and wound healing.

In addition, we continue to provide our patients with the nutrients, minerals and vitamins that are necessary for optimal strengthening of the immune system and for the best possible healing. For this purpose, our patients receive an individually tailored medication regimen, with which we have also had very good experience in terms of the healing processes and regeneration of our patients.

After the operation, pain and swelling of the affected area can be expected in the first few days. Of course, we provide our patients with adequate painkillers and additionally recommend cooling the affected area over the cheek.
In addition, physically strenuous activities such as sports should be avoided in the first few days after the operation and a lot of rest should be taken. It is also preferable to eat mushy food for a few days. It is essential that you stop drinking alcohol and nicotine for at least a few days – but preferably as long as possible – after the operation, as this greatly interferes with wound healing.