Facial Pain

Ischemic osteonecrosis refers to a condition in which bone ("osteo") tissue dies ("necrosis") due to lack of blood supply ("ischemia"). The condition may persist undetected for several years and may or may not produce painful symptoms. When pain is involved it may be referred to as a "neuralgia-inducing cavitational osteonecrosis" or "NICO".

Accurate diagnosis of ischemic osteonecrosis of the jaw can be elusive. It is important to understand that typically the affected area is not visible on radiographs (x-rays) and even when the necrosis shows up on an x-ray it is usually subtle and requires a dentist with significant diagnostic experience in this area to correctly interpret it. Additionally, the painful symptoms of neuralgia-inducing cavitational osteonecrosis are often similar to and easily confused with many other types of craniofacial pain.

The CAVITAT Bone Ultrasound System

The CAVITAT™ is an FDA approved ultrasonographic device which produces a three-dimensional, computerized image of voids in jawbones. It provides accurate analysis of the size and location of osteonecrosis in the maxillary and mandibular bones. The CAVITAT™ facilitates early diagnosis and more effective planning of treatment in a way that radiographs alone cannot.

Dr. Keller and his staff are certified in the use of this device and are proud to be one of the less than 100 dentists in the country who make this diagnostic tool available to patients.

A recent concern over the use of Fosamax has emerged. A growing number of physicians and oral surgeons fear that long-term use of Fosamax and similar "biphosphonates" can lead to "dead jaw" syndrome, or Osteonecrosis, a potential condition that can cause pain, swelling, tooth and gum infections, tooth loss, as well as numbness and a heavy feeling in the jaw. If any one you know is taking Fosamax, or have taken it in the past and have any of the above listed symptoms, a Cavitat Scan may be the answer.