Chronic Fibrosing Osteomyelitis

This is a chronically painful condition of one or both jaws wich can be debilitating. It was described over one hundred years ago by dental pioneer G.V. Black and has been identified by various names: Roberts bone cavity, Ratner bone cavity, NICO (Neuralgia-Inducing Cavitational Oesteonecrosis) and more recently C.F.O.

Characteristic symptoms are toothache-like pain in areas with or without teeth and often a foul taste in mouth, The affected bone can be tender to pressure or palpation. It does not typically appear on routine dental x-rays nor is there redness or swelling of the gums. The preliminary diagnosis is often made by exclusion; that is, by ruling out disease from the teeth or gums, Tempomandibular disfunction (TMD), myofacial pain or other oral and head/neck problems.

Other diagnostically useful tests are: Technetium 99 bone scans, injections of local anesthetic into the suspected diseased bone, and C.T. scans can reveal the absence of normal medullary. Ultimately the diagnosis is made by biopsy, a routine and simple dental surgery.