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Medical Forum / General / Dentistry / August 2004NICO
From: http://www.aae.org/nico.html Position Statement on NICO (Neuralgia-Inducing Cavitational Osteonecrosis) Lesions The following statement was prepared by the AAE Research and Scientific Affairs Committee to address issues being raised by some endodontic patients. AAE members may photocopy this statement for distribution to patients or referring dentists. The NICO lesion (Neuralgia-Inducing Cavitational Osteonecrosis, also known as Ratners bone cavity) was first described in the dental literature in 1920 by G.V. Black. The lesion consists of ischemic osteonecrosis found in the jaws of patients with symptoms of atypical facial pain or trigeminal neuralgia. Research has shown the lesions to be difficult to diagnose. The lesion will sometimes present very subtle radiographic changes often detectable only by a technetium scan or with multiple periapical radiographs. The overlying soft tissues show no changes. Many etiologies for NICO have been suggested, but none have been substantiated through research. According to noted oral pathologist Dr. J.E. Bouquot, the typical NICO case occurs as facial pain many years after an extraction or an infection in the area. Odontogenic infections and minor trauma have been suggested as initiators, and correlations to clotting or vascular abnormalities have been made based on anecdotal associations. No scientific studies have demonstrated a causative relationship between endodontic therapy and the formation of NICO. The recommended treatment for NICO is decortication and curettage of the bony tissues. While this practice has produced relief of pain in some cases, NICO has a strong tendency to recur and to develop in other jawbone sites. Most affected sites with a postoperative NICO diagnosis have been in edentulous areas. However, some patients with long, frustrating histories of pain associated with endodontically treated teeth have been presented the treatment option of tooth extraction followed by periapical curettage in an attempt to alleviate pain. The American Association of Endodontists cannot condone this practice when NICO is suspected. Because of the lack of clear etiological data, a NICO diagnosis should be considered only as a last resort when all possible local odontogenic causes for facial pain have been eliminated. If a NICO lesion is suspected in relation to an endodontically treated tooth, if possible, periradicular surgery and curettage should be attempted, not extraction. In addition, the practice of recommending the extraction of endodontically treated teeth for the prevention of NICO, or any other disease, is unethical and should be reported immediately to the appropriate state board of dentistry. References 1. Bouquot JE. In review of NICO (neuralgia-inducing cavitational osteonecrosis), GV Blacks forgotten disease. 1995, 4th ed. 2. Bouquot JE, Christian J. Long-term effects of jawbone curettage on the pain of facial neuralgia. J Oral Maxillofac Surg 1995;53:387397. 3. Ratner EJ, Langer B, Evins ML. Alveolar cavitational osteopathosis. Manifestations of an infectious process and its implication in the causation of chronic pain. J Periodont 1986; 58:593603. 4. Segall RO, del Rio CE. Cavitational bone defect: a diagnostic challenge. J Endodon 1991; 17:396400. ©1996 American Association of Endodontists, 211 East Chicago Avenue, Suite 1100, Chicago, IL 60611-2691 -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Another point that the NICO proponents seem to overlook...... Yes, the unexplained facial pain is often closely associated with teeth that have had root canals. *BUT* These root canals were often done in hopes of aleviating facial pain that was there for quite some time without any other explanation! IOW's the teeth may not have needed root canals in the first place, but the unexplained pain led some dentist somewhere to try endo to help the patient. Of course the endo didn't help because the teeth weren't the problem in the first place. These patients bounce around from physician to physician and from dentist to dentist trying to get rid of the pain. Once someone does endo, then subsequent observers wonder if something isn't quite right with the root canals. Retreatments, apicoectomies, and extractions often follow (with equal failure to relieve the pain). This is some kind of neuralgia, not NICO. Fawks > In addition, the practice of recommending the extraction of endodontically treated teeth for the > prevention of NICO, or any other disease, is unethical and should be reported immediately to the > appropriate state board of dentistry. > W_B >Another point that the NICO proponents seem to overlook...... > [quoted text clipped - 19 lines] > >Fawks Yep, Trigeminal Neuralgia ==> Tx with Tegretol. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > Another point that the NICO proponents seem to overlook...... > [quoted text clipped - 27 lines] > >> W_B I actually did an endo on one of my mother's upper lateral incisors for what did appear at the time to be pain of dental origin. The pain did not remit, and gradually became more generalized. Eventually a trigeminal neuralgia was diagnosed. She was on tegretol for the rest of her life, with mixed results. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > > Another point that the NICO proponents seem to overlook...... > > [quoted text clipped - 35 lines] > > Steve In response to the entire thread. This is an incredibly complex issue. For one thing, if jaw infection spreads into the nerves, it doesn't follow that removing the infection from the jaw will cure the infection from the nerves. Also if somone has facial pain of an origin that is not dental and not cured dentally it doesn't follow that in some cases dental infection cannot cause facial pain. What seems shameless to me is for the ADA to catagorically say that jaw infection can't cause nerve complications or sinus infection, thats absurb. Infection can spread from any other bone in the body, but not the jawbone? Osteomyletis and osteonecrosis can exist in any bone in the body and cause complications, but not the jawbone? The ADA also asserts that if an x-ray is not radiolucent infection cannot exist in the case of jaw infection, root canals etc. That's also false, which can be easily disproved by examing pictures of jawbone from cadavers and comparing with the x-rays of the jawbone or going into a root canal area which is infected even though it doesn't light up on the x-ray. The truth is that the ADA doesn't want to deal with a condition which is relatively rare and not easily diagnosed. They want to pretend that an x-ray is a magic device which can diagnose anything and they don't want to admit that dental procedures can result in infection which may not always be seen on x-ray. This keeps them in the position of power and minimizes libialbity while maximizing revenue, all at the expense of the patient. As far as the "cavitat" is concerned, I agree that the device is useless and shouldn't be used to diagnose jaw disease. A nickname many people give the cavitat is the "gagitat". As for pathology labs "diagnosing" NICO, that is absurb. All a pathology lab can do is look at a sample of bone and say if it shows signs of infection such as osteomyletis. There is no way to make a statement about nerve pain by looking at a piece of bone. "Clinton C Zimmerman" <clintonz@prodigy.net> ............................ > This is an incredibly complex issue. ............... Pretty good up to that point. carabelli >"Clinton C Zimmerman" <clintonz@prodigy.net> ............................ > [quoted text clipped - 3 lines] > >carabelli Good one! >This is an incredibly complex issue. No, it's not. >For one thing, if jaw infection >spreads into the nerves, it doesn't follow that removing the infection >from the jaw will cure the infection from the nerves. Human nervous tissue is highly resistant to infection. Myelin sheaths, the meninges, ect... Rabies comes to mind, as one of the few nervous tissue infections. Do you know of others that might not readily come to mind ? >Also... <snip magical thinking> >As far as the "cavitat" is concerned, I agree that the device is >useless and shouldn't be used to diagnose jaw disease. Shouldn't be used to diagnose anything ! >A nickname many people >give the cavitat is the "gagitat". Interesting. Who says you don't have a sense of humor ? >As for pathology labs "diagnosing" NICO, that is absurb. Absurd ? >All a >pathology [quoted text clipped - 3 lines] >pain >by looking at a piece of bone. Right-0 -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>This is an incredibly complex issue. >No, it's not. [quoted text clipped - 5 lines] >Human nervous tissue is highly resistant to infection. >Myelin sheaths, the meninges, ect... But susceptible to certain viruses ...... >Rabies comes to mind, as one of the few nervous tissue >infections. Do you know of others that might not readily >come to mind ? Shingles. Bell's Palsy >>Also... > [quoted text clipped - 24 lines] > >Right-0 >>Human nervous tissue is highly resistant to infection. >>Myelin sheaths, the meninges, ect... [quoted text clipped - 8 lines] > >Bell's Palsy All viral; good catch. Thanks, -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > >>Human nervous tissue is highly resistant to infection. > >>Myelin sheaths, the meninges, ect... Well let's take bone infection in the leg such as osteomyletis. Does that infection ever spread to nerves around the leg. If you have research to show it does not it would be interesting to see it. In terms of the infections agent, how about acitomites or other non-aerobic bacteria, staph or fungus. You'd also have to show that these cannot affect the blood supply to the nerves. Additionally if infection is present outside or near the nerve and fails to enter into the nerve, the toxins generated by the infected area could still also affect the nerve. I'm not a biologist and I'm not saying that causes of facial nerve pain outside of dental infection don't exist or aren't common but those seem like logical possibilites to address. As for catagorical statements by the ADA declaring no link between jaw infection and nerve pain, as usual I would ask you or Carabelli to post the studies. >> >>Human nervous tissue is highly resistant to infection. >> >>Myelin sheaths, the meninges, ect... > >Well let's take bone infection in the leg such as osteomyletis. Does >that infection ever spread to nerves around the leg. If you have >research to show it does not it would be interesting to see it. Proving a negative is tough! Here are some basics. Dentists study pathology and various prcesses such as inflammation, etc. So we look through a microscope, study slides, try to understand what is meant by the word, "INFECTION." It is a little different from your interpretation of the word. Infection can spread ........ this is getting tough here ........ similar to how rust on a fender can advance ....... from wheel well to side panel, etc. It does not slide up the rear lamp wiring or the brake light wiring up to the battery. That would be my analogy about why infection does not travel up nerves. However, as I stated avove, a virus can slide up a nerve and it does do so. These are the various polyneuropathies ~ the real ones, not the Jan Drew Amagamitis ones. Joel >In terms of the infections agent, how about acitomites or other >non-aerobic bacteria, staph or fungus. [quoted text clipped - 11 lines] >infection and nerve pain, as usual I would ask you or Carabelli to >post the studies. >>> >>Human nervous tissue is highly resistant to infection. >>> >>Myelin sheaths, the meninges, ect... [quoted text clipped - 4 lines] > >Proving a negative is tough! ... and almost never done... >Here are some basics. Dentists study pathology and various prcesses >such as inflammation, etc. [quoted text clipped - 3 lines] > >It is a little different from your interpretation of the word. a little ? How about totally in outer space ? >Infection can spread ........ this is getting tough here ........ >similar to how rust on a fender can advance ....... from wheel well to >side panel, etc. OK but a rough analogy. >It does not slide up the rear lamp wiring or the brake light wiring up >to the battery. That would be my analogy about why infection does not >travel up nerves. Bacteria: No ; Virii: Yes >However, as I stated avove, a virus can slide up a nerve and it does >do so. These are the various polyneuropathies ~ the real ones, not the >Jan Drew Amagamitis ones. Yep >Joel > >>In terms of the infections agent, how about acitomites or other >>non-aerobic bacteria, staph or fungus. What are acitomites ? non-aerobic = anaerobic Staph ? Which one, what species ? alpha-hemolytic ? No, that's strep. Fungi only feed on dead tissue. >>You'd also have to show that these cannot affect the blood supply to >>the nerves. Additionally if infection is present outside or near the >>nerve and fails to enter into the nerve, the toxins generated by the >>infected area could still also affect the nerve. >> >>I'm not a biologist Painfully obvious. >and I'm not saying You are not saying anything. >>that causes of facial nerve >>pain outside >>of dental infection don't exist or aren't common but those seem like >>logical possibilites to address. Disagree. >>As for catagorical statements by the ADA declaring no link between jaw >>infection and nerve pain, as usual I would ask you or Carabelli to >>post the studies. Do your own home work, we have better things to do than educate you. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Joel M. Eichen <joeleichen@yahoo.com> wrote in message > > However, as I stated avove, a virus can slide up a nerve and it does > do so. Once it is in the sheath? Are you saying that bacteria or fungus cannot move once it is in the nerve or that it can never get into the nerve. I know someone who developed a bacterial infection on the skin which was treated with antioboitcs. If bacteria can live and multiply on the skin, than why not the nerve? >Joel M. Eichen <joeleichen@yahoo.com> wrote in message > >> However, as I stated avove, a virus can slide up a nerve and it does >> do so. > >Once it is in the sheath? Are you saying that bacteria or fungus cannot >move once it is in the nerve or that it can never get into the nerve. TOO BIG! Bacteria are huge compared to viruses ..... >I know someone who developed a bacterial infection on the skin which >was treated with antioboitcs. If bacteria can live and multiply on the >skin, than why not the nerve? On the nerve ... yes. INSIDE the nerve no. VIRUSES? yes. >>Joel M. Eichen <joeleichen@yahoo.com> wrote in message > >>> However, as I stated avove, a virus can slide up a nerve and it does [quoted text clipped - 14 lines] > >VIRUSES? yes. Correct. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >Subject: Re: NICO >From: W_B no_one@nowhere.net [quoted text clipped - 21 lines] > >Correct. Prove it. Infection is in the blood, what makes you think blood doesn't get inside the nerve? Jan Jan, this is a classic. Kindness prevents me from elaborating further! But your heart is in it. Thanks. Joel >>>On the nerve ... yes. INSIDE the nerve no. >>> [quoted text clipped - 6 lines] > >Jan Blood-Brain Barrier. Blood never travels through nervous tissue. >Jan, this is a classic. Kindness prevents me from elaborating further! >But your heart is in it. Thanks. [quoted text clipped - 11 lines] >> >>Jan -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE Worse! Bllod is a tissue comprised of cells ... some big some small. NERVE is another tissue ......... comprised of ... cells ........ So the cells and the cells do not interact! One does not slip inside the other. Jan may not be aware of this. She may think blood is like very thick Kool-Aid. JOEL >Blood-Brain Barrier. Blood never travels through nervous tissue. > [quoted text clipped - 13 lines] >>> >>>Jan >Worse! > [quoted text clipped - 9 lines] > >JOEL Electric Kool-Aid ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > Worse! > [quoted text clipped - 4 lines] > So the cells and the cells do not interact! One does not slip inside > the other. Schwann cells take care of nourishment of the conduction parts of nerve cells. These cell do not have blood in them. If you think about it, if they did, there would be no possibility of nerve conduction, as these cells need to maintain an inside negative potential of 70mV DOrkydorkyDee sp SignatureTo reply: take out the TRASH... >> Worse! >> [quoted text clipped - 11 lines] >DOrkydorkyDee >sp Whoa. You are losing Jan. INSIDE NEGATIVE POTNETIAL of 70mV?????? That's not part of Break Dancing LESSONS! > Whoa. You are losing Jan. INSIDE NEGATIVE POTNETIAL of 70mV?????? > > That's not part of Break Dancing LESSONS! Just means that nerves are like mini-batteries. They get a charge and lose it occasionally S................................................eeeP SignatureTo reply: take out the TRASH... >> Worse! >> [quoted text clipped - 11 lines] >DOrkydorkyDee >sp Where's Keith Walsh when you need 350mV ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > >Schwann cells take care of nourishment of the conduction parts of nerve > >cells. These cell do not have blood in them. If you think about it, if [quoted text clipped - 7 lines] > -- > W_B True..... SP SignatureTo reply: take out the TRASH... >> >Schwann cells take care of nourishment of the conduction parts of nerve >> >cells. These cell do not have blood in them. If you think about it, if [quoted text clipped - 4 lines] >> >> Where's Keith Walsh when you need 350mV ? WoW! Enough to power five nerves ... without blood in them ...... Jan ....... 350mV divided by 70 mV equals FIVE! >> -- >> W_B > >True..... >SP >Worse! > >Bllod is a tissue comprised of cells ... some big some small. BLLOD is very similar to the other tissue ... BLOOD. >NERVE is another tissue ......... comprised of ... cells ........ > [quoted text clipped - 23 lines] >>>> >>>>Jan > Jan, this is a classic. Kindness prevents me from elaborating further! > But your heart is in it. Thanks. I'll admit I'm no expert in Biology, but a google search shows that on some occasions bacteria can infect and spread in the central nervous system even though the mylein makes this difficult. Regardless of how nerves are situated to blood supply the fact remains that bacterial infections can exist and spread in nerves. Also can't the blood supply in the jaw pass near the nerves in the jaw which are connected to nerves in the face? How are you taking the logical step from bacterial nerve infection is relatively unlikey to it doesn't happen? You also avoided the question of whether mycoplasmas or acitomytes which are crosses between bacteria and viruses (if I understand it right)can infect nerves. >> Jan, this is a classic. Kindness prevents me from elaborating further! >> But your heart is in it. Thanks. > >I'll admit I'm no expert in Biology, but a google search shows >that on some occasions bacteria can infect and spread in the central >nervous system That's different from blood in the nerves! > even though the mylein makes this difficult. Regardless >of how nerves are situated to blood supply the fact remains that >bacterial infections can exist and spread in nerves. Also can't the >blood supply in the jaw pass near the nerves in the jaw which are >connected to nerves in the face? YUP. Again different. >How are you taking the logical step from bacterial nerve infection is >relatively unlikey to it doesn't happen? [quoted text clipped - 3 lines] >are crosses between bacteria and viruses (if I understand it right)can >infect nerves. Nerves are cells ..... specialized cells ........ Bone is a collection of cells .. .specialized cells ....... When the bacteria get inside the bone (not cells, but the matrix), the bone responds by shrinking back ~ called osteoclastic activity -- "CLAST" means "to break down." This is aided by mediators of the inflammatory process, which accompanies the infection. This is day-in and day-out dentistry. NOW infection + nerve = nuttin' > How are you taking the logical step from bacterial nerve infection is > relatively unlikey to it doesn't happen? [quoted text clipped - 3 lines] > are crosses between bacteria and viruses (if I understand it right)can > infect nerves. Bacterial infection of intact nerves, IIRC, is not possible. They can, however, invade ganglionic tissue and damage nerves that way. Nerve Ganglions are places where nerves get together to interconnect. Off hand, I can't remember of a specific example, but if I do, I'll sing out. Don't confuse nervous ganglions with lymphatic ganglions. Mycoplasms are fungii, and, again, IIRC, it is not their physical presence but their toxins that are dangerous to nervous tissue. I can't answer wrt actinomycetic infection. Would be nice to cross over and ask this question on a medical NG, if that exists.... Pity, I used to know a couple of Neuros, but they've been swept away to bigger and better things than little Pee-Fart Quebec. HTH S..................++++++++++++++++Peeeeeee SignatureTo reply: take out the TRASH... >Subject: Re: NICO / Nerve Bacterial Infection >From: clintonz@prodigy.net (Clinton C Zimmerman) [quoted text clipped - 19 lines] >are crosses between bacteria and viruses (if I understand it right)can >infect nerves. At any rate heavy metals such as mercury can cause peripheral neuropathy. I had mercury poisoning. Both conditions were caused by mercury from amalgams. Jan >>Subject: Re: NICO / Nerve Bacterial Infection >>From: clintonz@prodigy.net (Clinton C Zimmerman) [quoted text clipped - 21 lines] > >At any rate heavy metals such as mercury can cause peripheral neuropathy. ....... and ruins one's chances of winning in the Break Dancing Olympics (2005) ...... >I had mercury poisoning. Both conditions were caused by mercury from amalgams. Did you nearly die? Were you eating thermometers? WHOT>>>??? >Jan "Jan" <jdrew63929@aol.com> wrote..................... > Prove it. Infection is in the blood, what makes you think blood doesn't get > inside the nerve? > > Jan My turn. "What are you drinking????" carabelli This kind of shows us we did LEARN something in dental school ..... >"Jan" <jdrew63929@aol.com> wrote..................... > [quoted text clipped - 7 lines] > >carabelli "Jan" <jdrew63929@aol.com>............... (as in aluminun is a heavy metal) wrote ............... > Prove it. Infection is in the blood, what makes you think blood doesn't get > inside the nerve? > > Jan Another idiocy posted by Jan - the only question is how long will it take the donkey to start braying in SMD again >"Jan" <jdrew63929@aol.com>............... > > (as in aluminun is a heavy metal) However of the heavy metals, it is one of the lighter ones ...... >wrote ............... > [quoted text clipped - 6 lines] >Another idiocy posted by Jan - the only question is how long will it take >the donkey to start braying in SMD again I am still trying to picture the red blood cells and the white blood cells INSIDE the dendrite ......... Even if it's not the same "J**", it's just as funny! A sane person would realize that after so many beliefs are so obviously wrong, their whole belief system is flawed. They would be embarrassed to type anything further. (just scanning messages on Monday morning), Fawks > Prove it. Infection is in the blood, what makes you think blood doesn't get > inside the nerve? > > Jan >Subject: Re: NICO >From: Steven Fawks tuthjockey@earthlink.net >Date: 8/30/2004 4:53 AM Pacific Standard Time >Message-id: <frFYc.2514$w%6.2159@newsread1.news.pas.earthlink.net> While you are busy belittling again, I might remind you of the mistake you made is a post about toot canals, As I recall you never did correct it. I could bring it up again, but I'm not as chilgish as you. Jan People who respect themselves view selfishness, loss of self-discipline, recklessness, cowardice and dishonesty as wrong and unworthy of them. They have inner strength and are unwilling to let others use or manipulate them. They know that showing patience or tolerance does not mean allowing others to mistreat them. >Subject: Re: NICO >From: jdrew63929@aol.com (Jan) >Date: 8/30/2004 5:20 PM Pacific Standard Time >Message-id: <20040830212028.07384.00000077@mb-m29.aol.com> Sorry for the typos, this will give Joel something to blather about for the next few years. Jan >>Subject: Re: NICO >>From: Steven Fawks tuthjockey@earthlink.net [quoted text clipped - 15 lines] >know that showing patience or tolerance does not mean allowing others to >mistreat them. >>Subject: Re: NICO >>From: jdrew63929@aol.com (Jan) [quoted text clipped - 5 lines] > >Jan ...amalgamitis ..... > Even if it's not the same "J**", it's just as funny! > > A sane person would realize that after so many beliefs are so obviously > wrong, their whole belief system is flawed. They would be > embarrassed to type anything further. Yes, a "sane person" would...wouldn't they! That explains a lot. T >Well let's take bone infection in the leg such as osteomyletis. Likely to lead to amputation. >Does that infection ever spread to nerves around the leg. Suppose it could but that is the least of the worries. BTW which 'leg bone' are you referring to ? >If you have >research to show it does not it would be interesting to see it. Negative research is unlikely, research about treatment(s) is *very* likely. Osteomyelitis, while somewhat uncommon, can be fatal. It's as hard to get rid of as it is to contract. How do you suppose that one would contract osteomyelitis in any of the 'leg bones' ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>Well let's take bone infection in the leg such as osteomyletis. > [quoted text clipped - 4 lines] >Suppose it could but that is the least of the worries. >BTW which 'leg bone' are you referring to ? The leg bone connected to the ....... shin bone ........ >>If you have >>research to show it does not it would be interesting to see it. [quoted text clipped - 7 lines] >How do you suppose that one would contract osteomyelitis >in any of the 'leg bones' ? > >>Does that infection ever spread to nerves around the leg. > > > >Suppose it could but that is the least of the worries. > >BTW which 'leg bone' are you referring to ? > > The leg bone connected to the ....... shin bone ........ I see you reply in Joel's post but I don't see the original post. > >>If you have > >>research to show it does not it would be interesting to see it. [quoted text clipped - 4 lines] > >Osteomyelitis, while somewhat uncommon, can be fatal. > >It's as hard to get rid of as it is to contract. There is the chronic type as well as the acute type. Same goes for osteonecrosis. The aim of the discussion is to discern the probability that chronic osteonecrosis exists in the jaw and then the probablity that Neuraliga Induced oseteonecrosis exists, or that chronic osteonecrosis in the jaw can cause nerve damage. > >How do you suppose that one would contract osteomyelitis > >in any of the 'leg bones' ? A google search shows that in 30% of osteonecrosis cases the cause is unkown. You can't exclude effect because you don't see a causative mechanism or based on the frequency of occurence, that's faulty logic. That is why I posted the Monty Hall problem because a false exclusion leads to the wrong conclusion even for the vast majority of people who consider themselves to be experts. By the way it is also interesting that some infectous organisms such as acitomytes and mycoplasmas are crosses between bacteria and viruses. Therefore even if your where able to prove that 100% of the time bacterial and fungal infections cannot cause nerve damage you still cannot disprove NICO based on an exclusion argument. That may be inconvient but who said that truth was a convience? >Subject: Re: NICO >From: W_B no_one@nowhere.net [quoted text clipped - 9 lines] > >Human nervous tissue is highly resistant to infection. WOW!!!! >Myelin sheaths, the meninges, ect... > >Rabies comes to mind, as one of the few nervous tissue >infections. Do you know of others that might not readily >come to mind ? Results 1 - 10 of about 204,000 for human nervous tissue infections. (0.51 seconds) >Also... > ><snip magical thinking> Well no that was above. >Human nervous tissue is highly resistant to infection. >>Subject: Re: NICO >>From: W_B no_one@nowhere.net [quoted text clipped - 11 lines] > >WOW!!!! Its true Jan. >>Myelin sheaths, the meninges, ect... There was an actor, .... Adolph Meninges I believe ....... >>Rabies comes to mind, as one of the few nervous tissue >>infections. Do you know of others that might not readily [quoted text clipped - 10 lines] > >>Human nervous tissue is highly resistant to infection. >> > Another point that the NICO proponents seem to overlook...... >> > [quoted text clipped - 40 lines] >This is an incredibly complex issue. For one thing, if jaw infection >spreads into the nerves, How so? Your "IF" is not correct. Joel M. Eichen > it doesn't follow that removing the infection >from the jaw will cure the infection from the nerves. Also if somone [quoted text clipped - 37 lines] >pain >by looking at a piece of bone. >>>Another point that the NICO proponents seem to overlook...... >>> [quoted text clipped - 45 lines] > facial > pain. In the larger sense you are partly right. Neurogenic viruses are known to be difficult to eradicate, regardless of the initial mode of entry. However, with dental infection we are largely talking about bacterial disease. While I can't absolutely say that there are no bacteria with neurotropic spread, I do know that the bacterial responsible for the most common dental disease do not spread this way--and if they did it would be most easy to detect. It is true that either root canal or extraction cause severing of sensory nerve fibers, and the healing of this amputation is matter of some controversy--ie: such entities as "phantom limb pain". However, in most cases of trigeminal neuralgia, a careful assessment of the symptoms and the prior dental history with regard to root canals, extractions etc. will demonstrate that there is no anatomic basis for an association. > What seems shameless to me is for the ADA to catagorically say that > jaw infection can't cause nerve complications or sinus infection, > thats absurb. Infection can spread from any other bone in the body, > but not the jawbone? > Osteomyletis and osteonecrosis can exist in any bone in the body and > cause complications, but not the jawbone? I have heard the ADA say no such thing. Dealing with sinus-tooth interactions, vascular anomalies and bone quality and healing potential are things that oral surgeons do every single day. I hope Dave King will weigh in here to briefly review some of the considerations. There is now increasing evidence of both metastatic infection and immunologic markers for a relationship between dental and cardiovascular, cerebrovascular and other disease. Far from ignoring it, I think dentistry is sometimes overplaying this issue. Steve > The ADA also asserts that if an x-ray is not radiolucent infection > cannot exist in the case of jaw infection, root canals etc. That's [quoted text clipped - 23 lines] > pain > by looking at a piece of bone. SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Retreatments, apicoectomies, and extractions > often follow (with equal failure to relieve the pain). > > This is some kind of neuralgia, not NICO. > > Fawks ... If this is true, then antidepressors may be the best bet to control the chronic pain. (Sorry, Gail). Just a thought SP SignatureTo reply: take out the TRASH... Any opportunity to talk of the hated and loved anti-depressants is fine with me. SP wrote, "This is some kind of neuralgia, not NICO. ...if this is true, then anti-depressants may be the best bet to control the chronic pain." Why anti-depressants, when pain pills in moderation would do. What is the reasoning for this.. To lift the spirits so as to forget the pain?. While someone may feel better in mood, how would it affect the feeling of pain. Even people not depressed would need a pain pill for neuralgia, I would imagine. Good opportunity to explain my version of why anti-depressants help for Crohns illness. As I have said, there is a mind/body connection which is the cause of crohns. And I have noted that when on anti-depressants. a person tends to not dwell on all people so much, including the person on the stimulant, and can divert their interest to other activities, thereby relieving the connection that causes the illness. And awareness of the cause helps in isolating the person responsible for creating the illness. Understanding, therefore like in all things can help ameliorate the situation. Images brought to mind can help. Therefore I keep an oil painting of some very odd person, that I try to associate the person on the stimulant with as someone I try to think I do not know. The illness is weird, so weird thoughts sometimes help. That is the difficulty of an illness that can't be explained to begin with. As someone wrote, the Mayor of Boston has crohns. Just the numbers in people affected with this syndrome, should be a hint that something strange is amiss. Wonder if it would be of use, to write an open letter to the Mayor, explaining that it is not an organic illness, it is simply a reaction (like the hives, not a good example, as only the word "reaction" applies") and everyone has an equal opportunity to experience this illness under the right circumstances. and under the right circumstances can be negated. What the doctors are thinking in prescribing the anti-depressants, is probably not the same, experience must have shown them that sometimes they work, therefore why not prescribe them. It would be interesting to know WHY and WHAT the physicians are thinking that make anti-depressasnts help in relieving the illness. Well, this is more than expected, but that is the danger of mentioning anti-depressants. Gail > Any opportunity to talk of the hated and loved anti-depressants is fine with > me. [quoted text clipped - 8 lines] > Even people not depressed would need a pain pill for neuralgia, I would > imagine. All I know is that I have many patients on antidepressants for chronic pains of many types. Cheeahs SP SignatureTo reply: take out the TRASH... >As I have said, there is a mind/body connection which is the cause of crohns. Sorry Gail, this is nothing but pure unadulterated BS. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE W-B, Sorry the truth has to be BS. No matter what it is called, the effects continue to be felt by millions. Or are the effects BS also. Is not possible for a mind/body connection to be part of the world's acceptance. Gail If this is the brain/body connection THREAD, then there is much we do not understand. During the 1980s a new program in psychoneuroimmunology was developed to address this discipline. I firmly BELIEVE that the brain, working through the peripheral nervous system, stimulates the perfusion of peripheral tissues, and therefore increases/decreases the metabolism. Conversely, various pathologic processes may be the reult of "brain activity." A simple example might be Jan Drew's mental state while attempting to Break Dance, and then finding "UNANSWERED ANSWERS" kind of a religious-type of revelation to her "CURE." Hey! Whatever woiks! NO STUDIES ... this is just a guess! JOEL >W-B, > [quoted text clipped - 5 lines] > >Gail >W-B, > [quoted text clipped - 5 lines] > >Gail You are dead wrong. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com In Italy its called "osso buco." >From: http://www.aae.org/nico.html > [quoted text clipped - 52 lines] >©1996 American Association of Endodontists, 211 East Chicago Avenue, Suite 1100, Chicago, IL >60611-2691 >In Italy its called "osso buco." Interesting clip from Aetna: http://www.aetna.com/cpb/data/CPBA0642.html Policy 1. Aetna considers surgery (including scraping of infected cavities and removal of root-canal-treated teeth) and/or any other therapies (e.g., rinsing the "cavity" with colloidal silver and administering chelation therapy and intravenous vitamin C) and bone graft replacement for the treatment of NICO related diagnoses to be experimental and investigational because the clinical significance of this syndrome is in question. 2. Aetna considers the Cavitat Ultrasonograph, an ultrasonograph bone densitometer that has primarily been used to detect neuralgia inducing cavitational osteonecrosis (NICO) in the jawbones, experimental and investigational because there is no scientific evidence to support its clinical value. There is much more on the page. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >From: W_B no_one@nowhere.net >Date: 8/25/2004 10:58 AM Pacific Standard Time >Message-id: <k71qi05uc2kqdl18etc0rcpo8bdj6uarrl@4ax.com> > >From: http://www.aae.org/nico.html The page cannot be found >From: http://www.aae.org/nico.html > >Position Statement on NICO (Neuralgia-Inducing Cavitational Osteonecrosis) Lesions The link has been changed to: http://12.107.100.106/NICOlesionsnew.pdf -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > >From: http://www.aae.org/nico.html > > > >Position Statement on NICO (Neuralgia-Inducing Cavitational Osteonecrosis) Lesions > > The link has been changed to: > http://12.107.100.106/NICOlesionsnew.pdf This document implies NICO can exist but then says treatment for it can not be allowed in many cases. Typical double speak from the dental association. I have not personally experienced "nerve pain" as a result of jaw bone infection, but the recommendation of eliminating all other causes seems like a joke. The person experincing nerve pain will simply be given a vague diagnosis of neuraliga or told it is stress. >> >From: http://www.aae.org/nico.html >> > [quoted text clipped - 7 lines] >association. I have not personally experienced "nerve pain" as a result >of jaw bone infection, Sorry Clinton, but we dentists are experts on jaw pain. We deal with it every day. Yes there ARE nerves within the jaw and YES they do become a source of pain. Well, they RELAY the pain, and are not the source. Joel > but the recommendation of eliminating all other >causes seems like a joke. The person experincing nerve pain will simply be >given a vague diagnosis of neuraliga or told it is stress. >>> >From: http://www.aae.org/nico.html >>> > [quoted text clipped - 17 lines] > >Joel A-delta and C fibers ring a bell ? Anyone ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > A-delta and C fibers ring a bell ? > > Anyone ? Slow conducting, partially myelinated, difficult to anesthetize, quite small diameters. Often they have very polysynaptic connections to superior sensory areas (meaning their conduction of sensations can be modullated at many levels). No, I don't remember them at all... ;-) HTH SP SignatureTo reply: take out the TRASH... >> A-delta and C fibers ring a bell ? >> [quoted text clipped - 6 lines] >HTH >SP That's pretty damn good bro. Nail ==> Head Right-0 -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > That's pretty damn good bro. > [quoted text clipped - 4 lines] > -- > W_B Should be... it was part a research project. Thanks SP SignatureTo reply: take out the TRASH... >> >From: http://www.aae.org/nico.html >> > [quoted text clipped - 5 lines] >This document implies NICO can exist but then says treatment for it >can not be allowed in many cases. Read it again for comprehension. >Typical double speak from the dental >association. American Association of Endodontists. >I have not personally experienced "nerve pain" as a result >of jaw bone infection, but the recommendation of eliminating all other >causes seems like a joke. No personal experience ? How would you know ? >The person experincing nerve pain will simply be >given a vague diagnosis of neuraliga or told it is stress. Pure unadulterated altie BS. Class dismissed. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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