Can Cavitation Return After Treatment?

Cavitations are not cavities. These are areas of chronic jawbone infection or necrosis, often occurring at sites where a tooth was extracted. If not properly treated, cavitations can return, continuing to harbor harmful bacteria and toxins that can affect your entire body.

In this blog, we’ll explore:

• What cavitations are
• Why they can recur even after treatment
• The misconception about the periodontal ligament (PDL)
• What a more complete resolution looks like

What Is a Cavitation?

A cavitation is essentially a hole or void in the jawbone that hasn’t healed properly, often due to incomplete bone regeneration after a tooth extraction. It may be filled with dead tissue, bacteria, and toxins — creating a perfect breeding ground for chronic infection.

They are sometimes referred to as NICO lesions (Neuralgia-Inducing Cavitational Osteonecrosis), Jawbone osteonecrosis, or Ischemic bone disease.

Why Cavitations Can Recur

Many patients undergo cavitation surgery only to find their symptoms, or the lesion itself, come back months or years later. Why?

Because removal of the periodontal ligament (PDL), though important, is not the only step required for long-term healing.

Let’s break that down:

1. Retained Periodontal Ligament Can Inhibit Healing

After a tooth is extracted, the PDL should be thoroughly removed. If left behind, it can act like a barrier that prevents blood supply from reaching the area, leading to poor bone regeneration. This is one of the biggest reasons cavitations form in the first place.

But here’s the key: removing the PDL is only one part of the solution.

2. Incomplete Debridement of Infected Bone

In many cases, the surrounding bone is already necrotic (dead) or severely infected. Simply removing the ligament and cleaning the socket superficially isn’t enough. If deeper, infected bone isn’t debrided and surgically removed, the infection can persist or re-establish itself.

3. Failure to Support Healing Post-Surgery

Cavitation healing is not just a surgical issue. It’s a biological one. The site needs proper oxygenation, blood flow, and immune support. Without additional measures (e.g., ozone therapy, PRF (platelet-rich fibrin) therapy, nutritional support), the area may not heal fully.

4. Undiagnosed Systemic Factors

If a patient has chronic inflammation, heavy metal toxicity, poor circulation, or immune dysregulation, even the best surgical procedure may not yield lasting results. The terrain matters.

Why Removal of the PDL Is Not a Cure-All

There’s a common belief in some biological dentistry circles that simply removing the PDL during a tooth extraction will prevent cavitations. While this is critical, it’s not a magic bullet.

Here’s why:

Bacteria can still remain deep in the bone.

Blood supply might not be adequately restored.

Biofilm — a slimy layer of bacteria — can persist without full debridement.

The body might lack the necessary resources to heal the area.

In other words, cavitation treatment is multifactorial.

What Proper Cavitation Treatment Looks Like

A successful, long-term resolution of cavitations usually involves:

Complete surgical debridement of all necrotic and infected tissues

Thorough removal of the PDL

Use of adjunct therapies such as Ozone therapy (to disinfect and promote healing) PRF or PRP (to stimulate tissue regeneration) Laser therapy Biological terrain support (nutritional and detox protocols) Addressing underlying health issues like heavy metals, infections, or immune stress

In Summary, cavitations are a serious and often overlooked source of chronic infection in the jaw. While the removal of the periodontal ligament is crucial during extractions or cavitation surgery, it alone does not guarantee healing.

For cavitations to be truly resolved and not return, treatment must be:

Thorough, Holistic, Personalized

If you suspect you have a cavitation, work with a knowledgeable biological or integrative dentist who understands both the surgical and systemic aspects of treatment.

Your mouth is not separate from the rest of your body. When dental procedures — especially extractions — aren’t handled properly, the effects can be felt systemically. Fortunately, with proper care, cavitations can be fully treated and healing can begin.

Have questions about cavitation diagnosis or treatment options? Feel free to leave a comment or reach out to a qualified biological dentist near you.