Ozone therapy for neuralgia-inducing cavitational osteonecrosis: case report

Introduction: Neuralgia-induced cavitational osteonecrosis of the jaw (NICO) is defined as a chronic pain syndrome, similar to trigeminal neuralgia. For the treatment of NICO, a curettage of the affected bone tissue is performed and, in this procedure, local infiltrations with antimicrobials and/or use of oral anticoagulants can be used, however, a pain reduction of only 50% of these observed conditions will be modified in patients. The present study aims to report a clinical case of NICO in the jaw and the benefits of using Ozone Therapy. Methods: A 74-year-old male patient with neuropathic trigeminal pain and presenting areas of necrosis in the jaw. On the day of the curettage surgery, complete debridement and local irrigation with ozone was performed in the 4th quadrant region. Result Discussion: The patient also received Ozone-induced Growth Factor Concentrates and finally a resorbable intraoral dressing was placed. On the day of surgery, the patient presented pain between 7 and 8 points, according to the visual pain scale (VPS). On the 4th postoperative day he was well, with 4 to 5 points on the VPS scale. The patient was asymptomatic after 30 days of follow-up and received an implant placement 90 days after the procedure for NICO. It is hypothesized that Ozone Therapy presents, as its possible mechanisms of action, tissue stimulation and oxygenation of the affected area, release of growth factors, and antimicrobial action. Therefore, Ozone Therapy has been considered beneficial and may become a possibility of adjuvant treatment for patients with NICO.