Publications

(See JE Bouquot, AM Roberts, P. Person and J. Christian, "Neuralgia-inducing cavitational osteonecrosis (NICO). Osteomyelitis in 224 jawbone samples from patients with facial neuralgia", Oral Surg Oral Med Oral Pathol. 1992, 73(3):307-319; J Bouquot, W Martin and G Wrobleski "Computer-based thru-transmission sonography (CTS) imaging of ischemic osteonecrosis of the jaws - a preliminary investigation of 6 cadaver jaws and 15 pain patients", Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001, 92:550.)

In the medical field, pulse-echo ultrasound is commonly used for imaging all types of soft tissue. In principle, images of structures in the body are generated by analysing the reflection of ultrasound waves. However, this method is not suitable for providing useful information about the status of the jawbone, as the ultrasound is almost completely reflected where the bone and soft tissue meet. In particular, the cancellous or spongy part of the jawbone cannot be examined with commonly used ultrasound devices. Therefore ultrasound has only been used in dentistry to a very limited extent. The condition of cancellous jawbone can be of great clinical importance. Prof. J. E. Bouquot has demonstrated anatomically that cancellous bone can be extensively degenerated, a phenomenon that he describes, among other things as, "ischaemic osteonecrosis leading to cavitation lesions". He relates this osteonecrosis of the jawbone to neuralgic pain and defines a disease called "neuralgia-inducing cavitation osteonecrosis (NICO)".

(cf. J. Lechner and V. von Baehr, "RANTES and fibroblast growth factor 2 in jawbone cavitations: triggers for systemic disease?" International Journal of General Medicine 2013, 6: 277-290; J. Lechner and W. Mayer "Immune messengers in neuralgia inducing cavitational osteonecrosis (NICO) in jawbone and systemic interference", Eur. J. Integr. Med. 2010, 2(2):71-77)

Dr. Dr. (PHD-UcN) Johann Lechner has made a name for himself over a period of 20 years with the detection of what are known as FDOJs. He closely examined the tissue in such jaw lesions, which appears as a lump of fat inside an intact cortical bone trough (in the mandible). This tissue was in an ischemic, degenerative-fatty state. Lechner therefore defines the observed changes as "fatty-degenerative osteolysis / osteonecrosis of the jawbone (FDOJ)". He demonstrated that the fat clumps found in the jawbone are biochemically extremely active and produce certain cytokines in large quantities, namely RANTES (CCL-5) and FGF-2, as well as PDGF and MCP-1. The expression levels of these cytokines are also elevated in a number of systemic diseases such as cancer, dementia, multiple sclerosis and arthritis. There is strong evidence – amazing clinical improvements after surgical removal of such FDOJ tissue – that the development and persistence of a variety of systemic diseases may be related to fatty degenerative osteolysis of the jawbone (FDOJ). In most of these cases, however, the local effect of neuralgic pain ("NICO") is absent.