FDOJ - Silent bone disease
FDOJ - A silent bone disease that sows inflammation throughout the body
Did you know that chronic inflammation in the body can originate where you least expect it? In the bone after an extracted tooth! Even if the wound has long since healed and you feel no pain, a disease process known as FDOJ (Fatty Degenerative Osteonecrotic Jawbone) can develop deep within the tissues. In German medical literature it is referred to as FDOK (Fettige Degenerative Osteonekrose des Kieferknochens), and in other countries it functions as NICO (Neuralgia-Inducing Cavitational Osteonecrosis).
This condition belongs to what is known as 'silent inflammation' - silent inflammation that does not give pain, but slowly deteriorates the whole body.
What is FDOJ/FDOK/NICO and where does it come from?
FDOJ is a necrotic lesion in the jawbone or mandible, where healthy bone tissue is replaced by degenerative fatty tissue. It is not a classic necrosis, but a 'softening' of the bone, through lack of mineralisation and filling with fatty tissue with reduced blood supply and metabolism.
These lesions most often develop in areas after tooth extractions, especially in the so-called triangular sinus cavities - regions after the removal of eights. Why exactly there? This area has a slightly weaker blood supply, which makes it difficult for bone to regenerate properly after extraction. However, FDOJ can occur after any extraction and even under conditions of good blood supply if the patient's body is in poor metabolic condition! - This can occur after the extraction of molars, incisors and even in areas after the removal of implants.
Who is at risk of developing FDOJ?
Although FDOJ can affect anyone, certain factors significantly increase the risk of its occurrence:
- Extractions of teeth - especially eights
- Vitamin and mineral deficiencies, especially vitamin D3, K2, magnesium and calcium.
- Lipid disorders - elevated LDL cholesterol and low HDL cholesterol
- Weakened immune system - chronic stress, infections, vitamin deficiencies.
- Circulatory disorders - poorer blood supply to bones after extraction slows down regeneration.
- Autoimmune diseases - the body is less able to rebuild tissues.
- Smoking - nicotine constricts blood vessels, slowing healing.
- Poisoning of the body (e.g. heavy metals) - can prevent the normal process of bone formation
What are the symptoms of FDOJ? - Silent Inflammation, or silent destroyer
FDOJ is an asymptomatic disease - which is why it is so difficult to diagnose. No pain, swelling or abscess appears. The lesion develops silently, but its impact on the body is enormous.
Typical systemic symptoms include:
- Permanent fatigue - constant exhaustion despite rest.
- Brain fog - problems with concentration and memory.
- Joint and muscle pain - caused by chronic inflammation.
- Sleep disorders - difficulty falling asleep, shallow sleep.
- Frequent infections - weakening of the immune system.
- Headaches - especially in the temporal region.
- Hormonal disorders - mood swings, weight problems.
What does the FDOJ sow on the whole body?
An FDOJ lesion is a local focus of chronic inflammation that acts as an 'inflammatory bomb', releasing harmful substances (oxidants) into the bloodstream.
The FDOJ area produces:
Pro-inflammatory cytokines:
- RANTES (CCL5): This is a key cytokine whose excess is associated with autoimmune diseases, chronic fatigue, muscle and joint pain.
- Interleukin-1β (IL-1β): Strongly pro-inflammatory, increases tissue damage.
- TNF-α (tumour necrosis factor): Enhances oxidative stress and disrupts cell metabolism.
- IL-6: Responsible for chronic inflammation and the development of chronic diseases.
Free radicals:
- Within the FDOJ, lipid peroxidation (perox) occurs, i.e. the oxidation of fats in the tissue, leading to damage to cells, proteins and DNA.
Bacterial toxins:
- Bacterial debris from necrotic tissue can enter the bloodstream, putting a strain on the liver, kidneys and immune system.
How do we diagnose FDOJ at Unident union?
At Unidentunion, we use modern diagnostic methods to precisely locate areas of FDOJ:
- CBCT tomography: a three-dimensional image that highlights areas of bone softening and radiolucent lesions (darker areas on the image).
- Ultrasound scanning (CaviTAU®): Precisely measures bone density, helping to locate FDOJ lesions, even when CBCT does not show them.
- Laboratory tests: Assessment of inflammatory markers (RANTES, CRP, lipidogram), which may indicate chronic inflammation.
What does the procedure to remove the FDOJ look like?
The patient usually comes to our clinic long after a tooth extraction, not realising that chronic inflammation is developing at the extraction site. The FDOJ extraction procedure at Unidentunion is carried out in a minimally invasive manner, without pain and in full patient comfort.
Step by step
1.Local anaesthesia:
- The treatment site is thoroughly anaesthetised, making the whole process completely painless.
2.Gingival incision:
- The doctor makes a small gingival incision over the area of suspected FDOJ to access the bone.
3.Penetration into the bone:
- Using precise surgical instruments, the doctor reaches the spongy bone where the lesion is located.
4. removal of degenerated fatty tissue:
- The fatty tissue of the FDOJ is carefully removed by spooning until a healthy, well-vascularised bone is obtained.
5. Rinsing the treatment area:
- The site of the removed lesion is carefully rinsed with saline and antiseptic to remove any remaining dead tissue.
6.Ozone therapy:
- After cleansing the area, we apply ozone therapy, an action of ozone gas, which has strong antibacterial properties and promotes tissue regeneration.
7.PRF application:
- Fibrin PRF membranes, obtained from the patient's blood, are applied to the site of the removed lesion to stimulate bone regeneration and accelerate healing.
8.Suturing the wound:
- Finally, the wound is sutured and the patient is given detailed post-operative instructions.
Recommendations after surgery - what to take? After FDOJ removal, tissue regeneration and keeping the body in a state conducive to healing is key.
We recommend:
- Vitamin D3 + K2 (MK7):
Maintain D3 levels of 80-100 ng/ml. Dosage: 4000-8000 IU per day, in combination with vitamin K2 (200 mcg). - Magnesium: Take 100 mg for every 10 kg of body weight. Example: Weight 60 kg = 600 mg magnesium per day. Weight 80 kg = 800 mg of magnesium per day.
- Vitamin C: 2000-4000 mg daily for 2-4 weeks after treatment.
- Omega-3: 1,000 mg per day, of which 1 g DHA - a key anti-inflammatory component.
- Zinc: 30 mg daily - supports regeneration and immunity.
- Probiotics: Rebuild the gut microbiota and support the immune system.
- Hydration: Drink 2-3 litres of water a day to support the removal of toxins from the body.
Anti-inflammatory diet:
- Avoid sugar, processed foods and alcohol.
- Bet on vegetables, healthy fats (oil, avocado), fish and nuts.
Why act?
Untreated FDOJ is a silent outbreak of inflammation that can lead to serious systemic disease:
- Autoimmune diseases - Hashimoto's, rheumatoid arthritis (RA).
- Heart disease - atherosclerosis, hypertension.
- Insulin resistance and type 2 diabetes.
- Chronic fatigue, fibromyalgia.
- Endocrine and metabolic disorders.
Unident union - Your health starts with your mouth At Unident union, we care for oral health in a systemic context. Using the latest diagnostic and treatment technologies, our specialists effectively diagnose and remove FDOJ, restoring balance to the body. If you are experiencing symptoms of chronic fatigue, joint pain, brain fog or other difficult-to-diagnose conditions - it's worth checking if FDOJ is the cause.
Make an appointment for a consultation today: (+48) 71 328 12 12
Your health starts here!
