Biological surgery · FDOK / NICO
Finding the inflammation that stays silent.
FDOK - known in English as NICO - is chronic, often painless degeneration in the jawbone. Because it hides from flat X-rays, we look for it in three dimensions and treat it gently, biologically.
01 What it is
One condition, two names.
FDOK and NICO describe the same problem: chronic, aseptic changes in the bone marrow of the jaw that, in the biological-dentistry model, are discussed as a quiet source of inflammatory signalling molecules. The bone never fully heals after an earlier injury or extraction, and a soft, fatty, poorly mineralised area is left behind - often without any pain to announce it.
In a whole-body view of health, these quiet zones are taken seriously. In the biological-dentistry model they are described as possible ongoing interference fields that some practitioners consider may release inflammatory messengers such as RANTES/CCL5 into the body - a viewpoint rather than an established medical fact. That is why, in biological dentistry, we look at them carefully even when nothing hurts.
FDOK
Fettig-degenerative Osteonekrose des Kieferknochens - fatty-degenerative osteonecrosis of the jawbone.
NICO
Neuralgia-Inducing Cavitational Osteonecrosis - the name more often used in English literature.
Fig. 01Reviewing jaw imaging - where silent areas first become visible.
02 Why it matters
A quiet area of bone
can still be worth attention.
An FDOK / NICO site rarely causes local pain - yet in the biological-dentistry model it is discussed as something that may keep releasing inflammatory messengers and act as a lasting interference field. Looking at the mouth as part of the whole body is the heart of a biological approach: the aim is to address possible causes, not only symptoms. Outcomes vary from person to person and cannot be promised.
Fig. 02A 3D dataset reveals bone density that a flat image cannot.
03 How we find it
Diagnosis in three dimensions.
The condition is notoriously hard to detect on standard two-dimensional X-rays - affected areas frequently look unremarkable while real pathology sits beneath the surface. So we do not rely on a flat shadow.
Instead we combine 3D CBCT imaging, which lets us judge bone density from any angle, with a careful clinical assessment and, where indicated, blood analysis of inflammatory markers such as RANTES/CCL5. Together these turn a vague suspicion into a clear picture before any treatment is considered.
- Three-dimensional view of bone density, not a flat overlap.
- Clinical history correlated with the imaging findings.
- Blood markers (e.g. RANTES/CCL5) where they add clarity.
04 The protocol
Gentle, biological surgery - step by step.
When treatment is the right choice, it follows a meticulous protocol, planned in advance from your 3D dataset.
Gentle removal
Under local anaesthesia, the necrotic, poorly healed bone is carefully removed and the area thoroughly cleaned.
Ozone disinfection
The site is disinfected with ozone - an effective, gentle way to reduce bacteria without harsh chemicals.
PRF from your own blood
PRF membranes, prepared from a small sample of your own blood, are placed to support natural regeneration.
Calm recovery
Recovery is typically straightforward, with most patients back to normal activities within a few days.
05 Why this way
Metal-free, body-first, fully explained.
Every choice in this protocol follows the same idea: work with the body rather than against it. We use no metal and no foreign growth additives - the regeneration is supported by your own blood in the form of PRF, and the disinfection is done with ozone rather than aggressive agents.
Just as importantly, you are never left guessing. We talk you through what the 3D scan shows, why treatment is or is not advised, and exactly what each step involves - in English, before anything begins.
- No metal, no foreign additives - a biological approach throughout.
- Regeneration supported by PRF from your own blood.
- Planned in advance from a precise 3D dataset.
- Findings and options explained clearly in English.
Fig. 03Treatment carried out gently, in our practice near Lübeck.
06 When to look closer
Who an FDOK / NICO assessment can help.
An assessment is worth considering when symptoms have no clear dental cause, or when a whole-body picture points back to the jaw.
Unexplained facial or jaw pain
Persistent neuralgia or discomfort that conventional dental findings cannot fully explain.
02Old extraction or root-canal sites
Areas where a tooth was removed long ago and the bone may not have healed completely.
03Search for possible interference fields
A possible chronic inflammatory load with no obvious source, considered as part of a whole-body biological assessment - a model used in biological dentistry rather than a confirmed diagnosis.
07 Questions
FDOK / NICO, answered plainly.
They describe the same condition. FDOK is the German term - fettig-degenerative Osteonekrose des Kieferknochens, fatty-degenerative osteonecrosis of the jaw. NICO is the term more common in English literature - Neuralgia-Inducing Cavitational Osteonecrosis. Both refer to chronic, often silent areas of poorly healed bone in the jaw, typically at former extraction sites.
These areas are usually painless, and on a conventional two-dimensional X-ray they often look unremarkable because overlapping structures hide them. This is why we rely on three-dimensional CBCT imaging, combined with a careful clinical history and, where indicated, blood analysis of inflammatory markers such as RANTES/CCL5.
Treatment follows a meticulous biological protocol. The affected bone is carefully removed under local anaesthesia, the site is disinfected with ozone, and PRF membranes prepared from the patient's own blood are placed to support natural regeneration. Each step is planned in advance from the 3D dataset.
PRF - platelet-rich fibrin - is prepared by spinning a small sample of your own blood. The resulting membrane is rich in your body's own growth factors and contains no foreign additives. Placed in the treated site, it supports the natural healing of bone and soft tissue, which fits the metal-free, biological approach of the practice.
Recovery is typically straightforward. Because the procedure is carried out gently and supported by PRF from your own blood, most patients return to their normal activities within a few days. We explain aftercare clearly and remain available for any questions.
Yes. The practice in Bad Schwartau near Lübeck welcomes English-speaking and international patients. We explain the diagnosis, the imaging findings and every step of treatment in English.
08 Related reading
The whole-body picture around the jaw.
Teeth and the immune system
How chronic inflammation at root-canal and extraction sites connects the mouth to the immune system - the oral-systemic link, explained responsibly.
iiTeeth and organs: the tooth-meridian chart
Which tooth is traditionally linked to which organ in biological dentistry - presented honestly as a model, not as anatomy.
Wondering if the jaw is the cause?
Tell us about your situation. We reply personally - in English - and let you know whether an FDOK / NICO assessment would help.
Request an appointmentMedical information notice. The descriptions of FDOK / NICO, interference fields and inflammatory markers on this page reflect concepts and viewpoints used within biological dentistry. They are offered for general information, are not universally accepted in conventional medicine, and are not a promise of diagnosis, healing or cure. Whether any assessment or treatment is appropriate can only be decided individually after a personal examination.