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Goldblatt LI, Adams WR et al. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124: 403–412

CFOJ is a condition which mimics dental pain but to which dental interventions offer no improvement. It has been known previously by other names (Ratner bone cavity, ischaemic osteonecrosis amongst others) but the authors suggest CFOJ is the most appropriate classification. Patients (n = 227, mean age 53) were sourced from a single endodontic practice between 2007 and 2013. Females outnumbered males 7:1.

Typified by intractable jaw pain, the bony lesions do not appear on standard intra-oral or panoramic radiographs but are visible on CBCT. They are most commonly found in the posterior regions but multiple sites are not unknown. Intra-oral symptoms include pain on palpation of the alveolar bone. A carefully placed local anaethetic injection into the lesion eliminates the pain temporarily. Treatment involves surgery and curettage of the lesions. Repeat surgery is sometimes required but most subjects reported improvements after one procedure.