Jawbone Cavitations: Current Understanding and Conceptual Introduction of Covered Socket Residuum (CSR)

Jawbone cavitations have been described for decades under various terminologies, including neuralgia-inducing cavitational osteonecrosis (NICO) and fatty degenerative osteolysis of the jawbone (FDOJ). Their biological nature and clinical relevance remain controversial. The present review aimed to summarize the current understanding of jawbone cavitations, identify relevant research gaps, and propose a unified descriptive terminology. This narrative literature review was conducted using PubMed/MEDLINE, Google Scholar, and manual searches of relevant journals. The available evidence was qualitatively synthesized. The results indicate that most published data on jawbone cavitations are derived from observational, retrospective, and cohort studies, with etiological concepts largely based on histopathological findings. Recent three-dimensional radiological analyses suggest that intraosseous non-mineralized areas frequently observed at former extraction sites may represent a physiological outcome of socket collapse and incomplete ossification rather than a pathological condition. This review introduces Covered Socket Residuum (CSR) as a radiological descriptive term and clearly distinguishes it from pathological entities such as NICO and FDOJ. Recognition of CSR is clinically relevant, particularly in dental implant planning, where unrecognized non-mineralized areas may compromise primary stability. The findings emphasize the role of three-dimensional radiological assessment for diagnosis and implant planning and discuss preventive and therapeutic strategies, including Guided Open Wound Healing (GOWHTM). Prospective controlled clinical studies are required to validate this concept and determine its clinical relevance.