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The risk of developing osteoradionecrosis (ORN) following resection of oral cavity carcinoma and subsequent reconstruction with free-tissue flaps is unknown. A retrospective study was conducted on 155 patients who underwent free-tissue reconstruction and postoperative IMRT between 2000 and 2019. The study found that the risk of ORN was comparable between osteocutaneous and soft-tissue reconstruction for resected oral cavity carcinoma. Osteocutaneous flaps can be safely performed with no excess concern for mandibular ORN. Post-radiation teeth extraction was found to be significantly associated with ORN. The one-year and ten-year ORN rates were found to be 5.2% and 10%, respectively.
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