Autogenous free fat graft combined with platelet-rich fibrin heals a refractory mandibular osteoradionecrosis

Osteoradionecrosis (ORN) is a well-recognized, debilitating complication of radiotherapy for patients with head and neck cancer. There is no universally accepted treatment for ORN of the jawbones. We report on a case of refractory mandibular ORN treated by sequestrectomy of mandible and autogenous transplantation of fat graft combined with platelet-rich fibrin (PRF). Improved perfusion was observed using the laser Doppler flowmetry. This case highlights the use of autogenous free fat graft and PRF as an adjunct therapy to sequestrectomy in the management of ORN.