This study examined the incidence of osteoradionecrosis after tooth extraction with low-epinephrine or epinephrine-free, nonlidocaine local anesthetics and conservative surgical techniques. Estimates of the absorbed radiation dose on irradiated alveolar bone were made by reviewing radiotherapy records. This investigation included 72 patients ranging in age from 22 to 80 years (median 57.4 years). We removed 449 teeth. Analysis of radiotherapy check films revealed that only 196 teeth (44%) were included within the treatment volume. The median prescribed tumor dose was 50 Gy (range 25 to 84 Gy) in 20 fractions (range 10 to 37), with a median dose per fraction of 2.5 Gy (range 1.88 to 3.14 Gy). Follow-up time ranged from 68 days to 19.3 years (median 4.8 years). No instances of osteoradionecrosis occurred as a result of dental extraction with this conservative method.
Maxymiw, Wood, Liu, , , , , , (1991). Postradiation dental extractions without hyperbaric oxygen. Oral surgery, oral medicine, and oral pathology, 1991 Sep;72(3):270-4. https://www.ncbi.nlm.nih.gov/pubmed/1923410