Osteoradionecrosis — MFDS Part 1 MCQ
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Correct answer: C — Mandible — dental extraction after radiotherapy
The correct answer is C. Osteoradionecrosis occurs more commonly in the mandible, where radiation-related fibrosis and vascular injury impair bone turnover and healing. Dental extraction after radiotherapy directly traumatises irradiated bone and is a recognised major precipitating event. Post-radiotherapy extraction therefore carries greater risk than extraction completed before radiotherapy with time for initial healing. The maxilla can develop osteoradionecrosis, but it is affected less often than the mandible. Supragingival scaling does not normally expose or surgically traumatise bone and is consequently much less likely to precipitate osteoradionecrosis. The condition may also develop without an identifiable dental trigger, but that does not outweigh the association with extraction from an irradiated mandibular site.
Reference: Faculty of Dental Surgery, Royal College of Surgeons of England. The Oral & Dental Management of Patients Before, During and After Cancer Therapy, sections 5.12–5.13. February 2026. https://www.rcseng.ac.uk/-/media/Files/RCS/FDS/Publications/The-oral-and-dental-management-of-patients-before-during-and-after-cancer-therapy.pdf