Abstract There were 114 patients with radiononecrosis of the maxillofacial region. A detailed analysis of surgical treatment was carried out and optimal tactics for selecting the appropriate plastic material was determined. It was found that the use of implants from various materials is irrational, since eruption of these materials within different terms (from 3 months to one year) results continuation of osteonecrotic process. Fibular autograft is optimal for complete maxillofacial repair. It is confirmed by our own research and analysis of density CT values in postoperative period. We identified a group of patients with severe concomitant diseases with contraindications for autotransplantation of pedicled flaps, prolonged surgery and rehabilitation. An original technique for selecting soft tissue flaps is indicated in these patients considering severity of radionecrotic process in soft tissues. Spread of necrosis is evaluated taking into account density CT-characteristics. Analysis of long-term outcomes resulted an algorithm for selecting the methods of maxillofacial defect repair in patients with radiononecrosis of the jaws. Clinical cases confirming the effectiveness of the work are shown.

Keywords. radionecrosis, reconstruction, autograft, flap, rehabilitation