The ongoing unnecessary debate regarding the risk factors for osteoradionecrosis of the jaw: Prescription dose versus mandibular doses

• Osteoradionecrosis of the jaw (ORNJ) affects 2% to 22% of irradiated head and neck cancer (HNC) patients. • Numerous patient-, tumor, and treatment-related factors may influence ORNJ development. • Prescribed tumor dose (PTD) has been frequently referred to as a significant risk factor in predicting ORNJ rates. • Available data suggest that mandible-related dosimetric factors, such as the mean dose or Vx (volume receiving X Gy or higher), are more robust predictors of ORNJ. • PTD may be affected by multiple variables and should not be preferred over mandible-related dosimetric measures in predicting ORNJ rates