Objective <p>Osteoradionecrosis (ORN) of the jaw is one of the most significant complications of radiotherapy (RT) for head and neck cancer (HNC), and is primarily attributable to tooth extraction. The objective of this study was to assess the efficacy of advanced platelet-rich fibrin (A-PRF) in preventing ORN after tooth extraction in patients with post-irradiated HNC and other postoperative complications.</p> Methods <p>The study population comprised 30 patients who previously underwent radiotherapy for HNC and subsequently underwent tooth extraction, with a total of 134 extractions performed. Extraction sockets were randomly assigned to receive either A-PRF (<i>n</i> = 67 [experimental group]); or clot maintenance alone (<i>n</i> = 67 [control group]). Patients were clinically evaluated at 7, 14, 30, 60, 90, and 120 days postoperatively to assess pain and healing of the surgical site. The intensity of postoperative pain was quantified using a visual analog scale. Patients were clinically evaluated for up to 120 days to diagnose ORN. Other postoperative complications, including edema, bleeding, tissue color, consistency, and suppuration, were also evaluated.</p> Results <p>In terms of pain and healing, there was no statistically significant difference between the two groups. No ORN or other surgical complications were observed. The use of A-PRF demonstrated no statistically significant differences compared with the control group in most of the parameters evaluated.</p> Conclusion <p>A-PRF yielded no additional benefits and did not influence the healing process in the short or medium term.</p> RBR- 3 tdk22p <p><b>Date of registration:</b>&#xa0;02/14/2022.</p>