Introduction: Osteoradionecrosis (ORN) of the jaws is a late complication of radiotherapy (RT) of the head and neck, with higher prevalence in the mandible. Treatment of the condition is controversial, ranging from conservative non-surgical management to extensive surgical resections with reconstruction. Drug therapy with pentoxifylline and tocopherol (PENTO) associated with adjuvant therapies has shown satisfactory clinical results, also in advanced stages of ORN. The present case report aims to describe the conservative management of an advanced mandibular ORN by medication with PENTO and other adjuvant therapies.Case Report: A 62-year-old Afro-descendent woman, with a history of oral squamous cell carcinoma in the left floor of the mouth, who was submitted to surgical resection, RT, and concomitant chemotherapy 17 years