Healing may fail after postradiation dental extractions, with a risk of followed osteoradionecrosis, and its dramatic prognosis. We propose a protocol for postradiation extractions.From January 2000 to December 2001, 107 patients underwent 287 dental extractions after radiation therapy: 80.5% in mandibular jaw, average radiation dose 61.6 Gy, average time between radiation and extraction 6 years. Extractions were performed under general anesthesia, diazanalgesia or local anesthesia, and extraction wounds were sutured after insertion of a collagenic sealant impregnated with gentamicin. General antibiotic prophylaxy was given.Healing failed in only two cases. The first case involved early-stage osteoradionecrosis and the second a tumoral localization. The rate of post-extraction osteoradionecrosis was thus 0.35%.A strict protocol associating non-traumatic surgery and an alveolar sealant can considerably decrease the risk of osteoradionecrosis after dental extraction in radiated bone.