I came across this 2010 discussion in Oral Oncology: Paradigm shifts in the management of osteoradionecrosis of the mandible by Adam Jacobson, Daniel Buchbinder, Kenneth Urken

There have been many published series involving various approaches to the management of ORN. However, most of these studies represent nothing more than a particular surgeon's experience or institutional experience with the management of ORN. These studies are plagued by small patient cohorts. This makes it difficult to reach statistical significance. Additionally, almost all of the published literature is based on retrospective chart reviews rather than prospective design.The studies do not provide strong scientific evidence for management decisions when dealing with ORN.

I find this depressing and frustrating.