The pectoralis major myocutaneous flap (PMMC) was first described by Pickrell in 1947, and perfected in 1979 by Ariyan. The reconstruction of oral cavity defects represent a challenge esthetically and functionally. The case reported, we reconstructed oral mucosa and skin cheek-labial in one-step procedure preserving the deltopectoral flap from the same side. The patient was a 55-year-old male who had sustained squamous cell carcinoma. The tumor ablation resulted in oral cavity exposure. A PMMC flap was used to reconstruct oral mucosa and skin cheek. We opted to preserve the deltopectoral flap in the event that skin island necrosis did occur. The pedicle pectoralis major myocutaneous (PMMC) flap based on the thoracoacromial artery procedure, has been widely used in the reconstruction of head and neck defects but in literature a few case of oral reconstruction is reported. PMMC flap applications mainly in oral cancer surgery include the tongue, floor of mouth, buccal, mandible reconstruction, reconstruction of full thickness defects of the cheek. It's due to its simple technical aspects, versatility and proximity to the oral cavity region. Disadvantages of the PMMC are reported and minor complications that did not require second procedures. The use of PMMC flaps in reconstructive oral surgery is a safe, quick, one-step procedure, not requiring microvascular experience that is particularly indicated in elderly patients and/or those with severe medical comorbidities. Whether the low rate of complications and donor site morbidity, we consider that the well-being of the patient should not be underestimated. Keyswords: Oral cancer, squamous cell carcinoma, pedicled flaps, pectoralis major myocutaneous flap, deltopectoral flap, oral reconstruction, cheek, labial, surgical procedure. Oral cancer, squamous cell carcinoma, pedicled flaps, pectoralis major myocutaneous flap, deltopectoral flap, oral reconstruction, cheek, labial, surgical procedure.

After the first report of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in 2003, it has increased significantly since then. We report a very rare extensive case never seen before in our experience of bone exposure with necrosis reaching the mandibular inferior border. Although the treatment modalities are not yet established, most researchers have recommended conservative approaches. The surgery was to be as conservative as possible, with a resection of the mandibular range followed by reconstruction using titanium plate with space maintainer. The authors would like to share their approach, management, and awareness.