Aim Acellular dermal matrix (ADM) materials such as Integra® Bilayer Wound Matrix are a recognised method of reconstruction for small defects in the oral cavity. NovoSorb® Biodegradable Temporising Matrix (BTM®) is a well-established ADM for reconstruction of cutaneous defects including burns and oncological resections. Unlike Integra®, BTM® has a synthetic composition which does not serve as a substrate for bacterial growth. This is the first pilot study evaluating the safety and feasibility of BTM as a reconstructive alternative to small soft tissue and osseous oncological defects of the oral cavity. Methodology Retrospective study of all patients undergoing surgical ablation of dysplastic or malignant disease with immediate coverage with NovoSorb® Biodegradable Temporising Matrix from December 2023 – January 2026 by 2 surgeons. Patients treated with skin grafts or other ADM substitutes were excluded. Outcomes assessed included satisfactory wound healing, specimen size and trismus. All patients were followed up for 3-24 months with photo documentation.. Results 13 patients underwent reconstruction with BTM. Average age was 71. The most common pathologies were SCC (6, 46%) and verrucous carcinoma/dysplasia (5, 38%). Oral cavity subsites included the mandible (5, 38%), buccal (4, 31%) and maxilla (4, 31%). All maxilla and mandible resections underwent a marginal resection in addition to mucosal excision. The average size of a mucosal defect was 1226mm2. 2 patients (15%) received immediate dental implants. Complete wound healing with good cellular integration occurred in all patients. A combination of stents, bolsters and quilting sutures were used to stabilise the membrane. Conclusion This small pilot study demonstrates promising results with a high take rate of BTM in the reconstruction of various oral cavity defects. The primary advantages are no donor site morbidity, acceptable wound bed healing, ability to heal over osseous defects and minimal infections.