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Purpose: Bisphophonates are drugs used to suppress osteoclastic activity and to treat osteoporosis, Pagetʼs disease of bone and bone metastasis. The purpose of this report is to review the literatures on bisphopsphonates use that could affect bone healing and cause osteonecrosis of the jaws. Materials and methods: Medline research was carried out to find relevant articles on bisphophonates and osteonecrosis of the jaw. Results: Oral administration of bisphopsphonates is reported to decrease the risk of adverse bone outcomes. On the contrary, IV bisphopsphonates is known to significantly increase the risk. Prevention of the osteonecrosis of the jaw is primary concern before usage. If the adverse bone reaction takes place, proper management and treatments are required to alleviate pain of patients and prevent further progression of necrosis. Conclusion: Case reports of bisphosphonates induced osteonecrosis of the jaw are increasing. Dentists and physicians should be aware of the higher frequency of osteonecrosis of the jaw in patients receiving IV bisphopsphonates and be prepared to prevent and cope with adverse bone reaction. (J Korean Acad Periodontol 2009;39:1-8)

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