當患者被診斷出患有骨質疏鬆症時通常會被開立口服的雙磷酸鹽藥物予以治療，但雙磷酸鹽會抑制破骨細胞的活性並影響骨頭正常的修補過程。雙磷酸鹽藥物所引起的顎骨骨性壞死(BRONJ)常會對患者的生活造成很大的傷害與影響，而口腔顎面外科醫師需面對與治療這類病人。使用雙磷酸鹽藥物時間的長短被認為與骨頭暴露的大小有關，且患者若同時併用類固醇類藥物會造成骨性壞死更快發生、病情更嚴重與停藥後復元變慢。在南台灣，許多老人針對疼痛或慢性疾病有長期服用類固醇的習慣，所以若此類患者同時患有BRONJ症狀時病情往往較嚴重。高雄長庚醫院口腔顎面外科針對4位臨床上確診為BRONJ的患者進行治療並獲得不錯的治療結果，針對這類口服雙磷酸鹽藥物所引起的顎骨骨性壞死患者，特別提供我們對危險因子的評估、預防與治療原則。

Patients first diagnosed with osteoporosis are often prescribed a oral bisphosphonate. Bisphosphonates inhibit osteoclastic activity and as a result will compromise the normal healing and remodeling processes within bone. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) adversely affects the quality of life and produces significant morbidity in afflicted patients. Oral and maxillofacial surgeons have been responsible for treating a majority of these patients. There was a direct exponential relationship between the size of the exposed bone and the duration of oral bisphosphonate use. The comorbidities of steroid along with a bispho-sphonate will cause the osteonecrosis to occur sooner, be more severe, and respond more slowly to a drug holiday. In the southern areas of Taiwan, a lot of elders are used to take long-term steroids to the pain or the chronic disease, so the conditions are often relatively serious when patients suffer from BRONJ simultaneously. The Department of Oral and Maxillofacial Surgery of Chang Gung Memorial Hospital-Kaohsiung Memorial Center specifically treat 4 patients who suffered from BRONJ. All of them were obtained good treatment result. From the data gained from studies and our clinical experience with the cases, we offer recommendations of risk factors, prevention, and treatment of BRONJ.