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Introduction: Bisphosphonate-associated osteonecrosis of the jaws is a rare but potentially severe complication related to the use of antiresorptive drugs. This condition represents a growing challenge for dental practice due to its negative impact on patients’ quality of life and the limitations it imposes on surgical interventions. Although knowledge about bisphosphonate-associated osteonecrosis of the jaws has advanced, controversies remain regarding early diagnosis and the most effective therapeutic strategies. Objective: To analyze the factors related to the prevention and management of osteonecrosis of the jaws in patients using bisphosphonates who undergo invasive dental procedures, identifying risks, preventive strategies, treatment protocols, and gaps for future research. Methodology: This study is an integrative literature review conducted in the databases SciELO, PubMed, Virtual Health Library (VHL), and Google Scholar, including articles in Portuguese, English, and Spanish published over the last 20 years. Descriptors such as “osteonecrosis of the jaws,” “bisphosphonates,” “dental surgery,” “prevention,” and “management” were used, combined with Boolean operators. In total, 18 studies met the inclusion criteria and were critically analyzed. Results: Prevention was mainly focused on prior dental evaluation before starting drug therapy, elimination of infectious foci, and maintenance of strict oral hygiene. Risk factors included duration of bisphosphonate use, route of administration, comorbidities, poorly fitted prostheses, and polypharmacy. Conservative clinical protocols involving antibiotics, analgesics, and antiseptics proved effective in the early stages. In advanced stages, surgical treatment combined with adjuvant therapies such as laser therapy, ozone therapy, and teriparatide use demonstrated promising but still heterogeneous results. Conclusion: The implementation of preventive strategies, early diagnosis, and treatment choice according to clinical staging are fundamental to reducing the incidence and severity of osteonecrosis of the jaws. Integration between medical and dental teams is essential to improve patient prognosis. Further longitudinal studies and clinical trials are required to standardize approaches and validate emerging therapies.
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