Case of dental implant prosthesis failure in71-year-old man after CPAP use: A report

The authors described a patient whose use of a CPAP machine and mask resulted in a catastrophic failure of mandibular full-arch dental implants.

"Clinicians should be cautioned when considering immediate loading of a full-arch implant prosthesis in individuals undergoing CPAP therapy for sleep apnea," Neeraj Surathu, Nova Southeastern University, Fort Lauderdale, FL, USA, and colleagues wrote in their study. "Comprehensive treatment planning and thorough discussions between the patient and the physician are critical to ensure successful outcomes and to minimize potential risks."

Full arch implant-supported restorations treat patients with a terminal dentition or an edentulous mouth. Several biological and mechanical factors contributing to failure or complications are already extensively documented. Some patients receiving complex implant-based treatment plans also have OSA (obstructive sleep apnea). Using a CPAP mask in some patients is a lesser-known factor that could contribute to implant failures or complications.

The authors present a 71-year-old man who experienced a catastrophic failure of a mandibular full-arch immediately loaded implant prosthesis and significant bone loss while undergoing continuous positive airway pressure therapy for sleep apnea. They suggested that the CPAP machine may have contributed to treatment failure.

After the failure, the man refrained from using the CPAP machine for three weeks as his sleep doctor and dentist instructed, and a revision implant surgery was completed.

The patient visited the dentist for restoration of his lower teeth. Imaging and clinical exam revealed terminal lower jaw dentition due to compromised stage II, grade B periodontal status and mobility. The man was a former smoker and took medication to manage high cholesterol, multivitamins and aspirin; he reported no allergies. It wasn't until after the initial all-on-four dental implant surgery and immediate loading was completed that the patient revealed his diagnosis of sleep apnea and that he used a CPAP at night for treatment.

"This patient treatment has demonstrated that sleep apnea and subsequent CPAP machine usage as a new landmarked risk factor demonstrated in this patient contribut[ed] to primary implant failure," Surathu and colleagues wrote.

"We described how using a CPAP machine may be a risk factor in implant dentistry," the researchers concluded. They described a patient whose CPAP machine and mask use led to a catastrophic failure of mandibular full-arch dental implants.

Reference:

Rodriguez JJ, Gertler A, Bender J, Surathu N, Balshi TJ. Catastrophic implant failure after immediate loading of full-arch implant prosthesis and its association with CPAP therapy: A case report. J Prosthodont. 2023 May 18. doi: 10.1111/jopr.13697. Epub ahead of print. PMID: 37199327.