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Catastrophic Implant Failure After Immediate Loading of Full-Arch Implant Prosthesis


Now online in the Journal of Prosthodontics, a new case report co-authored by ACP member Thomas J. Balshi, DDS, FACP, PhD.

This article describes how the use of a continuous positive airway pressure (CPAP) machine may be a risk factor in implant dentistry and relates a case of a patient whose use of a CPAP machine and mask led to a catastrophic failure of mandibular full-arch dental implants.

As described in the report, the patient presented to the clinic with terminal mandibular dentition. He met the criteria for being an implant reconstruction candidate, but he did not disclose a history of wearing a CPAP machine at night. However, CPAP mask use is not currently included in the dental literature as a potential risk factor for complications in all-on-four rehabilitations.

In this case, the authors note that the consequences of continuing to use a CPAP mask during the primary osseointegration period of an implant immediately loaded supported full-arch reconstruction was catastrophic failure. The use of a CPAP mask adds significant pressure to an immediately loaded prosthesis and indirectly adds to the load that the implants experience.

If a dental surgeon finds themselves with a catastrophic implant rehabilitation failure due to undisclosed CPAP machine usage this article proves there is a rebound strategy. First, immediate CPAP machine hiatus and an alternative sleep apnea treatment must be prescribed. Next, controlled healing of the bone necrosis and retreatment of the implant placement is appropriate.

Dental professionals should be aware of the risks of CPAP machine use during early osseointegration periods of full-arch implant-supported restorative treatment.

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; 1– 7. https://doi.org/10.1111/jopr.13697


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