Immediate Load-Implant-Supported Mandibular Advancement in a Collapsed Bite to Treat Obstructive Sleep Apnea: A Case...

Patients who are edentulous or have severe loss of occlusal vertical dimension (OVD) present unique challenges in managing obstructive sleep apnea (OSA).

This case report describes the full-mouth rehabilitation of a 62-year-old female with an extremely collapsed bite and OSA symptoms. A digital workflow was utilized to plan a mandibular advancement prosthesis supported by dental implants. Key treatment steps included: recording a protrusive centric relation bite, increasing the OVD by 5 mm, and performing immediate implant placement with immediate loading of a provisional prosthesis. Six implants were placed in the maxilla and mandible using a guided surgical approach, and a fixed polymethyl methacrylate (PMMA) provisional prosthesis was delivered on the same day to maintain the mandible in the therapeutic forward position.

After 3 months of uneventful healing and osseointegration, definitive telescopic crown prostheses were fabricated as the final restorations. Function and aesthetics were fully restored, and the patient reported marked improvement in snoring and sleep quality.

This report demonstrates that an implant-supported mandibular advancement, combined with OVD restoration and a digital workflow, can successfully rehabilitate a collapsed bite while concurrently alleviating OSA symptoms. The interdisciplinary approach highlights the expanding role of prosthetic driven implant therapy in managing complex cases at the interface of dentistry and sleep medicine.