Treatment of Patients with Obstructive Sleep Apnea Syndrome: What Shall Prosthodontists Consider?

Obstructive sleep apnea syndrome (OSAS) is a prevalent sleep-related breathing disorder associated with significant systemic comorbidity. While its medical consequences are well established, its potential impact on the dental and prosthetic environment has received comparatively less attention. This commentary reviews the evidence for a dual overload mechanism by which OSAS may compromise dental restorations and outlines key clinical considerations for prosthodontists managing patients with known or suspected OSAS.

A narrative review of the literature published between 2020 and 2025 on OSAS, sleep bruxism, gastroesophageal reflux, and restorative and implant outcomes was undertaken to synthesize the proposed pathophysiological mechanisms and their clinical implications for prosthodontics.

The reviewed evidence supports a dual overload mechanism combining mechanical overload driven by reactive-protective sleep bruxism and chemical overload arising from nocturnal gastroesophageal reflux; both may act synergistically to accelerate the deterioration of veneers, crowns, and implant-supported prostheses. Treatment of OSAS - whether through mandibular advancement device therapy or continuous positive airway pressure - may not only address the respiratory pathology but could also contribute to stabilizing the oral environment by reducing bruxism frequency and reflux episodes.

Prosthodontists, as clinicians who routinely encounter the oral sequelae of OSAS, may play an important role in the early identification and multidisciplinary management of this condition.