Clinical considerations for oral appliance use in obstructive sleep apnea patients with dental implants: a scoping review.

PURPOSE: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by recurrent upper airway obstruction during sleep and associated with important systemic health risks. Oral appliance (OA) therapy, particularly mandibular advancement devices (MADs), is an established treatment option for patients with mild to moderate OSA and for those who are unable to tolerate continuous positive airway pressure. However, in patients with dental implants, prosthodontic and biomechanical factors may influence the indication, design, retention, and safety of OA therapy. Therefore, the purpose of this review was to examine the existing literature on OA therapy in patients with OSA who have dental implants. METHODS: Scopus and PubMed were searched on April 2, 2026, for English-language articles published during the predefined 20-year period from January 1, 2006, through December 31, 2025. Eligible studies described patients with OSA whose dental implants or implant-supported prostheses influenced OA therapy. Data were synthesized descriptively. RESULTS: Of 36 records, four studies were included: two case reports, one case series, and one finite element analysis. Most patients were edentulous. Reported approaches included implant-retained mandibular advancement appliances, overdentures worn during sleep, and biomechanical evaluation of implant-supported OAs. Benefits included improved retention and favorable sleep-related outcomes, whereas mucosal discomfort and limited long-term safety data remained concerns. CONCLUSION: Evidence remains sparse, but implant-assisted OA therapy may be feasible in carefully selected patients, especially edentulous individuals with poor conventional OA retention.