top of page

Did you know an estimated 85-90% of OSA cases go undiagnosed? As prosthodontists, we have the power to spot signs others might miss. Here's what to look for...

Your OSA Screening Checklist

  • Oropharyngeal Structures: High arched palate, enlarged tonsils, elongated uvula, large tongue. [1,2,3] Assess for tori mandibularis and a narrowed lateral pharyngeal wall. [4]

  • Mallampati Score: This classification of soft palate and uvula position predicts OSA severity. [4,5]

  • Maxillary Constriction: Look for a narrow maxilla with a deep palatal vault. [5]

  • Mandibular Position: Evaluate for retrognathia, a risk factor for OSA. [1]

  • Breathing Patterns: Note signs of mouth breathing, suggesting airway difficulties. [3]

Beyond the Obvious

  • Bruxism (teeth grinding): May be the body repositioning the jaw for better airflow.

  • Scalloped Tongue: Indentations suggest pressure due to constricted space.

  • TMJ Issues: Ask about pain, clicking, or limited jaw movement.

If You See This, Then...

  • If You See This: Scalloped tongue, retrognathia Then: Consider adding a validated OSA screening questionnaire (STOP-BANG, etc.) to your intake forms.

  • If You See This: Enlarged tonsils, high Mallampati score Then: Refer to a sleep physician for further evaluation.

Special Considerations for Children

Keep OSA in mind with pediatric patients too. Look for signs of mouth breathing, hyponasal speech, and craniofacial abnormalities constricting the upper airway. [6,8] Early intervention may be life-changing for these children. [7]

By incorporating these simple observations into your exams, you become a frontline defender against the hidden risks of OSA.


  1. Lavigne, G., Lavigne, G., Babiloni, A., Babiloni, A., Beetz, G., Fabbro, C., Sutherland, K., Huynh, N., & Cistulli, P. (2019). Critical Issues in Dental and Medical Management of Obstructive Sleep Apnea. Journal of Dental Research, 99, 26 - 35.

  2. Schellenberg, J., Maislin, G., & Schwab, R. (2000). Physical findings and the risk for obstructive sleep apnea. The importance of oropharyngeal structures.. American journal of respiratory and critical care medicine, 162 2 Pt 1, 740-8 .

  3. Petrou-Amerikanou, C., Belazi, M., Daskalopoulou, E., Vlachoyiannis, E., Daniilidou, N., & Papanayiotou, P. (2005). Oral findings in patients with obstructive sleep apnea syndrome.. Quintessence international, 36 4, 293-8 .

  4. Ruangsri, S., Jorns, T., Puasiri, S., Luecha, T., Chaithap, C., & Sawanyawisuth, K. (2016). Which oropharyngeal factors are significant risk factors for obstructive sleep apnea? An age-matched study and dentist perspectives. Nature and Science of Sleep, 8, 215 - 219.

  5. Ashraf, A., Menon, I., Gupta, R., Arora, V., Ahsan, I., & Das, D. (2022). Oral findings as predictors of obstructive sleep apnea- A case-control study. Journal of Family Medicine and Primary Care, 11, 5263 - 5267.

  6. Drogomyretska, M., & Gergel, I. (2023). Results of dental examination of children with obstructive sleep apnea syndrome. SUCHASNA STOMATOLOHIYA.

  7. Toshniwal, N., Mani, S., Mote, N., & Nalkar, A. (2021). Obstructive Sleep Apnoea in Orthodontics - A Review. Journal of Evolution of Medical and Dental Sciences.

  8. Kawashima, S., Niikuni, N., Lo, C., Kohno, M., Nakajima, I., & Akasaka, M. (1999). Clinical findings in Japanese children with obstructive sleep apnea syndrome: focus on dental findings.. Journal of oral science, 41 3, 99-103 .

  9. Aurora, R., Casey, K., Kristo, D., Auerbach, S., Bista, S., Chowdhuri, S., Karippot, A., Karippot, A., Lamm, C., Ramar, K., Zak, R., Morgenthaler, T., & Tracy, S. (2010). Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults.. Sleep, 33 10, 1408-13 .

  10. Villa, M., Bernkopf, E., Pagani, J., Broia, V., Montesano, M., & Ronchetti, R. (2002). Randomized controlled study of an oral jaw-positioning appliance for the treatment of obstructive sleep apnea in children with malocclusion.. American journal of respiratory and critical care medicine, 165 1, 123-7 .

Obstructive sleep apnea (OSA) is a common yet serious condition where breathing repeatedly stops and starts during sleep. [1] As prosthodontists, we have a unique role in identifying and managing OSA, especially with oral appliance therapy for select patients.

Why Prosthodontists Should Care about OSA

Our in-depth understanding of oral structures places us at the forefront of recognizing OSA risk factors. OSA has far-reaching health consequences beyond just disruptive sleep – it's been linked to cardiovascular disease, hypertension, daytime sleepiness, and accidents. [2, 4, 5] By contributing to OSA care, we improve not only our patients' sleep, but their overall health and well-being.

Treatment and Diagnosis of OSA

While continuous positive airway pressure (CPAP) remains the gold-standard treatment for moderate to severe OSA, oral appliance therapy (OAT) is a valid option for mild to moderate cases or patients who cannot tolerate CPAP. [2, 4, 5] As prosthodontists, we're experts in custom-fitting and managing these appliances.

Confirming an OSA diagnosis typically involves overnight polysomnography (sleep study), with home testing as an alternative in certain cases. [4, 5] While screening questionnaires exist, it's important to remember they have limitations and shouldn't replace formal diagnosis. [5]

Collaboration is Key

Prosthodontists don't treat OSA in isolation. Successful patient outcomes often rely on referring to sleep physicians and working as part of a multidisciplinary team.

The Bottom Line

By understanding OSA, its health risks, and treatment options, prosthodontists can significantly improve patient care. Oral appliance therapy is a valuable tool in our arsenal, and collaboration with other healthcare providers leads to the best results for our patients.


  1. Mohan, S., Gowda, E., & Banari, A. (2015). Obstructive sleep apnea (OSA): A prosthodontic perspective.. Medical journal, Armed Forces India, 71 Suppl 2, S395-9 .

  2. Jordan, A., McSharry, D., & Malhotra, A. (2014). Adult obstructive sleep apnoea. The Lancet, 383, 736-747.

  3. Chander, N. (2020). Sleep apnea and prosthodontic implications. The Journal of the Indian Prosthodontic Society, 20, 335 - 337.

  4. Kabir, A., Ifteqar, S., & Bhat, A. (2013). Obstructive Sleep Apnea in Adults. Hospital Practice, 41, 57 - 65.

  5. Semelka, M., Wilson, J., & Floyd, R. (2016). Diagnosis and Treatment of Obstructive Sleep Apnea in Adults.. American family physician, 94 5, 355-60 .


Welcome to ProsthoInsights' Journal Round Up Series, where we explore the latest advances in prosthodontics. In this edition, we take a look at the September 2023 issue of the Journal of Prosthodontics, one of the leading journals in the field.

This issue is packed with exciting research, from new techniques for improving the wear resistance of denture teeth to the use of digital workflows to create more accurate and efficient restorations. We also explore the latest findings on implant placement, occlusal schemes, and denture adhesives.

Whether you're a practicing prosthodontist or a student of the field, this issue is essential reading. So sit back, relax, and let us take you on a journey through the latest advances in prosthodontics.

Brief Overview - Journal of Prosthetic Dentistry: September 2023 Edition:

  • Volume and Issue: Volume 130, Issue 3.

  • Page Range: Pages 273-416.

  • Cover Art: Immerse yourself in the tranquil "Evening glow at Horseshoe Bend, AZ," captured in the cover art.

  • About the Cover Artist: Dr. Kyung Chul Oh, a prosthodontics expert with a PhD in Dental Science from Yonsei University Graduate School. An assistant professor at Yonsei University College of Dentistry, specializing in digital dentistry and dental implantology.

  • Publisher: Published monthly by Elsevier, Inc., at 230 Park Avenue, Suite 800, New York, NY 10169-0901, USA.

  • ISSN: 0022-3913

Total Number of Articles: 20

Distribution of Articles by Category:

🔹Clinical Innovations in Prosthodontics: 4 articles

🔹Systematic Reviews in Prosthodontics: 6 articles

🔹Educational and Research Advances: 5 articles

🔹Technological Advancements: 5 articles

Article Overview of Journal of Prosthetic Dentistry: September 2023 Edition:

Journal Round Up- JPD Sept23
Download PDF • 278KB

Section 1: Clinical Innovations in Prosthodontics

The field of prosthodontics is constantly evolving, with new techniques and technologies being developed all the time. These innovations are designed to improve the quality of care for patients, making it possible to restore smiles and improve function in ways that were not possible before.

Subsection 1.1: Enhancing Denture Wear Resistance

Lee et al. evaluated the use of zirconia crowns to enhance the wear resistance of dentures. They found that zirconia crowns were significantly more resistant to wear than conventional acrylic resin crowns. This is because zirconia is a strong and durable material that is less likely to fracture or chip.

The findings of this study suggest that zirconia crowns may be a good option for patients who are looking for dentures that will last longer. Zirconia crowns are also more esthetically pleasing than acrylic resin crowns, making them a good choice for patients who want dentures that look natural.

Subsection 1.2: Digital Techniques for Restoration

Lin et al. have published a comprehensive article that provides a state-of-the-art overview of the use of digital techniques for custom post-and-core restorations. They discuss the advantages of digital techniques, such as their accuracy, efficiency, and reproducibility. They also provide a detailed overview of the different steps involved in the digital workflow for custom post-and-core restorations.

The work of Lin et al. demonstrates the potential of digital techniques to improve the quality of custom post-and-core restorations. These techniques can help to ensure that restorations are fabricated accurately and precisely, which can lead to improved patient outcomes.

Subsection 1.3: Complete Denture Workflow

Kamalakidis and Pissiotis have developed a novel complete denture workflow that integrates polished surface registration. This innovation has the potential to improve the stability and retention of complete dentures, leading to improved patient comfort and function.

The polished surface registration technique involves scanning the patient's oral cavity with a high-resolution scanner. The scan data is then used to create a virtual model of the patient's mouth. This virtual model can then be used to fabricate a denture that is perfectly adapted to the patient's anatomy.

The complete denture workflow developed by Kamalakidis and Pissiotis is a promising new approach to fabricating dentures. It has the potential to improve the comfort and function of dentures for patients.

Subsection 1.4: Fully Digital Workflow for Dentures

Wang et al. have presented a fully digital workflow for treatment dentures that promises high precision with minimal effort. This approach has the potential to revolutionize the way dentures are fabricated and delivered to patients.

The fully digital workflow starts with a digital scan of the patient's mouth. The scan data is then used to create a virtual model of the patient's mouth. This virtual model can then be used to design and fabricate the denture using a 3D printer.

The fully digital workflow eliminates the need for traditional methods, such as hand carving and casting. This can save time and money, and it can also improve the accuracy of the denture fabrication process.

The fully digital workflow for dentures developed by Wang et al. is still in its early stages of development, but it has the potential to revolutionize the way dentures are fabricated. It could make dentures more accurate, efficient, and affordable.

Section 2: Systematic Reviews in Prosthodontics

Systematic reviews are a valuable tool for synthesizing the results of multiple studies on a particular topic. They can help to identify the best evidence available to support clinical decision-making.

Subsection 2.1: Restoration Options for Endodontically Treated Teeth

Maurits C.F.M. de Kuijper et al. evaluated the different restoration options for endodontically treated posterior teeth.

  • They found that there is no clear consensus on the best restoration option.

  • However, they concluded that indirect restorations, such as crowns and bridges, are generally preferred over direct restorations, such as composite resin fillings.

  • This is because indirect restorations are more durable and can better withstand the forces of chewing.

Subsection 2.2: Immediate Implant Placement

Reza Amid et al. conducted a systematic review to investigate the outcomes of immediate implant placement in sockets that might be considered compromised.

  • They found that immediate implant placement can be a successful treatment option in these cases.

  • However, they also concluded that more research is needed to determine the long-term success of this approach.

Subsection 2.3: Photogrammetry Technology in Implant Dentistry

Mostafa Omran Hussein et al. conducted a systematic review to explore the potential of photogrammetry technology in implant dentistry.

  • They found that photogrammetry can be used to accurately transfer implant coordinates.

  • This can be useful for planning implant placement and for assessing the fit of implant-supported prostheses.

Subsection 2.4: Implant Abutment Connections

Octavi Camps-Font et al. conducted a network meta-analysis to compare the different implant abutment connection designs for implant-supported prostheses.

  • They found that there is no clear consensus on the best implant abutment connection design.

  • However, they concluded that certain designs may be associated with a lower risk of marginal bone loss and prosthetic complications.

Subsection 2.5: Denture Occlusal Schemes

Maria Helena Rossy Borges et al. led a systematic review of systematic reviews to investigate the influence of denture occlusal schemes on the performance of complete dentures and patient satisfaction.

  • They found that there is no clear consensus on the best denture occlusal scheme.

  • However, they concluded that some schemes may be associated with better patient satisfaction.

Subsection 2.6: Denture Adhesives

Olívia Maria Costa de Figueredo et al. conducted a systematic review to assess the impact of different denture adhesive presentations on masticatory function.

  • They found that there is no clear consensus on the best denture adhesive presentation.

  • However, they concluded that some presentations may be more effective than others in improving masticatory function.

Section 3: Educational and Research Advances

In addition to clinical innovations and systematic reviews, this journal also highlights educational and research advances in prosthodontics.

Subsection 3.1: Sinus Floor Augmentation

In a clinical retrospective study, Xiaoxu Guan et al. examined changes in bone graft height post-sinus floor augmentation.

  • They found that bone graft height was significantly increased at 12 months post-augmentation.

  • This research provides essential insights into the long-term outcomes of this procedure, offering valuable information for prosthodontic practice.

Subsection 3.2: Prosthesis Material Comparison

Francisco P. Curiel-Aguilera led a study comparing plaque accumulation between titanium and zirconia complete arch implant-supported fixed prostheses.

  • They found that zirconia prostheses had significantly lower plaque accumulation than titanium prostheses.

  • This research assists prosthodontists in selecting the most suitable material for their patients.

Subsection 3.3: Viral Contamination and Denture Bases

Nadia Elyassi Gorji and her team conducted a cross-sectional study investigating viral contamination of acrylic resin removable denture bases in patients with COVID-19.

  • They found that the prevalence of viral contamination was high, even in patients who had been diagnosed with COVID-19 in the past.

  • This research explores potential risks associated with removable dentures and viral transmission.

Subsection 3.4: Biomechanical Behavior of Abutments

Pongsakorn Poovarodom et al. employed a nonlinear finite element analysis study to evaluate how gingival height impacts the biomechanical behavior of custom implant abutments.

  • They found that gingival height has a significant impact on the stress distribution in the abutment.

  • This investigation provides critical insights into the mechanical aspects of implant components based on gingival height, aiding in prosthodontic decision-making.

Section 4: Technological Advancements

This section of the journal highlights the latest technological advancements in prosthodontics.

Subsection 4.1: 3D Printing and Accuracy

In an in vitro study, Yuming Chen et al. explored the influence of internal design on the accuracy of 3D printed dental casts.

  • They found that the internal design of the cast has a significant impact on its accuracy.

  • This research guides the optimization of internal designs for improved accuracy in dental cast fabrication.

Subsection 4.2: Facial Scanning and Virtual Facebow

Xabier Amezua and colleagues conducted an in vivo study that evaluated the precision of virtual facebow records.

  • They found that virtual facebow records are as accurate as traditional facebow records.

  • This research assesses the impact of different facial scanning methods on the accuracy of maxillary relationships in prosthodontics, providing insights into the reliability of digital workflows. .

Subsection 4.3: Zirconia Ceramic Color Management

Luiza Freitas Brum Souza led an in vitro study examining the influence of coloring techniques on the color stability of monolithic zirconia ceramic.

  • They found that different coloring techniques can have a significant impact on the color stability of zirconia ceramic.

  • This research assists prosthodontists in managing zirconia ceramic color, ensuring aesthetic excellence in prosthetic restorations.

Subsection 4.4: Biocompatibility of Recycled Co-Cr Alloy

Taghrid Aldhohrah and her team investigated the biocompatibility of Co-Cr alloys fabricated from recycled powder in an in vitro study.

  • They found that recycled Co-Cr alloys are biocompatible and can be used safely in prosthodontics.

  • This research contributes to our understanding of the safety and effectiveness of recycled Co-Cr alloys in prosthodontics.

Subsection 4.5: Skin Surface Reproduction in Prosthesis

Alexey Unkovskiy and colleagues quantified the transfer of skin surface details in digital workflows for facial prosthesis fabrication through an in vitro study.

  • They found that digital workflows can be used to accurately reproduce skin surface details in facial prostheses.

  • This research advances the art of facial prosthesis design, ensuring a lifelike appearance for patients.


The September 2023 edition of the Journal of Prosthetic Dentistry highlights the latest advances in the field, from clinical innovations to systematic reviews to educational and research advances. These articles provide valuable insights into the potential of new technologies and research to improve the quality of care for patients.

I hope you find this blog post informative and engaging. If you have any questions or comments, please feel free to leave them below.

P.S. If you're interested in learning more about the latest trends in prosthodontics, I encourage you to check out the September 2023 edition of JPD. It's a great resource for anyone who wants to stay up-to-date on the latest advances in this field.

Happy reading!

Check out other Journal Round Up Articles here

bottom of page