Background <p>Primary Hyperoxaluria Type 1 (PH1) is a rare metabolic disorder characterized by systemic oxalate deposition, which may influence bone metabolism through mechanisms such as oxalate accumulation in alveolar bone, renal osteodystrophy, and the long‑term effects of immunosuppressive therapy following transplantation. In the present case, conventional prosthetic options were unsuitable due to external root resorption and the poor prognosis of the remaining dentition.</p> Case presentation <p>This report describes implant‑supported oral rehabilitation in a medically complex patient with PH1 and a history of combined liver–kidney transplantation and multiple systemic comorbidities. Dental implant therapy was selected following comprehensive clinical and radiographic assessment. At six months, resonance frequency analysis demonstrated secondary stability with ISQ values of 75 (right) and 74 (left). Clinical and radiographic evaluation at 14 months showed stable peri‑implant conditions without detectable complications.</p> Conclusion <p>This case suggests that implant therapy may be feasible in selected patients with PH1 when thorough risk assessment, individualized planning, and close postoperative monitoring are ensured. However, the findings are limited by the single‑case design and relatively short follow‑up period, and should be interpreted as hypothesis‑generating rather than conclusive evidence regarding long‑term implant outcomes in this population.</p>