{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:31:40Z","timestamp":1787671900571,"version":"build-2736575974"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":70,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The All-on-4 implant technique offers an effective rehabilitation solution for maxillary bone - deficient patients, yet preventing and controlling complications in those with severe periodontitis and Parkinson\u2019s disease (PD) poses a clinical challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 63-year-old PD patient had multiple teeth extracted due to mobility years ago and a history of failed implant rehabilitation in the posterior maxilla at another hospital. He was diagnosed with dentition defect and chronic periodontitis upon admission. Immediate All-on-4 implant rehabilitation was performed after extraction of the remaining maxillary teeth. Three months postoperatively, implant at site 15 became loose and was removed; three months later, tilted implantation was performed at site 15, and simultaneous maxillary sinus floor elevation with implant placement was conducted at sites 16 and 17. Six months after the second operation, implant 25 failed and was extracted; two months later, tilted implantation was re-performed at site 25, and simultaneous maxillary sinus floor elevation with implant placement was carried out at sites 26 and 27. Final fixed prosthodontics was completed, and during the 55-month follow-up, the prosthesis has remained stable, and masticatory function has been significantly improved compared with the pre-treatment status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case report firstly presents a complication management protocol following All-on-4 rehabilitation in patients with PD. For PD patients complicated with severe maxillary bone deficiency and concurrent periodontitis, All-on-4 rehabilitation mandates rigorous preoperative periodontal treatment, individualized implant site design, reliable patient compliance, and standardized periodic postoperative maintenance. Dentists should stay alert to potential obstacles to oral self-care and xerostomia in PD individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-08944-w","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T13:25:46Z","timestamp":1781616346000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management and clinical analysis of complications following all-on-4 implant-supported rehabilitation in a patient with severe maxillary bone deficiency and periodontitis: a case report"],"prefix":"10.1186","volume":"26","author":[{"given":"Xun","family":"Xia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Qi","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang-Qin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Wu","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"issue":"1","key":"8944_CR1","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s00784-021-04213-y","volume":"26","author":"GSY Gon\u00e7alves","year":"2022","unstructured":"Gon\u00e7alves GSY, de Magalh\u00e3es KMF, Rocha EP, Dos Santos PH, Assun\u00e7\u00e3o WG. Oral health-related quality of life and satisfaction in edentulous patients rehabilitated with implant-supported full dentures all-on-four concept: a systematic review. Clin Oral Investig. 2022;26(1):83\u201394. https:\/\/doi.org\/10.1007\/s00784-021-04213-y.","journal-title":"Clin Oral Investig"},{"issue":"8","key":"8944_CR2","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1111\/j.1600-051X.2011.01745.x","volume":"38","author":"L Levin","year":"2011","unstructured":"Levin L, Ofec R, Grossmann Y, Anner R. Periodontal disease as a risk for dental implant failure over time: a long-term historical cohort study. J Clin Periodontol. 2011;38(8):732\u20137. https:\/\/doi.org\/10.1111\/j.1600-051X.2011.01745.x.","journal-title":"J Clin Periodontol"},{"key":"8944_CR3","doi-asserted-by":"publisher","first-page":"e080952","DOI":"10.1136\/bmj-2024-080952","volume":"388","author":"D Su","year":"2025","unstructured":"Su D, Cui Y, He C, Yin P, Bai R, Zhu J, Lam JST, Zhang J, Yan R, Zheng X, Wu J, Zhao D, Wang A, Zhou M, Feng T. Projections for prevalence of Parkinson\u2019s disease and its driving factors in 195 countries and territories to 2050: modelling study of Global Burden of Disease Study 2021. BMJ. 2025;388:e080952. https:\/\/doi.org\/10.1136\/bmj-2024-080952.","journal-title":"BMJ"},{"issue":"1","key":"8944_CR4","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1093\/ageing\/afaa099","volume":"50","author":"WM Thomson","year":"2021","unstructured":"Thomson WM, Ferguson CA, Janssens BE, Kerse NM, Ting GS, Smith MB. Xerostomia and polypharmacy among dependent older New Zealanders: a national survey. Age Ageing. 2021;50(1):248\u201351. https:\/\/doi.org\/10.1093\/ageing\/afaa099.","journal-title":"Age Ageing"},{"issue":"1","key":"8944_CR5","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s40120-021-00237-4","volume":"10","author":"ALC Martimbianco","year":"2021","unstructured":"Martimbianco ALC, Prosdocimi FC, Anauate-Netto C, Dos Santos EM, Mendes GD, Fragoso YD. Evidence-Based Recommendations for the Oral Health of Patients with Parkinson\u2019s Disease. Neurol Ther. 2021;10(1):391\u2013400. https:\/\/doi.org\/10.1007\/s40120-021-00237-4.","journal-title":"Neurol Ther"},{"issue":"8","key":"8944_CR6","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.3390\/ph16081136","volume":"16","author":"KN Kontogiannopoulos","year":"2023","unstructured":"Kontogiannopoulos KN, Kapourani A, Gkougkourelas I, Anagnostaki ME, Tsalikis L, Assimopoulou AN, Barmpalexis P. A Review of the Role of Natural Products as Treatment Approaches for Xerostomia. Pharmaceuticals (Basel). 2023;16(8):1136. https:\/\/doi.org\/10.3390\/ph16081136.","journal-title":"Pharmaceuticals (Basel)"},{"key":"8944_CR7","doi-asserted-by":"publisher","unstructured":"Bera RN, Tripathi R, Bhattacharjee B, Singh AK, Kanojia S, Kumar V. Implant survival in patients with neuropsychiatric, neurocognitive, and neurodegenerative disorders: A meta-analysis. Natl J Maxillofac Surg. 2021;12(2):162\u201370. https:\/\/doi.org\/10.4103\/njms.NJMS_230_20.","DOI":"10.4103\/njms.NJMS_230_20"},{"issue":"5","key":"8944_CR8","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1212\/wnl.17.5.427","volume":"17","author":"MM Hoehn","year":"1967","unstructured":"Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17(5):427\u201342. https:\/\/doi.org\/10.1212\/wnl.17.5.427.","journal-title":"Neurology"},{"issue":"1","key":"8944_CR9","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1034\/j.1600-0501.1990.010104.x","volume":"1","author":"D Buser","year":"1990","unstructured":"Buser D, Br\u00e4gger U, Lang NP, Nyman S. Regeneration and enlargement of jaw bone using guided tissue regeneration. Clin Oral Implants Res. 1990;1(1):22\u201332. https:\/\/doi.org\/10.1034\/j.1600-0501.1990.010104.x.","journal-title":"Clin Oral Implants Res"},{"issue":"3","key":"8944_CR10","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1111\/cid.13330","volume":"26","author":"M Serroni","year":"2024","unstructured":"Serroni M, Borgnakke WS, Romano L, Balice G, Paolantonio M, Saleh MHA, Ravid\u00e0 A. History of periodontitis as a risk factor for implant failure and incidence of peri-implantitis: A systematic review, meta-analysis, and trial sequential analysis of prospective cohort studies. Clin Implant Dent Relat Res. 2024;26(3):482\u2013508. https:\/\/doi.org\/10.1111\/cid.13330.","journal-title":"Clin Implant Dent Relat Res"},{"issue":"4","key":"8944_CR11","doi-asserted-by":"publisher","first-page":"e052329","DOI":"10.1136\/bmjopen-2021-052329","volume":"12","author":"MC Verhoeff","year":"2022","unstructured":"Verhoeff MC, Koutris M, Berendse HW, van Dijk KD, Lobbezoo F. Parkinson\u2019s disease, temporomandibular disorder pain and bruxism and its clinical consequences: a protocol of a single-centre observational outpatient study. BMJ Open. 2022;12(4):e052329. https:\/\/doi.org\/10.1136\/bmjopen-2021-052329.","journal-title":"BMJ Open"},{"issue":"2","key":"8944_CR12","doi-asserted-by":"publisher","first-page":"105","DOI":"10.11138\/orl\/2017.10.2.105","volume":"10","author":"P Bollero","year":"2017","unstructured":"Bollero P, Franco R, Cecchetti F, Miranda M, Barlattani A Jr, Dolci A, Ottria L. Oral health and implant therapy in Parkinson\u2019s patients: review. Oral Implantol (Rome). 2017;10(2):105\u201311. https:\/\/doi.org\/10.11138\/orl\/2017.10.2.105.","journal-title":"Oral Implantol (Rome)"},{"issue":"4","key":"8944_CR13","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.3233\/JPD-212605","volume":"11","author":"M Auffret","year":"2021","unstructured":"Auffret M, Meuric V, Boyer E, Bonnaure-Mallet M, V\u00e9rin M. Oral Health Disorders in Parkinson\u2019s Disease: More than Meets the Eye. J Parkinsons Dis. 2021;11(4):1507\u201335. https:\/\/doi.org\/10.3233\/JPD-212605.","journal-title":"J Parkinsons Dis"},{"issue":"4","key":"8944_CR14","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1111\/joor.13304","volume":"49","author":"MC Verhoeff","year":"2022","unstructured":"Verhoeff MC, Lobbezoo F, van Leeuwen AM, Schuller AA, Koutris M. Oral health-related quality of life in patients with Parkinson\u2019s disease. J Oral Rehabil. 2022;49(4):398\u2013406. https:\/\/doi.org\/10.1111\/joor.13304.","journal-title":"J Oral Rehabil"},{"key":"8944_CR15","doi-asserted-by":"publisher","unstructured":"van Dijk BDM, Verhoeff MC, van der Aa N, Lobbezoo F. Parkinson\u2019s Disease and Salivary Issues: A Survey. Gerodontology. 2026. https:\/\/doi.org\/10.1111\/ger.70049.","DOI":"10.1111\/ger.70049"},{"key":"8944_CR16","doi-asserted-by":"publisher","unstructured":"Tebbutt E, Marshman J, Baker ZR. Oral health experiences of people living with Parkinson\u2019s disease: a scoping review. Br Dent J. 2024;7. https:\/\/doi.org\/10.1038\/s41415-024-7058-8.","DOI":"10.1038\/s41415-024-7058-8"},{"key":"8944_CR17","unstructured":"Packer ME. A review of the outcome of dental implant provision in individuals with movement disorders. Eur J Oral Implantol. 2018;11 Suppl 1:S47-S63. PMID: 30109299."},{"issue":"6","key":"8944_CR18","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1034\/j.1600-0501.2000.011006566.x","volume":"11","author":"SM Heckmann","year":"2000","unstructured":"Heckmann SM, Heckmann JG, Weber HP. Clinical outcomes of three Parkinson\u2019s disease patients treated with mandibular implant overdentures. Clin Oral Implants Res. 2000;11(6):566\u201371. https:\/\/doi.org\/10.1034\/j.1600-0501.2000.011006566.x.","journal-title":"Clin Oral Implants Res"},{"issue":"1","key":"8944_CR19","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s40729-024-00557-8","volume":"10","author":"K Tokumoto","year":"2024","unstructured":"Tokumoto K, Mino T, Tosa I, Omori K, Yamamoto M, Takaoka K, Maekawa K, Kuboki T, Kishimoto H. Long-term follow-up of a patient with Parkinson\u2019s disease under nursing care after replacement of fixed implant-supported prostheses with an implant overdenture: a case report. Int J Implant Dent. 2024;10(1):37. https:\/\/doi.org\/10.1186\/s40729-024-00557-8.","journal-title":"Int J Implant Dent"},{"key":"8944_CR20","doi-asserted-by":"publisher","first-page":"145","DOI":"10.2147\/CCIDE.S462756","volume":"16","author":"T Barakati","year":"2024","unstructured":"Barakati T, Ghafari ES, Niakan S, Humkar O, Shadab H, Ehsan H. Clinical Report on an Implant-Supported Overdenture in a Parkinson\u2019s Patient. Clin Cosmet Investig Dent. 2024;16:145\u201352. https:\/\/doi.org\/10.2147\/CCIDE.S462756.","journal-title":"Clin Cosmet Investig Dent"},{"issue":"6","key":"8944_CR21","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1016\/j.prosdent.2015.07.007","volume":"114","author":"FC Liu","year":"2015","unstructured":"Liu FC, Su WC, You CH, Wu AY. All-on-4 concept implantation for mandibular rehabilitation of an edentulous patient with Parkinson disease: A clinical report. J Prosthet Dent. 2015;114(6):745\u201350. https:\/\/doi.org\/10.1016\/j.prosdent.2015.07.007.","journal-title":"J Prosthet Dent"},{"issue":"1","key":"8944_CR22","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1007\/s10006-025-01492-7","volume":"30","author":"CE Figueiredo","year":"2025","unstructured":"Figueiredo CE, de Oliveira NE, Cassimiro G, de Andrade Vieira W, de Paula Santos GP, Paranhos LR, Sotto-Maior BS. Rehabilitation of edentulous jaws using the All-on-Four treatment concept: an overview of systematic reviews. Oral Maxillofac Surg. 2025;30(1):6. https:\/\/doi.org\/10.1007\/s10006-025-01492-7.","journal-title":"Oral Maxillofac Surg"},{"issue":"1","key":"8944_CR23","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1186\/s12903-024-04821-6","volume":"24","author":"YF Huang","year":"2024","unstructured":"Huang YF, Chang CT, Lin CH, Shen YF. Prosthodontic rehabilitation with all-on-four implant treatment combined CAD\/CAM prosthesis in an oral cancer patient: a case report. BMC Oral Health. 2024;24(1):1080. https:\/\/doi.org\/10.1186\/s12903-024-04821-6.","journal-title":"BMC Oral Health"},{"issue":"4","key":"8944_CR24","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1111\/jcpe.13755","volume":"50","author":"Y Shimizu","year":"2023","unstructured":"Shimizu Y, Yamanashi H, Kitamura M, Miyata J, Nonaka F, Nakamichi S, Saito T, Nagata Y, Maeda T. Association between periodontitis and chronic kidney disease by functional atherosclerosis status among older Japanese individuals: A cross-sectional study. J Clin Periodontol. 2023;50(4):430\u20139. https:\/\/doi.org\/10.1111\/jcpe.13755.","journal-title":"J Clin Periodontol"},{"issue":"1","key":"8944_CR25","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.cden.2020.09.014","volume":"65","author":"MH Chan","year":"2021","unstructured":"Chan MH, Nudell YA. All-on-4 Concept Update. Dent Clin North Am. 2021;65(1):211\u201327. https:\/\/doi.org\/10.1016\/j.cden.2020.09.014.","journal-title":"Dent Clin North Am"},{"issue":"5","key":"8944_CR26","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1111\/cid.12380","volume":"18","author":"M Tallarico","year":"2016","unstructured":"Tallarico M, Meloni SM, Canullo L, Caneva M, Polizzi G. Five-Year Results of a Randomized Controlled Trial Comparing Patients Rehabilitated with Immediately Loaded Maxillary Cross-Arch Fixed Dental Prosthesis Supported by Four or Six Implants Placed Using Guided Surgery. Clin Implant Dent Relat Res. 2016;18(5):965\u201372. https:\/\/doi.org\/10.1111\/cid.12380.","journal-title":"Clin Implant Dent Relat Res"},{"key":"8944_CR27","doi-asserted-by":"publisher","unstructured":"Curi MM, Cardoso CL, Ribeiro Kde C. Retrospective study of pterygoid implants in the atrophic posterior maxilla: implant and prosthesis survival rates up to 3 years. Int J Oral Maxillofac Implants. 2015;30(2):378\u201383. https:\/\/doi.org\/10.11607\/jomi.3665.","DOI":"10.11607\/jomi.3665"},{"issue":"1","key":"8944_CR28","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1186\/s12903-024-05377-1","volume":"24","author":"Y Zhang","year":"2024","unstructured":"Zhang Y, Tang X, Zhang Y, Cao C. A network meta-analysis comparing treatment modalities of short and long implants in the posterior maxilla with insufficient bone height. BMC Oral Health. 2024;24(1):1574. https:\/\/doi.org\/10.1186\/s12903-024-05377-1.","journal-title":"BMC Oral Health"},{"issue":"4","key":"8944_CR29","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1111\/cid.13103","volume":"24","author":"G Lombardo","year":"2022","unstructured":"Lombardo G, Signoriello A, Pardo A, Serpa Romero XZ, Vila Sierra LA, Ar\u00e9valo Tovar L, Marincola M, Nocini PF. Short and ultra-short (<\u20096-mm) locking-taper implants supporting single crowns in posterior areas (part II): A 5-year retrospective study on periodontally healthy patients and patients with a history of periodontitis. Clin Implant Dent Relat Res. 2022;24(4):455\u201367. https:\/\/doi.org\/10.1111\/cid.13103.","journal-title":"Clin Implant Dent Relat Res"},{"issue":"1","key":"8944_CR30","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1111\/clr.12547","volume":"27","author":"YX Gu","year":"2016","unstructured":"Gu YX, Shi JY, Zhuang LF, Qian SJ, Mo JJ, Lai HC. Transalveolar sinus floor elevation using osteotomes without grafting in severely atrophic maxilla: a 5-year prospective study. Clin Oral Implants Res. 2016;27(1):120\u20135. https:\/\/doi.org\/10.1111\/clr.12547.","journal-title":"Clin Oral Implants Res"},{"issue":"6","key":"8944_CR31","doi-asserted-by":"publisher","first-page":"667","DOI":"10.7518\/hxkq.2020.06.011","volume":"38","author":"JQ Huang","year":"2020","unstructured":"Huang JQ, Hu CQ, Xia X, Guo SG, Gong JM, Wei HW. Retrospective study on transcrestal sinus floor elevation with simultaneous implantation of short implants. Hua Xi Kou Qiang Yi Xue Za Zhi. 2020;38(6):667\u201371. https:\/\/doi.org\/10.7518\/hxkq.2020.06.011. Chinese.","journal-title":"Hua Xi Kou Qiang Yi Xue Za Zhi"},{"issue":"12","key":"8944_CR32","doi-asserted-by":"publisher","first-page":"300060521106067","DOI":"10.1177\/03000605211060674","volume":"49","author":"X Xia","year":"2021","unstructured":"Xia X, Wei ZY, Wei HW. Displacement of the full body of a dental implant into the sinus space without membrane perforation and subsequent osseointegration: a case report. J Int Med Res. 2021;49(12):3000605211060674. https:\/\/doi.org\/10.1177\/03000605211060674.","journal-title":"J Int Med Res"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-026-08944-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08944-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08944-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:04:43Z","timestamp":1787670283000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12903-026-08944-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8944"],"URL":"https:\/\/doi.org\/10.1186\/s12903-026-08944-w","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"assertion":[{"value":"1 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This retrospective case report was conducted in accordance with the Declaration of Helsinki. The study involved only anonymized, pre-existing clinical data with no intervention or identifiable personal information. Patient information has been anonymized. Informed consent about clinical management was obtained from the patient in this case.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent for publication was obtained from the patient to publish all clinical date and any accompanying images.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1593"}}