Prevotella denticola is an anaerobic gram-negative rod that commonly inhabits the oral cavity and is associated with periodontal and periapical infections. Vertebral osteomyelitis caused by Prevotella species is uncommon, and reports involving P. denticola are exceedingly rare. A 65-year-old man presented with progressive low back pain and difficulty walking following multiple falls. Lumbar magnetic resonance imaging demonstrated L2-L3 spondylodiscitis with an epidural abscess. Fluoroscopy-guided disc aspiration and subsequent full-endoscopic spinal surgery with percutaneous endoscopic discectomy and drainage were performed. Both blood cultures and disc aspirate cultures yielded P. denticola. Further investigation by dental specialists revealed a periapical lesion and periodontal disease, suggesting an odontogenic source of bacteremia. The patient was successfully treated with surgical source control and prolonged antimicrobial therapy, resulting in resolution of inflammatory markers and clinical improvement. This case highlights the importance of considering anaerobic odontogenic pathogens as potential causes of hematogenous vertebral infections. Comprehensive source investigation, including dental evaluation, should be considered when anaerobic organisms are isolated from blood or spinal specimens.

This case report describes guided pulpal regeneration (GPR) of two immature permanent molar teeth with chronic apical abscess, thin dentinal walls, and open apices. Both teeth were treated with an identical protocol in two sessions, with minimum instrumentation with hand files, irrigation with 1.5% sodium hypochlorite (NaOCl), and application of 1:1 mixture of ciprofloxacin and metronidazole as an intracanal medicament, blood clot as a scaffold, and mineral trioxide aggregate (MTA) as the capping material. At the one-year follow-up, both treated teeth were asymptomatic. However, the root development procedure was different even in different roots of the same tooth, varying from only an increased thickness of dentinal walls to complete closure of the apex along with an increase in root length and dentinal wall thickness. It is concluded that the outcome of GPR is not completely predictable, and may vary among teeth with similar initial conditions and treatment approaches.

Dental pulp infection is predominantly initiated by anaerobic, gram-negative bacterial flora introduced through dental caries, operative dental procedures, or severe tooth injury, which can lead to pulp necrosis. A 39-year-old man developed an extra-nasal sinus tract on the right side of the nostril following trauma to the right maxillary central incisor. He presented with a chief complaint of a painful mass inside the right nostril after the right maxillary central incisor was traumatized in a fall down the stairs. A diagnosis of a periapical abscess with a sinus tract on the right side of the nostril was made. The patient was managed with endodontic treatment of the non-vital maxillary central incisor followed by debridement of the periapical lesion, resulting in complete resolution of the lesion and nasal swelling. Clinicians should be aware of both odontogenic and non-odontogenic causes of lesions associated with sinus pathologies and should carefully evaluate the pathways of infection through thorough clinical and radiographic examination.

X-linked hypophosphatemia (XLH) is a PHEX-related disorder causing elevated FGF23, chronic hypophosphatemia, and impaired skeletal and dental mineralization, leading to frequent endodontic abscess in clinically sound teeth due to intrinsic structural failure, periapical lesions and early tooth loss. To address the lack of standardized oral management, a comprehensive literature review was conducted using EMBASE, MEDLINE, PubMed, Scopus, and Cochrane databases (1988-2024), adhering to PRISMA-ScR guidelines. Based on this evidence, multidisciplinary recommendations were developed to provide diagnostic and therapeutic strategies across dental specialties, including periodontics, endodontics, surgery, orthodontics, and restorative dentistry. The review describes specific clinical and radiographic diagnostic criteria and proposes preventive interventions and minimally invasive treatment planning. Key recommendations highlight that interdisciplinary management is critical to reducing complications and improving long-term oral health. Dentists should recognize XLH's characteristic dental manifestations to ensure timely diagnosis. Implementing these evidence-based strategies may enhance prevention, reduce endodontic complications, and significantly improve the quality of life in affected patients. LAY SUMMARY: X-Linked Hypophosphatemia (XLH) is a genetic condition that weakens bones and teeth. Patients often suffer from tooth infections (abscesses) and lose teeth early because their dental structure is fragile. This study reviewed dental research from 1988 to 2024 to identify the best ways to care for these patients. We developed evidence-based recommendations to help dentists diagnose the disease early and use specific treatments to prevent complications. These strategies aim to reduce pain and tooth loss, significantly improving the quality of life for people living with XLH.

This retrospective matched case-control study aimed to identify potential risk factors associated with the development of dental abscesses during or after endodontic treatment. The study analyzed data from 133 patients (74 males, 58 females; mean age 43.1 ± 16.5 years) with abscess formation of endodontic origin and compared them with a 1:1 matched control group without abscess. Matching was performed based on age and the specifically treated tooth. Collected variables included preoperative symptoms, radiographic findings, type and stage of endodontic intervention, and systemic medical conditions. Statistical analysis used chi-square or Fisher exact tests to compare between groups. STROBE and PROBE guidelines were followed. Among 2637 maxillofacial infections of odontogenic origin, 526 cases (19.9%) were related to endodontic treatment. No statistically significant associations were found regarding age, sex, or underlying systemic diseases (p > 0.05). Teeth exhibiting apical radiolucency were at significantly higher risk for abscess development (p < 0.001). Teeth that had undergone definitive root canal filling were significantly less likely to develop abscesses compared to those left without temporary filling after trepanation (p < 0.001) or treated with intracanal medication and temporary filling (p = 0.009). The highest incidence of abscess formation was observed within the first four days post-treatment (p < 0.001). Within the limitations of this retrospective study, abscess formation during or after endodontic treatment was linked to local procedural and radiographic factors, whereas systemic diseases did not demonstrate a measurable influence. The absence of temporary sealing and the presence of apical radiolucency were identified as significant risk indicators and may warrant increased clinical attention, particularly in the early postoperative period. Given the retrospective design and limited sample size, these findings should be interpreted with caution and require confirmation in prospective studies.

Tooth autotransplantation (TA) is indicated in cases of structurally compromised teeth with poor prognosis when a donor tooth is available. This case report describes the TA of a mandibular right third molar (48) into the position of the mandibular right second molar (47) in a 32-year-old male patient. Clinically, extensive coronal destruction and a sinus tract were observed in tooth 47, rendering retreatment unfavorable. The tooth was diagnosed as previously treated, with a chronic apical abscess. Therefore, tooth 48 was autotransplanted into the 47 position. Four months later, apical external inflammatory root resorption was observed. However, root canal treatment was performed one year after TA because the patient did not adhere to follow-up recommendations. After two years, the tooth remained asymptomatic, with no signs of periapical lesions or periodontal changes. In conclusion, TA may serve as a viable strategy for replacing structurally compromised permanent molars, thereby preserving the function of the natural dentition.