The severity of pulpitis is a crucial factor in determining the suitable treatment. There are no clear objective indicators to assess the stage of pulp inflammation that could be used in clinical practice. The change in blood pH of the pulp during the inflammatory phase could hypothetically serve as an indicator of the pulp inflammation severity. The aim of this study was to assess the pH values in the pulpal blood of mature teeth in patients with symptomatic pulpitis, in comparison with the healthy controls. The study included patients with symptoms of pulpitis in premolar or molar teeth (Test group; n = 24, mean age 36.04, SD 7.10), and healthy controls (Control group, n = 6, mean age 24.5, SD 5.94) referred for extraction of premolars or third molars, for orthodontic reasons. The pulpal blood was taken at the opening of the endodontic access cavity, and the pH value was measured in both groups. Statistical analysis was performed using the SPSS 27.0 program with a significance level of p ≤ 0.05. The Mann–Whitney test for dependent samples was performed to evaluate the statistical difference between the groups. The patients with symptomatic pulpitis had significantly decreased pulpal blood pH compared to the healthy controls (p ≤ 0.05). The mean pulpal blood pH was 7.27 (SD 0.06) and 7.40 (SD 0.02) in Test and Control groups, respectively. In the Test group, the pulpal blood pH values were significantly lower in the patients who had symptoms for 3 days or more (7.25, SD 0.05) than in those who had symptoms for up to 3 days (7.33, SD 0.03) (p < 0.001). The pH value of the pulpal blood gradually declines in cases of symptomatic pulpitis, along with increasing duration of the symptoms.

Background and Objectives: The inappropriate use of antibiotics can lead to antimicrobial resistance. Overprescribing in dental practice has been reported. This study aimed to describe patterns of antibiotic prescription for treating and preventing odontogenic infections based on reports from Lithuanian dentists. Materials and Methods: Questionnaires were sent to all 4751 Lithuanian dentists registered in the database of the Lithuanian Dental Chamber who had consented to participate in surveys. The questionnaire addressed antibiotic prescription preferences for the treatment and prevention of various dental pathologies. The statistical analysis included chi-square tests and a factor analysis to evaluate prescription frequences in different clinical scenarios considering the respondents’ specialty and age. Results: Of 647 responses, 497 were from general dentists, 35 from oral surgeons, 40 from endodontists, 20 from periodontists, and 35 from prosthodontists. Respondents were grouped by age: A (≤35 years, n = 207), B (36–50 years, n = 224), and C (≥51 years, n = 209). Amoxicillin was the first-choice antibiotic for 81.1% of respondents (group A more frequently than other groups, p = 0.001). A 7-day treatment duration was preferred by 60.8%, while 33.6% chose 5 days. For patients allergic to β-lactam antibiotics, 63% preferred clindamycin. Over 90% cited acute apical abscess with systematic involvement as an indication for antibiotic prescription. A factor analysis of 18 clinical scenarios revealed prescription differences among dental specialists, oral surgeons, and periodontists prescribing antibiotics more frequently than general dentists and endodontists. For prophylaxis, 87.5% recommended antibiotics for patients at risk of infectious endocarditis after a cardiologist’s consultation (group C less frequently than other groups, p = 0.021). Conclusions: Lithuanian dentists generally prefer narrow-spectrum antibiotics for the treatment of odontogenic infections. There are notable differences in prescription patterns among dental specialists, with younger dentists showing a trend towards more rational antibiotic use.

Limited visibility of the operating field can lead to difficulties in relation to adequate retrograde filling during periapical surgery in specific clinical situations. Solid and homogenic root filling material that does not need to be removed after apicoectomy could be used as an alternative to retrograde filling. This study aims to compare the micro‐hardness of mineral trioxide aggregate (MTA) considering retrograde vs. orthograde obturation during root end resection in vitro. Methods: 20 roots of maxillary incisors were chemo‐mechanically prepared and divided into 2 groups: group A ( n = 10)—retrograde filling and group B ( n = 10)—orthograde filling. The specimens of group A were filled with gutta‐percha and resin‐based sealer, 3 mm of the apical area were removed after the incubation period. Retrograde cavities of a depth of 3 mm were made and filled with MTA. In group B, apical 7 mm of the roots was filled with MTA in an orthograde manner. After the incubation, 3 mm of the root ends were removed. Vickers microhardness test was applied to the MTA No statistically significant difference in micro‐hardness between groups was found ( p > 0.05). The assessment of retrograde filling did not reveal significant differences of MTA micro‐hardness in different parts of the material ( p > 0.05). The assessment of orthograde filling revealed that MTA micro‐hardness 3 mm from the apex was significantly higher when compared to the distance of 1 and 2 mm from the root apex ( p > 0.05). The obturation method did not affect the hardness of MTA during root end resection in vitro.