Aim To determine the knowledge of final year undergraduate students attending Italian universities on the appropriate use of systemic antibiotics for endodontic infections. Methodology Final year dental students from twenty Italian universities completed a one‐page questionnaire on antibiotic use for the treatment of endodontic infections. Data were analysed using descriptive statistics and chi‐square tests. Results A total of three hundred and three students completed the questionnaire. The average duration of antibiotic prescription proposed by respondents was 5.48 ± 1.06 days. Amoxicillin with clavulanic acid was the first‐choice antibiotic (85.2%) followed by amoxicillin alone (13.5%), azithromycin (1.0%) and clarithromycin (0.3%), for patients not allergic to penicillin. Clarithromycin was the first‐choice drug for patients with a penicillin allergy (56.1%), followed from azithromycin (31.7%), clindamycin (11.9%) and levofloxacin (0.3%). Alveolar abscess with systemic manifestations was reported as the principal reason to prescribe antibiotics (97.7%) followed by the same condition without systemic manifestations (85.5%). For the scenario of irreversible pulpitis, 5% of students considered antibiotics necessary. Almost 52% of students would prescribe antibiotics for apical acute periodontitis; 29.7% would prescribe antibiotics for chronic apical periodontitis with sinus tract, and 13.5% indicated these drugs for chronic apical periodontitis without sinus tract. Conclusions The results demonstrate that it is necessary to improve the knowledge of Italian students on antibiotics and indications for their use in endodontics.

Hypochlorite accidents are relatively rare events. Therefore, there is a lack of precise and accurate reports in the scientific literature that could help clinicians better understand the phenomenon and associated risk factors. This study reported four hypochlorite accidents attributable to 5% NaOCl extrusion in patients who had undergone treatment of the maxillary elements canal treatments. In all cases, the accidents occurred during the irrigation phase and were characterised by intracanal bleeding, ecchymosis, and swelling on the hemiface corresponding to the treated tooth. Antibiotics, paracetamol, NSAID, corticosteroids, and cold or warm compresses for oedema were prescribed to treat the symptoms of the accidents. Significant improvement of symptoms was observed in all patients after 5–6 days. Anatomic risk factors such as apical fenestration, root perforation, and large foramina were identified as possible risk factors for the accidents. After the accidents, clinicians applied endodontic procedures for which there is no scientific evidence to continue endodontic treatments, such as changing the type of irrigant or the irrigation method. Our results suggest that using a standardised approach to document each hypochlorite accident will allow researchers to collect more accurate and detailed data that can subsequently be used to identify potential risk factors and better manage the symptomatology of hypochlorite accidents.