In contemporary periodontal practice, the balance between extracting teeth affected by periodontitis and preserving the natural dentition has become increasingly relevant. While often presented as a progressive or “modern” solution, the widespread replacement of periodontally compromised teeth with implants stands in contrast to what is considered most advanced in contemporary medicine: minimally invasive, biologically driven approaches focused on disease control, and tissue preservation. Patients are increasingly offered full-mouth extractions followed by implant-based rehabilitation, yet the infectious–inflammatory dysbiosis that affects natural teeth may also compromise peri-implant tissues, contributing to peri-implant disease and implant failure. Importantly, when periodontal disease is properly treated and oral ecological homeostasis is reestablished, natural teeth can remain functional and healthy for extended periods of time.

Within this biological framework, mechanical periodontal therapy remains the foundation of treatment, but adjunctive strategies have long been proposed to enhance clinical outcomes in selected patients. Among these, systemic antibiotics have played a central yet controversial role. While antibiotics can meaningfully improve treatment response in specific clinical scenarios, their indication, timing, and long-term value continue to be debated. Inappropriate or indiscriminate use raises legitimate concerns related to antimicrobial resistance, adverse effects, and limited sustainability.

This webinar will provide a critical, evidence-based discussion on when and how systemic antibiotics should be incorporated into periodontal therapy to support the preservation of natural teeth. The session will explore patient- and disease-specific factors that influence treatment response, including disease severity and host-related modifiers. Practical aspects of antibiotic protocols, such as drug selection, dosage, duration, and timing relative to mechanical therapy, will be addressed in a clinically applicable manner. Finally, the webinar will briefly introduce how emerging artificial intelligence–driven models, integrating clinical, microbiological, and host-response data, may support more tailored, patient-specific decision-making in periodontal therapy.

The ultimate goal is to empower clinicians to make informed, responsible treatment decisions that optimize periodontal outcomes, minimize unnecessary extractions, and preserve natural teeth whenever possible.