Indications for tooth extraction in periodontal treatment with particular emphasis on the role of patient’s oral hygiene

Research objective: To present current indications for the extraction of teeth affected by periodontal disease, highlighting the significance of the patient’s oral hygiene as a key prognostic factor in treatment outcomes. Methodology: A narrative review of recent literature and clinical guidelines focusing on indications for tooth extraction in periodontal therapy, considering both local and systemic factors, as well as patient behavior related to oral hygiene. Main conclusions: The decision to extract teeth in the context of periodontal disease depends on a combination of tissue condition, systemic health, and especially the patient’s commitment to oral hygiene. Poor hygiene is associated with lower treatment success and worsened prognosis, regardless of surgical or non-surgical approaches. Application of the study: The findings can support clinical decision-making by providing a clearer understanding of when extraction is justified and how patient compliance impacts treatment planning in periodontology. Originality/Novelty of the study: The study emphasizes the often underappreciated yet crucial role of oral hygiene in determining the long-term prognosis of periodontally compromised teeth, offering a comprehensive view that integrates both clinical and behavioral determinant.