title: Antiplaque effect of essential oils and 0.2% chlorhexidine on an in situ model of oral biofilm growth: a randomised clinical trial.
abstract: OBJECTIVE
  To evaluate the in situ antiplaque effect after 4 days of using of 2 commercial antimicrobial agents in short term on undisturbed plaque-like biofilm.
  An observer-masked, crossover randomised clinical trial on 15 oral and systemically healthy volunteers between 20-30 years who were randomly and sequentially allocated in the same group which performed 3 interventions in different randomised sequences.
  
  
  METHODS
  The participants wore an appliance in 3 different rinsing periods doing mouthwashes twice a day (1/0/1) with essential oils, 0.2% chlorhexidine or sterile water (negative control). At the end of each 4-day mouthwash period, samples were removed from the appliance. Posteriorly, after bacterial vital staining, samples were analysed using a Confocal Laser Scanning Microscope.
  
  
  METHODS
  Bacterial vitality, thickness and covering grade by the biofilm after 4 days of applying each of the mouthwashes.
  
  
  RESULTS
  The essential oils and the 0.2% chlorhexidine were significantly more effective than the sterile water at reducing bacterial vitality, thickness and covering grade by the biofilm. No significant differences were found between the 0.2% chlorhexidine and the essential oils at reducing the bacterial vitality (13.2% vs. 14.7%). However, the 0.2% chlorhexidine showed more reduction than the essential oils in thickness (6.5 μm vs. 10.0 μm; p<0.05) and covering grade by the biofilm (20.0% vs. 54.3%; p<0.001).
  
  
  CONCLUSIONS
  The essential oils and 0.2% chlorhexidine showed a high antiplaque effect. Although the 0.2% chlorhexidine showed better results with regard to reducing the thickness and covering grade by the biofilm, both antiseptics showed a high and similar antibacterial activity.
  
  
  CONCLUSIONS
  Daily essential oils or 0.2% chlorhexidine mouthwashes are effective when reducing dental plaque formation in the short term. Although 0.2% chlorhexidine continues to be the "gold standard" in terms of antiplaque effect, essential oils could be considered a reliable alternative.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02124655.
authors.affiliation: Oral Sciences Research Group, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Quintas
authors.affiliation: Oral Sciences Research Group, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Prada-López
authors.affiliation: Periodontology Unit, UCL Eastman Dental Institute, London, United Kingdom.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Donos
authors.affiliation: Oral Sciences Research Group, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Suárez-Quintanilla
authors.affiliation: Oral Sciences Research Group, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Tomás
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development*; D002710:Chlorhexidine / Q000494:pharmacology*; D018592:Cross-Over Studies; D003773:Dental Plaque / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D050296:Microbial Viability / Q000187:drug effects; D009067:Mouthwashes / Q000494:pharmacology*; D009822:Oils, Volatile / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D009822:Oils, Volatile; D002710:Chlorhexidine