Changes in the quality of life in patients undergoing orthognathic therapy - A systematic review.

The aim of this study was to investigate the impact of orthognathic therapy on patients' quality of life. Therefore, a systematic review was conducted including all prospective studies that compared pretherapeutic and posttherapeutic Oral Health Impact Profile (OHIP) or Overall Quality of Life (OQOL) questionnaire scores. Studies in patients with congenital deformities, clefts, or posttraumatic or cancer-associated deformities were excluded. Overall, 23 prospective studies were included; 8 used OHIP, 9 used OQOL and 6 used both questionnaires. A total of 1039 patients were identified (60.29% women, 39.71% men), with a mean age of 45.17 years. All analyzed studies showed in both OHIP and OQLQ an improvement of the quality of life in patients after orthognathic therapy. While improved scores could be observed in all investigated criteria, the studies demonstrated that social and aesthetic aspects showed the most prominent impact. Comparison of different Angle Classes showed, furthermore, that Class III patients had an even greater advantage over those with a Class II deformity. The review confirms that the quality of life in patients with orthognathic therapy improves significantly in all observed aspects. With regard to Angle Classes, Class III patients showed an even greater improvement than Class II patients.

Steam-sterilized and degradable fused filament fabrication-printed polylactide/polyhydroxyalkanoate surgical guides for dental implants: Are they accurate enough for static navigation?

Three-dimensional (3D) printing is a rapidly evolving field and has gained increasing importance in the medical sector. However, the increasing usage of printing materials is accompanied by more wastages. With a rising awareness of the environmental impact of the medical sector, the development of highly accurate and biodegradable materials is of great interest. This study aims to compare the accuracy of polylactide/polyhydroxyalkanoate (PLA/PHA) surgical guides printed by fused filament fabrication and material jetted guides of MED610 in fully guided dental implant placement before and after steam sterilization. Five guides were tested in this study and each was either printed with PLA/PHA or MED610 and either steam-sterilized or not. After implant insertion in a 3D-printed upper jaw model, the divergence between planned and achieved implant position was calculated by digital superimposition. Angular deviation and 3D deviation at the base and the apex were determined. Non-sterilized PLA/PHA guides showed an angle deviation of 0.38 ± 0.53° compared to 2.88 ± 0.75° in sterile guides (P > 0.001), an offset of 0.49 ± 0.21 mm and 0.94 ± 0.23 mm (P < 0.05), and an offset at the apex of 0.50 ± 0.23 mm before and 1.04 ± 0.19 mm after steam sterilization (P < 0.025). No statistically significant difference could be shown for angle deviation or 3D offset at both locations for guides printed with MED610. PLA/PHA printing material showed significant deviations in angle and 3D accuracy after sterilization. However, the reached accuracy level is comparable to levels reached with materials already used in clinical routine and therefore, PLA/PHA surgical guide is a convenient and green alternative.

The impact of the COVID-19 pandemic on the dental-maxillofacial emergency service of a German university hospital in the year 2020.

OBJECTIVES: COVID-19 is considered one of the most serious pandemic in history and has posed major challenges to the world's health care. Dentistry and oral and maxillofacial surgery (CMFS) are particularly affected due to direct exposure to the respiratory tract, as the reservoir of SARS-CoV-2. In this study, the impact of the COVID-19-pandemic on a dental and CMFS emergency services in Germany in 2020 was first time investigated and correlated with governmental restriction measures in public life. MATERIALS AND METHODS: Epidemiological data of a German University Hospital were analysed from a total of 8386 patients in 2019 and 2020. Parameters included information on demographics, time, weekday and reason for presentation, as well as diagnosis and therapy performed. Data from 2020 were compared with those from 2019, taking into account the nationwide periods of public life restrictions. RESULTS: In 2020, 22% fewer patients presented via dental and CMFS emergency service. In a monthly comparison, there were negative peaks of up to - 41% in November, but also a plus of 26% in July. The largest decreases were recorded during the lockdown periods in spring (- 33%) and winter (- 39%). Further, a threefold increase in actual emergencies and inpatient admissions revealed during these time periods (p < 0.001). CONCLUSIONS: COVID-19 pandemic had a significant impact on the dental and CMFS emergency service in 2020 resulting in more severe cases. CLINICAL RELEVANCE: This study underlines the importance of maintaining an emergency service system and basic outpatient care in these specialities, which requires uniform recommendations from the medical-dental societies and politics.

Dynamic contrast-enhanced magnetic resonance imaging for monitoring neovascularization during bone regeneration-a randomized in vivo study in rabbits.

OBJECTIVES: Micro-computed tomography (µ-CT) and histology, the current gold standard methods for assessing the formation of new bone and blood vessels, are invasive and/or destructive. With that in mind, a more conservative tool, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), was tested for its accuracy and reproducibility in monitoring neovascularization during bone regeneration. Additionally, the suitability of blood perfusion as a surrogate of the efficacy of osteoplastic materials was evaluated. MATERIALS AND METHODS: Sixteen rabbits were used and equally divided into four groups, according to the time of euthanasia (2, 3, 4, and 6 weeks after surgery). The animals were submitted to two 8-mm craniotomies that were filled with blood or autogenous bone. Neovascularization was assessed in vivo through DCE-MRI, and bone regeneration, ex vivo, through µ-CT and histology. RESULTS: The defects could be consistently identified, and their blood perfusion measured through DCE-MRI, there being statistically significant differences within the blood clot group between 3 and 6 weeks (p = 0.029), and between the former and autogenous bone at six weeks (p = 0.017). Nonetheless, no significant correlations between DCE-MRI findings on neovascularization and µ-CT (r =-0.101, 95% CI [-0.445; 0.268]) or histology (r = 0.305, 95% CI [-0.133; 0.644]) findings on bone regeneration were observed. CONCLUSIONS: These results support the hypothesis that DCE-MRI can be used to monitor neovascularization but contradict the premise that it could predict bone regeneration as well.

Differences in the expression of caveolin-1 isoforms in cancer-associated and normal fibroblasts of patients with oral squamous cell carcinoma.

OBJECTIVES: For many years, tumor development has been viewed as a cell-autonomous process; however, today we know that the tumor microenvironment (TME) and especially cancer-associated fibroblasts (CAFs) significantly contribute to tumor progression. Caveolin-1 (Cav-1) is a scaffolding protein which is involved in several cancer-associated processes as important component of the caveolae. Our goal was to shed light on the expression of the two different isoforms of Cav-1 in normal fibroblasts (NFs) and CAFs of patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Fibroblasts from normal mucosa and CAFs were isolated and propagated in vitro. Gene expression of the different Cav-1 isoforms was assessed via quantitative real-time PCR (qPCR) and supplemented by protein expression analysis. RESULTS: We could show that the Cav-1ß isoform is more highly expressed in NFs and CAFs compared to Cav-1α. Furthermore, the different Cav-1 isoforms tended to be differently expressed in different tumor stages. However, this trend could not be seen consistently, which is in line with the ambiguous role of Cav-1 in tumor progression described in literature. Western blotting furthermore revealed that NFs and CAFs might differ in the oligomerization profile of the Cav-1 protein. CONCLUSION: These differences in expression of Cav-1 between NFs and CAFs of patients with OSCC confirm that the protein might play a role in tumor progression and is of interest for further analyses. CLINICAL RELEVANCE: Our findings support a possible role of the two isoforms of Cav-1 in the malignant transformation of OSCC.

Hyperspectral analysis for perioperative perfusion monitoring-a clinical feasibility study on free and pedicled flaps.

OBJECTIVES: In reconstructive surgery, flap monitoring is crucial for early identification of perfusion problems. Using hyperspectral imaging (HSI), this clinical study aimed to develop a non-invasive, objective approach for perfusion monitoring of free and pedicled flaps. MATERIAL AND METHODS: HSI of 22 free (FF) and 8 pedicled flaps (PF) in 30 patients was recorded over time. Parameters assessed were tissue oxygenation/superficial perfusion (0-1 mm) (StO2 (0-100%)), near-infrared perfusion/deep perfusion (0-4 mm) (NIR (0-100)), distribution of haemoglobin (THI (0-100)), and water (TWI (0-100)). Measurements up to 72 h were correlated to clinical assessment. RESULTS: Directly after flap inset, mean StO2 was significantly higher in FF (70.3 ± 13.6%) compared with PF 56.2 ± 14.2% (p = 0.05), whereas NIR, THI, and TWI were similar (NIR_p = 0.82, THI_p = 0.97, TWI_p = 0.27). After 24 h, StO2, NIR, THI, and TWI did not differ between FF and PF. After 48 h, StO2, NIR, and TWI did not differ between FF and PF whereas THI was significantly increased in FF compared with PF(p = 0.001). In three FF, perfusion decreased clinically and in HSI, 36(1), 40(2), 5(3), and 61(3) h after flap inset which was followed by prompt intervention. CONCLUSIONS: StO2 < 40%, NIR < 25/100, and THI < 40/100 indicated arterial occlusion, whereas venous problems revealed an increase of THI. In comparison with FF, perfusion parameters of PF were decreased after flap transfer but remained similar to FF later on. CLINICAL RELEVANCE: HSI provides objective and non-invasive perfusion monitoring after flap transplantation in accordance to the clinical situation. With HSI, signs of deterioration can be detected hours before clinical diagnosis.

Ankylosis of the temporomandibular joint-impression free CAD/CAM based joint replacement using patient-specific implants.

In recent years, alloplastic temporomandibular joint (TMJ) replacement has become a permissible procedure for the reconstruction of severely destroyed TMJs. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) has extended the range of applications to complex anatomical situations. The aim of the treatment is to improve the usually restricted mouth opening and thus oral hygiene and nutrition, which leads to a regular improvement in the general quality of life. The following case report describes the bilateral replacement of ankylotically destroyed TMJs using patient-specific endoprostheses with simultaneous displacement of the maxilla. Innovative in the case described is the impression-free CAD/CAM planning, whereby the upper and lower prostheses were produced on the basis of 3D printed patient models.

Comparative analysis of the impact of e-cigarette vapor and cigarette smoke on human gingival fibroblasts.

Human gingival fibroblasts (HGF) play a vital role in wound healing, oral cancer, and are among the first cells being exposed to e-cigarette vapor (eCV) or cigarette smoke (CS) during inhalation. Although the cell-damaging effect of CS has been well studied, the effects of eCV on gingival cells are still unclear. The aim of this in vitro study was to compare the effects of eCV and CS on HGF in terms of proliferation, metabolic activity, cell death, and formation of reactive oxygen species (ROS). After 24 h cell numbers in CS-exposed cells in contrast to eCV-exposed cells were significantly decreased compared to the control. At later points in time, such differences could no longer be observed. Compared to the control, HGF stimulated with eCV showed a significantly higher metabolic activity 1 h, 24 h, and 48 h after exposure. 24 h after exposure, the metabolic activity was increased in both test groups. No caspase 3/7 activation nor significant differences in the amount of apoptosis/necrosis among the groups were seen. Only in CS-exposed cells ROS formation was increased at 1 h, 3 h, and 6 h after exposition. In conclusion, when compared to conventional CS, a less harmful effect of eCV on HGF can be assumed.

[Digitalization and use of artificial intelligence in microvascular reconstructive facial surgery]. / Digitalisierung und Ansätze künstlicher Intelligenz in der mikrovaskulär-rekonstruktiven Gesichtschirurgie.

BACKGROUND: When using digitalization and artificial intelligence (AI), large amounts of data (big data) are produced, which can be processed by computers and used in the field of microvascular-reconstructive craniomaxillofacial surgery (CMFS). OBJECTIVE: The aim of this article is to summarize current applications of digitalized medicine and AI in microvascular reconstructive CMFS. MATERIAL AND METHODS: Review of frequent applications of digital medicine for microvascular CMFS reconstruction, focusing on digital planning, navigation, robotics and potential applications with AI. RESULTS: The broadest utilization of medical digitalization is in the virtual planning of microvascular transplants, individualized implants and template-guided reconstruction. Navigation is commonly used for ablative tumor surgery but less frequently in reconstructions. Robotics are mainly employed in the transoral approach for tumor surgery of the hypopharynx, whereas the use of AI is still limited even if possible applications would be automated virtual planning and monitoring systems. CONCLUSION: The use of digitalized methods and AI are adjuncts to microvascular reconstruction. Automatization approaches and simplification of technologies will provide such applications to a broader clientele in the future; however, in CMFS, robotic-assisted resections and automated flap monitoring are not yet the standard of care.

In vitro surface characteristics and impurity analysis of five different commercially available dental zirconia implants.

BACKGROUND: The aim of this study was to assess surface characteristics, element composition, and surface roughness of five different commercially available dental zirconia implants. Five zirconia implants (Bredent whiteSKY™ (I1), Straumann® PURE Ceramic (I2), ceramic.implant vitaclinical (I3), Zeramex® (I4), Ceralog Monobloc M10 (I5)) were evaluated. METHODS: The evaluation was performed by means of scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and confocal laser scanning microscopy (CLSM). RESULTS: The semi-quantitative element composition showed no significant impurity of any implant tested. Both the machined and the rough areas of the investigated implants were predominated by zirconium, oxygen, and carbon. Roughness values (Sa) showed highest values for I2 and I5. CONCLUSIONS: The investigated zirconia implants showed surface characteristics and roughness values close to those of conventionally produced titanium implants, making them a promising alternative. However, zirconia implants have yet to prove themselves in clinical practice and clinical controlled trials.

Osseous response on linear and cyclic RGD-peptides immobilized on titanium surfaces in vitro and in vivo.

Biomimetic surface modifications of titanium (Ti) implants using the Arg-Gly-Asp-sequence (RGD) are promising to accelerate bone healing in cases of medical implants. Therefore, we compared the impact of linear and cyclic RGD (l- and c-RGD) covalently coupled onto Ti surfaces on the osseous response in vitro and in vivo. In vitro, osteoblasts' behavior on different surfaces (unmodified, amino-silanized [APTES], l- and c-RGD) was analysed regarding adhesion (fluorescence microscopy), proliferation (resazurin stain) and differentiation (reverse transcription polymerase chain reaction on alkaline phosphatase and osteocalcin). In vivo, osteosynthesis screws (unmodified n = 8, l-RGD n = 8, c-RGD n = 8) were inserted into the proximal tibiae of 12 rabbits and evaluated for bone growth parameters (bone implant contact [%] and vertical bone apposition [VBA;%]) at 3 and 6 weeks. In vitro, c- as well as l-RGD surfaces stimulated osteoblasts' adherence, proliferation and differentiation in a similar manner, with only subtle evidence of superiority of the c-RGD modifications. In vivo, c-RGD-modifications led to a significantly increased VBA after 3 and 6 weeks. Thus, coating with c-RGD appears to play an important role influencing osteoblasts' behaviour in vitro but especially in vivo. These findings can be applied prospectively to implantable biomaterials with hypothetically improved survival and success rates. © 2017 Wiley Periodicals Inc. J Biomed Mater Res Part A: 106A: 419-427, 2018.

Cervical Metastases Behavior of T1-2 Squamous Cell Carcinoma of the Tongue.

INTRODUCTION: The cervical lymph node metastasis (CM) is one of the most important prognostic factors for oral squamous cell carcinoma. Although the frequency and distribution of CM for tongue carcinoma (TC) are well documented in the literature, there is only little data on metastasis patterns depending on the location of the cancer within the tongue. MATERIALS AND METHODS: In a retrospective study all patients with a T1-T2 TC who were treated between 1997 and 2013 were analysed regarding epidemiological data, risk factors, and tumour parameters such as exact localization, CM. RESULTS: 204 patients (59 ± 15 years; ♀37 %, ♂63 %) were included. At the initial diagnosis 23 % had an advanced tumour stage (III-IV) due to CM. The occurrence of CM was significantly higher for T2, advanced G-status and the localization in the posterior area of the tongue. The presence of CM-but not the recurrence-had a significant influence on the survival rate. CONCLUSION: The small TC has an aggressive metastatic behaviour depending not only on the classical prognostic factors such as grading and tumour size, but is also strongly influenced by the posterior location within the tongue.

Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.

BACKGROUND: The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of the patients for the first time. METHODS: In 17 patients, 21 different regions were augmented with an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany). For the augmentation, a mixture of autologous bone and deproteinized bovine bone mineral (DBBM) or autologous bone alone was used. Reentry with explantation of the TM and simultaneous implantation of 44 implants were performed after 6 months. Preoperative and 6-month postoperative cone beam computed tomographies (CBCT) were performed to measure the gained bone height. RESULTS: The success rate for the bone grafting procedure was 100%. Thirty-three percent of cases presented an exposure of the TM during the healing period. However, premature removal of these exposed meshes was not necessary. Exposure rate in augmentations performed with mid-crestal incisions was higher than in augmentations performed with a modified poncho incision (45.5 vs. 20%, p = 0.221). In addition, exposure rates in the maxilla were significantly higher than in the mandible (66.7 vs. 8.3%, p = 0.009). Gender, smoking, periodontal disease, gingiva type, used augmentation material, and used membrane had no significant influence on the exposure rate (p > 0.05). The mean vertical augmentation was 6.5 ± 1.7 mm, and the mean horizontal augmentation was 5.5 ± 1.9 mm. Implant survival rate after a mean follow-up of 12 ± 6 months after reentry was 100%. CONCLUSION: Within the limits of the retrospective character of this study, this study shows for the first time that individualized CAD-CAM TM provide a sufficient and safe augmentation technique, especially for vertical and combined defects. However, the soft tissue handling for sufficient mesh covering remains one of the most critical steps using this technique.

Cellular fluid shear stress on implant surfaces-establishment of a novel experimental set up.

BACKGROUND: Mechanostimuli of different cells can affect a wide array of cellular and inter-cellular biological processes responsible for dental implant healing. The purpose of this in vitro study was to establish a new test model to create a reproducible flow-induced fluid shear stress (FSS) of osteoblast cells on implant surfaces. METHODS: As FSS effects on osteoblasts are detectable at 10 dyn/cm2, a custom-made flow chamber was created. Computer-aided verification of circulation processes was performed. In order to verify FSS effects, cells were analysed via light and fluorescence microscopy. RESULTS: Utilising computer-aided simulations, the underside of the upper plate was considered to have optimal conditions for cell culturing. At this site, a flow-induced orientation of osteoblast cell clusters and an altered cell morphology with cellular elongation and alteration of actin fibres in the fluid flow direction was detected. CONCLUSIONS: FSS simulation using this novel flow chamber might mimic the peri-implant situation in the phase of loaded implant healing. With this FSS flow chamber, osteoblast cells' sensitivity to FSS was verified in the form of morphological changes and cell re-clustering towards the direction of the flow. Different shear forces can be created simultaneously in a single experiment.

Impact of maxillary sinus augmentation on oral health-related quality of life.

BACKGROUND: The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient. METHODS: Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University, Mainz, Germany, between July 2002 and December 2007 were included in this retrospective study. Total implant survival was assessed. Completion of a modified 26-item version of the Oral Health Impact Profile (OHIP-G) for assessing the oral health-related quality of life before and after the treatment was asked for. Subcategories were (1) functional limitations, (2) physical and psychological disabilities, and (3) complaints due to the surgical procedure. In 53 patients available for clinical follow-up examination, assessment of soft tissue parameters was performed. RESULTS: After an average time in situ of 41.2 ± 27 months (3.4 years), the in situ rate was 95.4%. One-year survival rate and five-year survival rate according to Kaplan Meier were 95.4 and 94.4%. Concerning functional limitations, significant better values for OHRQoL after sinus augmentation procedure than before the treatment (p < 0.001) were seen. In the subcategory physical and psychological disabilities, all questions had significant better values after the sinus lift (p < 0.001). Concerning complaints due to the surgical procedure, mean total scores were 5.1 ± 5.4 pre-operative, 6.9 ± 6.1 (0-31) post-operative, and 2.4 ± 3.7 recently. This meant a significant difference between "pre-operative" vs. "post-operative" (p = 0.003), "pre-operative" vs. "recently" (p < 0.001), and "post-operative" vs. "recently" (p < 0.001). Concerning the influence of implant indication, edentulous patients showed the most distinct improvement after the procedure. Clinical assessment showed stable soft tissue parameters. CONCLUSIONS: Evaluation of OHRQoL after sinus augmentation showed a significant improvement indicating a remarkable benefit for the patients through this procedure.

Catalogue of Interactive Learning Objectives to improve an Integrated Medical and Dental Curriculum.

INTRODUCTION: Online learning media are increasingly being incorporated into medical and dental education. However, the coordination between obligatory and facultative teaching domains still remains unsatisfying. The Catalogue of Interactive Learning Objectives of the University Clinic of Mainz (ILKUM), aims to offer knowledge transfer for students while being mindful of their individual qualifications. Its hierarchical structure is designed according to the Association for Dental Education in Europe (ADEE) levels of competence. MATERIALS AND METHODS: The ILKUM was designed to establish a stronger interconnection between already existing and prospective learning strategies. All contents are linked to the current lectures as well as to e-learning modules, e.g., clinical case studies and OR videos. Students can conduct self-examinations regarding specific learning objectives. Since 2007, ILKUM has been developed and analyzed regarding its acceptance among dental students. RESULTS: These improved e-learning techniques foster time and location-independent access to study materials and allow an estimation of the knowledge achieved by students. Surveys of our students clearly show a large demand for upgrading ILKUM content (89%; n = 172) with integrated self-testing (89%; n = 174). In parallel to the advancement of our e-learning offering, a portion of internet-based learning is constantly rising among students. CONCLUSION: The broad acceptance and demand for the development of ILKUM show its potential. Moreover, ILKUM grants fast, topic-oriented querying of learning content without time and locale limitations as well as direct determination of the individually needed knowledge conditions. CLINICAL SIGNIFICANCE: The long-term goal of the ILKUM project is to be a sustainable, important additional modality of teaching and training for dental and medical students.

Tissue engineered pre-vascularized buccal mucosa equivalents utilizing a primary triculture of epithelial cells, endothelial cells and fibroblasts.

Artificial generated buccal mucosa equivalents are a promising approach for the reconstruction of urethral defects. Limiting in this approach is a poor blood vessel supply after transplantation, resulting in increased morbidity and necrosis. We generated a pre-vascularized buccal mucosa equivalent in a tri-culture of primary buccal epithelial cells, fibroblasts and microvascular endothelial cells, using a native collagen membrane as a scaffold. A successful pre-vascularization and dense formation of capillary-like structures at superficial areas was demonstrated. The lumen size of pre-formed blood vessels corresponded to the capillary size in vivo (10-30 µm). Comparing native with a highly cross-linked collagen membrane we found a distinct higher formation of capillary-like structures on the native membrane, apparently caused by higher secretion of angiogenic factors such as PDGF, IL-8 and angiopoietin by the cells. These capillary-like structures became functional blood vessels through anastomosis with the host vasculature after implantation in nude mice. This in vitro method should result in an accelerated blood supply to the biomaterial with cells after transplantation and increase the succes rates of the implant material.

Antimicrobial effect of Australian antibacterial essential oils as alternative to common antiseptic solutions against clinically relevant oral pathogens.

BACKGROUND: The aim of the study was to examine the in vitro antibacterial activity of different oils in comparison to antiseptics against oral microorganisms. METHODS: The antimicrobial effect of tea tree oil (TTO), eucalyptus oil (EO), lemon grass oil (LGO), and a eucalyptus-based oil mixture (MXT) were tested in comparison to chlorhexidine digluconate (CHX), povidone-iodine (BTA), and octenidine dihydrochloride (OCT). Oral bacterial strains and candida species using the agar diffusion test were used for the antimicrobial study. RESULTS: All tested oils showed antimicrobial potency against the tested biological indicators. In comparison of all tested substances the largest effective zones were measured for LGO, followed from MXT and CHX. TTO and EO were less effective against the tested microorganisms followed from BTA. CONCLUSIONS: The results of this study show that some essential oils have better antimicrobial properties than standard oral antiseptics. In a follow-up step, the ideal concentrations, the composition of essential oils, and the mode of application will be evaluated. The antibacterial efficacy of essential oils might be promising for use in clinical and oral hygiene applications. The cost reduction and availability particularly in rural areas with easy access to the originating plants might be advantageous factors to be considered.