Dentistry Commons^™

Use Of Micro-Ct To Examine Effects Of Heat On Coronal Obturation, Ivy Shen, Joan Daniel, Kali Vo, Chul Ahn, Carolyn Primus, Takashi Komabayashi

Dental Medicine Faculty Publications

Purpose: The aim of this study was to categorize the effects of heat on coronal obturation with gutta-percha and sealer using X-ray micro-computed tomography (micro-CT).
Methods: Ten single-rooted, extracted human teeth were shaped using ProTaper NEXT files to size X5 (#50/Taper 6%) with 2.5% NaOCl irrigation. A single ProTaper NEXT X5 gutta-percha point was then inserted with epoxy resin (AH Plus) or tricalcium silicate (EndoSequence BC) sealer (n = 5/group), and cut at the cemento-enamel junction. The teeth were scanned using micro-CT (SkyScan1272) to obtain 11 sagittal 2-D images. Three calibrated raters categorized the coronal 0.5 mm of the …

Coronal And Apical Leakage Among Five Endodontic Sealers, Kali Vo, Joan Daniel, Chul Anh, Carolyn Primus, Takashi Komabayashi

Dental Medicine Faculty Publications

Purpose: The aim of this study was to use dye penetration to measure apical and coronal leakage simultaneously in single-canal teeth that had been treated endodontically using a single-cone obturation technique.

Methods: One hundred single-canal, extracted human teeth were cleaned and shaped with ProTaper NEXT rotary files to size-X5 (50/.06), then randomly assigned to five sealer groups for single-cone gutta-percha obturation. The teeth were soaked in 0.6% rhodamine B at 37°C for seven days, then the roots were ground mesiodistally and the maximum apical and coronal dye penetration was measured. Differences in leakage among the sealer groups were examined using …

Effects Of Heat On Seven Endodontic Sealers, Daniel Chavarria-Bolanos, Takashi Komabayashi, Ivy Shen, Jose Vega-Baudrit, Maria G. Gandolfi, Carlo Prati, Mauricio Montero-Aguilar

Dental Medicine Faculty Publications

Purpose: To examine the microscopic surface features, chemical composition, and thermodynamic profile of seven endodontic sealers (AH Plus, Adseal, MTA-Fillapex, RoekoSeal, GuttaFlow 2, GuttaFlow BioSeal, and EndoRez) exposed to high-temperature changes using an endodontic obturation device.

Methods: The thermal properties were examined using scanning calorimetry (DSC) and thermogravimetric analysis (TGA). Then, six disc-shaped specimens of each sealer were prepared and divided into two groups – a room temperature group and a heat exposure group – for analysis of surface and chemical changes using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS).

Results: DSC analysis showed that AH Plus had …

Dental Pulp Stem Cell Heterogeneity: Finding Superior Quality “Needles” In A Dental Pulpal “Haystack” For Regenerative Medicine-Based Applications, Zi Y. Kok, Nadia Y.A. Alaidaroos, Amr Alraies, John S. Colombo, Lindsay C. Davies, Rachel J. Waddington, Alastair J. Sloan, Ryan Moseley

Dental Medicine Faculty Publications

Human dental pulp stem/stromal cells (hDPSCs) derived from the permanent secondary dentition are recognised to possess certain advantageous traits, which support their potential use as a viable source of mesenchymal stem/stromal cells (MSCs) for regenerative medicine-based applications. However, the well-established heterogeneous nature of hDPSC subpopulations, coupled with their limited numbers within dental pulp tissues, has impeded our understanding of hDPSC biology and the translation of sufficient quantities of these cells from laboratory research, through successful therapy development and clinical applications. This article reviews our current understanding of hDPSC biology and the evidence underpinning the molecular basis of their heterogeneity, which …

Education Regarding And Adherence To Recommended Nutrition Guidelines Among Dental Students, Camille Frayna, Christoffer Devantier, Braden Harris, Karl Kingsley, Joshua M. Polanski

Dental Medicine Faculty Publications

The Dietary Guidelines for Americans (DGA) were developed to reduce or prevent many types of chronic illness, including cancer, heart disease and diabetes. Healthcare provider recommendations may be influenced by understanding of and adherence to the DGA, which may be incorporated into provider training, medical and dental clinical curricula—although few studies have evaluated adherence to the DGA among dental students. This approved retrospective study of voluntary student responses from a first-year dental school nutrition course included a short dietary and exercise survey administered as part of the DGA learning module. A total of N = 299 students completed the voluntary …

Molecular Screening And Analysis Reveal Novel Oral Site-Specific Locations For The Cariogenic Pathogen Scardovia Wiggsiae, Steven Mcdaniel, Jaydene Mcdaniel, Katherine M. Howard, Karl Kingsley

Dental Medicine Faculty Publications

Introduction: Scardovia wiggsiae (SW) is a newly identified cariogenic pathogen associated with severe early childhood caries and oral disease. New studies have confirmed the presence of this organism among clinical samples from both pediatric and adult patients. However, the recent discovery of this organism has left researchers with only limited information available regarding the prevalence of this organism—and virtually no information regarding oral site-specific locations. Based upon this lack of information, the overall objective of this study was to perform an oral site-specific analysis of SW prevalence from clinical samples. Methods: Using an approved human subjects protocol, samples (n = …

Assessment Of Microrna (Mir)-365 Effects On Oral Squamous Carcinoma Cell Line Phenotypes, Jeffery Coon, Karl Kingsley

Dental Medicine Faculty Publications

miR-365 is a microRNA that regulates transcription and has been demonstrated to promote oncogenesis and metastasis in some cancers while suppressing these effects in others. Virtually no information is known about the presence or function of miR-365 in oral cancers. Based upon this information, the primary goal of this project was to evaluate the expression of miR-365 in existing oral cancer cell lines. Five commercially available oral cancer cell lines (SCC4, SCC9, SCC15, SCC25, and CAL27) were obtained and cultured. RNA was then screened by PCR using primers specific for miR-365, as well as matrix metalloproteinase (MMP-2) and a downstream …

Microbial Screening Reveals Oral Site-Specific Locations Of The Periodontal Pathogen Selenomonas Noxia, Jaydene Mcdaniel, Steven Mcdaniel, Beanca Jhanine Samiano, Matthew Marrujo, Karl Kingsley, Katherine M. Howard

Dental Medicine Faculty Publications

Introduction: Selenomonas noxia (SN) is an important periodontal pathogen, associated with gingivitis and periodontitis. Many studies have found associations between SN and indicators of poor health outcomes, such as smoking, low socioeconomic status and obesity. However, less is known about the prevalence of this organism and more specifically about other oral site-specific locations that may harbor this organism. Methods: Using an existing patient repository (n = 47) of DNA isolated from saliva and other oral sites (n = 235), including the dorsum of the tongue, lower lingual incisor, upper buccal molar and gingival crevicular fluid (GCF), molecular screening for SN …

Longitudinal Curricular Assessment Of Knowledge And Awareness Of Intimate Partner Violence Among First-Year Dental Students, Charles Buchanan, Karl Kingsley, Rhonda J. Everett

Dental Medicine Faculty Publications

Background: Intimate partner violence (IPV) has previously been recognized as a major public health issue. Oral healthcare providers, such as dentists, are crucial to the screening and identifying of individuals experiencing IPV, since most injuries occur in the head and neck region. A lack of knowledge and awareness regarding teaching and learning about IPV in dental school curricula has been identified. Based upon the overall lack of knowledge, the objective of this study was to conduct a longitudinal assessment of knowledge, awareness, and beliefs regarding IPV among dental students in their first year of education. Methods: All students (n = …

Transcriptomic Phases Of Periodontitis Lesions Using The Nonhuman Primate Model, Jeffrey L. Ebersole, Radhakrishnan Nagarajan, Sreenatha Kirakodu, Octavio A. Gonzalez

Dental Medicine Faculty Publications

We used a nonhuman primate model of ligature-induced periodontitis to identify patterns of gingival transcriptomic after changes demarcating phases of periodontitis lesions (initiation, progression, resolution). A total of 18 adult Macaca mulatta (12–22 years) had ligatures placed (premolar, 1st molar teeth) in all 4 quadrants. Gingival tissue samples were obtained (baseline, 2 weeks, 1 and 3 months during periodontitis and at 5 months resolution). Gene expression was analyzed by microarray [Rhesus Gene 1.0 ST Array (Affymetrix)]. Compared to baseline, a large array of genes were significantly altered at initiation (n = 6049), early progression (n = 4893), and late progression …

Micro-Computed Tomographic Evaluation Of Single-Cone Obturation With Three Sealers, Sahar Zare, Ivy Shen, Qiang Zhu, Chul Ahn, Carolyn Primus, Takashi Komabayashi

Dental Medicine Faculty Publications

Objectives
This study used micro-computed tomography (µCT) to compare voids and interfaces in single-cone obturation among AH Plus, EndoSequence BC, and prototype surface pre-reacted glass ionomer (S-PRG) sealers and to determine the percentage of sealer contact at the dentin and gutta-percha (GP) interfaces. Materials and Methods
Fifteen single-rooted human teeth were shaped using ProTaper NEXT size X5 rotary files using 2.5% NaOCl irrigation. Roots were obturated with a single-cone ProTaper NEXT GP point X5 with AH Plus, EndoSequence BC, or prototype S-PRG sealer (n = 5/group). Results
The volumes of GP, sealer, and voids were measured in the region …

A Retrospective Evaluation Of The Prevalence Of Cracked Teeth Among An Adult Population In Nevada, Jacob Ozuna, Benjamin Barborka, Neamat Hassan Abubakr

Dental Medicine Faculty Publications

Objective: To identify the distribution and characteristics of cracked teeth in a Southern Nevada population attending the dental clinics of the School of Dental Medicine, University of Nevada, Las Vegas (SDM, UNLV). Methods: A retrospective keyword search of the clinical notes of SDM, UNLV patient charts in AxiUm™ was performed using the search terms “crack” and “fracture” to discern the number of patients that had clinically identifiable teeth with cracks, and which teeth (if any) had documented symptoms consistent with the cracks. The inclusion criteria for the record search were individuals ≥ 18 years old, seen at the dental clinic …

Characterization Of Dental Pulp Stem Cell Responses To Functional Biomaterials Including Mineralized Trioxide Aggregates, Sejin Bae, Bueonguk Kang, Hyungbin Lee, Harrison Luu, Eric Mullins, Karl Kingsley

Dental Medicine Faculty Publications

Introduction: Many studies in stem cell biology have demonstrated that dental pulp stem cells (DPSC) may be highly proliferative and capable of pluripotent differentiation into many different tissue types. Recent advances in stem cell research have outlined methods for directing in vitro or in vivo growth, viability, and proliferation, as well as differentiation of DPSC-although much remains to be discovered. Based upon this information, the primary objective of this study was to understand the functional biomaterials needed to more effectively direct DPSC viability, growth, and proliferation. Methods: Using an approved protocol, previously collected and isolated samples of DPSC from an …

Micro Ct Pilot Evaluation Of Removability Of Two Endodontic Sealers, David Colmenar, Tenzin Tamula, Qiang Zhu, Chul Ahn, Carolyn Primus, Takashi Komabayashi

Dental Medicine Faculty Publications

Purpose: This study compared the removability of AH Plus and EndoSequence BC sealers using in vitro micro-computed tomography. Methods: Ten single-canal, extracted human teeth were cleaned and shaped with ProTaper NEXT rotary files to size X5 (50/0.06) (DentsplySirona). Canals were obturated with a single cone gutta-percha and either AH Plus (Dentsply-Sirona) (Group A) or EndoSequence BC (Brasseler) (Group B). ProTaper Universal Retreatment files (Dentsply-Sirona) were used to remove obturation materials after 90 days at 37o C/100% humidity. Each tooth was scanned using micro-computed tomography (SkyScan 1272; Bruker) at an isotropic resolution of 6 μm from which the percent of material …

Oral Microbiome And Gingival Tissue Apoptosis And Autophagy Transcriptomics, Jeffrey L. Ebersole, Sreenatha S. Kirakodu, Elliot Neumann, Luis Orraca, Janis Gonzalez Martinez, Octavio A. Gonzalez

Dental Medicine Faculty Publications

Objective: This study focused on documenting characteristics of the gingival transcriptome during various stages of periodontitis targeting genes associated with apoptotic and autophagic pathways and changes that specifically associate with features of the oral microbiome. Methods: Macaca mulatta (n = 18; 12-23 years) were examined at baseline and 0.5, 1, and 3 months of disease progression, as well as 5 months with clinical disease resolution. 16S sequencing and microarray analyses examined changes in the microbiome and gingival transcriptome, respectively, at each time point from every animal. Results: Specific patterns of apoptotic and autophagic genes were identified related to the initiation …

The Impact Of Impression Coping Geometrical Design On Accuracy Of Implant Impressions: An Experimental Study, Motaz Osman Osman, Neamat Hassan Abubakr, Ahmed Suliman, Hassan Ziada

Dental Medicine Faculty Publications

Aim This in vitro study aimed to evaluate the effect of implant impression coping geometrical designs on the accuracy of open and closed impression techniques and in the parallel and nonparallel implant positions. Material and methods Three custom-made acrylic resin models of three tested implant systems (Straumann (R), SIC Invent (R), and Osstem (R)) with diverse coping geometrical designs were evaluated in simulated cases of two parallel and two nonparallel implants. The horizontal and vertical discrepancies were measured and analyzed. Results No statistically significant differences between the two impression techniques in either parallel or nonparallel implants were observed. The high …

Prevalence Of Hyperdontia, Hypodontia, And Concomitant Hypo-Hyperdontia, Nareh Eshgian, Tanya Al-Talib, Stanley Nelson, Neamat Hassan Abubakr

Dental Medicine Faculty Publications

Background/purpose: Anomalies in human dentition are some of the most common occurrences of congenital abnormalities. Present study aimed to determine the prevalence of hypodontia, hyperdontia and concomitant hypo-hyperdontia (CHH) among patients attending the University of Nevada, Las Vegas (UNLV) School of Dental Medicine clinics. Materials and methods: Retrospective search was conducted on patients’ clinical notes in AxiUm. Search included using keywords such as “hypodontia”, “hyperdontia”, “supernumerary teeth” and “congenitally missing”. Panoramic radiographs were used to confirm the hyperdontia, hypodontia or CHH for patients attending the UNLV SDM clinics from 2010 to 2018. Collected data were analyzed using the chi-square test. …

Mir-365 (Microrna): Potnetial Biomarker In Oral Squamous Cell Carcinoma Exosomes And Extracellular Vesicles, Jeffery Coon, Karl Kingsley, Katherine M. Howard

Dental Medicine Faculty Publications

Introduction: miR-365 is a non-coding microRNA that regulates transcription and has been demonstrated to promote oncogenesis and metastasis in some cancers, while suppressing these effects in others. Many microRNAs are produced and then exported extracellularly in exosomes, which are small extracellular vesicles ranging from 30 to 100 nm that are found in eukaryotic fluids and facilitate many cellular functions. Exosomes and extracellular vesicles are produced by many cell types, including oral cancer cells—although no study to date has evaluated miR-365 and oral cancer exosomes or extracellular vesicles. Based on this information, our research question was to evaluate whether oral cancers …

Comparison Of Dna Extracted From Pediatric Saliva, Gingival Crevicular Fluid And Site-Specific Biofilm Samples, Jason Emett, Roxanne David, Jaydene Mcdaniel, Steven Mcdaniel, Karl Kingsley

Dental Medicine Faculty Publications

(1) Introduction: Due to the non-invasive nature of saliva, many methods have been used to isolate and collect DNA from saliva samples for microbial screening. Many oral microbes also inhabit the oral biofilm, which may represent significantly different microbial constituents that may contribute to oral health and disease, including caries and periodontal disorders. Moreover, the biofilm may vary within the same patient at different sites. Few studies have evaluated the comparison between DNA isolated from saliva and DNA from site-specific biofilm, with virtually no studies addressing this analysis among pediatric patients. (2) Methods: An existing repository of paper point derived …

Human Papillomavirus (Hpv) Vaccine Knowledge, Awareness And Acceptance Among Dental Students And Post-Graduate Dental Residents, Steve Kent Mann, Karl Kingsley

Dental Medicine Faculty Publications

Introduction: The recent development of a vaccine that is highly effective against the human papillomavirus (HPV) has been met with widespread clinical and public health professional acceptance. However, social and societal barriers to vaccination may hamper public health efforts to prevent HPV-mediated diseases. Although a few studies have evaluated knowledge or awareness of HPV vaccination among dentists or dental educators, few studies have evaluated the acceptance, knowledge and awareness of HPV vaccination among dental students and post-graduate dental residents. The primary goal of this study is to evaluate survey responses regarding acceptance, knowledge and awareness of HPV vaccination among dental …

Craniofacial Analysis May Indicate Co-Occurrence Of Skeletal Malocclusions And Associated Risks In Development Of Cleft Lip And Palate, Denise K. Liberton, Payal Verma, Konstantinia Almpani, Peter W. Fung, Rashmi Mishra, Snehlata Oberoi, Figen Ç. Şenel, James K. Mah, John Huang, Bonnie L. Padwa, Janice S. Lee

Dental Medicine Faculty Publications

Non-syndromic orofacial clefts encompass a range of morphological changes affecting the oral cavity and the craniofacial skeleton, of which the genetic and epigenetic etiologic factors remain largely unknown. The objective of this study is to explore the contribution of underlying dentofacial deformities (also known as skeletal malocclusions) in the craniofacial morphology of non-syndromic cleft lip and palate patients (nsCLP). For that purpose, geometric morphometric analysis was performed using full skull cone beam computed tomography (CBCT) images of patients with nsCLP (n = 30), normocephalic controls (n = 60), as well as to sex- and ethnicity- matched patients with an equivalent …

Adea‐Adee Shaping The Future Of Dental Education Iii: Assessment In Competency‐Based Dental Education: Ways Forward, Ingrid Tonni, Cynthia C. Gadbury-Amyot, Marjan Govaerts, Olle Ten Cate, Joan Davis, Lily T. Garcia, Richard W. Valachovic

Dental Medicine Faculty Publications

Assessment in competency-based dental education continues to be a recognized area for growth and development within dental programs around the world. At the joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, the workshop on assessment was designed to continue the discussion started in 2017 at the ADEA-ADEE Shaping the Future of Dental Education II.1 The focus of the 2019 conference involved examining the potential of entrustable professional activities (EPAs) and current thinking about workplace-based assessment (WBA) within competency-based education in the 21st century. Approximately …

Adea-Adee Shaping The Future Of Dental Education Iii: Engaging With Global Networking To Enable Global Oral Health, Upen S. Patel, Lior Shapira, Jennifer E. Gallagher, Joan Davis, Lily T. Garcia, Richard W. Valachovic

Dental Medicine Faculty Publications

Global networking has been identified as an important method of enhancing health care education and services in the field of dentistry.1 The ability to share expertise, resources, knowledge, and experience to benefit all is highly desired among students, educators, health care professionals, and communities globally. Both our student and patient populations are dynamic societies that are becoming increasingly complex and facing growing needs and expectations, which is a constant challenge for educators and health care professionals to satisfy.2 The key question, stemming from the Global Networking (GN) workshop of the 2017 ADEE‐ADEA Shaping the Future of Dental Education II meeting, …

Comprehensive Review Of Current Endodontic Sealers, Takashi Komabayashi, David Colmenar, Nicholas Cvach, Aparna Bhat, Carolyn Primus, Yohji Imai

Dental Medicine Faculty Publications

Endodontic sealers for non-surgical root canal treatment (NSRCT) span many compositions and attributes. This comprehensive review discusses current types of endodontic sealers by their setting reaction type, composition, and properties: zinc oxide-eugenol, salicylate, fatty acid, glass ionomer, silicone, epoxy resin, tricalcium silicate, and methacrylate resin sealers. Setting time, solubility, sealing ability, antimicrobial, biocompatibility, and cytotoxicity are all aspects key to the performance of endodontic sealers. Because sealing ability is so important to successful outcomes, the relative degree of microleakage among all the relevant sealers was calculated by way of a meta-analysis of relevant literature. Compared to AH Plus, tricalcium silicate …

Pink Tooth Of Mummery In The Maxillary Left Canine After Fixed Partial Denture (Fpd) Preparation, Eger V. Korolevsky, Takashi Komabayashi, Denise Foran

Dental Medicine Faculty Publications

Pink tooth of Mummery is typically found after trauma. However, this case report describes an unusual occurrence of pink tooth in a 67-year-old Caucasian male after fixed partial denture (FPD) tooth preparation. Pink tooth in this case may be due to one or more factors: tooth reduction and heat generation during tooth preparation; heat generation during polymerization of provisional material; and hyperocclusion of a provisional FPD. This case highlights the importance of choosing the appropriate materials and techniques to avoid pulpal complications after dental prosthesis work.

Impact Of Two Distinct Dental Anesthesia Simulation Models On The Perception Of Learning By Students, Jadith Merino-Parra, Ricardo E. Madrazo-Meneses, Takashi Komabayashi, Bernardino I. Cerda-Cristerna

Dental Medicine Faculty Publications

We evaluated an infiltration anesthesia simulation model (IAM) and a conduction anesthesia simulation model (CAM) on the perception of learning by Mexican dental students. Our aim was to compare the perception of learning by dental students trained with two distinct dental anesthesia simulation model (DASM) with dental students who were not trained with a DASM. 3 groups participated in the study: G1 (N=12 students) learned to block the mental nerve (BMN) by participating in a theoretical lecture (stage 1) and a clinical demonstration (stage 2); G2 (N=12 students) learned the BMN by participating in the stage 1, stage 2, and …

Efficacy Of A Dissolvable Strip With Calcium Sodium Phosphosilicate (Novamin®) In Providing Rapid Dentine Hypersensitivity Relief, John Gallob, Martin R. Ling, Pejmon Amini, Avinash Patil, Mounir Atassi

Dental Medicine Faculty Publications

Objective To evaluate the efficacy of a dissolvable strip containing 15% w/w calcium sodium phosphosilicate (CSPS) (Novamin®) in providing rapid relief from dentine hypersensitivity (DH). Methods In this examiner-blind, proof-of-principle study, 120 healthy adults with DH were randomized 1:1 to the Test strip, professionally applied to facial surfaces of two selected teeth, or to No treatment. Sensitivity was assessed at baseline and 10 min, 2 h and 4 h post-application in response to evaporative (air) and tactile stimuli (measured by Schiff sensitivity scale/a numeric rating scale and tactile threshold, respectively). Change from baseline was analyzed by ANCOVA. Results At 10 …

Epidemiologic Evaluation Of Nhanes For Environmental Factors And Periodontal Disease, P. Emecen-Huja, H-F Li, Jeffrey L. Ebersole, J. Lambert, H. Bush

Dental Medicine Faculty Publications

Periodontitis is a chronic inflammation that destroys periodontal tissues caused by the accumulation of bacterial biofilms that can be affected by environmental factors. This report describes an association study to evaluate the relationship of environmental factors to the expression of periodontitis using the National Health and Nutrition Examination Study (NHANES) from 1999–2004. A wide range of environmental variables (156) were assessed in patients categorized for periodontitis (n = 8884). Multiple statistical approaches were used to explore this dataset and identify environmental variable patterns that enhanced or lowered the prevalence of periodontitis. Our findings indicate an array of environmental variables were …

Differential Microrna Expression Of Mir-21 And Mir-155 With Oral Cancer Extracellular Vesicles In Response To Melationin, Matthew Hunsaker, Greta Barba, Karl Kingsley, Katherine M. Howard

Dental Medicine Faculty Publications

Objective: Extracellular vesicles derived from oral cancer cells, which include Exosomes and Oncosomes, are membranous vesicles secreted into the surrounding extracellular environment. These extracellular vesicles can regulate and modulate oral squamous cell carcinoma (OSCC) progression through the horizontal transfer of bioactive molecules including proteins, lipids and microRNA (miRNA). The primary objective of this study was to examine the potential to isolate and evaluate extracellular vesicles (including exosomes) from various oral cancer cell lines and to explore potential differences in miRNA content. Methods: The OSCC cell lines SCC9, SCC25 and CAL27 were cultured in DMEM containing 10% exosome-free fetal bovine serum. …

Reliability Of Colour And Hardness Clinical Examinations In Detecting Dentine Caries Severity: A Systematic Review And Meta-Analysis., Larry Hon, Ahmed Mohamed, Edward Lynch

Dental Medicine Faculty Publications

Dental caries is the most common human infectious disease and is caused by microorganisms producing acids, resulting in changes in dental tissue hardness and colour. However, the accuracy and reliability of dentine colour and hardness as indicators for carious lesion severity has never been assessed in a systematic review. By applying strict criteria, only seven papers (five randomized control trials and two diagnostic studies) were considered for full text qualitative and quantitative assessment. Only three studies produced high quality evidence and only four articles were considered for meta-analysis, as these provided log10 colony forming units (CFU) data from caries biopsies …