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Fulltext Perception Regarding the NICE Guideline on Antibiotic Prophylaxis against Infective Endocarditis Following Dental Procedures: A Cross-Sectional Study

Mohd Yunus SS, Nabil S, Rashdi MF, Nazimi AJ, Nordin R, Tan HL, et al.

Antibiotics (Basel), 2023 Apr 02;12(4).
PMID: 37107058 DOI: 10.3390/antibiotics12040696

This study explores the opinions of Malaysian clinical specialists on the antibiotic prophylaxis against infective endocarditis (IE) as described in the 2008 National Institute for Health and Care Excellence (NICE) guideline. This cross-sectional study was performed from September 2017 to March 2019. The self-administered questionnaire comprised two sections: background information of the specialists and their opinions on the NICE guideline. The questionnaire was distributed to 794 potential participants, and 277 responded (response rate of 34.9%). In general, 49.8% of the respondents believed that clinicians should adhere to the guideline, although the majority of oral and maxillofacial surgeons (54.5%) actually disagreed with this view. The dental procedures that were perceived as presented moderate-to-high risk for IE were minor surgery for an impacted tooth with a recent episode of infection, dental implant surgery, periodontal surgery and dental extraction in patients with poor oral hygiene. The cardiac conditions that were strongly recommended for antibiotic prophylaxis were severe mitral valve stenosis or regurgitation and previous IE. Less than half of Malaysian clinical specialists agreed with the changes in the 2008 NICE guideline, contributing to their insistence that antibiotic prophylaxis is still needed for high-risk cardiac conditions and selected invasive dental procedures.
Pediatric craniomaxillofacial injuries after road traffic crashes: characteristics of injuries and protective equipment use

Yunus SS, Ngeow WC, Ramli R

Am J Emerg Med, 2015 Sep;33(9):1253-7.
PMID: 26026365 DOI: 10.1016/j.ajem.2015.05.009

A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated.
Pattern of maxillofacial injuries in motorcyclists in Malaysia

Ramli R, Abdul Rahman R, Abdul Rahman N, Abdul Karim F, Krsna Rajandram R, Mohamad MS, et al.

J Craniofac Surg, 2008 Mar;19(2):316-21.
PMID: 18362705 DOI: 10.1097/SCS.0b013e318163f94d

Motorcycle casualties represent significant number in road traffic accidents in Malaysia, and among all the injuries, facial injuries pose many significant problems physiologically, functionally, and aesthetically. The aim of this study was to analyze the pattern of maxillofacial as well as other injuries in motorcyclists who were seen at Hospital Universiti Kebangsaan Malaysia.Patients' records from January 2004 to December 2005 were reviewed. Data related to demographics, vehicle/object involved in collision, involvement as a rider or pillion, whether a helmet was worn or not, location of injuries on the face/facial bones, and other associated injuries were collected.A total of 113 cases of motorcycle accidents were recorded; 106 males and 7 females were involved. Mean age was 25.8 years. Among all the races, Malay had the highest involvement (72.3%), followed by Chinese (14.3%), Indians (8.9%), and others (5.4%). The types of collision were either a single-vehicle collision (i.e., skidded) or with another vehicle/s or object (e.g., tree, stone, or lamppost). The injuries were mainly seen on the lower face (46.9%) followed by midface (25.7%) and a combination of the midface and lower face (15%) and others (12.4%). The most frequent other associated injuries recorded were orthopedic and head injuries.
Fulltext Passively mode locked thulium and thulium/holmium doped fiber lasers using MXene Nb2C coated microfiber

Ahmad H, Ramli R, Ismail NN, Aidit SN, Yusoff N, Samion MZ

Sci Rep, 2021 Jun 02;11(1):11652.
PMID: 34078979 DOI: 10.1038/s41598-021-90978-x

As a result of the emergence of two-dimensional (2D) materials for various opto-electronics applications, a new class of materials named MXenes have been attracting interests due to their outstanding nonlinear properties. In this work, an MXene niobium carbide (Nb2C) was proposed and demonstrated as a saturable absorber to induce mode-locking in thulium- and thulium/holmium-doped fiber lasers. The Nb2C solution was first prepared using the liquid exfoliation technique, and then deposited onto a microfiber for integration into the laser cavity. Stable mode-locking operation was observed in both laser cavities, where the center wavelengths of the laser were recorded at 1944 nm for the TDFL and 1950 nm for the THDFL. The generated pulses in the TDFL and THDFL had repetition rates of 9.35 and 11.76 MHz respectively, while their corresponding pulse widths were 1.67 and 1.34 ps. Both of the lasers were highly stable, having SNR values of more than 52 dB and showed no major fluctuations when tested for their long-term stabilities. The results demonstrate an excellent performance of the Nb2C as a saturable absorber, offering opportunities to further explore MXenes for future photonics devices.
Fulltext Painless Giant Submandibular Gland Sialolith: A Case Report

Thong HK, Othman IA, Ramli R, Sabir Husin Athar PP

Cureus, 2021 Nov;13(11):e19429.
PMID: 34926020 DOI: 10.7759/cureus.19429

Sialolithiasis is one of the most common diseases involving the salivary glands. It is a condition that occurs due to an obstruction in a salivary gland or its duct due to a calculus. The formation of a salivary stone is believed to be secondary to the deposition of mineral salts around a nidus, which is frequently associated with a recurrent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. The size of the calculus varies from <1 mm to a few centimeters. The frequency of sialolithiasis is relatively common. It is estimated to affect 12 in 1000 of the adult population. However, the occurrence of giant sialoliths, >15 mm in any diameter, is rare. Here, we describe our experience with a case of giant submandibular sialolithiasis measuring 25 mm presenting as a painless submandibular mass. The patient underwent submandibular gland excision followed by a full recovery.
Fulltext Osteo-odonto-keratoprosthesis for end-stage cornea blindness

Wong HS, Then KY, Ramli R

Med J Malaysia, 2011 Oct;66(4):369-70.
PMID: 22299563 MyJurnal

We report the first case of Osteo-odonto-keratoprosthesis (OOKP) who successfully underwent surgery in Malaysia following a grade 4 (severe) chemical injury in both eyes in 2006. The patient's left eye was eviscerated and his right eye underwent penetrating keratoplasty. However, the corneal graft failed and became opaque. His right eye could only perceive light. The OOKP was offered to him hoping to recover some functional vision. He underwent a 2-stage surgery to implant the OOKP into his right eye. However, 2 months post-operation, he developed vitreous haemorrhage. A successful pars plana vitrectomy (PPV) was performed via the limited view through the lens. He attained a final visual acuity of 6/60 (N36). He was able to mobilize more independently, feed, dress himself and read large print.
Fulltext Oral myiasis : case report

Ramli R, Abd Rahman R

Malays J Med Sci, 2002 Jul;9(2):47-50.
PMID: 22844224

Myiasis occurs when living tissues of mammals are invaded by eggs or larvae of flies, mainly from the order of Diptera. Most of the previousty reported cases are in the tropics and they were usually associated with inadequate personal hygiene, sometimes with poor manual dexterity. This report describes two cases of oral myiasis in cerebral palsy patients in Seremban General Hospital, Malaysia. This article also discusses the therapeutic property of maggots and highlights the importance of oral health care in the special needs patients.
Onchocerca takaokai n. sp. (Nematoda: Filarioidea) in Japanese wild boars (Sus scrofa leucomystax): Description and molecular identification of intradermal females

Uni S, Fukuda M, Agatsuma T, Bain O, Otsuka Y, Nakatani J, et al.

Parasitol Int, 2015 Dec;64(6):493-502.
PMID: 26165205 DOI: 10.1016/j.parint.2015.07.001

Human zoonotic onchocercosis is caused by Onchocerca dewittei japonica, parasitic in wild boars (Sus scrofa leucomystax) in Japan. Previously, microfilariae longer than those of Onchocerca dewittei japonica were observed in skin snips from wild boars during the study of O. dewittei japonica. Moreover, the third-stage larvae (L3) of these longer microfilariae were obtained from the blackfly Simulium bidentatum after experimental injections. Based on morphometric and molecular studies, similar L3 were found in blackflies during fieldwork in Oita, Japan. However, except for O. dewittei japonica, adult worms of Onchocerca have not been found in wild boars. In this study, we discovered adult females of a novel Onchocerca species in the skin of a wild boar in Oita, and named it Onchocerca takaokai n. sp. Females of this new species had longer microfilariae and differed from O. dewittei japonica in terms of their morphological characteristics and parasitic location. The molecular characteristics of the cytochrome c oxidase subunit 1 and 12S rRNA genes of the new species were identical to those of the longer microfilariae and L3 previously detected, but they differed from those of O. dewittei japonica at the species level. However, both species indicated a close affinity among their congeners and Onchocerca ramachandrini, parasitic in the warthog in Africa, was basal in the Suidae cluster of the 12S rRNA tree.
Non-pulsatile traumatic pseudoaneurysm of the internal maxillary artery following trauma to mandible

Soh HY, Muda AS, Jabar NA, Nordin R, Nabil S, Ramli R

Oral Maxillofac Surg, 2015 Dec;19(4):423-5.
PMID: 25903486 DOI: 10.1007/s10006-015-0497-2

Traumatic pseudoaneurysm involving the maxillary artery is rare. Owing to its anatomic location, internal maxillary artery is usually protected by its surrounding structures. Formation of pseudoaneurysm usually takes place after several weeks to months of the initial injury. In this case, we reported a pseudoaneurysm arising from left internal maxillary artery following blunt injuries within 3 hours after a road accident and the treatment with endovascular embolization with titanium coils prior to open reduction and internal fixation of the fractured mandibles.
Niche shift in three foraging insectivorous birds in lowland Malaysian forest patches

Mansor MS, Nor SM, Ramli R, Sah SAM

Behav Processes, 2018 Dec;157:73-79.
PMID: 30193765 DOI: 10.1016/j.beproc.2018.09.001

With the rapid growth of agricultural areas globally, forest birds increasingly encounter fragmented landscapes in which forest patches are surrounded by an agricultural plantation matrix, yet how birds respond behaviourally to this fragmentation is poorly understood. Information on microhabitat requirements of birds is scarce, but nevertheless essential to predicting adaptation of bird species to the patchy landscapes. We investigated foraging patterns of three tropical insectivorous birds, Green Iora Aegithina viridissima, Pin-striped Tit-Babbler Macronus gularis and Chestnut-winged Babbler Cyanoderma erythropterum, to determine whether they vary in foraging methods in different forest patches. Our study area encompassed old-logged lowland forest; one continuous forest and three forest patches. Observations were performed for 15 days every month for a period of 13 months. Information on foraging height, substrate, attack manoeuvres, and foliage density was collected independently for each foraging bird individual. All three species used different foraging substrates and attack manoeuvres in different habitat types. The Green Iora frequently used lower strata when foraging in forest patches as opposed to continuous forest, while the Pin-striped Tit-Babbler tended to forage in more dense vegetation in patches. Only Chestnut-winged Babbler displayed complete foraging plasticity across all study parameters. Different habitat features (e.g., edges, microclimates) between continuous forest and forest patches significantly influenced the foraging strategies of the study species. These changes in foraging strategies suggest that some Malaysian forest birds (e.g. generalist species) can respond behaviourally to fragmentation and habitat loss. Although continuous forest has critically important characteristics that need to be conserved, remnant forest patches are also important as ecological movement corridors and foraging grounds for birds.
Niche separation in flycatcher-like species in the lowland rainforests of Malaysia

Mansor MS, Ramli R

Behav Processes, 2017 Jul;140:121-126.
PMID: 28438691 DOI: 10.1016/j.beproc.2017.04.010

Niche theory suggests that sympatric species reduce interspecific competition through segregation of shared resources by adopting different attack manoeuvres. However, the fact that flycatcher-like bird species exclusively use the sally manoeuvre may thus challenge this view. We studied the foraging ecology of three flycatcher-like species (i.e. Paradise-flycatcher Terpsiphone sp., Black-naped Monarch Hypothymis azurea, and Rufous-winged Philentoma Philentoma pyrhoptera) in the Krau Wildlife Reserve in central Peninsular Malaysia. We investigated foraging preferences of each bird species and the potential niche partitioning via spatial or behavioural segregation. Foraging substrate was important parameter that effectively divided paradise-flycatcher from Black-naped Monarch and Rufous-winged Philentoma, where monarch and philentoma foraged mainly on live green leaves, while paradise-flycatcher foraged on the air. They also exhibited different foraging height preferences. Paradise-flycatcher, for instance, preferred the highest studied strata, while Black-naped Monarch foraged mostly in lower strata, and Rufous-winged Philentoma made use of the lowest strata. This study indicates that niche segregation occurs among sympatric species through foraging substrate and attack manoeuvres selection.
Fulltext New zoonotic cases of Onchocerca dewittei japonica (Nematoda: Onchocercidae) in Honshu, Japan

Uni S, Fukuda M, Otsuka Y, Hiramatsu N, Yokobayashi K, Takahashi H, et al.

Parasit Vectors, 2015;8:59.
PMID: 25623081 DOI: 10.1186/s13071-015-0655-2

Zoonotic infections with Onchocerca species are uncommon, and to date only 25 clinical cases have been reported worldwide. In Japan, five previous zoonotic infections were concentrated in Oita, Kyushu (the southern island), with one previous case in Hiroshima in the western part of Honshu (the main island). The causative agent in Japan was identified as Onchocerca dewittei japonica Uni, Bain & Takaoka, 2001 from Japanese wild boars (Sus scrofa leucomystax Temminck, 1842). Here we report two infections caused by a female and male O. dewittei japonica, respectively, among residents of Hiroshima and Shimane Prefectures in the western part of Honshu.
Fulltext Nesting biology of Black-shouldered Kite (Elanus caeruleus) in oil palm landscape in Carey Island, Peninsular Malaysia

Ramli R, Fauzi A

Saudi J Biol Sci, 2018 Mar;25(3):513-519.
PMID: 29686514 DOI: 10.1016/j.sjbs.2016.01.017

Black-shouldered Kite (Elanus caeruleus) is a well-known raptor that inhabits open areas such as oil palm plantation or paddy field. To determine preferable habitat and nesting site of Black-shouldered Kite in oil palm landscape, we conducted a study on Black-shouldered Kite's nesting biology in Carey Island, Selangor, Malaysia. We divided the island into six types of habitat and conducted road-side count of Black-shouldered Kite from April 2009 to February 2011. Whenever the Black-shouldered Kite was detected, we thoroughly searched the surrounding area for their nest. In total, we have recorded forty nests. The nests were built on 15 species of trees but most of the trees shared common physical characteristics. Some novice breeders also used oil palm tree as their nesting site. Structure and building materials of nests constructed on oil palm trees were different from nests built on other trees. Of all breeding attempts, only four nests which were located in residential area adjacent to young oil palm habitat were successful. Among important characteristics of successful nesting site include taller trees with strong branches and good leaf coverage. These trees not only protect nests from predator detection (except from other predatory birds) and physical environment but also facilitate Black-shouldered Kite's foraging activities by providing good vantage point.
Necrotizing gingivitis: a possible oral manifestation of ticlopidine-induced agranulocytosis

Rajandram RK, Ramli R, Karim F, Rahman RA, Fun LC

N Z Med J, 2007;120(1256):U2590.
PMID: 17589558

Agranulocytosis is a rare complication of ticlopidine and can be life-threatening. We report a case of ticlopidine-induced agranulocytosis and neutropenia (neutrophil count of 0.1 x 10(9)/L) with necrotizing gingivitis in a 54-year-old Malaysian-Chinese female. She was started on ticlopidine 250 mg twice daily 3 weeks prior to this hospital admission. We started her on intravenous metronidazole and amoxicillin and clavulanic acid (Augmentin) and concurrently stopped ticlopidine. A series of clinical and laboratory investigations were carried out and a final diagnosis of necrotizing gingivitis possibly secondary to agranulocytosis was made. The patient was discharged home after 2 weeks of hospitalisation.
Fulltext Nasal bridge intramuscular hemangioma

Hamir Basah Z, Mohamad I, Ramza Ramli R, Gayadh MK, Mutum SS

Case Rep Otolaryngol, 2015;2015:412625.
PMID: 25709848 DOI: 10.1155/2015/412625

Intramuscular haemangioma (IMH) is a benign mesenchymal tumour. It appears as a deep, nontender mass within the soft tissue, particularly in the extremities. This tumour may not be obvious on clinical examination. Head and neck IMHs represent only 13.5% of the total IMHs. The most common site for a head and neck IMH is the masseter muscle, followed by trapezius, sternocleidomastoid, and very rarely temporalis muscle. We present a patient with left nasal bridge swelling which was excised and histologically confirmed as intramuscular hemangioma.
MyWSL: Malaysian words sign language dataset

Johari RT, Ramli R, Zulkoffli Z, Saibani N

Data Brief, 2023 Aug;49:109338.
PMID: 37600131 DOI: 10.1016/j.dib.2023.109338

Deaf and hard-of-hearing individuals use sign language as a means of communication. However, those around them, especially family members like the children of deaf adults, may face communication challenges if they are unfamiliar with sign language. This issue has prompted numerous researchers to conduct studies on sign language translation and recognition. However, there is currently no publicly available dataset specifically for Malaysian sign language. This article introduces an image dataset of the Malaysian Sign Language (MySL) hand gestures used in everyday situations. The dataset, named MyWSL2023, comprises 3,500 images of ten static Malaysian sign language words collected from five participants (two males and three females) aged between 20 and 21 years old. The data collection took place indoors under normal lighting conditions. The MyWSL2023 dataset, which has been made freely accessible to all researchers, serves as a valuable resource for not only investigating and developing automated systems for hearing-impaired and deaf individuals but also gesture and sign language recognition using vision-based methods. The dataset can be accessed for free at https://data.mendeley.com/datasets/zvk55p7ktd.
Motorcycle helmet visor-related facial injury and its potential mechanism of injury: Evidence-based case study

Ramli R, Oxley JA

Traffic Inj Prev, 2019;20(3):332-335.
PMID: 30995129 DOI: 10.1080/15389588.2018.1557640

Objectives: We encountered an unusual facial laceration wound in relation to motorcycle helmet visor use during our clinical practice. We aimed to assess the prevalence of this unusual facial injury among motorcyclists who sustained facial injuries in selected hospitals and to determine the possible mechanism involved. Methods: We used our prospective cross-sectional substudy involving injured motorcyclists presenting at major trauma hospitals in Southern Klang Valley, Malaysia, between March 2010 and March 2011. of 391 subjects with facial injuries, 2 male motorcyclists sustained this laceration. The wounds were assessed and we believed that each was associated with the helmet visor. One of the visors was collected and the edge was inspected using scanning electron microscopy (SEM). Results: The prevalence of this unusual injury was 0.51% (95% confidence interval, 0.002-0.012) among motorcyclists who sustained facial injuries. Both cases were involved in a head-on collision with their colliding partners and their helmets were intact throughout the crash. The visor in case 1 was intact, but the visor in case 2 was broken. SEM analysis showed that the visor in case 1 had a potential cutting surface. We postulated that with helmet rotation in the forward and downward position and with some degree of visor bending or with a dislodged visor, the sharp-edged visor could potentially severely lacerate the face. Conclusion: This injury affects facial aesthetics and early referral to the facial surgery team is advocated. Documentation of the mechanism of injury, the patient's helmet and visor is obligatory, so that this information can be delivered to the regional road safety authority for preventive measures.
Motorcycle helmet fixation status is more crucial than helmet type in providing protection to the head

Ramli R, Oxley J

Injury, 2016 Nov;47(11):2442-2449.
PMID: 27645615 DOI: 10.1016/j.injury.2016.09.022

INTRODUCTION: In Malaysia, motorcyclists continue to outnumber other road users in injuries and deaths. The objective of this study was to determine the association between helmet fixation and helmet type with head injury and severity of head injury among Malaysian motorcyclists.
METHODS: The study design was a prospective cross-sectional study. The participants involved injured motorcyclists who were admitted in five selected hospitals in Klang Valley, Malaysia. Participants who sustained head injury were selected as the cases while those with injury below the neck (IBN) were selected as the controls. Questionnaire comprising motorcyclist, vehicle, helmet and crash factors was examined. Diagnoses of injuries were obtained from the participants' medical records.
RESULTS: The total subjects with head injuries were 404 while those with IBN were 235. Majority of the cases (76.2%) and controls (80.4%) wore the half-head and open-face helmets, followed by the tropical helmets (5.4% and 6.0% of the cases and controls, respectively). Full-face helmets were used by 1.2% of the cases and 4.7% of the controls. 5.7% of the cases and 6.0% of the controls did not wear a helmet. 32.7% of the cases and 77.4% of the controls had their helmets fixed. Motorcyclists with ejected helmets were five times as likely to sustain head injury [adjusted odds ratio, AOR 5.73 (95% CI 3.38-9.73)] and four times as likely to sustain severe head injury [AOR of 4.83 (95% CI 2.76-8.45)]. The half head and open face helmets had AOR of 0.24 (95% CI 0.10-0.56) for severe head injury when compared to motorcyclists who did not wear a helmet.
CONCLUSION: Helmet fixation is more effective than helmet type in providing protection to the motorcyclists.
Fulltext Morphological and molecular characteristics of Malayfilaria sofiani Uni, Mat Udin & Takaoka n. g., n. sp. (Nematoda: Filarioidea) from the common treeshrew Tupaia glis Diard & Duvaucel (Mammalia: Scandentia) in Peninsular Malaysia

Uni S, Mat Udin AS, Agatsuma T, Saijuntha W, Junker K, Ramli R, et al.

Parasit Vectors, 2017 Apr 20;10(1):194.
PMID: 28427478 DOI: 10.1186/s13071-017-2105-9

BACKGROUND: The filarial nematodes Wuchereria bancrofti (Cobbold, 1877), Brugia malayi (Brug, 1927) and B. timori Partono, Purnomo, Dennis, Atmosoedjono, Oemijati & Cross, 1977 cause lymphatic diseases in humans in the tropics, while B. pahangi (Buckley & Edeson, 1956) infects carnivores and causes zoonotic diseases in humans in Malaysia. Wuchereria bancrofti, W. kalimantani Palmieri, Pulnomo, Dennis & Marwoto, 1980 and six out of ten Brugia spp. have been described from Australia, Southeast Asia, Sri Lanka and India. However, the origin and evolution of the species in the Wuchereria-Brugia clade remain unclear. While investigating the diversity of filarial parasites in Malaysia, we discovered an undescribed species in the common treeshrew Tupaia glis Diard & Duvaucel (Mammalia: Scandentia).
METHODS: We examined 81 common treeshrews from 14 areas in nine states and the Federal Territory of Peninsular Malaysia for filarial parasites. Once any filariae that were found had been isolated, we examined their morphological characteristics and determined the partial sequences of their mitochondrial cytochrome c oxidase subunit 1 (cox1) and 12S rRNA genes. Polymerase chain reaction (PCR) products of the internal transcribed spacer 1 (ITS1) region were then cloned into the pGEM-T vector, and the recombinant plasmids were used as templates for sequencing.
RESULTS: Malayfilaria sofiani Uni, Mat Udin & Takaoka, n. g., n. sp. is described based on the morphological characteristics of adults and microfilariae found in common treeshrews from Jeram Pasu, Kelantan, Malaysia. The Kimura 2-parameter distance between the cox1 gene sequences of the new species and W. bancrofti was 11.8%. Based on the three gene sequences, the new species forms a monophyletic clade with W. bancrofti and Brugia spp. The adult parasites were found in tissues surrounding the lymph nodes of the neck of common treeshrews.
CONCLUSIONS: The newly described species appears most closely related to Wuchereria spp. and Brugia spp., but differs from these in several morphological characteristics. Molecular analyses based on the cox1 and 12S rRNA genes and the ITS1 region indicated that this species differs from both W. bancrofti and Brugia spp. at the genus level. We thus propose a new genus, Malayfilaria, along with the new species M. sofiani.
Fulltext Miswak and oral health: An evidence-based review

Nordin A, Bin Saim A, Ramli R, Abdul Hamid A, Mohd Nasri NW, Bt Hj Idrus R

Saudi J Biol Sci, 2020 Jul;27(7):1801-1810.
PMID: 32565699 DOI: 10.1016/j.sjbs.2020.05.020

Poor oral health has been associated with several chronic and systemic disease. Currently, the most common method of teeth cleaning is the use of a toothbrush together with dentifrices. However, natural chewing stick such as S. persica miswak is still used in many developing countries due to their low cost and availability. The present review aims to summarize the evidences on effectiveness of miswak in promoting oral health. The search was performed using Medline via Ebscohost, Scopus and Google Scholar database to obtain relevant articles published between 2010 to May 2020 using the following set of keywords 1) Miswak OR Salvadora OR persica AND 2) dental OR caries OR plaque OR oral OR orthodontics. Isolated microbial inhibition studies were excluded from the review due to its well-established wealth of literature. Miswak was administered as ten different forms, namely mouthwash, toothpaste, chewing stick, essential oil, aqueous extract, ethanol extract, probiotic spray, dental varnish, dental cement or chewing gum. All studies reported a positive effect of miswak as an anti-plaque, anti-gingivitis, anti-cariogenic, promotion of gingival wound healing, whitening properties, orthodontic chain preservation, and biocompatibility with oral cells. Miswak in its different forms demonstrated positive effect towards oral health maintenance and management.

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