日本大学歯学部紀要 34，47‑58，2006

Team teaching a medical and dental English program
Clive Langham
Abstract
This paper describes the development of a reading skills program for third year dental
students.Changes in the program since its inception in 2001 are described and examples ofthe
curriculum and teaching materials are given.Coordination of the program,as well as teacher
training, is considered. Feedback from a questionnaire for teachers reveals interesting insights concerning how a medical and dental English program is perceived by Japanesedentists involved in teaching the program.
Key words: case studies, English for specific purposes, medical and dental English,reading
skills, team teaching

Background
Changes in English language teaching at all levels of education in Japan are taking place
rapidly. The M inistry of Education, Culture, Sports, Science and Technology unveiled a
program called Good Practice (M EXT,2004)designed to institute reform at university level by
rewarding forward‑thinking English language programs that attempt to link classroom learning and what happens in the real world.Moves away from general English courses to ones that
focus on specific language skills designed to meet studentsʼneeds are becoming more commonplace.We find,for example,an explanation of the case for English for Specific Purposes (ESP)in Japan being put forward by Orr (1998)who states that,“Anyone current on the latest trends in Japanese higher education knows that university
administrators and faculty in Japan are very interested in English for Specific Purposes (ESP).
M otivated by new policies and priorities at national and local levels,Japanese universities are
now in the midst of rethinking their English language curriculums and searching for better
options. ESP is growing in popularity and university educators in Japan are expressing greatinterest in this new phenomenon since it holds promise for more effective and genuinely useful
English language instruction for Japanese students who increasingly need English for specificpurposes in academic, vocational, or professional contexts.”
M ore recently, the same sentiments have been echoed by Okamoto, Kamimura, Noguchi, &M iyama, (2006). Additionally, the case for ESP in Japanese universities has been put forward
strongly by Evans, & Squires (2006), who state that,“We foresee that English for Specific Purposes (ESP) will become the norm not the
exception in Japanese universities, replacing general English curricula.”
日本大学歯学部

英語

Nihon University School of Dentistry
1‑8‑13 Kanda‑Surugadai, Chiyoda‑ku, Tokyo 101‑8310, Japan〒 101‑8310 東京都千代田区神田駿河台１‑８‑13(受理：2006年９月 29日）

47

日本大学歯学部紀要 34，47‑58，2006

All of the above suggest that as the need for ESP is increasingly realized,such programs will
become more prevalent at Japanese universities and colleges.

What is ESP?
For the most part, ESP indicates a kind of instructional focus that is designed to prepare
students or adults in the workplace for the English they will encounter in specific disciplines,
vocations or professions. ESP is to be contrasted with English for General Purposes (EGP)
which largely characterizes what takes place in high schools and a lot of universities here in
Japan, not to mention EFL/ESL classrooms all over the world. The nature of ESP is definedby Dudley‑Evans (1988) as having ʻ
absolute characteristicsʼand ʻ
variable characteristicsʼasfollows.
Absolute characteristics of ESP
1.

It meets the specific needs of the learners.

2.

It employs the underlying methodology and activities of the discipline/field it serves.

3.

It focuses on grammar, lexis, register, discourse and genre of the above.

Variable characteristics of ESP
1.

It can be related to or designed for specific disciplines.

2.

It employs a methodology different from EGP.

3.

It is generally used with adult learners in higher education or the workplace.

4.

It is taught at a level of intermediate or above.

5.

It assumes a solid understanding of basic general English.

For teachers of ESP relevance is the key,as is giving students opportunities to fully engage inactivities related to their own goals and needs. As Hutchinson et. al. (1987)point out,
“ESP is an approach to language teaching in which all decisions as to content and method
are based on the learnersʼreason for learning.”

ESP programs at Japanese universities
Responding to M EXTʼs attempts to improve English language teaching at the level of higher
education, universities and colleges throughout Japan are moving in the direction of specialist
programs for English.The aim being to forge a concrete link between university programs andwhat actually happens in the real world. The number of universities with the clear goal of
producing graduates who can function in English in their chosen field continues to grow year
byyear.The author is aware of several ESP programs in operation at Japanese universities andthe number of such programs continues to grow.At Kitasato University,an ESP program has
been developed around adapted real‑life video and audio tape interactions between patients andhealthcare workers for use with medical,nursing and pharmacy students.For more details see
Dias (1999). At Nagaoka University a program focusing on reading skills for engineering
students has been developed.The program teaches reading skills byanalyzing abstracts written
48

Team teaching a medical and dental English programin English taken from specialized journals in engineering fields. For more information see
Nagano (1998).At Tokyo M edical University an English for Medical Purposes Program (EMP)
is in existence that uses complete articles from the New England Journal of Medicine.Each unitof the program consists of an article reproduced from the above journal along with a list of key
words. Students read the article and answer comprehension questions. This is followed by a
medical interview which is on tape. The program is taught by native speakers. A Japanese
doctor is on hand to answer any technical questions by video link that may arise.Additionally,
there are other ESP programs currently in operation in Japan, particularly in the fields ofinformation technology,economics,business,medicine and dentistry.The above are just a few
examples of ESP programs in Japan.

The Medical and Dental English Program at Nihon University School of Dentistry
The M edical and Dental English program (MDE) at Nihon University School of Dentistry(NUSD)is another example of an ESP program.The program first made an appearance on the
curriculum in 2001.It is interesting to note that the need for such a program was first realized
by the members of the educational affairs committee and was not instituted at the request of
the English department. Indeed, in the original conception of the program,the English department was not consulted about content,methodology or teaching staff.As new people joined theuniversity and others retired,the program was put on the curriculum,suggesting some opposition to an ESP type program of this type. The aims of the program, as first envisaged, were
to have students read papers from journals in the fields of medicine and dentistry and more
specifically to improve studentsʼreading ability and range of specialized vocabulary.Anothergoal was to give students an idea of how technical words are pronounced.
In this way, a course entitled M edical and Dental English was introduced for all third year
students. The course involves two fifty‑minute classes a week over one semester, one taught
by a native speaker of English entirely in English and the other in Japanese byspecialists in thefield of dentistry.For the first three years of the program,classes focused on the abstracts ofacademic papers in fields related to dentistry. These papers were chosen by the Japaneseteachers involved in the program and were mainly in the field of basic research.The thinking
behind the decision to adopt abstracts,in preference to full scientific papers,was that students
would not be able to read full papers and that abstracts would be more accessible.This choice,however,created problems for the English department as it was difficult to create meaningfulteaching materials and tests from what were mostly ten or so lines of very densely packed
information containing difficult vocabulary and concepts. It seems not uncommon for ESP
reading programs to focus on abstracts.Indeed,among many Japanese teachers of science andtechnical subjects, the case for studying abstracts, as opposed to full papers, in the English
language classroom is frequently made. In other words, it is a commonly held belief among
Japanese scientists that abstracts from scientific articles are a good source of accessible
49日本大学歯学部紀要 34，47‑58，2006

reading materials for students. The feeling of this author is that this approach is less thansatisfactory, as the level of difficulty means that students become stuck on understanding
meaning at word and single sentence level,and consequently never build up any reading speed
or fluency. This, in turn, prevents them from improving their reading skills. Discussions withJ Patrick Barron at Tokyo M edical University have resulted in the same conclusion. For theabove and other reasons, using abstracts alone is not a suitable way of developing studentsʼ
reading skills in an ESP reading program.As a way out of this problem,in the first three yearsof the program, abstracts were supplemented with general texts in the field of dentistry withspeed reading and vocabulary exercises. The texts, selected by the English department, were
mostly derived from Internet sources, and were at an intermediate level. A representative
example is attached as Appendix 1. In terms of level, as we have seen from the list of
characteristics of ESP by Dudley‑Evans (1998), ESP courses are generally taught at the levelof intermediate or above. This presupposes that students have been through adequate general
English courses. We know that students without a basic grounding in English will find ESP
programs very demanding. As Evans & Squires (2006)rightly point out,
“English programs should begin with some review and practice of previously learned
English skills to build confidence and better prepare learners for ESP content.”
For educators developing ESP programs at universities in Japan,this is of crucial importance.
If some of the students are at a level below intermediate, the benefits of the program areseverely restricted and accordingly remedial steps need to be taken.

The Move to Case Studies
As mentioned above, the English teachers considered that focus on abstracts was counterproductive in helping students to comprehend scientific papers,as it was a barrier to developing
reading fluency and gave no opportunity to focus on necessary reading skills such as skimmingand scanning and so on. It also made creation of classroom materials and tests very difficultand meant that students did not get any of the satisfaction that could have been derived fromreading a paper in its entirety.Also,the fact that the subject matter was basic research rather
than subjects directly relevant to people who would soon become dentists was a problem.The
English teachers felt that using case studies as the basis for the program offered several
advantages in comparison with abstracts from scientific papers on basic research.Case studies
are generally more accessible since they deal with a story having human interest with abeginning,middle and an end.Additionally,the subjects covered were more likelyto be of direct
relevance to students in their dental work after graduation.It is interesting to note that in thepast couple of years, the number of English language teaching texts in medical, dental andnursing fields involving the use of case studies has increased, suggesting that the potential ofsuch an approach has been recognized.The following topics were studied in the fourteen week
program : restorative dentistry, orthodontics, prosthodontics, endodontics, periodontics and50

Team teaching a medical and dental English program

oral and maxillofacial surgery. Please see Appendix 2 for a list of the case studies used.

Team Teaching and Teacher Training
One of the unique points of the M DE program at NUSD is that it is based on team teaching
involving Japanese members of staff from the dental hospital who are specialists in a particulararea of dentistry,as well as native‑speakers from the English department.People current with
the English language teaching scene in Japan will know that team teaching has been used inhigh schools for a number of years with varying degrees of success. On the Assistant English
Teacher program in high schools across Japan,it has provoked serious debate,including a lotof criticism, over its effectiveness and even validity. The program at NUSD adopted teamteaching in order to involve members of different departments and establish a joint enterprisein which the teaching of M edical and Dental English was the goal.We felt that it was extremely
important for students to see Japanese members of staff as role models using English actively
in their professional capacity as specialists in dentistry. It was also considered important for
the various departments to come together in MDE lectures and to try to establish a method of
producing students with the English skills they will need in their future careers. This wasparticularly important considering that under normal circumstances communication between
clinical departments and the English department was almost non‑existent.
It needs to be pointed out that in the three years in which abstracts derived from papers in
the field of basic research were the main focus of study, there was little if any coordination
between teachers and few meetings to exchange ideas or establish policy.Decisions were madeby the person in charge of the program and implemented without recourse to the opinions ofothers.This was due to the extremely busy schedules of the teachers involved and the fact thatseven different departments were involved. The English department considered this to be a
problem and asked the group leader to arrange a meeting so that planning could take place.
Eventually,in the months before the start of the new semester a meeting was called.All of thedentists involved in teaching attended the meeting which was chaired by the English department. At the meeting, a representative of the English department asked the other Japaneseteachers to do the following in their lectures:
1.

At the start of the lecture,to provide a 5 minute talk with slides based on their experienceoverseas,to explain how theyuse English in their jobs and how theylearned or are learning
English.It should be pointed out that all Japanese teachers had spent at last two years ormore at universities overseas in a research capacity.The aim was to motivate students byshowing them the teachersʼ
overseas experience, the need for English and also ways ofapproaching it.

2.

The teachers were asked to select a case study in their field that was straight‑forward andrelatively short. They were specifically asked not to use translation from English into
Japanese as a way of teaching or testing students.
51日本大学歯学部紀要 34，47‑58，2006

3.

Teachers were asked to create classroom activities that involved the use of skimming andscanning using the case studies.Also,the need for summarizing,reporting back and group
work was stressed.

4.

Teachers were asked to create lists of keywords based on the vocabularyitems in the casestudies for each class and to explain these words giving their Japanese equivalent.

5.

Teachers were asked to give an easy overview of their field and introduce the clinicalconcepts in the case report. This was done in Japanese in the first of their two lectures.

6.

Teachers were asked to give students time and space to read the case studies, to discussquestions with other students and also to ask questions. In other words, teachers werecautioned against producing an overly teacher‑centered approach.
The English department felt that the results of the team teaching orientation had been very

worthwhile and that teachers had generally had a positive attitude to the program.There was,however, a feeling that with more time more could have been achieved. As mentioned above,time was very limited particularly for dentists who were involved in the daily treatment ofpatients.

The Classes
M DE classes run each year from April to July with 14 classes given by Japanese faculty and28 given by the English department. The English department gives the same lecture twice totwo groups of about 60 students in a large auditorium. The same two groups meet for thelecture given by the Japanese specialists,forming a single group of approximately120 students.
Lectures are 50 minutes each and run back to back. A member of the English department
observed all of the lectures given in Japanese by Japanese members of staff,and attempted toencourage coordination between staff members during the program.It soon became clear thatseveral of the Japanese teachers fell back on grammar translation as a method of teaching
during their lectures despite having been asked not to do this in the team teaching orientation.
It is worth noting that according to Kitao et al.(1985),the grammar translation method is stillwidely used in English language classes at universities in Japan with classes involving students
translating sentences from an English language textbook into Japanese.The grammar‑translation method has been widely criticized in the past, but in the context of Japan, where classes
can be very large, it should be remembered that it is a method that can be easily applied andalso one which fits in well with studentsʼprevious learning experience.As the author observed
the lectures given by Japanese faculty members,it became clear that several teachers resorted
to translation as a teaching technique particularlyin the second of their two lectures.Generally,
the first lecture was taken up with their experience of living overseas,the need for English anda general overview of the field and introduction of key words, and as such there was no needto require students to translate. At the end of the first lecture, it was not uncommon forteachers to divide up the case study line byline and assign each section to groups of four or five52

Team teaching a medical and dental English program

students who worked on the assigned sections as homework.In the following lecture,students
were called upon to deliver translations into Japanese of the particular sections.Some students
coped well and had clearly put a lot of time and effort into the translation. In some cases,
students appeared to have used automatic translation services available on the Internet,
sometimes with disastrous results since much of the medical and dental vocabulary was nottranslated accurately. The use of translation as a teaching technique was, however, notoverwhelming and several lecturers put questions on a power point presentation slide andrequired students to search for specific information in the text by answering the questions.
Students responded well to this technique by working alone, or in pairs and groups, scanning
the text for the required information.Students wrote their answers down on small slips of paperthat were provided by the lecturer. M any students wrote in English, and some in Japanese.
M embers of the English department circulated through the lecture hall and offered help andadvice in English to students during the activity. The lecturer remained at the front of thelecture hall.After about ten minutes,students came to the front of the room either one by one
or in pairs and submitted their answers to the teacher who checked them and gave confirmation
and advice as required. Students were then free to leave. From the viewpoint of the English
teachers,this kind of approach seemed particularly promising as it was more student‑centeredand did not involve the use of translation.More specifically,it involved students in developing
the skills that we know must be acquired to become a proficient reader.

Creation of Teaching and Testing Materials by the English Department
At the orientation meeting,teachers had been asked to select case studies in their field thatwere straight‑forward and relativelyshort.This was in response to the problems created bythelevel of difficulty presented by the abstracts used in the first three years of the program.The
selected papers varied from 4 to 8 pages.The task of creating appropriate teaching materials
from authentic texts is a difficult one that requires time,experience and a willingness to accessthe target genre by non‑specialist teachers.On the point of appropriate ESP materials for use
in class, Orr (1998)points out that,“Few materials sold in bookstores fit the specific needs identified in a needs analysis.”
Similarly, Dias (1999)points out that many commercially available texts are,“Far removed artificial approximations of the reality they profess to capture.”
In fact, material production was probably the most challenging part of the program formembers of the English Department.As you will see from the materials shown in Appendix 3,teacher‑created materials focused on the introduction of vocabulary and comprehension
questions based on the case study. Examinations were mostly of the same format. Evans &Squires (2006)report on the de‑emphasis on vocabulary due to the fact that the ESP teacher isusually not a specialist in the field. Additionally, it is assumed that students will naturally
acquire the target vocabulary in their own content courses.It is interesting to note that in the53

日本大学歯学部紀要 34，47‑58，2006

feedback comments from Japanese faculty, concern was expressed about studentsʼlack ofknowledge of technical vocabulary in both Japanese and English. Some teachers made comments suggesting theythought students do not know enough about dentistry,indicating this wasa barrier to understanding the case studies.
In order to facilitate communication between teachers, the English teachers frequently
visited the Japanese teachers involved in the program and decided on which parts of the casestudy to focus on in upcoming lessons.This provided considerable benefits and aided communication and coordination between teachers which,in turn,increased the quality of the teaching
and materials.However,due to busy schedules,this was not always possible.Often,the English
department found that it was creating materials only a few days before the lesson was actuallytaught.The workload involved in teaching an MDE program is considerable and should not be
underestimated. Since authentic texts are used, all teaching materials have to be tailor‑madeand, as mentioned above, there is virtually nothing commercially available that is suitable.

Examinations
For the end of semester examination,students were told to study two of the six case studies
that had been covered. It was thought that requiring students to prepare all six case reports
would have been too demanding. A variety of vocabulary and comprehension questions weremade as a final examination.In the early years of the program,a section in Japanese had been
included that tested students on scientific content. This was subsequently dropped.

The Way Forward
The first thing to be said about the M DE program at NUSD is that the team teaching aspect
is fairlyunique for Japan.In the case of NUSD,the link up between the English department andother departments bodes well for the future of the program.It is probable that more training,
coordination and exchange of ideas will significantlyimprove the qualityof the program.Thereis also perhaps a need to put all case studies into a booklet form that students can use.For thisto happen,permission from the copyright holders to reproduce the papers would be necessary.
Additionally,more work on vocabulary acquisition is necessary,as well as improved forms ofassessment.

Teacher Feedback
Two months after the program ended, a brief questionnaire was created by the English
department and given to the Japanese teachers as a way of getting feedback and also as an
impetus to begin the planning process for the following yearsʼclasses.It is worth going throughand analyzing some of the comments made by the teachers, as this gives insights into peopleʼ
s thinking on the program.I will deal with relevant answers for each of the questions.Questions
are in bold,numbered from 1 to 6 followed by a selection of edited answers from the teachers.
54

Team teaching a medical and dental English program

1. What were your goals in your lectures?
・To let students know English is a powerful tool for communication
・To have students understand basic dental terms and treatment methods
・To have students think about the importance of reading scientific articles in English
・To motivate students to understand dental English
Answers to question 1 indicate that the goals of most of the teachers have a good fit with themain objective of reading scientific articles in English.
2. How did you achieve these goals?
・I introduced recent topics in endodontic treatment using newly published material
・I lectured with simple and easy English
・I used slides, scientific papers and my clinical experience to motivate students
・I showed clinical photos and provided clinical articles
Answers to question 2 again show unanimity of purpose with most teachers concentrating on
the introduction of clinical concepts and practices in simple terms.
3. How was your lecture different from other lectures you usually give?
・Basically, students do not know much about endodontic treatment or basic research.
Therefore, I explained about these.
・I tried to explain many kinds of keywords.
・I tried to talk to students individually
A keypoint here is the statement that students do not know much about the target subject,eventhough they are 3 year dental students.This suggests that teachers felt students did not haveenough background knowledge to tackle the case studies. This is a legitimate concern that
requires discussion by the various departments involved.
4. How and why is Medical and Dental English important for students?
・To read papers,communicate with non‑Japanese and get information from around the world
・To understand the present status of Dental Science from a worldwide viewpoint,
dentists have to read papers in English, as well as communicate in English
・When we make a treatment plan or conduct research, we have to access papers in English
The above comments show the importance that the Japanese teachers involved in the program
attach to English
5. What problems did you have?
・I donʼt know what students know about dentistry
・Students donʼt know dental terms in either English or Japanese・This is the first time to teach 3rd grade students.I wonder if they can understand my lecture
・The most difficult part was teaching the background to oral surgery as simply as possible
Once again teachers were very conscious of studentsʼlack of knowledge of the target subject,suggesting that from the point of view of specialists in the field,teaching an MDE program to
3 year dental students is perhaps over‑ambitious.
55

日本大学歯学部紀要 34，47‑58，2006

6. Give suggestions for improving the lectures for next year.
・I would like to choose an easier case study
・Reduce the amount of scientific papers covered・It might be an idea to have students choose papers and have small groups discussions andpresentations
・Select shorter papers
M ost comments here are concerned with difficulty and this reflects the fact that teachers werevery conscious of the fact they might be introducing material students could not cope with.

Conclusion
With the M inistryof Education,Culture,Science and technologypromoting improved English
language teaching programs and more universities and colleges adopting specialist programs,
it appears there are significant changes taking place in English language teaching in Japan.
M any universities are striving to introduce programs that meet the needs of studentsʼfuture
career goals. At NUSD, an M DE program has been in operation since 2001.The program has
moved from emphasis on abstracts from papers in the field of basic research to case studies.
This has been in response to perceived levels of difficulty and the need to get students to readmore extensively and acquire good reading skills.Team teaching such a program has brought
together teachers from a number of different departments,raising questions about how to bestorganize and coordinate the program. The need for leadership, planning and ongoing teacher
training has become apparent. Even though progress has been made and the program has
improved, a number of problems still remain. These are as follows: creation of adequate
teaching materials based on the selected case studies is a big challenge for the English
department,as is creation of effective test materials.Also,dealing with students who are at a
pre‑intermediate level is a problem that needs to be addressed.Finally,the points made in thequestionnaire by the Japanese teachers need to be considered. These are: whether 3 year
students have enough background knowledge in dentistry to follow the case reports and also
whether the level and amount of material is appropriate for the program.

Acknowledgment
This investigation was supported by the Sato Fund, Nihon University School of Dentistry.

Appendix 1 : Supplementary material used in years 1 to 3 of the program
Speed reading 1: You have ten minutes to read this passage and answer the questions below.

Cell treatment stops teeth from falling out
Researchers at Nagoya University have found a way to restore decaying bone surrounding
the base of the teeth. This is a condition that causes teeth to become loose and fall out. The
research group is headed by Prof.M inoru Ueda.He says bones can be restored with injectionsof the patientʼs own bone marrow and blood platelets.
56

Team teaching a medical and dental English program

The advantages of the procedure are that the patient does not need to be hospitalized andthere is no risk of infection. It is thought that the treatment could be available next year at
major hospitals nationwide.
It was found that after four months of treatment,teeth that were on the verge of falling out
had been restored to almost full health.The patients no longer had loose teeth or suffered fromtoothache. Professor Ueda said that the same method could be used to knit together brokenbones in elderly patients.
1.

Where was the research done?

2.

What is injected into the bones?

3.

How many advantages of the procedure are there?

4.

When will the treatment become available?

5.

How long did it take for teeth to be restored to full health?

Find a word in the text that means the same as
1. repair 2. around 3. danger 4. join 5. old

Appendix 2 : List of seven case studies used, as shown in the syllabus.
1.

M atis BA, Cochran M A, Wang G, Franco M, Eckert GJ, Carlotti RJ, Bryon C. A clinical
Evaluation of bleaching using whitening wraps and strips. Oper Dent 2005; 30: 588‑592

2.

Bolan M ,Ferreira M C,Almeida ICS,Derech CD,Ribeiro CLU.Palatal expansion and theKlippel‑Trenaunay‑Weber syndrome,Am J Orthod Dentofacial Orthop 2005; 128: 385‑387

3.

Santos A, Goumenos G, Pascual A. Management of gingival recession by the use of anacellular dermal graft material: a 12‑case series. J Periodontol 2005; 76: 1982‑1990

4.

M atsumura H,Atsuta M .Repair of an eight‑unit fixed partial denture with a resin‑bonded
overcasting : A clinical report. J Prosthet Dent 1996; 75: 594‑596

5.

Gozneli R,Ozkan YK,Kazazoglu E,Akakin ZF.Effects of Bartterʼs syndrome on dentitionand dental treatment : A clinical report. J Prosthet Dent 2005; 93: 522‑525

6.

Ohki H,M atsumoto M ,Hasegawa M ,Shimizu O,Mukae S,Amano Y,Komiyama K (2005)
Unusual cyst‑like lesions in the arapharyngeal space associated with recurrence of tongue
carcinoma, J Oral Sci 2005; 407: 219‑222

7.

Kayaoglu G, Erten H, Alacam T, Orstavik D, Short‑term antibacterial activity of root
canal sealers towards Enterococcus faecalis, Int Endod J 2005, 38, 483‑488

Appendix 3 : Unit 14 of the MDE program (student handout)
M & D 14: Short‑term antibacterial activity of root canal sealers towards
Enterococcus faecalis
M aterials and M ethods: persistent endodontic infection,maintained,colonies,adhered,immersed, excess liquid, exposure1.

How many sealers were tested?

2.

What was used as the test microorganism?
57日本大学歯学部紀要 34，47‑58，2006

3.

What was the bacterial growth overnight?

4.

What was used to show bacterial cells?

5.

Instead of a sealer, what was used as a control?

6.

What was the time from sampling to incubation?

7.

At what temperature and for how long were plates incubated?

Results: significantly, insertion, dramatically, impaired
1.

Which sealers reduced bacterial numbers?

2.

What were the results of inserting a filter membrane?

Discussion : finding, exerted strong microbial activity,
1.

How many sealers had strong antimicrobial activity on E. faecalis?

penetration, embedded, employed, limited, barrier,1.

Why might sealer penetration decrease?

2.

In this study, how was contact between sealers and bacteria limited?

3.

How do the results of this study compare with previous studies?

Conclusions: effective, direct contact, restricted, ineffective, short‑term experiment
1.

Which sealers were effective?

2.

Which sealers were ineffective?
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