eCommons at Roseman University

Barlow, Andrew

Examining Current Resources Available for Stroke Caregivers

Ram, Josephine

Bhandi, Shilpa

Awan, Kamran H.

Licari, Frank

Patil, Shankargouda

Clinical Effects of Lactobacillus Reuteri Probiotic in the Treatment 
of Chronic Periodontitis: A Systematic Review of Randomized 
Controlled Trials
Josephine Ram1, Shilpa Bhandi2, Kamran H Awan2; Frank Licari2; Shankargouda Patil2
AIM & OBJECTIVE
The aim of this systematic review was to
examine the effectiveness of Lactobacillus
reuteri as an adjunct as compare to scaling and
root planning in the treatment of chronic
periodontitis.
RESULTS
A total of eleven studies were included. 369 adults (18-70
years) suffering from chronic periodontitis were evaluated.
Eight out of the eleven studies reported statistically
significant improvement in the intergroup pocket depths
whereas seven studies showed a statistically significant
reduction in the clinical attachment levels in the probiotic
group as compared to the controls. Three studies showed no
significant improvement in the pocket depth levels in the
probiotic group as compared to the controls. Four studies
showed no significant reduction in the clinical attachment
levels between the two groups. The overall risk of bias was
high in four studies while seven studies reported some
concerns with the risk of bias.
MATERIALS & METHODS
Scopus, Embase, Medline, and Web of Science databases
were searched in October 2022. Randomized control trials
that evaluated the effects of probiotic Lactobacillus reuteri in
patients with periodontitis were included. The primary
outcome was the pocket depth and clinical attachment levels
while the secondary outcome was bleeding on probing and
microbial levels. Articles in languages other than English
were excluded. Data extraction and quality assessment were
performed independently by two authors, with a third author
consulted when needed. Study quality was assessed based on
the Cochrane Handbook for Systematic Reviews of
Interventions Handbook guidelines and the ROB2 tool.
1 College of Graduate Studies, Roseman University of Health
Sciences, South Jordan, Utah
2 College of Dental Medicine, Roseman University of Health
Sciences, South Jordan, Utah
CONCLUSION
Based on the limited evidence available, the
adjunctive use of Lactobacillus reuteri to scaling
and root planning may provide some additional
benefits in terms of improvement of periodontal
parameters.


English

Clinical Effects of Lactobacillus Reuteri Probiotic in the Treatment of Chronic Periodontitis: A Systematic Review of Randomized Controlled Trials

ROBINSON, RYANNA

Atere, John

printed by
www.postersession.com
STATISTICS
The COVID-19 pandemic has presented orthodontists with 
several obstacles, as well as a shift in perspective on 
approaches to treatment planning and treatment. Due to the 
practice limitations imposed by the spread of the virus, many 
orthodontic offices turned to tele-orthodontics and greater use 
of clear aligner treatment. This study will survey orthodontists 
to determine whether adopters have found both tele-
orthodontics and an increase in clear aligner treatment to be 
positive additions to their practice and a treatment modality 
that is effective and efficient for patient care and that they 
intend to continue. If not, why.
1. Kotantoula G, Haisraeli-Shalish M, Jerrold L. Teleorthodontics. American Journal of Orthodontics and
Dentofacial Orthopedics. 2017;151(1):219-221. doi:10.1016/j.ajodo.2016.10.012
2. Bustati N, Rajeh N. The impact of COVID-19 pandemic on patients receiving orthodontic treatment: An
online questionnaire cross-sectional study. J World Fed Orthod. 2020;9(4):159-163.
doi:10.1016/j.ejwf.2020.10.003
3. Park J, Rogowski L, Kim J, Al Shami S, Howell S. Teledentistry Platforms for Orthodontics. Journal of
Clinical Pediatric Dentistry. 2021;45(1):48-53. doi:10.17796/1053-4625-45.1.9
4. Kaur H, Kochhar A, Gupta H, Singh G, Kubavat A. Appropriate orthodontic appliances during the COVID-
19 pandemic: A scoping review. J Oral Biol Craniofac Res. 2020;10(4):782-787.
doi:10.1016/j.jobcr.2020.10.014
5. Saccomanno S, Quinzi V, Sarhan S, Laganà D, Marzo G. Perspectives of tele-orthodontics in       the
COVID-19 emergency and as a future tool in daily practice. Eur J Paediatr Dent. 2020;21(2):157-162.
doi:10.23804/ejpd.2020.21.02.12
6. Sharan J, Chanu N, Jena A, Arunachalam S, Choudhary P. COVID-19—Orthodontic Care During and After
the Pandemic: A Narrative Review. Journal of Indian Orthodontic Society. 2020;54(4):352-365.
doi:10.1177/0301574220964634
1. To determine if the pandemic changed future treatment
choices amongst orthodontists
2. To determine if orthodontists use clear aligner
treatment more often than they did prior to the
pandemic
3. To determine how many orthodontic offices that used
tele-orthodontics during the pandemic plan to continue
with it into the future
OBJECTIVES
REFERENCES
Did the Pandemic Change Future Treatment Choices Amongst 
Orthodontists?
Atere J, DDS; Robinson R, DDS; Jones-Rudolph, K, DMD, MPH, MHA, PhD (c) 
Data collected will be analyzed with IBM® SPSS® version 26 (Armonk, NY). 
Descriptive statistics will be calculated using Chisquare tests.
INTRODUCTION
METHODS
This research will consist of an exploratory study, assessed 
through a 19-question survey. The survey will have a cover letter 
discussing the aims of the study and will be distributed through 
the American Association of Orthodontists to approximately 6600 
members, with the intention of recruiting a minimum of 50 
respondents. The survey is composed of 19 questions, but some 
respondents will answer fewer questions depending on their 
response to earlier questions. The planned statistical analysis will 
be descriptive information analyzed in the form of percentage of 
categorical responses. This data will be compared according to 
various demographic information such as gender, years of 
practice, type of practice, etc. 
The survey questions were designed to: 1) establish 
demographics, 2) determine whether tele-orthodontics and clear 
aligners are used by the orthodontists in their practices 3) Assess 
whether or not the usage of clear aligners and tele-orthodontics 
has changed due to the Covid-19 pandemic. This study has been 
approved by the Roseman University of Health Sciences 
Institutional Review Board [#2021-025]. Data collected will be 
analyzed with IBM® SPSS® version 26 (Armonk, NY). 
Descriptive statistics will be calculated using Chisquare tests.
1. There will be no difference in treatment choices
post-pandemic.
2. There will be no difference in the use of clear
aligners post-pandemic.
NULL HYPOTHESES
Dependent: 
• Percentage increase or decrease of the use of Clear
aligner therapy and teleorthodontics as a result of the
pandemic.
Independent:
• 19 question survey designed to:
• establish demographics,
• determine whether tele-orthodontics and clear
aligners are used by the orthodontists in their
practices
• assess whether or not the usage of clear aligners
and tele-orthodontics has changed due to the
Covid-19 pandemic
• The 6600 members in which the questionnaire is
sent to, with the intention of recruiting a minimum of
50 respondents.
RESEARCH DESIGN & SAMPLE
• An exploratory study  research design
• 50 participants minimum
INCLUSION & EXCLUSION CRITERIA
VARIABLES
ANTICIPATED OUTCOMES
It is anticipated that 20% of orthodontists that 
incorporated tele-orthodontics into their practice will 
continue to offer this service into the future. It is also 
anticipated that there will be an increase in the use of 
clear aligners by 10%
.
Exclusion Criteria
• 6600 Orthodontist associated with
the American Association of
Orthodontics
• Orthodontist not included from the
AAO selection.
• Orthodontist included in the list but
not currently practicing at a practice
or institution.


Did the Pandemic Change Future Treatment Choices Amongst Orthodontists?

Ricks, Benjamin

Comparison of Radiographic Exposure During RCT Under Endodontist vs General Dentist Supervision: A Retrospective Study

Grossman, Parker

Mandal, Manas

New Year, New Variant or A Subvariant of Old Omicron?
Parker Grossman1, and Manas Mandal2, 
1 PharmD Candidate; 2 Fulbright Scholar and Professor
Roseman University of Health Sciences College of Pharmacy, Henderson , NV
Contact: mmandal@roseman.edu
The purpose is to provide an overview of coronavirus infectious 
disease 2019 (COVID-19) variants, subvariants and vaccine-
induced immune protection against Omicron variant and 
subvariant of Omicron XBB.1.5.
Keyword search and review of COVID-19 variants, subvariants 
was performed using primary and tertiary literatures available in 
medRxiv, PubMed, CDC and NIAID databases. 
The search focused on emergence of COVID-19 variants of 
concern (VOC), subvariants, infectivity, vaccination, real-world 
protection data, waning of immune-protection, and 
bivalent booster recommendation and immune protection.
Purpose
Results
Conclusion
Methods
Fig 7. Neutralizing beneficial responses against Omicron subvariants with bivalent booster.
▪ COVID-19 vaccine real-world data showed strong and durable humoral and cellular immunity 
with high degree of protection against the original strain led severe infection, hospitalization and 
death. 
▪But durability of vaccine-induced immune protection waned after about 6 months from vaccination 
requiring a booster dose to enhance immune protection. 
▪ Recent VOC Omicron and its subvariants particularly XBB.1.5. is the predominant infective strain 
in U.S. and  world-wide.
▪ XBB.1.5 appears to be more contagious compared to other Omicron subvariants and Delta 
variant. XBB.1.5 accounted for 27% of the cases as of 1/7/23 lower than predicted 41% in US. 
▪ 69.1% of the total U.S. population have received a primary series vaccination while only 15.4% 
have received an updated, Omicron-adapted (BA.4/BA.5) bivalent booster dose as of 1/4/23. 
▪ A small study immunogenicity data indicated 1.9% infection in the original vaccine-booster 
recipients compared to 3.2% in bivalent booster recipients.
▪ Another study found an 81% reduction in in hospitalizations in people 65 & older with 2 doses of 
vaccination but not the bivalent booster. This study demonstrated a substantial reduction in 
COVID-19 mortality by the 2nd booster dose.
▪ Overall, primary series vaccination complemented with a booster dose are still effective against 
severe infection, hospitalization and death by Omicron and subvariants BA.4/ BA.5 & XBB.1.5 
infection.
▪ Development of safe and effective COVID-19 vaccines and boosters have been accomplished. 
▪ Emergence of new VOC and subvariants possess a challenge to successful control of the 
pandemic.
▪ Receipt of 3 doses of mRNA vaccine offered protection 
▪ Increased immunization and robust clinical efficacy data on primary, and bivalent booster 
immunization is required for protection, to control and end COVID-19 pandemic.
Reference
Fig 1.  Delta Vs Omicron Variant. Note the difference in number 
of mutations between Delta vs Omicron. 
Fig 2. COVID-19 Community Levels*
As of 1/5/2023, there are 628 (19.5%) counties, districts, 
or territories with a high COVID-19 Community Level, 
1,351 (41.9%) with a medium Community Level, and 
1,241 (38.5%) with a low Community Level. 
Fig 3. As of 1/4/2023, the current 7-day average of 
weekly new cases (67,243) increased 16.2% 
compared with the previous 7-day average (57,847).
Fig 4. Daily Change in the Total Number of 
Administered COVID-19 Vaccine Doses Reported 
to CDC by the Date of Administration, US.
7-Day moving average
Fig 5. Updated bivalent booster dose administered  
by age group
Fig 6. Daily Trends in Number of New COVID-19 Hospital 
Admissions in US.
1. https://covid.cdc.gov/covid-data-tracker/#datatracker-home
2. Research Square https://orchid.org/0000-0002-6058-8665
3. JAMA, Jan 2022
4. NEJM, 388:2, 2023.


New Year, New Variant or A Subvariant of Old Omicron?

Nama, Chandrika

Wisniewski, John, Dr.

Emergence of Dental Nanomaterials: “Their Role in Performing Endodontic Therapy”

MANDAL, MANAS

Discussion
Impact of Progesterone Surge On Oral Health and Hygiene During 
Menstrual Cycle and Pregnancy
Shreya Govindaraj* and Manas Mandal**
*Senior, Coral Academy of Science Sandy Ridge High School, **Professor & Fulbright Scholar, 
Roseman University College of Pharmacy
I would like to acknowledge Dr. Manas Mandal for 
mentoring me and providing me the support that I 
needed throughout the entire research process.
Purpose
Results
Conclusion
Acknowledgements
The purpose of this study is to understand the effect of 
progesterone surge on oral health and hygiene during 
menstruation and pregnancy.
• Progesterone surge during menstruation and 
pregnancy in women leads to oral mucosal 
inflammation and plaque buildup thus impacting oral 
health and hygiene. 
• Certain measures such as increased intake of vitamin B 
and C, stress reduction can directly affect progesterone 
production, therefore improving oral health-related 
problems in these conditions.
● A correlation was observed between progesterone 
surge during menstruation and pregnancy, and oral 
health. 
● Progesterone surges during pregnancy have also been 
correlated with oral cancerous lesions observed in 
about 5% of pregnancies.
● Hormonal changes during menstruation and pregnancy 
impact the blood supply to the oral mucosal area and 
plaque buildup leading to oral mucosal inflammation.
1. Al-Amad, Suhail H. “Ulcerative Stomatitis as the Sole Manifestation 
of Progesterone Hypersensitivity.” Oman medical journal vol. 35,6 
e202-e2020. 29 Nov. 2020, doi:10.5001/omj.2020.96
2. Andreza Maria Fábio Aranha, Fernanda Zanol Matos, Orlando 
Aguirre Guedes.
References
Methods
A keyword-based primary literature search in PubMed 
and Google Scholar database was conducted to 
understand the effect of progesterone surge during 
pregnancy and menstruation cycle that affects oral health 
and hygiene. Retrospective clinical data analysis included 
published original research and review articles with 
keywords progesterone surge, premenstrual syndrome, 
menstrual cycle, pregnancy, oral health, oral hygiene, 
and physiological variables.
Results Contd.
• Higher levels of progesterone can increase susceptibility to 
bacterial plaque buildup causing gingivitis most noticeable 
during the second to eighth month of pregnancy.
• Clinical diagnosis during gestation was correlated with the total 
bacterial count. A higher prevalence of Tannerella forsythia and 
was identified in the first trimester of pregnancy that was 
correlated with the diagnosis of gingivitis in these women. 
Porphyromonas gingivalis showed a positive correlation with 
progesterone levels in the first trimester.
• Certain oral contraceptives that contain progesterone may also 
cause gum inflammation due to increased plaque buildup and 
heightened immune response to the toxins produced by plaque-
associated commensals turned into pathogens.
Progesterone surge impacting oral health is a topic that currently 
lacks detail molecular information specifically regarding its control 
mechanisms. Further research on  the impact of progesterone 
surge during pregnancy and menstruation related to oral health 
can help serve the discovery of imperative knowledge. To 
illustrate, progesterone surge has led to the formation of oral 
cancerous lesions and can even lead to oral plaque and oral 
mucosal inflammation. It would be interesting to find whether 
control of such progesterone surge would prevent oral cancerous 
development.


Roseman Research Symposium

Lambert, S. Quinn

Thompkins, Stephanie A.

Madar, Zeinab A.

Junsanto-Bahri, Tipsuda, MD

Exercise & Depression in 
Osteopathic Medical Students
S. Quinn Lambert, OMS2, Stephanie Thompkins OMS1, Zeinab Madar OMS1, and Tipsuda Junsanto-Bahri, MD
Noorda College of Osteopathic Medicine (NoordaCOM)
The NoordaCOM curriculum emphasizes and integrates 
wellness. The campus environment is very supportive to the 
student body. The rigorous preclinical curriculum, exams, 
and the striving for performing well can be very stressful for 
medical students. 
A 2016 systematic review estimated that 27% of 
allopathic medical students had depression or depressive 
symptoms and 11% had suicidal ideation.1 These rates are 
higher than the general population. Additionally, these 
studies did not include osteopathic medical students. 
The osteopathic principles advocate a balance “between 
the body and mind” and not much literature is available 
regarding how wellness and the osteopathic tenets play a role 
in the daily lives, mental health and wellness of osteopathic 
medical students. 
A 2018 study examined 1st year osteopathic medical 
students’ attitudes towards importance of physical activity 
and priority placed on exercise. This importance can also be 
translated to exercise counseling for their future patients. 
Figure 1. At the heart of NoordaCOM’s mission to produce competent, confident, and compassionate 
physicians is a focus on its students’ health and wellness.
Hypothesis
Methods & Materials
Students are invited to participate in a paper survey 
comprised of 26 questions divided into 5 sections: the 
Beck Depression Inventory (BDI-ii), Morgenstern 
Exercise Survey (MES), survey questions related to 
osteopathic tenets, and general demographics.
The BDI-ii instrument has been shown to correlate 
with clinicians’ ratings of depression.2 The prevalence 
of no, light, moderate, and severe levels of depression 
will be obtained. Students will be able to determine 
their scores. Participants can detach the cover letter and 
their score. They are encouraged to seek advisement 
and counseling if they receive moderate and severe 
levels of depression.
The MES is a short physical activity survey that 
captures all types and levels of exercise which can be 
appropriately applied to medical students’ lifestyles. 
Osteopathic-tenet survey questions inquire about: 
1) “Do you feel that your values towards 
mental health and exercise align with an 
osteopathic mindset?” 
2) “Do you feel that your values towards 
mental health and exercise played a factor in 
applying to osteopathic medical school?” 
Institutional culture 
affects student health
Background
References
1 Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, 
and other indicators of psychological distress among U.S. and Canadian medical 
students. Acad Med. 2006;81(4):354-73).
2 Beck A, Steer R, Garbin M. Psychometric properties of the Beck Depression 
Inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8:77–100.
Conclusions
Osteopathic students may have a better mental health 
profile compared to allopathic students and want to 
determine:
1) Prevalence of depression amongst NoordaCOM
osteopathic medical students 
2) Correlation of exercise with the degree of depression 
3) Whether the application of the osteopathic principles 
and tenets play a role in their mental health and correlate 
with their level of physical activity
The research is ongoing and requires further 
statistical analysis. The issue with students and 
moderate to severe levels of depression needs to be 
addressed. Students spend up to 5hr/week with 
combinations of light, moderate, and vigorous 
exercise. NoordaCOM campus environment and the 
alignment of osteopathic tenets may contribute to 
decreased prevalence of depression amongst 
NoordaCOM students.
Preliminary Results:
• Response rate: 42% (94/225)
• Levels of depression:
• None-66% (32 Male; 29 Female)
• Light/MMD-25% (14 Male; 9 Female)
• Moderate-4% (3 Male; 1 Female)
• Severe-1% (1 Male)
• Exercise hours:
• ≤5hrs/week: Light 80%, Moderate 88%, and 
Vigorous 72%
• 6-19hrs/week: Light 16%, Moderate 6%, and 
Vigorous 22%
• Osteopathic alignment:
• 87% strongly agree/agree that their values align 
with an osteopathic mindset
• 65% strongly agree/agree that their mental health 
and exercise were a factor in osteopathic medical 
school application


Exercise & Depression Amongst Osteopathic Medical Students

Gardner, Bryce

Increased Student Confidence and Decreased Anxiety through Peer Mentoring Programs

Sanne, Anagha

The Effect of Augmented Reality Feature in Complete Anatomy Application on 
Educational Outcomes in Students with Autism Spectrum Disorder
Anagha Sanne and Kevin Steed, Ph.D
Noorda College of Osteopathic Medicine
● Autism Spectrum Disorder (ASD) is an early appearing neurological 
disorder characterised by features that affect how people communicate, 
interact and learn from their environment. Common features and signs 
include:
○ Deficiency in social communication skills
○ Symptoms that can affect day-to-day functioning and learning
○ Hyperfocused interests 
○ Repetitive behaviors
● Augmented Reality (AR) is an interactive experience that inserts 
computer generated images onto real world environment, as seen on 
technological devices.
● Recent developments in AR are being studied and used in educational 
institutions to enhance learning experiences and outcomes in students.
○ Complete Anatomy is an iOS/Android application which is used by 
students to get a better understanding of human anatomy. One special 
feature of this application is the AR perspective of human anatomy. 
             Figure 1: Human skull as seen in Complete Anatomy through the AR feature 
● Past studies have shown improved educational outcomes when using 
AR to study human anatomy by students in undergraduate and medical 
universities. Additionally, studies have shown better outcomes in Global 
Reading when students with ASD used AR technologies to learn. 
Background
Methods
AR feature of Complete Anatomy 
improves the educational experience 
of students with ASD
Conclusion
 
● AR feature of Complete Anatomy may improve the educational 
experience of students with ASD. 
● The  results from this study may  be applied to reform anatomy 
education for students with ASD in order to implement a more 
student-centric curriculum.
● Location: A local high school in Provo, Utah
● Participants: Students diagnosed with ASD, currently attending the same 
high school
● Method
○ The students are randomly divided into control and intervention groups.
○ The control and intervention groups will receive a 30-minute lecture 
about extremity muscles using Microsoft PowerPoint, on separate days.
■ Intervention group will receive 20 minutes to use AR in Complete 
Anatomy.
○ Both groups will complete and submit a pre- and post-intervention 
questionnaire of 10 multiple choice questions each. 
● Data Analysis: Quizzes will be scored out of 10 and plotted on bar and line 
graphs in Microsoft Excel for analysis.  
Expected Results 
Purpose
The purpose of this study is to determine the effect of using the AR 
feature in the Complete Anatomy application, on educational 
outcomes in students with ASD who are taking the Human Anatomy 
elective as a part of their high school curriculum.  
● Based on existing studies, we expect to see an improvement in the 
post-intervention quiz score averages of both groups when compared to 
mean scores of pre-intervention quizzes.
● Mean post intervention quiz score will be higher for the intervention 
group learning with AR compared to mean scores of control group. 
References


The Effect of Augmented Reality Feature of Complete Anatomy Application on Educational Outcomes in Students with Autism Spectrum Disorder

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