Influence of Different Build Directions on the Fracture Load and Surface Roughness of Additively Manufactured Three-unit Provisional Restoration and Comparison with Conventional Methods of Provisional Fabrication.

PURPOSE: To compare the influence of 0, 45 and 90 degrees build direction on fracture load and surface roughness of additively manufactured three-unit fixed provisional restoration, and to compare with provisionals fabricated using conventional materials. MATERIAL AND METHODS: Mandibular typodont right second molar and premolar were prepared for missing mandibular first molar to receive three-unit fixed partial denture. Six groups of 10 samples each, 3-unit provisionals were fabricated using additional manufacturing at 0,45 and 90 degrees, heat polymerized polymethyl methacrylate, auto polymerizing resin and bis-acryl composites resins and tested for fracture load and surface roughness. One way ANOVA and Tukey tests were used to analyze the data. RESULTS: For fracture load, lowest mean value was obtained for auto polymerizing bis-acrylic resin (464.9N) and highest value for 0 degree (596 N), while surface roughness values were lowest for heat polymerized polymethyl methacrylate (0.132µm), and the highest for auto polymerizing polymethyl methacrylate (0.836 µm). Significant differences were obtained between three build directions for fracture load and surface roughness (p=0.001); in all pairwise comparisons except between 0 and 90 degrees (p=0.502) for fracture load; and between all three build directions for surface roughness (p=0.01). On comparing with other provisional materials, significant difference (p=0.001) was observed between all groups. Conclusion- Build direction affected the mechanical properties of additively manufactured three-unit provisionals with 0 degree printed provisionals showing highest fracture load and lowest surface roughness. On comparing with other provisional materials, 0 degree showed highest fracture load, with surface roughness similar to heat polymerized provisionals.

A Homozygous Missense Variant in INPP5E Associated with Joubert Syndrome and Related Disorders.

Joubert syndrome and related disorders (JSRD; ORPHA 140874) is a complex set of neurodevelopmental disorders with multiple organ involvement. JSRD is a type of ciliopathy which is caused by the presence of defective primary cilia in an individual. JSRD is commonly inherited in an autosomal recessive pattern, and more than 23 genes are known to be associated with JSRD. We report a novel homozygous mutation identified in the INPP5E gene, c.1303C>T, which leads to a change of an amino acid from arginine to tryptophan at residue 435 in the protein chain. In silico analysis indicates that p.Arg435Trp substitution affects the functionality of the protein product of the gene. Our result adds to the growing body of evidences that underlines the clinical utility of next-generation sequencing in the diagnosis of a genetic disorder when clinical features are inconclusive.

Amplification of specific chromosomal regions assessed by fluorescent in situ hybridization on Pap smears to be added as screening tool for identifying women at risk of progressing to cervical cancer.

Cervical carcinoma is a frequent malignancy in developing countries despite being a preventable disease. For the first time, four screening tests were used simultaneously for identifying women with a risk of developing cervical cancer, to help clinicians and policy makers to implement the best strategy for reducing the burden of this disease. Women visiting a hospital in India were enrolled after institutional ethics clearance and informed consent. Visual inspection using acetic acid and Pap smear tests were performed on 2683 women, and 104 had abnormal cytology: atypical squamous cells of undetermined significance (n = 29), low-grade squamous intraepithelial lesion (n = 41), high-grade squamous intraepithelial lesion (n = 17), and squamous cell carcinoma (n = 17). These and 96 samples, with normal cytology, were subjected to high-risk human papilloma virus testing and fluorescent in situ hybridization evaluation. Women with abnormal cytology were followed for 5 years and evaluated with colposcopy-guided biopsy. Three accepted methods of screening and one novel fluorescent in situ hybridization assay were carried out in 200 cases. Cutoffs for fluorescent in situ hybridization were established. The screening methods had 88%-96% negative predictive value, while positive predictive value was low (20%) for visual inspection using acetic acid, 47% for fluorescent in situ hybridization, 56% for high-risk human papilloma virus, and 73% for combined high-risk human papilloma virus and fluorescent in situ hybridization. Combined high-risk human papilloma virus and fluorescent in situ hybridization had 94% sensitivity, specificity, and negative predictive value, suggesting that simultaneous screening with these two tests is appropriate for identifying women progressing to cervical cancer and not visual inspection using acetic acid, which has low positive predictive value and Pap cytology which requires to be repeated. Policy makers and clinicians can assess feasibility of incorporating this screening strategy to prevent cervical cancer.