Carboxymethyl Chitosan-Fluoride-doped Amorphous Calcium Phosphate: A Novel Remineralizing Gel.

Background: There is a need for innovative remineralizing gel formulations based on calcium and phosphates that can slowly release fluoride ions and enhance the formation of fluorapatite crystals that are more resistant to dissolution in an acidic environment. Aim: The aim of the work was to formulate a remineralizing agent that remineralizes enamel through the release of Ca2+, PO4³-, and F- ions for a prolonged period of time. Materials and methods: The gel was based on carboxymethyl chitosan (CMC) as a bioinspired gelling agent and on Fluoride-doped Amorphous Calcium Phosphate (F-ACP) as a remineralizing agent. This gel was tested in vitro on the enamel of extracted premolars after demineralization with methacrylic acid gel. Results: When compared to the control group and demineralized enamel group, the enamel slabs remineralized with CMC/F-ACP showed a higher calcium phosphate ratio in Energy-Dispersive X-ray (EDX) and better surface morphology under scanning electron microscope (SEM). Conclusion: Remineralization tests performed on demineralized human permanent teeth proved that CMC/F-ACP gel has excellent efficacy, inducing a complete remineralization of the outermost layers of enamel as well as a full restoration of lost mineral content. How to cite this article: Nimbeni BS, Nimbeni SB, Divakar DD, et al. Carboxymethyl Chitosan-Fluoride-doped Amorphous Calcium Phosphate: A Novel Remineralizing Gel. Int J Clin Pediatr Dent 2023;16(5):734-739.

Suspicion Is Key: Diagnosing Elusive Cytoplasmic Antineutrophil Cytoplasmic Antibody (c-ANCA)-Positive Vasculitis.

We present a case of a 53-year-old black male with a past medical history of type 2 diabetes presenting with fatigue, generalized myalgias, and unintentional weight loss developed over several months. The patient was diagnosed with cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA)-positive vasculitis. Renal biopsy confirmed antineutrophil cytoplasmic antibody (ANCA) crescentic necrotizing glomerulonephritis. c-ANCA was positive by enzyme-linked immunosorbent assay. Anti-myeloperoxidase antibody was positive. Without paranasal or lung involvement, the diagnosis was made of renal-limited necrotizing and crescentic glomerulonephritis. The patient was treated with rituximab and prednisone therapy.

Vertebral Osteomyelitis Secondary to Bacillus Calmette-Guérin Instillation Therapy for Transitional Cell Carcinoma In Situ.

Transitional cell carcinoma is the sixth most common cancer among men and the 17th most common cancer in women. The treatment methods for the condition range from noninvasive chemotherapy to more invasive procedures like cystectomy and complete transurethral resection of bladder tumor (TURBT) followed by intravesical Bacillus Calmette-Guérin (BCG) therapy (BCG). Intravesical BCG treatment is known to be effective as it is associated with increased survivability and long-term benefits, especially in early-stage, minimally-invasive disease. It is generally considered to be safe, even though some adverse reactions have been described. Vertebral osteomyelitis secondary to intravesical BCG therapy is a rare complication but one that has been reported in the literature. Although our patient had multiple comorbidities, including a previous vertebral compression fracture prior to treatment, complications from intravesical BCG treatment should always be considered in the differential. Further multi-center retrospective studies are needed to better ascertain its true risk given its increasing use as a treatment modality for transitional cell carcinoma.