Cirurgia de segundo estágio em implantes na maxila com deficiência de tecido queratinizado: uma nova abordagem com a técnica de reposição apical com retalho palatino / Second-stage surgery for maxillary dental implants with keratinized tissue defi ciency: a new approach with the apical positioning palatal rotation technique

O aspecto natural e a estética da interface dos tecidos moles e restaurações peri-implantares requerem uma faixa adequada de tecido queratinizado. A ausência desta representa um obstáculo à higiene bucal. O objetivo deste artigo foi descrever uma nova abordagem para o segundo estágio cirúrgico para implantes adjacentes na região posterior da maxila, visando aumentar a quantidade e a qualidade do tecido queratinizado em áreas onde este se encontra reduzido ou inexistente. A técnica de reposição apical com retalho palatino (Rarp) foi realizada e descrita em detalhes, através de um relato de caso clínico.

The natural aspect and esthetics of the peri-implant tissues and restorations requires a suitable range of keratinized tissue. Their absence also represents an obstacle to the oral hygiene. The pur pose of this article is to describe a new approach at the second surgical stage for adjacent implants in the posterior region of the maxilla aiming to increase the quantity and quality of the keratinized tissue in areas where it is reduced or nonexistent. The apical repositioning with palatal rotation (RARP) technique was performed and described in detail using a clinical case report.

Osteonecrose induzida pelo uso de bisfosfonatos após instalação de implantes dentários – relato de dois casos / Bisphosphonate-associated osteonecrosis of the jaw following dental implant placement – a report of two cases

A osteonecrose dos maxilares é uma das principais complicações relacionadas ao uso de medicamentos antirreabsortivos. Este artigo teve como objetivo relatar dois casos clínicos nos quais as pacientes desenvolveram osteonecrose dos maxilares induzida por bisfosfonatos, após instalação de implantes dentários. Em ambos os casos, as pacientes não relataram uso de bisfosfonatos. No primeiro caso, a região afetada foi a maxila, tendo sido utilizado o tratamento para infecção durante muitos meses até que, após remoção de sequestro ósseo, obteve-se o diagnóstico da patologia. O tratamento conservador com laser de baixa potência e antibioticoterapia obteve sucesso. No segundo caso, a paciente apresentou sequestro ósseo na região dos implantes dentários após realizar clareamento de um dente vizinho à região. O tratamento conservador não foi bem-sucedido, e a cirurgia para ressecção em bloco foi necessária. Nas duas situações, as pacientes só revelaram ter feito uso de medicação antirreabsortiva após serem questionadas diretamente, quando apresentaram sequestro ósseo. Uma anamnese dirigida e medidas para prevenção da complicação devem ser tomadas em pacientes que fazem ou fi zeram uso deste tipo de droga.

The osteonecrosis of the jaws is the main complication related to the use of anti-resorptive drugs. This article aims to report two clinical cases where the patients developed bisphosphonate-associated osteonecrosis of the jaw following dental implant installation. In both cases, both patients did not report use of bisphosphonates. In the first case, the affected region was the maxilla and it was treated as an infection for several months, until removal of bone sequestration, with the pathology diagnosed. The conservative treatment with low intensity laser and antibiotic therapy achieved success. In the second case, the patient presented bone sequestration around dental implants after performing internal tooth whitening in the neighboring region. The conservative treatment was not successful and surgery for bone resection was necessary. In both cases, the patients revealed to have used anti-resorptive drugs only after being directly questioned when bone sequestration was observed. A directed medical history and preventive measures should be taken with patients that use or have used this medication.

Embryo sac development in yellow passion fruit Passiflora edulis f. flavicarpa (Passifloraceae)

The yellow passion fruit, Passiflora edulis f. flavicarpa, is one of the most important Brazilian fruit crops. It is an allogamous, diploid, and self-incompatible species. It has hermaphrodite, solitary flowers, located in the leaf axils and protected by leaf bracts. The flower has an androgynophore, which is a straight stalk supporting its reproductive parts. There are usually five anthers, located at the tip of each of the five filaments. The ovary is borne just above the filaments, at the top of the androgynophore; there are three styles that are united at their base, and at the top there are three stigmas. The objective of this research was to observe embryo sac development in yellow passion flowers. Ovaries at different stages of development were fixed in FAA (formalin, acetic acid and alcohol solution), hydrated, stained with Mayer's hemalum, and dehydrated. Ovules were cleared by using methyl salicylate, mounted on slides, and observed through a confocal scanning laser microscope. The yellow passion fruit ovule is bitegmic, crassinucellate, and anatropous, and its gametophyte development is of the Polygonum type. After meiosis, functional megaspores under go three successive mitotic divisions, resulting in an eight-nucleate megagametophyte: the egg apparatus at the micropylar end, two polar nuclei at the cell center, and three antipodals at the chalazal end. The egg apparatus is formed by an egg cell and two synergids, each with a filiform apparatus. The mature embryo sac has an egg cell, two synergids, two polar nuclei, and three antipodes, as has been described for most angiosperms