Differentiation between the normal variant cleft epiphysis and Salter-Harris type III fracture of the first proximal phalanges of the foot in children might be challenging. The authors describe a case of a 10-year-old ballet dancer girl with bilateral epiphyseal segmentation of the first proximal phalanges of the foot, unresponsive to conservative treatment. Considered a nonhealing stress-induced fracture, operative treatment with closed reduction and Herbert screw insertion was chosen on both sides. Complete union was achieved, with significant reduction of pain. The presented case suggests that internal fixation can be a viable option in the treatment of the problem.

The objective of this study was to explore dental students’ facial profile preferences in a large sample of students. Nine hundred and nineteen dental students of four dental schools were involved. As part of a larger study on dentofacial esthetics, six photo series consisting of one unaltered and four altered variants of the same female profile were distributed among the students. The altered features were ones that are esthetically significant according to the literature. The students had to indicate the photo in each series that they preferred. The data were analyzed in a regression model in which preference in the given photo series was the dependent variable and gender, grade of studies, and dental school were the factors. Eight hundred and sixty-one students (93.7%) responded. Gender and dental school were not associated with the observed preferences, but the grade of studies was associated for three of the modified parameters: chin prominence, the sagittal position of the maxillary dental arch, and the simultaneous modification of the prominence of the chin and the nose. This study has confirmed several earlier observations, and new observations have also been made. We have demonstrated that the anteroposterior position of the maxillary incisors may be an important determinant of profile esthetics, even if this position does not influence the situation of the soft tissues and if the forehead cannot be used as a reference. We have also shown that the harmony between the nose and the chin overrides the importance of their individual dimensions.

In the last decade, the use of surgical guides in dentistry has expanded to include endodontic surgery, yet most studies have focused on accuracy rather than potential heat generation. This in vitro study evaluated heat generation during bone drilling with custom-made bone trephines, both with and without static surgical guides, and compared the results to those of 2 mm pilot drills. Drilling was performed on porcine rib bone specimens under controlled conditions, with heat generation measured using an infrared thermometer. None of the groups exceeded the critical temperature of 47 °C; although, the guided trephine group recorded the highest peak temperature (7.9 °C above baseline). Significant differences in heat increments were observed among the groups. Post hoc analyses revealed that the guided pilot drill produced significantly lower heat increments compared to the trephine groups, particularly during the penetration of the second cortical layer and at peak temperatures (p < 0.05). The use of a surgical guide did not limit the cooling and lubricating effects of irrigation in the trephine groups. Regression analyses confirmed a strong relationship between drilling time and temperature increase, with guided trephines showing a steeper temperature rise compared to pilot drills. These findings emphasize the importance of proper irrigation, sharp instruments, reduced drilling speeds, and careful technique to minimize heat generation during guided bone drilling procedures.