Guided Implant Placement Using an Internally Cooling Surgical Template: A Technical Note
Cooling irrigation during implant bed preparation is mandatory to avoid overheating. Due to the surgical guide design, external cooling systems do not reach the point of entry of the implant burr. Here, a new technique for irrigation during guided implant surgery for direct rinse of the burr is described. Using computer-aided design/computer-aided manufacturing additive technology, a pin of a cooling pipe was designed and implemented in a surgical guide template. The implant bed preparation was performed while the cooling pipe was connected to the surgical guide. During surgery, the irrigation solution was directly rinsing the burr at the point of entry through the irrigation channel. The use of a cooling surgical guide seems to improve the cooling of the bone during implant bed preparation. This might lead to less thermal effect of bone cells. However, systematic studies are needed to confirm the observations of the presented case report.
Figure 1. Prosthetic-driven implant positioning in the region of the missing first premolars. Figure 2. Setting the guide sleeves (red) and adding generic sleeves (light blue) representing in shape the end of the cooling tube for designing an internally cooled surgical guide. Figure 3. The 3-dimensional design of the internally cooled surgical guide.
Figure 4. The designed guide was 3-dimensionally printed and the guided sleeves added. Figure 5. The cooling tube was connected safely with the surgical guide. Irrigation solution flowed through the constructed internal channels. Figure 6. Implant bed preparation using an internally cooled drill guided by internal irrigation channels.
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