The 3D Printing and Evaluation of Surgical Guides with an Incorporated Irrigation Channel for Dental Implant Placement

Abstract

Dental implant insertion requires the preparation of the implant bed via surgical drilling. During this stage, irrigation is essential to avoid thermal damage to the surrounding bone. Surgical guides enhance the accuracy of the implant site preparation, but they mask the drilling site, hampering coolant delivery. A variety of designs are aimed at improving the coolant access to the target site. Using standard dental implant simulation software, this paper presents an in-house design and 3D printing workflow for building surgical guides that incorporate a coolant channel directed toward the entry point of the burr. The proposed design was evaluated in terms of the bone temperature elevations caused by drilling performed at 1500 rpm, under an axial load of 2 kg, and irrigation with 40 mL/min of saline solution at 25 °C. Temperature measurements were performed on porcine femoral pieces, in the middle of the cortical bone layer, at 1 mm from the edge of the osteotomy. The mean temperature rise was 3.2 °C for a cylindrical sleeve guide, 2.7 °C for a C-shaped open-sleeve guide, and 2.1 °C for the guide with an incorporated coolant channel. According to a one-way ANOVA, the differences between these means were marginally insignificant (p = 0.056). The individual values of the peak temperature change remained below the bone damage threshold (10 °C) in all cases. Remarkably, the distribution of the recorded temperatures was the narrowest for the guide with internal irrigation, suggesting that, besides the most effective cooling, it provides the most precise control of the intraosseous temperature. Further studies could test different design variants, experimental models (including live animals), and might involve computer simulations of the bone temperature field.

Cooling Efficiency of Sleeveless 3D-Printed Surgical Guides with Different Cylinder Designs

“…Tuce et al [28] designed and printed three surgical guides: solid, open sleeve, and lateral irrigation channel. These guides were utilized to simulate guided surgery on porcine bone, with temperature evaluation conducted using a digital thermometer and subsequent recording of differential temperatures.…”

Assessment of Thermal Osteonecrosis during Bone Drilling Using a Three-Dimensional Finite Element Model

“…While numerous technical studies have explored methods to mitigate the heat effects on bone, such as utilising coolant irrigation, optimising drill bit geometry [ 9 ], enhancing wear resistance [ 51 ], implementing step-power drilling [ 52 ], etc., there is no conclusive evidence to indicate that irrigation cooling been universally adopted as a standard practice, despite strong recommendations from major implant manufacturers. However, clinically, irrigation cooling is standard practice and is strongly advocated for by leading implant manufacturers [ 53 , 54 , 55 , 56 ]. Although coolant irrigation applied to the bone surface can effectively lower surface temperatures, insufficient evidence confirms its penetration into the borehole for temperature reduction.…”

Leveraging Additive Manufacturing and Reverse Engineering for Circular Economy-Driven Remanufacturing of Hydraulic Drive System Components

“…The process of 3D additive manufacturing offers a multitude of advantages, facilitating the swift, cost-effective creation of physical prototypes with minimal equipment and intermediate production steps. The specialized literature showcases numerous instances [30][31][32] where additive manufacturing is leveraged to produce various functional components.…”