Internal Irrigation Surgery

Heat generation during osteotomy and implant placement is a critical concern in implant dentistry, as excessive temperatures can lead to bone necrosis, impaired healing, and early implant failure. A temperature increase of 10°C can be considered a threshold for potential issues. Bone cell damage can occur if the temperature reaches 47°C.3 A temperature of 47°C for 1 minute can impair implant osseointegration. The current standard of care involves the use of external irrigation to reduce heat generation during the drilling process. However, this method has limitations including poor visibility of surgical site, uneven cooling at the drill-bone interface, and inability to directly cool in guided surgery.

To address these concerns, recent innovations include surgical guides with integrated irrigation channels, which direct cooling fluid more efficiently to the drilling site and may reduce the risk of heat-induced bone injury. However, clinical evidence supporting the superiority of these advanced irrigation guides over traditional designs is still limited, highlighting the need for further research to optimize both surgical safety and outcomes.

This study aims to evaluate the effectiveness of an internal irrigation surgical guide system in reducing heat generation during osteotomy and improving outcomes of dental implant surgery. The findings from this study could inform clinical practice and contribute to the development of safer, more effective implant placement protocols.

Inclusion criteria

• Patients aged 25+
• Patients requiring a dental implant in the maxilla or mandible
• Patients with sufficient bone volume for implant placement.
• Patients classified as ASA I or II based on the American Society of Anesthesiologists (ASA) physical status classification system.
• Patients capable of providing informed consent and willing to adhere to study procedures and follow-up appointments.
• Patients with adequate interarch space to accommodate guided implant surgery.
• No history of implant placement at the experimental or control site.

Exclusion criteria

• ASA class 3 or higher
• Currently undergoing or history of bisphosphonate or antiresorptive therapy
• Patients who have received prior radiation therapy to the head and neck.
• Patients with contraindications for implant placement, such as active infections or severe periodontal disease.
• Pregnant or breastfeeding
• Patients with psychiatric or cognitive conditions impairing informed consent or compliance