Guided implant placement: water cooling issues?

Authors

Does the use of a surgical guide prevent the proper cooling of the bur upon entering the bone? With external cooling, water has limited access to the osteotomy when a surgical guide envelopes the area. Is this an important factor in the use of guides? There are some publications ( I don’t have any references at this time) that claim that some research revealed that water cooling is unessential because every next drill removes the layer of charred bone. The final drill supposedly was of no consequence. What is your experience with surgical guides from that point of view?

9 Comments on Guided implant placement: water cooling issues?

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Rand
1/29/2018
I approach this in one of two ways. a: I only use the guide for the pilot drill and hence can use regular drilliing and irrigation thereafter. b: If I use all drills, I just drill at 50 rpms. It is a good technique if you also wish to harvest bone from the osteotomy. Proceeding in this manner has worked well for me for many years.
Dr. David Morales (mansai
1/29/2018
I do the same as Rand. I use the surgical guide for the initial mark and then proceed with the drill sequence. I use external water cooling. This has worked for the past 19 years.
Dok
1/29/2018
I innovated a customizable surgical guide system ( working prototype ) that has an internal irrigating channel that allows for irrigant flow to be directed into the osteotomy as the drill sequence occurs. It connects to an external source ( same as your drill motor ). It was initially presented/disclosed to 360Imaging Corp. with little or no interest by them. Anyone out there interested in viewing this technology for the purpose of development ?
Johann
1/30/2018
Yes, I am interested. Pictures/photos?
Dok
1/30/2018
Anyone interested in seeing the prototyped irrigating surgical guide..... kindly send me an e-mail with an address that I can reply to and I will send images. Please note that these guides are custom fabricated/fitted guides ( as they usually are ) that have the capability of delivering irrigant directly to the osteotomy during surgery without being intrusive, bulky or bothersome.
OsseoNews
1/30/2018
Please do not post email addresses online. It simply invites spam or worse. Any email addresses posted here will be deleted. If you wish to communicate with anyone, you may post a website link to provide more information. Thanks for your understanding.
Dok
1/30/2018
Sorry for the mistake. Didn't realize I posted an email address here. Certainly wouldn't want to disclose new ideas on this forum. As others have stated, dry osteotomies are perfectly OK.
Dr. Arturo Gonzalez
1/30/2018
One solution is using guides with irrigation canals The guides I use by DentArt Digital Dental Labs (dentartlabs(dot)com, are amazing and provide irrigation canals this allows proper irrigation of the osteotomy and flutes in order to not have to worry about this issue. Also keep in mind to not go above recommended rpms for the drill you are using. They generally change according to the diameter and all my drilling protocols from DentArt always have them per drill, which is really nice.
Dr. Arturo Gonzalez
1/30/2018
DentArt Digital Dental Labs has pictures on the portfolio page of a guide with irrigation canal. Since links are ok here is the link: http://dentartlabs.com/portfolio/ I think its the last/3rd case on that page. Ive used tons and they are the best I have ever used so far!