Drill irrigation during in vitro drilling with three static computer-assisted implant surgery systems

Static computer-assisted implant surgery (sCAIS) allows for accurate implant placement. However, the currently available systems usually block drill irrigation, increasing the risk of overheating and tissue damage. The present in vitro study evaluates the volume of irrigation solution that passes through the guide sleeve during implant drilling with different sCAIS systems.

The volume of irrigation solution that passed through a designed guide sleeve was measured on a 5ml syringe. The following sCAIS systems and groups were evaluated: A sleeve-in-sleeve with drill handle system (Straumann® sCAIS system); an integrated sleeve-in-drill system (RealGuide™ Z3D sCAIS system), and an integrated sleeve-in-drill system with irrigation channels (Adin® sCAIS system). The control group had neither drill handle nor sleeve-in-drill. The first pilot drill from each system was used, and drilling was performed for 10 seconds. The experiment was repeated 10 times for each group, and a blinded investigator measured the amount of irrigation solution in ml/s. A descriptive and bivariate analysis was performed.

The median volume of irrigant collected over 10 seconds was: Sleeve-in-sleeve group, 0.35 (IQR: 0.04) ml/s; sleeve-in-drill group, 0.07 (IQR: 0.04) ml/s; sleeve-in-drill system with channels group, 0.46 (IQR: 0.12) ml/s; and control group, 0.54 (IQR: 0.02) ml/s. The differences between groups were statistically significant (p=0.0001), except for the Adin sCAIS® system, which was not different from the control group (p=0.085).

Within the limitations of the study, the volume of irrigation seems to be influenced by the design and sCAIS system used. Although all guides impeded irrigation, the Adin® sCAIS system facilitated irrigation the most.