{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:07:10Z","timestamp":1783937230252,"version":"3.55.0"},"reference-count":16,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Technologically Enabled Advancements in Dental Medicine","award":["760235\/28.12.2023"],"award-info":[{"award-number":["760235\/28.12.2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Thermal injury during implant osteotomy is a recognized complication of guided surgery. Closed guide architectures and metallic sleeves restrict coolant access to the drill\u2013bone interface, reducing the effectiveness of conventional external irrigation. This study aimed to describe the design and fabrication of a 3D-printed surgical guide system with integrated internal irrigation channels and to evaluate its technical and clinical feasibility in guided implant surgery. Methods: The system was developed by integrating CBCT and IOS data into BlueSky Bio planning software. Irrigation channels were generated by CAD subtraction. Guides were fabricated by additive manufacturing\u2014digital light processing (DLP) in biocompatible Asiga DentaGuide resin and, in one case, selective laser melting (SLM) in Mediloy metal\u2014with metal auxiliary components incorporated where required. Channel patency was confirmed by flow equivalence testing and visual inspection. The design was evaluated for compatibility with the BioHorizons Pro Surgical Guide Kit and the Ticare Fidelis Kit. Clinical feasibility was assessed in two cases: maxillary All-on-6 rehabilitation and immediate implant placement in the esthetic zone. Results: Both guides were successfully fabricated with confirmed patent irrigation channels. Guide seating was verified through occlusal fenestrations and secured with fixation pins. Irrigation flow remained unobstructed throughout all osteotomy steps, and no guide-related or irrigation-related complications were observed. The system was integrated into standard drilling protocols without modification for either implant platform. Conclusions: This proof-of-concept study demonstrates the technical feasibility of an internally irrigated surgical guide across two implant systems and distinct clinical scenarios. The proposed design was successfully integrated into standard guided surgery workflows and maintained functional irrigation. Further in vitro thermal studies and prospective clinical investigations are required to evaluate its effect on temperature control.<\/jats:p>","DOI":"10.3390\/jcm15145468","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:53:58Z","timestamp":1783932838000},"page":"5468","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Liquid Guide System: Design and Clinical Feasibility of an Internally Irrigated 3D-Printed Surgical Guide for Implant Surgery"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5692-2133","authenticated-orcid":false,"given":"Adrian Teodor","family":"Moga-Rogoz","sequence":"first","affiliation":[{"name":"Department of Radiology, Faculty of Dental Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tudor","family":"Matei","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Dental Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9543-3674","authenticated-orcid":false,"given":"Mihaela","family":"Hede\u0219iu","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery and Radiology, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"B\u0103ciu\u021b","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery and Radiology, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0584-5649","authenticated-orcid":false,"given":"Sorana","family":"Eftimie","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery and Radiology, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Steigmann","sequence":"additional","affiliation":[{"name":"Steigmann Institute, 69151 Neckargemund, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ali, A., Brintouch, I., Romanos, G., and Delgado-Ruiz, R. (2024). Cooling Efficiency of Sleeveless 3D-Printed Surgical Guides with Different Cylinder Designs. Medicina, 60.","DOI":"10.3390\/medicina60020239"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rivara, F., Naty, G., Galli, C., Vanali, M., Rossetti, S., and Calciolari, E. (2025). Closed- vs. Open-Frame Surgical Guides: An Ex-Vivo Analysis of the Effects of Guide Design on Bone Heating. Prosthesis, 7.","DOI":"10.3390\/prosthesis7040076"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Chen, Y.-C., Tsai, Y.-J., Hsiao, H.-Y., Chiu, Y.-W., Hong, Y.-Y., Tu, Y.-K., and Hsiao, C.-K. (2024). Assessment of Thermal Osteonecrosis during Bone Drilling Using a Three-Dimensional Finite Element Model. Bioengineering, 11.","DOI":"10.20944\/preprints202405.0221.v1"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Parvizi, S., Cameron, A., Tadakamadla, S., Figueredo, C.M.S., and Reher, P. (2023). 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Sq., 1\u201322.","DOI":"10.21203\/rs.3.rs-7276802\/v1"},{"key":"ref_16","first-page":"e76251","article-title":"Full-Arch Rehabilitation Using Implant-Guided Surgery and Ozone Therapy to Prevent Complications in a Systemically Compromised Patient","volume":"16","author":"Formiga","year":"2024","journal-title":"Cureus"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/14\/5468\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:13:38Z","timestamp":1783934018000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/14\/5468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":16,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15145468"],"URL":"https:\/\/doi.org\/10.3390\/jcm15145468","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]}}}