25 April 2023

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Robotic implant surgery: Will it be the future?

Lara Figini

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Computer-assisted robotic implant surgery (r-CAIS) has emerged very recently as a new digital technology in oral and maxillofacial surgery. It combines the benefits of real-time feedback and accurate operative manipulation. 

The r-CAIS technology involves a tactile guide robot, a semi-active robotic assistance system, consisting of an operating arm and a coordinate measuring machine arm, which provides visual guidance and physical or tactile feedback during movement. In the task-autonomy robotic system, the dental surgeon has a fair amount of control over the system. For example, the surgeon indicates where an implant should be placed, and the robotic system autonomously performs the osteotomy task while the surgeon monitors and intervenes as needed.

Materials and methods

In a clinical study, published online in February 2023 in the Journal of Dentistry, the authors investigated the accuracy of computer-assisted robotic autonomous implant surgery (r-CAIS) for single-tooth implant placement. 

Researchers enrolled patients with a single missing tooth for autonomous robotic implant surgery. Patients underwent a cone beam computed tomography (CBCT) scan with a placement marker. Virtual preoperative implant placement and a drilling plan were created prior to surgery. 

The autonomous robotic system included an operating system, a robotic arm, an optical tracker system and a positioning indicator. The robotic system automatically performed the osteotomy for implant placement and intraoperative positioning under the supervision of the surgeon. A postoperative CBCT scan was performed to evaluate deviations between the planned and placed implants.

Results

The team enrolled 10 patients with a single dental implant. They reported no adverse surgical events or postoperative complications (e.g., infection and early implant failure). 

Robotic autonomous implant surgery showed a mean overall coronal deviation of 0.74 mm (95% CI: 0.53 to 0.94 mm), a mean overall apical deviation of 0.73 mm (95% CI: 0.53 to 0.93 mm) and an angular deviation of 1.11◦ (95% CI: 0.78 to 1.44◦), respectively.

Conclusions

From the data of this study, researchers concluded that autonomous computer-assisted robotic implant surgery has a high accuracy for placing single implants thanks to the control of angular deviation and axial errors.

Clinical significance

The main findings of this study provide significant evidence to support the autonomous robotic implant surgery system as a potential alternative in dental implant surgery.

Shuo Yang, Jiahao Chen, An Li, Ke Deng, Ping Li and Shulan Xu. “Accuracy of autonomous robotic surgery for single-tooth implant placement: A case series.” Journal of Dentistry. Volume 132, May 2023, https://doi.org/10.1016/j.jdent.2023.104451