01 June 2023

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Is robotic implant surgery precise enough?

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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 precise operational manipulation.

This technology involves a tactile guiding robot and a semi-active robotic assistance system, consisting of an operating arm and a coordinate measuring machine arm that provides visual guidance and tactile feedback during movement. In the robotic system, the dental surgeon has considerable control. For example, the surgeon indicates where an implant should be placed, and the robotic system autonomously performs the osteotomy task while the surgeon supervises and intervenes as necessary.

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.

The researchers enrolled patients with only one missing tooth for autonomous robotic implant surgery. Patients underwent cone beam computed tomography (CBCT) with marker placement. Before surgery, virtual preoperative implant placement and a drilling plan were created.

The autonomous robotic system included an operating system, a robotic arm, an optical tracking 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 assess deviations between the planned and placed implants.

Results

The team enrolled 10 patients with a single dental implant. They did not report adverse surgical events or postoperative complications (e.g., infection and early implant failure).

Robotic autonomous implant surgery showed an overall mean coronal deviation of 0.74 mm (95% CI: 0.53 to 0.94 mm), an overall mean 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 in this study, the researchers concluded that computer-assisted autonomous robotic implant surgery has high precision for placing single implants by controlling 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.

This article originally appeared on Odontolgia33. 

Shuo Yang, Jiahao Chen, An Li, Ke Deng, Ping Li, Shulan Xu, "Accuracy of autonomous robotic surgery for single-tooth implant placement: A case series," Journal of Dentistry, Volume 132, February 2023, 104451, ISSN 0300-5712, https://doi.org/10.1016/j.jdent.2023.104451.