In vitro and in vivo accuracy of autonomous robotic vs. fully guided static computer‐assisted implant surgery

Abstract

ObjectivesTo assess the accuracy of autonomous robotic and fully guided static computer‐assisted implant surgery (sCAIS) performed on models and patients.Materials and MethodsThis study was divided into in vitro and in vivo sections. In vitro, 80 operators were assigned to two groups randomly. Forty operators performed forty autonomous robotic implant (ARI group) surgeries and the remaining forty operators carried out forty fully guided sCAIS (FGI group) surgeries on maxillary models, respectively. Each operator placed an implant in one maxillary model. In vivo, 60 patients with 113 implants from 2019 to 2023 (ARI group: 32 patients, 58 implants; FGI group: 28 patients, 55 implants) receiving implant surgeries were incorporated in this retrospective research. The preoperative and postoperative cone beam computer tomographs (CBCTs) were utilized to estimate the linear deviations and angular deviations in two‐dimensional (2D) and three‐dimensional (3D) space. The Pearson's chi‐square test, Shapiro–Wilk test, Student's t test, Mann–Whitney U test and mixed models were applied, and p <0.05 was considered statistically significant.ResultsIn vitro, a total of 80 implants were enrolled and significant differences were found between the two groups (p < 0.001): The 3D deviation at the platform of ARI and FGI group was 0.58 ± 0.60 mm and 1.50 ± 1.46 mm, respectively, at the apex was 0.58 ± 0.60 mm and 1.78 ± 1.35 mm, respectively, and angle was 1.01 ± 0.87° and 2.93 ± 1.59°, respectively. Also, except for mesiodistal deviation at the implant platform, the rest linear and angular deviations in the ARI group were significantly lower than those in the FGI group in 2D space (p < 0.001). In vivo, a significantly lower mean of angular deviation (0.95 ± 0.50°, p < 0.001) and the linear deviation at both platform (0.45 ± 0.28 mm, p < 0.001) and apex (0.47 ± 0.28 mm, p < 0.001) were observed in ARI group when compared to the FGI group (4.31 ± 2.60°; 1.45 ± 1.27 mm; 1.77 ± 1.14 mm).ConclusionsThe use of autonomous robotic technology showed significantly higher accuracy than the fully guided sCAIS.

The evolution of robotics: research and application progress of dental implant robotic systems

“…However, in vitro studies cannot fully simulate the patients’ oral condition and bone quality. Recent clinical studies 89 , 92 , 93 have shown a lower deviation in robotic-assisted implant placements compared to static-guided and dynamic-navigated implant placements. Common reasons for deviations in static-guided and dynamic-navigated implant placements include the following: deflection caused by hand tremors due to dense bone during surgery, surgeons’ experience, and other human factors.…”