Accuracy and safety of a haptic operated and machine vision controlled collaborative robot for dental implant placement: A translational study.

OBJECTIVES: Multiple generations of medical robots have revolutionized surgery. Their application to dental implants is still in its infancy. Co-operating robots (cobots) have great potential to improve the accuracy of implant placement, overcoming the limitations of static and dynamic navigation. This study reports the accuracy of robot-assisted dental implant placement in a preclinical model and further applies the robotic system in a clinical case series. MATERIALS AND METHODS: In model analyses, the use of a lock-on structure at robot arm-handpiece was tested in resin arch models. In a clinical case series, patients with single missing teeth or edentulous arch were included. Robot-assisted implant placement was performed. Surgery time was recorded. Implant platform deviation, apex deviation, and angular deviation were measured. Factors influencing implant accuracy were analyzed. RESULTS: The in vitro results showed that with a lock-on structure, the mean (SD) of platform deviation, apex deviation, and angular deviation were 0.37 (0.14) mm, 0.44 (0.17) mm, and 0.75 (0.29)°, respectively. Twenty-one patients (28 implants) were included in the clinical case series, 2 with arches and 19 with single missing teeth. The median surgery time for single missing teeth was 23 (IQ range 20-25) min. The surgery time for the two edentulous arches was 47 and 70 min. The mean (SD) of platform deviation, apex deviation, and angular deviation was 0.54 (0.17) mm, 0.54 (0.11) mm, and 0.79 (0.22)° for single missing teeth and for 0.53 (0.17) mm, 0.58 (0.17) mm, and 0.77 (0.26)° for an edentulous arch. Implants placed in the mandible had significantly larger apex deviation than those in the maxilla. CONCLUSION: Cobot-assisted dental implant placement showed excellent positional accuracy and safety in both the in vitro study and the clinical case series. More technological development and clinical research are needed to support the introduction of robotic surgery in oral implantology. Trial registered in ChiCTR2100050885.

Energy consumption, environmental pollution, and technological innovation efficiency: taking industrial enterprises in China as empirical analysis object.

Facing increasingly serious environmental problems, technological innovation has become the key for industrial enterprises to coordinate energy conservation and emission reduction constraints and achieve steady growth of the industrial economy. Considering the impact of energy consumption and environmental pollution on the technological innovation efficiency of industrial enterprises, this paper incorporates industrial energy consumption, pollution control, and wastewater and exhaust emissions into the technical inefficiency equation. Based on the panel data of industrial enterprises in 30 provinces and autonomous regions in China from 2009 to 2016, the stochastic frontier analysis (SFA) model is used to study the effect of energy consumption and environmental pollution on technological innovation efficiency of industrial enterprises. The research results show that reducing energy consumption and increasing pollution treatment investment both have a significant driving effect on the improvement of industrial enterprises' technological innovation efficiency. Industrial wastewater and exhaust emissions have the opposite effect; unreasonable input mode of pollution control and personnel allocation have hindered the improvement of industrial enterprises' technological innovation efficiency. The average annual trend of technological innovation efficiency in industrial enterprises shows a curve of first rising, then falling, and rising again. The average values of Chongqing, Zhejiang, and Hunan rank in the top three, and the average values of Qinghai, Heilongjiang, and Inner Mongolia rank the bottom three. The average values of other provinces are higher than 0.9, and the difference is small. A suitable incentive mechanism should be established for industrial enterprises to save energy and reduce emissions and strengthen pollution control, improve the training program for environmental protection technical personnel, and provide important support for improving the green competitiveness of industrial enterprises.