An in vitro analysis of the accuracy of static and robot-assisted implant surgery.

OBJECTIVES: Robot-assisted implant surgery (RAIS) is purported to improve the accuracy of implant placement. The objective of this study was to compare RAIS with static computer-assisted implant surgery (sCAIS) in a controlled environment. MATERIALS AND METHODS: A total of n = 102 implants were placed in the same modified typodont (n = 17 repeated simulated implant surgeries with each n = 3 implants per group) using robot-assisted or static computer-assisted implant surgery. The final implant positions were digitized utilizing cone-beam tomography and compared with the planned position. The angular deviation was the primary outcome parameter. 3D deviations at the implant platform level and the apex were secondary outcome parameters. Accuracy in terms of trueness and precision were assessed. Means, standard deviation, and 95%-confidence intervals were analyzed statistically. RESULTS: The overall angular deviation was 2.66 ± 1.83° for the robotic system and 0.68 ± 0.38° for guided surgery using static guides (p < .001), the 3D-deviation of the implant platform at crest level was for sCAIS 0.79 ± 0.28 mm and RAIS 1.51 ± 0.53 mm (p < .001) and at the apex for sCAIS 0.82 ± 0.26 mm and for RAIS 1.97 ± 0.79 mm (p < .001), respectively. CONCLUSIONS: Robotically guided implant surgery was less accurate in terms of trueness (planned vs. actual position) and precision (deviations among implants) than traditional static computer-assisted implant surgery in this in vitro study.

Accuracy and Deviation Analysis of Static and Robotic Guided Implant Surgery: A Case Study.

Guided dental implant surgery can optimize implant placement positioning, increase predictability, and decrease surgical invasiveness through flapless techniques. Static surgical guides have been used to accomplish this task, though limitations of patient opening and lack of coolant contact with the surgical site have been clinically significant weaknesses. Technologic advances have allowed robotically guided implant placement using haptic guidance. The absence of a static stereolithographic guide over the surgical area allows for optimal access and adequate cooling during osteotomies. The aim of this case series was to present the workflows of both static and robotic guidance in the same patient and measure deviations from the presurgical planning software to determine the practicability and accuracy of robotic guidance. Based on this case series, it can be concluded that using robotically assisted implant surgery can yield deviation results that are comparable to static CAD/CAM stereolithographic surgical guides. Robotic surgery can be performed predictably with minimal deviation in both simple and complex clinical situations. Further testing and analysis are needed to confirm this case study's results in a larger cohort of patients.