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Using a robot system to prepare guiding planes for removable partial dentures: An in vitro study
Yi Li1, Chuyue Yang2, Xunning Cao2
1Graduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
Statement Of Problem:
Ensuring that guiding planes are parallel and that they maintain alignment with the path of insertion are essential for the success of a removable partial denture (RPD). However, freehand preparation and the use of digital guides have shortcomings, while the feasibility of using a robot system to prepare the guiding planes is unknown.
Purpose:
The purpose of this in vitro study was to evaluate the effect of robot-assisted guiding plane preparation for an RPD.
Material And Methods:
Fifteen mandibular typodonts, each without first molars bilaterally, were custom designed, and an indicator rod was placed on the lingual side of the anterior teeth. A split-mouth design was used, and the partially edentulous areas on the left and right sides of typodonts were randomly assigned to 2 groups based on the preparation technique: the robot or freehand. The guiding planes for the distal surface of the second premolar and the mesial surface of the second molar were prepared by a robot or freehand. For the robot group, the intraoral scan data of the typodonts were imported into a software program, and the trajectory of the handpiece was drawn in the edentulous area. The handpiece orientation in the software program was adjusted to align with the direction of the indicator rod on the typodont. Subsequently, a robotic arm equipped with a high-speed handpiece was used to perform the preparation procedures. For the freehand group, a dentist prepared the guiding planes by referring to the indicator rod with the naked eye. Postoperatively, the typodonts were scanned to evaluate the angles between the 2 guiding planes and the angular deviation between the guiding planes and indicator rod. The independent samples t test was used to analyze the angle between the 2 guiding planes, and 2-way analysis of variance (ANOVA) and the least significant difference (LSD) post hoc test were used to compare the angular deviation between the guiding planes and the indicator rod (α=.05).
Results:
The data are presented as mean ±standard deviation [minimum, maximum]. The angles between the 2 guiding planes prepared by the robot and freehand were 1.93 ±1.04 degrees (0.70 degrees, 3.93 degrees) and 13.41 ±8.86 degrees (2.91 degrees, 33.84 degrees), respectively (P<.001). The angular deviation between the guiding planes and indicator rod prepared by the robot in the second premolar and molar were 2.81 ±1.78 degrees (0.55 degrees, 5.70 degrees) and 2.48 ±2.21 degrees (0.28 degrees, 8.80 degrees), respectively (P=.715). The angular deviation of the freehand group in the second premolar and molar was 8.18 ±5.71 degrees (0.98 degrees, 25.53 degrees) and 15.37 ±8.55 degrees (3.26 degrees, 32.86 degrees), respectively (P<.001). The angular deviation between the guiding plane and indicator rod prepared by the robot was significantly lower than that of freehand (P<.001).
Conclusions:
The robot system offers a feasible strategy for the preparation of parallel guiding planes for an RPD. The robot method prepared the guiding planes more accurately than the freehand method.
