Surgical protocol affecting robotic implant accuracy: Ex-vivo study.

Area of Science:

• Dental Implantology
• Robotic Surgery
• Surgical Navigation

Background:

• Robotic-computer aided implant surgery offers potential for enhanced precision.
• Different surgical protocols exist, including fully guided and partially guided approaches.
• Surgeon experience may influence the effectiveness of various robotic protocols.

Purpose of the Study:

• To compare the accuracy of three robotic-assisted implant surgical protocols.
• To evaluate fully guided surgery, partially guided surgery by a novice, and partially guided surgery by an experienced surgeon.
• To assess angular and vertical deviations in implant placement.

Main Methods:

• A randomized controlled study involving 81 implant placements in porcine ribs.
• Three protocols were compared: fully guided, novice partially guided, and experienced partially guided.
• Implant positions were digitally planned, and accuracy was assessed using cone-beam computed tomography.

Main Results:

• Novice surgeons showed significantly greater angular deviation than experienced surgeons and the robot.
• No significant difference in angular deviation was found between experienced surgeons and the robot.
• The robot exhibited worse vertical deviation compared to both surgeons.

Conclusions:

• Fully guided robotic surgery enhances angular precision for novice surgeons, potentially at the cost of increased vertical deviation.
• Partially guided robotic surgery combined with freehand insertion optimizes both angular and vertical accuracy for experienced surgeons.
• Tailored robotic-assisted surgical strategies based on surgeon expertise can improve implant placement accuracy.