[Accuracy comparison of an autonomous dental implant robotic system in immediate and delayed implant placement]

Objective: To compare the three-dimensional positional deviations of immediate and delayed implant placement by using autonomous dental implant robotic system, and to evaluate the clinical applicability and operational stability of the robotic system under different conditions. Methods: This retrospective study included 44 patients (25 males and 19 females, aged 22-45 years) who underwent autonomous oral implant robotic surgery at the Department of Oral Implantology, The Affiliated Hospital of Qingdao University, between April 2022 and August 2025. A total of 60 implants were placed, with 20 patients (30 implants) in the immediate implant group and 24 patients (30 implants) in the delayed implant group. Preoperative cone-beam CT and intraoral scans were performed on all patients, and preoperative three-dimensional implant planning was conducted based on the imaging data. The autonomous oral implant robotic system autonomously completed osteotomy and implant placement according to the preoperative plan. Postoperatively, cone-beam CT was taken and superimposed with the preoperative plan, and the deviations in the implant site, apex point, and angular deviation were calculated as precision evaluation indicators. The normality of the data was assessed using the Shapiro-Wilk test. Differences between the two groups were evaluated using the Student's t-test, Welch's t-test, or Mann-Whitney U test. Results: The median (interquartile range, IQR) of the implant site deviation, apex point deviation, and angular deviation in the immediate implant group were 0.325 (0.190), 0.375 (0.380) mm, and 0.645° (0.170°), respectively. In the delayed implant group, the corresponding values were 0.365 (0.200), 0.350 (0.100) mm, and 0.665° (0.160°). Statistical analysis showed no significant differences in the three-dimensional positional accuracy between the two groups (all P>0.05). Conclusions: The autonomous dental implant robotic system provides excellent three-dimensional positioning accuracy in both immediate and delayed implant placements, effectively compensating for complex extraction socket anatomy and operator variability.