Robot-assisted jaw-in-a-day based on the sandwich approach: case series

The "jaw-in-a-day" (JIAD) concept involves integrating the resection of mandibular tumors with mandibular defect repair and immediate implant-supported prosthetic rehabilitation into one surgical operation. This approach aims to reduce the overall treatment cycle, with the goal of improving patients' quality of life. However, traditional JIAD frequently employs static surgical guides, which can introduce variability in implant placement accuracy. Robot-assisted surgery has emerged as a promising alternative, with the potential to improve surgical precision through real-time navigation and haptic feedback technology.

This retrospective case series reported five cases of mandibular tumors treated using the robot-assisted JIAD. Surgical planning involved virtual surgical simulation and computer-aided design/manufacturing based on sandwich planning technology. A robotic surgical system was utilized to prepare the implant site and place the implant under real-time navigation guidance. Immediate provisional prostheses were placed during the same surgery. All robot-assisted JIAD surgeries were performed as planned. The robot-assisted preparation and placement of implant sites yielded a mean angular deviation of 1.17° ± 0.30° and a linear deviation of less than 0.5 mm. Radiographic analysis at six months post-surgery revealed signs consistent with implant stability and osseointegration.

The robot-assisted JIAD technique, based on the sandwich planning approach, appears to be a feasible approach that may enhance implant placement accuracy in complex mandibular reconstructions. However, these preliminary findings require further validation in larger, controlled studies.