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Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Reverse compensation technique achieves accurate robotic-assisted implant surgery in the anterior maxilla: A
Xiao-Jiao Fu1, Ying-Xin Gu1, Xin-Yu Wu1
1Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 200011, China.
Objectives:
To evaluate the implant positional accuracy and clinical outcomes of robotic-assisted implant surgery using the Reverse Compensation Technique (RCT) in the anterior maxilla.
Methods:
Patients requiring implant placement and simultaneous guided bone regeneration in the anterior maxilla with sloped bone morphology (buccolingual bone inclination >45°) were recruited. The RCT approach was used to compensate for potential drill deviation during osteotomy preparation. Guided bone regeneration was performed to manage implant fenestration or dehiscence. Outcome measures included implant positional accuracy, blood perfusion, surgical duration, patient-reported and operator assessments, and adverse events.
Results:
Eighteen patients with 27 implants were included. The mean global deviations at the implant platform, apex, and angle were 0.59 ± 0.31 mm, 0.60 ± 0.32 mm, and 1.60° ± 1.27°, respectively. Blood perfusion decreased immediately after surgery (from 187.46 ± 46.41 to 52.27 ± 16.92 LSPU, P < 0.001), rebounded above baseline by day 3 (248.69 ± 76.69 LSPU, P = 0.002), and plateaued through day 14 (P > 0.050). Patients reported high overall satisfaction (VAS: median=100.00, IQR=20.00), while operators reported moderate procedural difficulty (VAS: median=45.00, IQR=62.50). The mean times for preparation, implant surgery, and guided bone regeneration were 39.72 ± 15.56, 24.78 ± 16.46, and 30.83 ± 13.03 min, respectively.
Conclusions:
Within the limitations of this study, the RCT approach facilitated accurate robot-assisted implant placement in challenging anterior maxillary sites exhibiting sloped bone morphology.
Clinical Significance:
The RCT allows operators to counteract deviations, enabling precise implant placement under complex anatomical conditions. This finding underscores that contemporary robotic systems function as surgical augmenting tools rather than as direct replacements for clinical expertise.
