Robot-assisted haptic guidance in endodontics: A pilot study evaluating efficiency and tooth structure preservation

A robot-assisted haptic guidance system (RA) has recently been introduced to facilitate implant placement. Unlike dynamic navigation systems, this platform uses haptic guidance to constrain operator movement along a predefined path. We hypothesized that RA-guided access preparation would reduce operative time while minimizing the volume of tooth structure removed. Therefore, the aim of this study was to evaluate the effectiveness and precision of the RA approach compared with the freehand (FH) approach across three in vitro endodontic treatment modalities: (A) access to calcified canals, (B) fiber post removal, and (C) endodontic microsurgery.

Extracted teeth for each treatment modality were divided into three groups: an RA group treated by a resident, an FH group treated by the same resident, and a separate FH group treated by an experienced endodontist. Effectiveness was assessed based on the time required to reach the predefined endpoint for each procedure. Precision was evaluated by measuring the volume of tooth structure removed using cone-beam computed tomography images obtained after treatment. One-way analysis of variance and Kruskal-Wallis tests were used to analyze differences between the RA and FH approaches with respect to operative time, volume of tooth structure removed, and bevel angle.

Compared with the FH approach, the RA approach significantly reduced operative time and the volume of tooth structure removed across all three treatment modalities. Additionally, the RA approach resulted in a significantly smaller bevel angle following root-end resection.

The robot-assisted haptic guidance approach demonstrated improved efficiency and precision in challenging endodontic procedures.

Robot-assisted haptic guidance may enhance the efficiency and precision of complex endodontic procedures while preserving tooth structure. This technology has potential clinical value in managing challenging conditions requiring procedures such as access to calcified canals, fiber post removal, and endodontic microsurgery.