Robotic Guidance and Optical Navigation for Precision Implant Placement: a Prospective Comparative Clinical Study

Accurate three-dimensional implant positioning is essential for prosthetically driven implant dentistry and for reducing the risk of injury to adjacent anatomical structures.

This prospective randomized comparative study included 180 adults requiring single delayed implant placement, who were assigned to robotic-guided (RG) surgery (n=60), optical dynamic navigation-guided (ONG) surgery (n=60), or conventional freehand (CF) surgery (n=60) groups. Preoperative and postoperative cone-beam computed tomography (CBCT) datasets were superimposed to measure angular, apical, coronal and depth deviations between planned and actual implant positions. Secondary outcomes included operative time, postoperative pain, six-month satisfaction and early complications.

The final analysis included 176 patients. The mean angular deviation was the lowest in the RG group (1.82°±0.64°), followed by ONG (2.34°±0.89°) and CF groups (4.87°±1.53°; p<0.001). Apical and coronal deviations showed the same pattern. Robotic-guided surgery required longer surgical time than ONG and CF, but early complications were less frequent in RG (3.4%) and ONG (6.8%) than CF (15.5%; p=0.042).

Within the limitations of a single-center study and short follow-up, RG achieved the highest placement accuracy, while dynamic optical navigation provided clinically meaningful improvement over freehand placement. Long-term survival, prosthetic outcomes and cost-effectiveness require further evaluation.