Robotic surgery vs dynamic navigation: does greater accuracy make the difference in implant dentistry?

Wei H, Shu Z, Tian M, Ge Y, Li D. The Accuracy of Autonomous Robotic Surgery vs. Dynamic Navigation in Implant Placement: An Open-Label, Double-Arm, Randomized Controlled Clinical Trial. Clin Oral Implants Res. 2025;36:1486 -97 DESIGN: Double-arm, randomized controlled clinical trial comparing the accuracy and early clinical outcomes of autonomous robotic surgery and dynamic navigation for single-tooth implant placement. Both systems used the same optical tracking technology, allowing a more standardized comparison between the two computer-assisted surgical approaches.

Forty healthy adult patients requiring single implant-supported restoration were included and randomly allocated to either the autonomous robotic surgery group or the dynamic navigation group. Eligible patients presented with adequate soft tissue dimensions, sufficient bone volume, good oral hygiene, and no limitation in mouth opening. Patients with systemic contraindications to implant surgery, conditions or treatments affecting osseointegration, pregnancy or nursing status, recent head and neck radiotherapy, or inability to comply with follow-up were excluded.

Implant placement accuracy was assessed by superimposing preoperative and postoperative CBCT scans. The primary outcomes were coronal, apical, and angular deviations between planned and actual implant positions. Secondary outcomes included surgical time, postoperative pain, edema, complications, and early implant success. Between-group comparisons were performed using parametric or non-parametric tests according to data distribution, with additional regression analysis to adjust for baseline variables.

Autonomous robotic surgery showed significantly lower angular deviation than dynamic navigation. No statistically significant differences were observed for coronal or apical deviations. Robotic procedures required significantly longer surgical time than dynamic navigation. Postoperative pain, edema, complications, and early implant success were comparable between groups, with all implants meeting success criteria after 3 months of healing.

Autonomous robotic surgery may provide superior angular accuracy compared with dynamic navigation when both systems use the same optical tracking technology. However, this advantage was not accompanied by significant improvements in linear accuracy or early clinical outcomes, and robotic surgery required longer operative time. These findings support the potential of autonomous robotic systems for precise implant placement, while emphasizing the need for larger clinical trials, longer follow-up, and evaluation in more complex scenarios before broad clinical superiority can be established.