How Robotics is Shaping the Future of Dental Implant Surgeries

By Nidhi DhullReviewed by Susha Cheriyedath, M.Sc.Apr 16 2024

A recent review published in the International Journal of Oral Science explored the advancements in the research and practical applications of dental implant robotic systems. The article discussed the evolution of medical robotics, drawing on seminal research papers. It also features a detailed study of autonomous dental implant robots, highlighting their benefits and future potential in the medical field.

Evolution of Medical Robotics

The first instance of robots in history dates to over 3000 years ago and the world’s first robot-manufacturing factory is attributed to Joseph Engelberger in 1958. Since then, constant advancements in sensors, intelligent algorithms, and multidisciplinary integration have evolved initial industrial robotic arms to bionic robots, nanorobots, soft robots, etc.

Medical robotics emerged in 1985 with the introduction of the Puma 200, utilized for needle placement during a brain biopsy in the US. Today, medical robotics offer numerous advantages across various applications, including diagnosis (offering safe and convenient examinations), surgery (providing minimally invasive and precise procedures), nursing (enabling constant monitoring), medical transportation, rehabilitation (through therapeutic and assistive robotics), and patient consultation.

While medical robots range in autonomy from requiring human operators for all tasks to achieving partial autonomy for complex surgeries and therapies, fully autonomous robots capable of practicing medicine independently remain a topic of ethical and legal consideration. Nonetheless, conditionally autonomous robots are widely employed for their precision, stability, and reliability in enhancing medical procedures and patient care.

Dental Implant Robotics

The success of dental implant surgeries is measured by esthetic and functional outcomes, which depend on correct and prosthetically driven implant placement. Incorrect implant placement can damage surrounding blood vessels, nerves, and tooth roots and cause sinus perforation. Thus, utmost precision is required during operation to ensure quality and reduce postoperative side effects.

Currently prevalent implant placement approaches include free-hand, static computer-aid, and dynamic computer-aid. These are highly dependent on the manual operations of surgeons. Human factors like hand tremble, and fatigue impact the accuracy of implant placement. Robotic-assisted implant surgery can overcome human errors through automatic calibration, registration, and drilling.

Current approaches to implant placement predominantly involve manual techniques such as free-hand procedures or computer-aided methods, both static and dynamic. However, these methods are susceptible to human factors like hand tremors and fatigue, which can compromise accuracy. Robotic-assisted implant surgery emerges as a promising solution to mitigate such errors through automatic calibration, registration, and drilling.

Dental implant robotic systems typically comprise hardware for surgical data acquisition and execution. This involves perceiving, identifying, and understanding the surgical environment—including positions, shapes, sizes, and surface features—both before and during the procedure in real-time. Moreover, these systems often integrate image-guided technology to ensure precise positioning during surgery.

Various configurations of dental implant robotics have been proposed, ranging from serial-linked industrial robotic arms to dual-arm robots and laser-assisted non-contact systems. These systems aim to enhance surgical efficiency, achieve precise implant placement according to pre-planned positions, and ensure patient safety throughout the procedure.

Clinical Research on Dental Implant Robotics

Clinical research on dental implant robotics has yielded valuable insights into the accuracy and efficacy of robot-assisted implant surgeries, both in laboratory settings (in vitro) and in clinical practice (in vivo). Numerous studies have demonstrated significant angular deviations, which can be attributed to variations in perception and responsiveness to complex bone structures among different robotic systems. However, these discrepancies can potentially be mitigated by enhancing the autonomy of implant robots.

Research indicates that robotics plays a pivotal role in assisting dental implant surgeries across all stages of the procedure. This includes preoperative phases, where robotics aid in obtaining digital intraoral casts and computed tomography data, as well as intraoperative stages involving tracking and calibration. Additionally, postoperative phases benefit from robotics by facilitating imaging and accuracy measurement.

Currently, commercial dental implant robotic systems operate at varying levels of autonomy. Some provide visual and tactile guidance to the surgeon, while others offer partial autonomy by performing specific surgical tasks.

Current Challenges in Dental Implant Robotics

While the integration of dental implant robotics promises enhanced accuracy and treatment outcomes, several hurdles impede its seamless adoption. Complex registration, calibration, and verification procedures not only prolong surgery time but also contribute to patient dissatisfaction. Additionally, the rigid drill tips at the extremities of robotic arms pose significant challenges in accessing posterior sections and can compromise surgical precision. The high initial equipment investment further exacerbates the financial burden, compounded by the necessity for specialized technical training among dental surgeons.

Thus, further simplification of surgical procedures and improvement in the flexibility of dental implant robotic systems are essential to promote their large-scale adoption in clinical processes. Multifunctional robots, validated in large-scale clinical trials, are required for various dental treatments and to realize the full potential of medical robotics.

Conclusion and Future Prospects

Overall, the high-precision sensing and positioning capabilities of medical robots enable accurate small-scale operations. For instance, multiple clinical trials have confirmed the high accuracy of implant placement using robots and the long-term success of such implants. Apart from benefitting patients in terms of low risks, minimal trauma, short hospitalization, and speedy recovery, medical robotics improve surgeons’ quality of life by reducing mental and physical stress. In conclusion, medical robotics is transforming all aspects of healthcare.

In the future, robots may provide intelligent and personalized treatment plans by leveraging machine learning and artificial intelligence technologies, thereby improving diagnostic efficiency. Further innovation in robotics and related technologies will enable remote operations and consultations, thus increasing access to quality medical assistance for all. As technology advances, robotics and artificial intelligence will continue to drive innovations in medicine and healthcare.

Journal Reference

Liu, C., Liu, Y., Xie, R., Li, Z., Bai, S., & Zhao, Y. (2024). The evolution of robotics: research and application progress of dental implant robotic systems. International Journal of Oral Science/International Journal of Oral Science, 16(1). https://doi.org/10.1038/s41368-024-00296-x, https://www.nature.com/articles/s41368-024-00296-x 

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