In a recent study published in the journal BDJ Open, researchers proposed an integrated robotic system called the high-precision all-in-one, dual-arm robot for oral implant surgery (HADAROIS) that can perform oral implant surgery with high efficiency and safety. This solution could help advance the field of dental implantology.
Study: Advanced Robotic Solution for Dental Implants. Image Credit: SibFilm/Shutterstock.com
Background
Oral implant surgery, a procedure for replacing missing teeth with artificial ones anchored into the jawbone, significantly enhances both the function and aesthetics of the mouth. This surgery requires meticulous accuracy and precision during the implant placement.
Recent research has focused on the integration of medical robots into oral implant surgery to boost accuracy and improve convenience. Medical robots are sophisticated devices designed to perform surgical tasks, either autonomously or under the supervision of human surgeons. The use of these robots brings several advantages, such as heightened precision, improved efficiency, the ability to perform minimally invasive procedures, and increased safety.
Despite these benefits, current robotic systems designed for oral implant surgery face several challenges. These include extensive preoperative preparation, intricate operational demands, high implementation costs, and susceptibility to occlusion or interference during surgeries, which can complicate the procedure and affect outcomes.
About the Research
In this paper, the authors introduced HADAROIS, a new oral implant surgery navigation and positioning system. This system consisted of a support body, a control panel, two robotic arms, and an image acquisition device. The upper arm held the surgical tool, known as the "oral implant handpiece," while the lower arm featured a miniature multi-eye gaze positioning camera. The system also included three key modules for controlling the movement and function of the robotic arms: the occluded target tracking module (OTTM), the planting plan development module (PPDM), and the path formulation module (PFM).
The OTTM played a crucial role in the positioning and tracking of the target implant site during oral implant surgeries. It was specifically designed to identify and navigate around occlusions caused by medical instruments, the human body, or nearby organs, ensuring clear access to the implant area.
The PPDM (Patient-Specific Planning Data Module) utilized data from computed tomography (CT) scans to create an optimal surgical plan tailored to the patient's unique anatomical structure. This module's role was critical in planning precise implant positions based on detailed internal imagery.
HADAROIS (High Accuracy Dual-Arm Robotic Oral Implant System) took advantage of cone-beam CT (CBCT) imaging to gather precise anatomical details of the patient’s oral cavity. Using this information, HADAROIS generated an optimal plan for implant placement. The PFM (Positioning and Feedback Module) was responsible for determining the posture, position, and movement speed of the robotic arms, ensuring their coordinated movements were synchronized and accurate during the surgery. This coordination was vital for the smooth execution of complex surgical tasks.
Designed to streamline the surgical workflow, HADAROIS aimed to reduce preoperative preparation times and simplify the operation process by integrating dual robotic arms and eliminating the need for manual calibration or registration. This system enabled dynamic adjustments to the surgical plan, allowing for real-time feedback and surgical interventions by the operating surgeon.
With these innovations, HADAROIS was expected to significantly enhance the precision, efficiency, and safety of oral implant surgery, making it a promising advancement in robotic-assisted surgical technologies.
Research Findings
The researchers evaluated the system's accuracy and feasibility through simulation experiments and clinical trials. In the simulation experiments, they used five different dental models and performed ten implant surgeries. They measured the angular and entry point errors of the implant placement and found that the average angular error was 1.54° and the average entry point error was 0.33 mm, both within the clinically acceptable range.
The study compared these outcomes with other published studies and found that the system achieved the lowest angular error and entry point error among all the studies. In the clinical trials, HADAROIS was used to perform oral implant surgeries on six patients, with accuracy measured using CBCT images.
The average angular error was 2.1°, and the average entry point error was 0.39 mm, which was also within the clinically acceptable range. Furthermore, the study demonstrated excellent accuracy and positioning capabilities in clinical practice, and the patients were satisfied with the aesthetic and functional outcomes of the implant surgery.
Applications
The system's potential applications in oral implant surgery are substantial, as it provides high-precision navigation and positioning for implant placement. By reducing the time required for preoperative preparation and simplifying the operation process, it not only enhances the efficiency but also increases the safety of surgeries.
Moreover, its capability to offer real-time guidance and adjustments during the procedure enhances the flexibility and adaptability of the surgical process. This dynamic capability allows surgeons to make immediate modifications based on intraoperative findings, which is a significant advancement over more static surgical techniques.
Additionally, the system is designed to improve patient outcomes and experiences. By minimizing surgical trauma, it promotes faster recovery and reduces discomfort, leading to higher patient satisfaction. The precise placement of implants also ensures better aesthetic and functional results, further enhancing the overall success of the treatment and the well-being of patients.
Conclusion
The novel system has been shown to effectively improve oral implant surgery by overcoming the limitations of current robotic systems, such as prolonged preoperative preparation, complex usability, elevated costs, and vulnerability to occlusions or interference. The system demonstrated high precision, efficiency, and safety in both simulated and clinical settings.
Looking ahead, the authors propose further enhancements and optimizations to the system. They also emphasize the need for additional clinical trials to confirm its effectiveness and safety. Furthermore, the system holds promising applications in other areas of oral surgery, such as orthognathic surgery, maxillofacial trauma surgery, and oral tumor surgery.
Journal Reference
Tang, G., Liu, S., Sun, M. et al. High-precision all-in-one dual robotic arm strategy in oral implant surgery. BDJ Open 10, 43 (2024). https://doi.org/10.1038/s41405-024-00231-6, https://www.nature.com/articles/s41405-024-00231-6
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