Analysis of the clinical application value of minimally invasive non-flap technique based on autonomous robot implant surgery

doi:10.12337/zgkqzzxzz.2023.06.006

Abstract

Abstract: Objective To compare the accuracy and postoperative pain response of autonomous robotic and traditional free-hand implantations. Methods This study reviewed patients with dentition defects who underwent autonomous robotic (non-flap technique) and free-hand (flap technique) implantations at the Affiliated Hospital of Stomatology of the Zhejiang University School of Medicine from August 2022 to April 2023. Preoperative and postoperative cone beam computer tomography (CBCT) was used to compare the accuracy. The NRS score was applied to evaluate the pain response of patients in the first week after surgery. Results The linear and angular deviations in the robot group were significantly lower than those of the free-hand group [platform: (0.57±0.12)mm vs. (1.43±0.54)mm, apex: (0.59 ± 0.99)mm vs. (2.17±0.78)mm, angle: 1.13°±0.46 ° vs. 7.36°±4.02° (P < 0.05). ] NRS scores showed that patients in the robot group had a significantly lower pain response compared to the free-hand group on the 1st, 2nd, and 7th postoperative days. Conclusion The non-flap autonomous robotic implantation makes oral implant surgery more accurate and minimally invasive, and reduces the postoperative pain response, providing a promising alternative in the future clinical implant surgery.

Key words: Autonomous robot, Minimally invasive non-flap technique, Oral implant surgery, Accuracy

He Jin, Ren Lingfei, Zhang Qinmeng, Jiang Zhiwei, Yang Guoli. Analysis of the clinical application value of minimally invasive non-flap technique based on autonomous robot implant surgery[J]. Chinese Journal of Oral Implantology, 2023, 28(3): 159-164.

References

[1] Yang GZ, Cambias J, Cleary K, et al. Medical robotics-regulatory, ethical,legal considerations for increasing levels of autonomy[J]. Sci Robot, 2017,2(4):eaam8638. DOI: 10.1126/scirobotics.aam8638.
[2] Bolding SL, Reebye UN.Accuracy of haptic robotic guidance of dental implant surgery for completely edentulous arches[J]. J Prosthet Dent, 2022,128(4):639-647. DOI: 10.1016/j.prosdent.2020.12.048.
[3] 白石柱, 任楠, 冯志宏, 等. 自主式口腔种植机器人手术系统动物体内种植精度的研究[J]. 中华口腔医学杂志, 2021, 56(2) : 170-174. DOI: 10.3760/cma.j.cn112144-20210107-00008.
[4] Yang S, Chen JH, Li A, et al.Accuracy of autonomous robotic surgery for single-tooth implant placement: a case series[J]. J Dent, 2023, 132(5):104451.DOI: 10.1016/j.jdent.2023.104451.
[5] Tao B, Feng Y, Fan X, et al.Accuracy of dental implant surgery using dynamic navigation and robotic systems: an in vitro study[J]. J Dent, 2021, 123(8):104170.DOI: 10.1016/j.jdent.2022.104170.
[6] Nan X, Wang C, Li L, et al.Application of three-dimensional printing individualized titanium mesh in alveolar bone defects with different Terheyden classifications: a retrospective case series study[J].Clin Oral Implants Res, 2023,34(6):639-650. DOI: 10.1111/clr.14062.
[7] Akhbar M, Sulong AW.Surgical drill bit design and thermomechanical damage in bone drilling: a review[J]. Ann Biomed Eng, 2021,49(1):29-56. DOI: 10.1007/s10439-020-02600-2.
[8] Matsumura A, Nakano T, Ono S, et al.Multivariate analysis of causal factors influencing accuracy of guided implant surgery for partial edentulism: a retrospective clinical study[J]. Int J Implant Dent, 2021,7(1):28. DOI: 10.1186/s40729-021-00313-2.
[9] Han JJ, Woo SY, Yi WJ, et al.Robot-assisted maxillary positioning in orthognathic surgery: a feasibility and accuracy evaluation[J]. J Clin Med, 2021,10(12):2596.DOI: 10.3390/jcm10122596.
[10] Yan B, Zhang W, Cai L, et al.Optics-guided robotic system for dental implant surgery[J]. Chin J Mech Eng, 2022,35(3):135-147.DOI: 10.1186/s10033-022-00732-1.
[11] Mozer PS.Accuracy and deviation analysis of static and robotic guided implant surgery: a case study[J]. Int J Oral Maxillofac Implants, 2020,35(5):e86-e90. DOI: 10.11607/jomi.8231.
[12] Lindeboom JA, van Wijk AJ. A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement[J]. Clin Oral Implants Res, 2010,21(4):366-370. DOI: 10.1111/j.1600-0501.2009.01866.x.
[13] Jané-Salas E, Roselló-LLabrés X, Jané-Pallí E, et al.Open flap versus flapless placement of dental implants. A randomized controlled pilot trial[J]. Odontology, 2018,106(3):340-348. DOI: 10.1007/s10266-018-0343-8.
[14] Divakar TK, Gidean Arularasan S, Baskaran M, et al.Clinical evaluation of placement of implant by flapless technique over conventional flap technique[J]. J Maxillofac Oral Surg, 2020,19(1):74-84. DOI: 10.1007/s12663-019-01218-9.
[15] Frizzera F, Calazans N, Pascoal CH, et al.Flapless guided implant surgeries compared with conventional surgeries performed by nonexperienced individuals: randomized and controlled split-mouth clinical trial[J]. Int J Oral Maxillofac Implants, 2021,36(4):755-761. DOI: 10.11607/jomi.8722.
[16] Kan TS, Cheng KJ, Liu YF, et al.Evaluation of a custom-designed human-robot collaboration control system for dental implant robot[J]. Int J Med Robot Computer Assist Surg, 2022,18(1):e2346. DOI: 10.1002/rcs.2346.
[17] Linn TY, Salamanca E, Aung LM, et al.Accuracy of implant site preparation in robotic navigated dental implant surgery[J]. Clin Implant Dent Relat Res, 2023. DOI: 10.1111/cid.13224.
[18] Ozan O, Orhan K, Turkyilmaz I.Correlation between bone density and angular deviation of implants placed using CT-generated surgical guides[J]. J Craniofacial Surg, 2011,22(5):1755-1761. DOI: 10.1097/SCS.0b013e31822e6305.
[19] Bishop ES, Hall JL, Handel I, et al.Sequential drilling and drill angulation reduce the accuracy of drill hole start location in a synthetic bone model[J]. Vet Rec, 2019,184(12):383. DOI: 10.1136/vr.104897.
[20] Putra RH, Yoda N, Iikubo M, et al.Influence of bone condition on implant placement accuracy with computer-guided surgery[J]. Int J Implant Dent, 2020,6(1):62. DOI: 10.1186/s40729-020-00249-z.
[21] Fardal Ø, McCulloch CA. Impact of anxiety on pain perception associated with periodontal and implant surgery in a private practice[J]. J Periodontol, 2012,83(9):1079-1085. DOI: 10.1902/jop.2011.110562.