Chinese Journal of Oral Implantology

Preface to the special section on dental implant robots

2023, 28(3): 133-133. DOI: 10.12337/zgkqzzxzz.2023.06.001

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Expert consensus on the clinical application of dental implant robots (first edition)

Chen Jiang, Su Yucheng, Shen Guofang, Zhou Yanmin, Man Yi, Wu Yiqun, Yang Guoli, Zhang Yufeng, Tang Chunbo, Liu Qian, Fu Gang, Du Liangzhi, Liu Feng, Gao Yongbo, Yang Xingmei, Chen Deping, Chen Zhuofan, Xu Shulan, Wang Liping, Zhang Sihui

2023, 28(3): 134-139. DOI: 10.12337/zgkqzzxzz.2023.06.002

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Dental implant robot is a new clinical technology in the field of dental implantology in recent years. In view of its high accuracy and stability, it has been applied in many professional fields of stomatology, such as dental implant, oral and maxillofacial surgery, etc. On the basis of clinical application and document retrieval, this consensus discusses the definition of related terms, clinical application requirements, operation specifications and risk prevention of dental implant robots, putting forward consensus views based on the clinical operation experience of some domestic experts.

Robotic computer-assisted implant surgery: opportunities and challenges

Xu Shulan, Li Ping

2023, 28(3): 140-145. DOI: 10.12337/zgkqzzxzz.2023.06.003

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The precise placement of dental implants is crucial for successful implant surgery. As a technological innovation, robotic-assisted technology offers personalized, predictable, and exact surgical methods for implant placement. With the gradual expansion of robotic-assisted technology in the field of oral implantology, it provides new directions and opportunities for development, as well as challenges and difficulties. This article aims to introduce the basic principles and clinical applications of robotic-assisted technology, as well as to discuss the emerging opportunities and challenges that come with its use in oral implantology.

Progress in clinical application of implant robotics, dynamic navigation system and full-guide template in the field of oral implantology

Man Yi, Yang Mutong

2023, 28(3): 146-151. DOI: 10.12337/zgkqzzxzz.2023.06.004

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With the development of digital technology in dental implantology, from the full-guide template to the dynamic navigation system, and now to the implant robotics, implant accuracy has always been a topic of concern in the field of dental implantology. In this paper, the clinical application process of full-guide template, dynamic navigation system, and implant robotics was described, and their respective advantages were analyzed. The purpose of this study is to provide a reference for clinical implantologists when selecting digital technology.

Study on the surgical accuracy of dental implant robot with different optical tracking systems

Xie Rui, Li Zhiwen, Ren Nan, Zhao Ruifeng, Bai Shizhu

2023, 28(3): 152-158. DOI: 10.12337/zgkqzzxzz.2023.06.005

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Objective To evaluate the effect of different optical tracking systems on the surgical accuracy of the dental implant robot for clinical application. Methods Visible light guidance and infrared light guidance were integrated into the experimental platform of the implant robot. After planning the implant position and path, the robot prepared the implant beds on the modular dentition defect implant models autonomously. 20 implant beds were prepared under each guidance. After the preparation, CBCT scanned the implant models, reconstructed the three-dimensional shape of the implant beds and compared them with the planned implant position to obtain the shoulder deviation, root deviation and angle deviation. An independent sample t-test was performed to analyze the effect of the two optical tracking systems on the accuracy of the dental implant robot. Results The mean and standard deviation of shoulder deviation, root deviation and angle deviation of the preparation guided by infrared light guidance were （0.39±0.14）mm,（0.60±0.19）mm and（2.03±0.84）degrees. The mean and standard deviation of shoulder deviation, root deviation and angle deviation of the preparation guided by visible light guidance were （0.57±0.21） mm,（0.89±0.30）mm and（3.08±1.13）degrees. The results of the independent sample t-test showed that there was a significant difference in the accuracy of implant bed preparation guided by two different principles of optical tracking systems (P<0.05). Conclusion The results of the in vitro model experiments showed that the deviation of the surgical accuracy of the dental implant robot guided by visible light is greater than that guided by infrared light.

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

He Jin, Ren Lingfei, Zhang Qinmeng, Jiang Zhiwei, Yang Guoli

2023, 28(3): 159-164. DOI: 10.12337/zgkqzzxzz.2023.06.006

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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.

Research on the accuracy of dental implant robot in immediate implantation

Jiang Yuxi, Sun Shichen, Wan Linzi, Liu Wenfeng, Yang Zhikang, Wu Xifeng, Sun Haipeng, Li Shuchun, Gao Yongbo

2023, 28(3): 165-171. DOI: 10.12337/zgkqzzxzz.2023.06.007

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Objective To investigate the accuracy error of dental implant robots in immediate and delayed implantation. Methods Implant patients who met the requirements of implant restoration treatment were divided into two groups: immediate implant (n=4) and delayed implant (n=6). Each group was implanted with a dental implant robot. Preoperative CBCT, implant position design, surgical procedure planning, robotic arm registration and alignment were routinely performed, and implant socket preparation and implant placement were performed by the robot. The implant placement error was analyzed by CBCT after surgery. Results The dental implant robot surgery was successfully completed, and there were no complications during and after the surgery. The deviation of the implant depth at the apical point was (0.25±0.13) mm in the immediate the implant group and (-0.88±0.49) mm in the delayed implant group, and the deviation of the implant angle was 1.38°±0.14° in the immediate implant group and 0.59°±0.08° in the delayed implant group. There was a statistical difference between the two groups (P<0.05). Conclusion The dental implant robot showed good accuracy in both immediate and delayed implantation. The accuracy of the implant point and the apical point of the dental implant robot during immediate implantation is close, and the angle deviation is greater than that of the delayed implant.

Accuracy analysis of dental implant robot in immediate implantation in the anterior region

Huang Hong, Fu Gang, Chen Xi, He Tian

2023, 28(3): 172-178. DOI: 10.12337/zgkqzzxzz.2023.06.008

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Objective To investigate the accuracy of the autonomous implant robot-assisted immediate implant surgery in the anterior region. Methods Ten cases with 10 implant sites in the anterior region requiring immediate implantation were included according to the inclusion criteria. The implant bed preparation and placement were performed according to the standardized procedure of the dental implant robot. After surgery, CBCT was taken again and the deviation between the actual implant sites and the designed sites was evaluated using the robotic navigation software. Results The average total deviation of the implant neck was（ 0.86±0.40）mm, the lateral deviation was （0.69±0.36）mm, and the depth deviation was（ 0.28±0.57） mm. The average total deviation of the implant apex was（0.98±0.49） mm, the lateral deviation was （0.81±0.49 ）mm, the depth deviation was（0.29±0.58）mm, and the angular deviation was 1.09°±0.61°. Conclusion The autonomous robot-assisted immediate implantation in the anterior region is highly accurate and can achieve satisfactory clinical results.

Clinical study of dental implant robot-assisted implant surgery and immediate restoration in esthetic area

Pi Xuemin, Chen Deping, Ren Bin, Pan Hong, Su Yucheng, Liu Qian, Wang Xia

2023, 28(3): 179-185. DOI: 10.12337/zgkqzzxzz.2023.06.009

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Objective To study the clinical application of dental implant robot-assisted implant surgery and immediate restoration in esthetic zone. Methods The dental implant robot-assisted surgery and immediate restoration cases in the aesthetic area were reviewed at the Beijing Citident Hospital of Stomatology, and the deviation between the preoperative design and the actual postoperative position of the implant was analyzed. Results In this study, 10 patients were treated with 12 implants which were placed by the dental implant robot. The total deviation of the implant points was (0.488 ± 0.268) mm (range 0.110 to 0.810 mm), and the total deviation of the apex point was (0.573±0.278)mm(range 0.180 to 1.040 mm), and the average angular deviation was 1.166°±0.439°(range 0.290° to 1.690°). The total deviation of the implant points from the apex was highly correlated with the lateral deviation and weakly correlated with the depth deviation. Conclusion The implant robot has high navigation accuracy and can accurately perform the preoperatively designed implant position during surgery. It is suitable for assisting with implant bed preparation and implant placement in the esthetic area, and is conducive to the rapid and accurate completion of clinical procedures such as immediate restoration.

Meta-analysis of the accuracy of robotic system-assisted dental implant surgery

Li Yanqin, Chen Jiang

2023, 28(3): 186-192. DOI: 10.12337/zgkqzzxzz.2023.06.010

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Objective To systematically evaluate the accuracy of robotic system-assisted dental implant surgery . Methods A search was performed for studies on surgical robot-assisted implantation, including in vitro model tests, animal experiments, and clinical studies that were published before January 2023, from the databases including PubMed, Embase, Cochrane library, CNKI, VIP, Wanfang and CBM databases. The main outcome index was the deviation between the preoperative design of the implant and the actual position in the three-dimensional direction, including the implant platform, the implant apex and the implant axial angle. Data were combined and analyzed using Stata 17.0. The subgroup analysis was used to compare the deviations of different research designs, with or without implant placement, and different robot systems. Results A total of 14 papers were included, including 9 model trials, 3 clinical studies and 3 animal studies, with a total of 705 implant sites. According to the results of meta-analysis, the deviation of the platform in the robot-assisted implant surgery is 0.72mm (95%CI:0.63-0.81, I²=93.2%), the apex deviation is 0.90mm (95%CI:0.76-1.03, I²=95.7%), and the angle deviation is 1.57° (95%CI:1.26-1.88, I²=98.1%). Conclusion The accuracy of implant surgery robot has reached an acceptable clinical level. Most studies are model trials, and more clinical studies are needed to enrich the data.

Research and application progress of surgical robot system for zygomatic implant placement

Tao Baoxin, Wang Wenying, Wu Yiqun

2023, 28(3): 193-197. DOI: 10.12337/zgkqzzxzz.2023.06.011

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The application of robot technology in the field of oral implantology is in the rise. The robotic system enables higher accuracy in dental implant site preparation and implant placement, making the implant surgery more personalized and predictable. As a complex surgery in dental implantology, zygomatic implant surgery requires higher accuracy due to its long drilling path, complex adjacent anatomical structures, and poor view. These problems also increase the difficulty of zygomatic implant surgery. Robotic technology seems to be an efficient method to improve the accuracy and predictability of zygomatic implantation surgery. This review introduces the composition, principle, research progress, and clinical application of robotic system for zygomatic implant surgery, and discusses the optimization considerations of the robotic system.

Force analysis of personalized titanium mesh for guided bone regeneration based on finite element method

Ma Rui, Wang Zhihui, LiuYang, Gao Yang

2023, 28(3): 198-203. DOI: 10.12337/zgkqzzxzz.2023.06.012

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Objective Based on finite element analysis, the stress and displacement distributions of the titanium mesh were analyzed under different thicknesses, different porosities and different rod diameter of the fillings of the convention unit cell structure in response to vertical external forces. The results of the analysis can provide a biomechanical basis for the design of personalized titanium mesh when used to guide bone regeneration in the treatment of jawbone defects. Methods The mandible of a patient with 31-32 defects was used as a study carrier for small-sized titanium mesh (S-type), and the mandible of a patient with 33-37 defects was used for large-sized titanium mesh (L-type). A 3D model reconstruction of the jaws was performed for their CBCT images, respectively. Based on this, titanium mesh with different thicknesses, porosities, and rod diameters was designed, and 3D finite element models were established. The stress and displacement distribution of the titanium mesh under stress conditions was analyzed by FEM analysis. Results With an increase in titanium mesh thickness, the stresses and displacements of titanium mesh show a decreasing trend; with an increase in the porosity of titanium mesh, the stresses and displacement of titanium mesh show an increasing trend; with an increase in the diameter of the titanium mesh rod, the stress and displacement of S-type titanium mesh showed a decreasing trend, while the stress and displacement of L-type titanium mesh showed no obvious trend. Conclusion The stress values of all titanium meshes are within the safe equivalent stress range with sufficient strength for thicknesses of 0.4 mm and above, considering that too thick titanium mesh will stimulate the mucosa, 0.4mm thickness titanium mesh is more suitable for clinical needs; stress values were within the safe equivalent force range for S-type with 55% porosity and below, and L-type with 55%~68% porosity, with sufficient strength, increasing the porosity of titanium mesh can provide more adequate blood channels to the mucosa, reducing the risk of mucosal ischemia atrophy and cracking, L-type titanium mesh should try to choose 68% porosity, S-type titanium mesh should choose 55% porosity; S-type titanium mesh rod diameter at 0.7 mm and above, L-type titanium mesh rod diameter at 0.5 mm and above, can meet the strength requirements , comprehensive porosity and other comprehensive factors, considering that the larger the rod diameter, the mucosal stimulation increases, so the 0.7 mm rod diameter titanium mesh is more suitable for clinical needs.

Mechanical properties of homogeneous and gradient porosity Gyroid structures and porous implant additive manufacturing

Song Yihan, Zheng Xiaoxiao, Sun Zihui, Zhang Yan, Han Zekui, Su Yucheng, Wang Xinyu

2023, 28(3): 204-209. DOI: 10.12337/zgkqzzxzz.2023.06.013

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Objective To study the mechanical properties of Gyroid structures with different porosity and gradient porosity, and to design and prepare a new type of porous implant. Methods Gyroid structure models with homogeneous porosity of 60%, 65%, 70%, 75%, 80% and 60%~80% gradient were established by MSLattice and Magics software. The mechanical properties of Gyroid structures with different porosity were compared by finite element analysis and mechanical compression test respectively. A new porous implant was designed and fabricated by selective laser melting (SLM). Results As the porosity increases, the elastic modulus and compressive strength of the Gyroid structure decreased. At the same porosity, the differences in the elastic modulus of the Gyroid structures were not statistically significant (P>0.05), and the maximum compressive strengths of the gradient Gyroid structures were lower than those of the homogeneous porosity Gyroid structures. Conclusion The gradient Gyroid structure matches the elastic modulus of cortical bone and cancellous bone, and the strength is similar to that of human bone, which has excellent mechanical properties and is expected to be used in dental implants.

Digital technology-assisted implant-supported full-arch fixed prosthesis: a case report

2023, 28(3): 210-214. DOI: 10.12337/zgkqzzxzz.2023.06.014

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The first summit of domestic oral implant material research and development

2023, 28(3): 215-215.

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