Evaluation of the accuracy of dynamic navigation versus robot-assisted dental implant placement in models with one missing tooth or multiple missing teeth with a free-end: an in vitro study.

Objectives: To assess and compare the accuracy of robot-assisted and dynamic navigation systems for dental implant placement in models with either a single missing tooth or multiple consecutive missing teeth at the distal extension.

Methods: Thirty-two models and 86 implants were utilized. Implant placement was randomly assigned using either a robot-assisted or dynamic navigation system. The accuracy was evaluated by superimposing planned and actual implant positions. The primary study outcome was angular deviation, while secondary outcomes included three-dimensional deviations at the implant entry and apex levels.

Results: Across all models, the robot-assisted group demonstrated a median angular deviation of 1.15°, compared to 1.99° with the dynamic navigation system (P < 0.01). Entry and apex deviations were 0.90 mm vs. 0.92 mm and 1.00 mm vs. 0.99 mm, respectively. In single-tooth cases, significant differences between groups were observed in entry and apex depth deviations (P = 0.038 and P = 0.032, respectively). In models with multiple missing teeth, the robot-assisted system showed significantly lower angular, apex, and apex horizontal deviations than dynamic navigation system (P < 0.05).

Conclusion: Both approaches yield a high degree of accuracy in vitro for implant placement. However, the robot-assisted approach may offer improved precision, particularly in complex cases involving multiple missing teeth.

Clinical Significance: The lower deviations in terms of accuracy demonstrated by the robot-assisted approach in the study would have potential benefits for the application of robots in relatively complex implant surgeries.