Feasibility and accuracy of a task-autonomous robot for zygomatic implant placement

Abstract

Zygomatic implants (ZIs) should be placed accurately as planned preoperatively to minimize complications and maximize the use of the remaining bone. Current digital techniques such as static guides and dynamic navigation are affected by human error; therefore, new techniques are required to improve the accuracy of ZI placement. The purpose of this clinical study was to assess the feasibility and accuracy of a task-autonomous robot for ZI placement. Patients indicated for ZI placement were enrolled, and an appropriate surgical positioning piece was selected based on the presence of natural teeth in the maxilla. Preoperative cone beam computed tomography (CBCT) scanning was performed with the surgical positioning piece, and virtual implant design and socket preparation procedures were initiated. Implant socket preparation and placement were automatically performed by the robot according to the preoperative plan under the supervision of the surgeon. Postoperative CBCT scanning was performed to evaluate deviations between the virtual and actual implants. All quantitative data were expressed as standardized descriptive statistics (mean, standard deviation, minimum, maximum, and 95% confidence interval [CI]). The Shapiro-Wilk test was used to assess the normal distribution of all variables (α=.05). Six participants were enrolled, and 8 ZIs were inserted. No intraoperative or postoperative complications were observed. Robotic ZI placement showed a global coronal deviation of 0.97mm (95% CI: 0.55 to 1.39 mm), a global apical deviation of 1.27mm (95% CI: 0.71 to 1.83 mm), and an angular deviation of 1.48 degrees (95% CI: 0.97 to 2.00 degrees). Task-autonomous robots can be used for ZI placement with satisfactory accuracy. Robotic ZI surgery can be an alternative to static guidance and dynamic navigation to improve the accuracy of implant placement.