A fully digital approach to autonomous robot-assisted immediate implant and interim restoration placement in the maxillary anterior esthetic zone: A case series.

Abstract

Statement of problem: Immediate implant and interim restoration placement in the maxillary anterior esthetic zone presents challenges in achieving optimal implant positioning, esthetics, and peri-implant tissue stability. A more accurate and efficient clinical workflow is needed to address these demands.

Purpose: This study aimed to establish a fully digital workflow that combines autonomous robotic-assisted immediate implant placement and prefabricated interim restorations in the maxillary anterior esthetic region and to evaluate its accuracy and short-term clinical outcomes.

Material and methods: Patients requiring immediate implant and interim restoration placement in the anterior esthetic zone were enrolled. A digital workflow was applied, including the virtual implant planning and computer-aided design and computer-aided manufacturing (CAD-CAM) fabrication of interim prostheses. During surgery, the robotic computer-assisted implant surgery (r-CAIS) system autonomously performed osteotomies and implant placement under clinical supervision. Prefabricated interim prostheses were delivered immediately after implantation. Implant placement accuracy was assessed using postoperative cone beam computed tomography (CBCT) imaging. Peri-implant soft and hard tissue status was clinically evaluated during definitive restoration delivery.

Results: Six patients (with 7 implants) completed the protocol without complications. All interim restorations were seated immediately after surgery without the need for major adjustments. The mean ±standard deviation of coronal, apical, and angular deviations were 0.66 ±0.13 mm, 0.62 ±0.17 mm, and 1.45 ±0.51 degrees, respectively. At the 6-month follow-up, the mean ±standard deviation of marginal bone loss was 0.49 ±0.26 mm. The mean ±standard deviation of the pink esthetic score was 11.14 ±1.95, and the mean ±standard deviation of the visual analog scale score was 9.00 ±0.22, reflecting satisfactory esthetic outcomes and a high level of patient satisfaction.

Conclusions: The integration of autonomous r-CAIS with prefabricated CAD-CAM interim restorations demonstrates high accuracy, favorable esthetic outcomes, and excellent patient satisfaction in immediate implant and interim restoration placement. Long-term, controlled studies are necessary to evaluate the stability and clinical advantages of this approach.