Comparison of implant placement deviation between dynamic- and robotic-assisted implant surgery for complete arch implant-supported prostheses: An in vitro study.

Abstract

Statement of problem: Although dynamic- and robotic-assisted systems have enhanced control over implant placement, evidence comparing their performance for complete arch implant-supported prosthesis procedures, especially with tilted implants, is lacking.

Purpose: The purpose of this in vitro study was to compare the implant placement deviations of dynamic computer-assisted implant surgery (dCAIS) and robotic-assisted implant surgery (RAIS) in a complete arch implant-supported prosthesis protocol by focusing on deviations between planned and actual implant positions.

Material and methods: A total of 512 implants were placed in 64 maxillary and 64 mandibular edentulous resin models, with 256 implants per group. Each model received 2 anterior axial and 2 posterior tilted implants. Postoperative cone beam computed tomography (CBCT) scans were superimposed with preoperative plans to measure entry, exit, and angular deviations. Linear mixed-effects models (LMMs) were used for analysis, with the phantom as a random intercept and jaw type, implant angulation, and side as fixed effects (α=.05).

Results: Linear mixed model analysis identified a significant effect of surgery type on angular deviation (P<.001). Side significantly affected exit (P=.025) and angular deviation (P=.002). Significant interactions were observed between surgery type and implant axial type for entry deviation (P=.011) and between surgery type and side for angular deviation (P=.027). Post hoc analysis revealed a significant difference in entry deviation between axial and tilted implants within the dCAIS group (P=.003) and a side-related difference in angular deviation within the RAIS group (P=.005).

Conclusions: RAIS showed reduced deviations, especially for tilted implants, suggesting its potential to enhance control in complete arch implant-supported prostheses.