Accuracy of flapless implant surgery using an autonomous robotic system in full-arch simultaneous immediate restoration: a report of three cases.

OBJECTIVES: This observational study aimed to evaluate the accuracy of robotic computer-assisted implant surgery (r-CAIS) for full-arch immediate restoration and to analyse possible factors contributing to deviations.

METHODS: Three edentulous patients (five arches) underwent r-CAIS. Osteotomies were performed using an autonomous robot under the surgeon's supervision, and implant placement was performed in a freehand or robotic manner. Prefabricated provisional prostheses were delivered immediately after surgery. Postoperative cone beam computed tomography scans were performed to assess the deviations between the planned and placed implants. Statistics were compared with deviations of s-CAIS outlined in a meta-analysis.

RESULTS: A sum of 28 implants were used. The mean global coronal and apical deviations measured 0.91 ±0.43 mm and 1.01 ±0.45 mm, respectively, and the mean angular deviation measured 1.21 ±1.24 º. The r-CAIS showed significantly better precision than the s-CAIS in full-arch cases (P <0.001). The implants inserted using the robotic arm exhibited fewer deviations than those placed in the freehand manner. Eighty percent of prefabricated provisional prostheses were successfully delivered.

CONCLUSIONS: Within the limitations of the present study, our data suggest that autonomous r-CAIS is a feasible approach for simultaneous immediate restoration in edentulous patients, showing better accuracy than s-CAIS. Further large-scale studies are necessary to verify the advantages and disadvantages of this novel technique and to explore possible factors that influence its accuracy.

CLINICAL SIGNIFICANCE: Autonomous r-CAIS can provide clinically acceptable implant placement accuracy in edentulous patients, significantly surpassing s-CAIS. This level of accuracy may represent a viable therapeutic approach for simultaneous immediate full-arch restoration.