In-Vivo Accuracy of Autonomous Dental Implant Robotic Surgery: Systematic Review and Meta-Analysis

Purpose: To systematically analyze the accuracy of autonomous dental implant robotic (ADIR) surgery for dental implant placement. Materials and methods: PubMed, Embase, and Cochrane CENTRAL were searched on February 21, 2024. Any clinical studies, with the exception of case reports, assessing ADIR accuracy by superimposing preoperative digital planning with postoperative CBCT images were included. The risk of bias was assessed, and a meta-analysis was performed using a random-effect model to evaluate linear and angular deviations between planned and placed implants. Results: Data from six clinical studies reporting ADIR accuracy in 96 patients with 299 dental implants were included (102 implants in 69 partially edentulous patients, 197 implants in 27 complete-arch scenarios). The meta analysis at the implant level reported a mean overall accuracy of ADIR of 0.60 mm (95% CI [0.5133; 0.6965]) at the platform and 0.63 mm (95% CI [0.5663; 0.6909]) at the apex and 1.242 degrees (95% CI [1.2182; 1.6320]) of angular deviation. ADIR accuracy resulted in significantly higher values than static and dynamic computer-assisted implant surgery. Conclusions: Within the limitations of this review, ADIR surgery has shown to be feasible for placing implants in both partially and completely edentulous patients, achieving consistent mean linear and angular deviations of approximately 0.6 mm and 1.40 degrees, respectively. However, clinical practicality of ADIR surgery remains cumbersome, with well-trained operators needed to plan and assist ADIR procedures as well as a technical expert providing backup control.