Oral and Maxillofacial Surgeon, PreciDent Center for Facial and Dental Medicine, St. Petersburg, FL.
Oral and Maxillofacial Surgeon, Triangle Implant Center, Durham, NC.
J Prosthet Dent. 2022 Oct;128(4):639-647. doi: 10.1016/j.prosdent.2020.12.048. Epub 2021 Mar 5.
The accuracy of single implant placement is critical, as errors may cause problems with vital structures intraoperatively, as well as postoperatively with the prostheses. These issues may be exacerbated in complete-arch edentulous treatments requiring relative accuracy among multiple implants, particularly with prefabricated prosthetic structures.
The purpose of this clinical study was to determine the accuracy of dental implant placement by using haptic robotic guidance in completely edentulous participants.
In a prospective single-arm clinical study, 5 qualified participants elected to receive dental implants placed by using haptic robotic guidance to restore either the maxillary or mandibular arch, or both, with complete-arch implant-supported prostheses. Three dual-arch participants and 2 single-arch participants resulted in 38 endosteal dental implants being placed. A virtual preoperative restorative and surgical plan was created before surgery. This plan was matched to the surgical workspace on the day of surgery by using a bone-mounted fiducial splint fabricated from a cone beam computed tomography (CBCT) scan. Intraoperatively, the surgeons maneuvered a handpiece attached to the robotic guidance arm, osteotomies were created with a haptically constrained handpiece, and the implants were placed with 3-dimensional haptic constraints as per the virtual plan. Postoperative CBCT scans allowed the evaluation of the deviations of the actual implant placement relative to the plan.
Twenty-three implants were placed in the mandible and 15 in the maxilla. The mean ±standard deviation global angular deviation was 2.56 ±1.48 degrees, while the crown of the placed implant showed a deviation from the plan of 1.04 ±0.70 mm and the apex of 0.95 ±0.73 mm. The signed depth deviation was 0.42 ±0.46 mm proud. No adverse events were reported.
This clinical series for treating completely edentulous patients by using haptic robotic guidance was found to be safe and accurate. While further longer-term clinical studies are necessary to measure outcomes and to assess differences as compared with nonrobotic implementations, haptic robotic preparation appears to confer additional intraoperative advantages over other techniques for treating completely edentulous arches.
单颗种植体的精确放置至关重要，因为术中的任何误差都可能导致重要结构受损，术后修复体也可能出现问题。在需要多个种植体相对精确的全口无牙颌治疗中，这些问题可能会更加严重，特别是在使用预制修复结构的情况下。
本临床研究旨在评估使用触觉机器人引导技术在全口无牙颌患者中种植体放置的精确性。
这是一项前瞻性单臂临床研究，5 名合格的参与者选择接受使用触觉机器人引导技术植入种植体，以修复上颌或下颌弓，或两者同时修复，使用全口种植体支持式修复体。3 名双弓参与者和 2 名单弓参与者共植入 38 颗骨内种植体。手术前，先制定虚拟术前修复和手术计划。在手术当天，通过使用从锥形束 CT（CBCT）扫描获得的骨载 fiducial 夹将该计划与手术工作空间相匹配。术中，外科医生操纵连接到机器人引导臂的手机，使用触觉受限手机进行截骨，然后根据虚拟计划进行 3 维触觉约束下的种植体放置。术后 CBCT 扫描可评估实际种植体位置相对于计划的偏差。
23 颗种植体植入下颌，15 颗种植体植入上颌。总的平均±标准偏差的角度偏差为 2.56 ±1.48 度，而种植体冠部相对于计划的偏差为 1.04 ±0.70 毫米，根尖部为 0.95 ±0.73 毫米。实际植入物的深度偏差为 0.42 ±0.46 毫米。无不良事件报告。
本临床研究发现，使用触觉机器人引导技术治疗全口无牙颌患者是安全且精确的。虽然需要进一步进行更长时间的临床研究来测量结果，并评估与非机器人技术相比的差异，但与其他治疗完全无牙颌弓的技术相比，触觉机器人准备似乎在术中提供了额外的优势。
