Evaluation of the accuracy of semi-autonomous robotic system versus dynamic navigation in completely edentulous implant surgery: an in vitro study

摘要

BACKGROUND: This study compared the accuracy (defined by trueness and precision) of implant placement between a semi-autonomous robotic system (SARS) and a dynamic navigation system (DNS) in completely edentulous models, evaluating the influence of alveolar bone morphology and implant orientation. METHODS: Thirty-two completely edentulous models were divided by anterior ridge morphology (well-rounded or narrow). Following the All-on-4 protocol, anterior implants were placed vertically, and posterior implants were inserted vertically or at a distal tilt using either SARS or DNS. Planning was conducted virtually, and deviations were assessed postoperatively via CBCT. Mann-Whitney U test and linear mixed model were used for statistical analysis. RESULTS: All 128 implants were placed successfully. Platform global deviations were 0.69 ± 0.29 mm (SARS) and 0.72 ± 0.41 mm (DNS); apical global deviations were 0.74 ± 0.27 mm (SARS) and 0.70 ± 0.40 mm (DNS). SARS achieved significantly lower angular deviation (superior trueness) overall (P < .05), particularly in distally tilted implants (P < .001). On well-rounded ridges, SARS showed smaller global and lateral platform deviations (P < .05). On narrow ridges, SARS had larger platform and apical depth deviations (P < .01) but maintained better angular control (P < .01). Precision analysis revealed that SARS achieved superior platform precision under complex conditions (distally tilted implants and narrow ridges), while on well-rounded ridges, it showed higher apical precision and more consistent angular control. CONCLUSION: Both SARS and DNS demonstrated excellent accuracy in completely edentulous models. Furthermore, the SARS showed superior angular trueness and platform precision in distally tilted implant placement and complex bone morphology.