This past Saturday a Chinese dental clinic announced that in a one-hour procedure, a robot, carried out the first successful autonomous implant surgery by installing two implants into woman™s mouth. Although there were human medical staff present during the implant surgery, the staff was not actively involved in the actual surgery. The implants were fitted to within a margin of error of 0.2-0.3mm.
China has a particular need for robotic surgery, because of the shortage of qualified dentists in the country who can place dental implants. A recent survey reported that there were about 400 million patients needing new teeth in China, but the number of qualified dentists could not possibly meet that need. Although, one million implants are placed in China annually, the quality of surgery is still not considered ideal.
While the exact details of the operation in China are still awaited, this news still begs question if robotic-assisted implant surgery will soon become a reality?
Interestingly, in the US market, there is a company Neocis, that announced earlier this year FDA clearance to introduce Yomi, the first robotically assisted system for dental implant surgery. Yomi™s software is used to plan a procedure based on a patient™s CT scan. During the procedure, the system continuously tracks the patient and controls the direction of the drill as the clinician advances it into tissue. This is supposed to guarantee that the physician doesn™t stray away from the correct location, depth, and orientation of the plan, while still controlling the actual drill delivery. Basically, you always know where the drill bit and implant are in relation to your patient™s anatomy and your preoperative plan. Below is a video describing Yomi.
What are you thoughts? Is Robot-assisted Implant Surgery the future?
6 Comments on Robot-assisted Implant Surgery: the future?
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Robert J Miller
Tell me how the clinical outcome is better? Short of that, it's technology for the sake of technology. A huge added expense in infrastructure for no real benefit. There is a robotic unit available in the US for $100,000 and was released at the AO meeting this year. They will sell a handful to entrepreneurs and early adopters that will be used simply as marketing devices. With passive guided surgery using printed guides, and active (dynamic) surgical guidance using computers, we can achieve outstanding precision in implant placement at a fraction of the cost. In the end, you balance outcome with ROI. In this case, robotic implant surgery make no sense for the vast majority of implant surgeons. RJM
Dr. Vishal Sahayata
I think error of 2-3mm is not accepatable, especially in single tooth replacements.
The article says 0.2 - 0.3mm, not 2-3mm.
Raymond E La Vigne, DDS
I totally agree the ROI is not at all practical. As Dentists we are even more careful than carpenters who believe :measure twice , cut once" We measure many more than two and we do our work in increments checking ourselves often. A robot apparently will take aim and go all the way. Even with CBCT and surgical stents can we really believe there will not be need for professional judgment and hand / eye? Can a robot account for patient's movement or must a patient be fixated and therefore completely sedated.
Another question or comment - if 100,000 implants are needed in China and there truly is that desire and willingness to pay then why couldn't there be an alternative of American and other dentists going there temporary or long term to provide that instead of an expensive robot and a select few?
I wonder how the robot copes with a live patient eg. if the patient tilts the head a little this way instead of that way, whether anaesthesia has taken effect, the assurance and calming down that patients need as it might be a little intimidating to sit through the procedure, quick thinking needed in case the procedure doesn't go a 100% as planned (as it may happen even with the most meticulously planned cases).
Wasn't that long ago that CBCT's were considered not really necessary for most implants. Now I won't do an implant without a cone beam. Simplified, predictable placement would bring implant surgery back to most GP's who currently don't do these surgeries. That will lower costs to patients, not increase them as suggested.