Precise surgical positioning according to a digital plan is important for aesthetic and biologically stable dental implant restorations. This randomized controlled trial compared implant placement assisted by robotic surgery (RS), dynamic navigation (DN), or 3-dimensional printed static guide (SG). An overall 45 patients with a missing tooth in the premolar/molar region were randomly assigned to 1 of the 3 groups. Implant positional accuracy (primary outcome), early wound healing, soft tissue microcirculation, patient-reported outcome measures, and surgeon preference were measured by calibrated blind examiners. One adverse event occurred in DN and RS. In RS ( n = 15), the global platform, apex deviation, and angular deviations (mean ± SD) were 1.1 ± 0.4 mm, 1.5 ± 0.6 mm, and 4.7° ± 2.5°, respectively. Similarly, deviations were 1.3 ± 0.6 mm, 1.9 ± 0.9 mm, and 5.5° ± 3.5° in the DN group ( n = 14) and 1.1 ± 0.6 mm, 2.0 ± 1.2 mm, and 6.2° ± 4.0° in the SG group ( n = 13). Significantly smaller differential deviations (mesial-distal) at the platform and apex levels were found in the RS group than the SG group ( P < 0.05). Surgery was significantly shorter with a SG ( P < 0.001), and this was associated with better postoperative recovery at 3 d. The surgeon assessed DN as providing easier access to reach the surgical site. No significant differences were found upon comparing soft tissue microcirculation and oxygen saturation immediately, 1 h, or 7 d after surgery. Patient-reported outcomes were comparable in the 3 groups, except that patients in the SG group reported better oral health–related quality of life 3 d after surgery. It can be concluded that RS showed near-zero 3-dimensional systematic error in implant position, while DN and SG demonstrated a centrifugal error pattern. All 3 guided approaches had uneventful wound healing and acceptable patient-reported outcomes. The 3 groups had specific cost-benefit profiles. After additional technical developments, future trials with larger sample sizes and longer follow-up periods should be performed to analyze the cost-effectiveness of different guided surgical approaches.

中文翻译：

---

种植体精度与机器人、导航或静态导板的比较


根据数字计划进行精确的手术定位对于美观和生物稳定的种植牙修复体非常重要。这项随机对照试验比较了机器人手术 （RS） 、动态导航 （DN） 或 3 维打印静态导板 （SG） 辅助种植体植入。总共 45 例前磨牙/磨牙区域缺失的患者被随机分配到 3 组中的 1 组。由校准的盲人检查者测量植入物位置准确性 （主要结果）、早期伤口愈合、软组织微循环、患者报告的结果测量和外科医生的偏好。DN 和 RS 发生 1 例不良事件。在 RS （ n = 15） 中，整体平台、顶点偏差和角度偏差 （SD ±平均值） 分别为 1.1 ± 0.4 mm、1.5 ± 0.6 mm 和 4.7° ± 2.5°。同样，DN 组 （n = 14） 的偏差分别为 1.3 ± 0.6 mm、1.9 ± 0.9 mm 和 5.5° ± 3.5°，SG 组 （n = 13） 的偏差分别为 1.1 ± 0.6 mm、2.0 ± 1.2 mm 和 6.2° ± 4.0°。RS 组在平台和根尖水平的差异偏差 （近中-远端） 显著小于 SG 组 （ P < 0.05）。SG 手术时间显著缩短 （ P < 0.001），这与 3 d 术后恢复较好相关。外科医生评估 DN 可以更轻松地到达手术部位。比较术后即刻、1 h 或 7 d 的软组织微循环和氧饱和度，未发现显著差异。3 组患者报告的结果具有可比性，除了 SG 组患者在手术后 3 d 报告了更好的口腔健康相关生活质量。 可以得出结论，RS 在种植体位置显示接近零的 3 维系统误差，而 DN 和 SG 表现出离心误差模式。所有 3 种引导方法均具有顺利的伤口愈合和可接受的患者报告结局。这 3 组具有特定的成本效益概况。在额外的技术发展之后，未来应进行样本量更大、随访期更长的试验，以分析不同引导手术方法的成本效益。