Robotassisted Endodontic Microsurgery On Maxillary Premolars Adjacent To Maxillary Sinus

Current apicoectomy limitations include excessive osteotomy from imprecise lesion localization. Robotic systems show potential in enhancing precision in endodontic microsurgery. This case demonstrates successful robot-assisted apicoectomy for a maxillary sinus floor-adjacent periapical lesion. A 27-year-old woman was diagnosed with previously treated, symptomatic apical periodontitis in the maxillary right first and second premolars. The affected root apex is located less than 1 mm from the maxillary sinus floor. Intraoral scans and CBCT data were integrated in xxx for 3D surgical planning. The xxxBot system performed autonomous osteotomy and 3-mm root resection using spatial alignment. Despite meticulous surgical technique, minor maxillary sinus floor perforation occurred following root resection, which was subsequently repaired with collagen membrane by the operator. After confirming no cracks, the clinician completed microscopic root-end filling. At 6-month follow-up, the patient was asymptomatic with improved soft tissue healing and reduced periapical radiolucency. The affected tooth's root apex closely approximated the maxillary sinus floor, creating substantial apicoectomy challenges where even slight deviations risked sinus perforation. Robotic guidance ensured precise 3-mm apex resection, minimizing errors, tissue trauma, and improving accuracy/safety. However, the current system still requires repeated intraoperative confirmation and adjustment of the robotic arm's approach, resulting in prolonged operation time and significant technical challenges for surgeons. Robot-assisted apicoectomy in maxillary premolars demonstrates efficacy in mitigating the risk of maxillary sinus perforation. Current clinical evidence confirms its safety, stability, and reliability in surgical practice.