Robot-Assisted Transcrestal Sinus Floor Elevation With Osseodensification Technology

This study investigated the efficacy of force-feedback-guided autonomous implant robotics integrated with osseodensification (OD) for transcrestal sinus floor elevation (TSFE), focusing on intraoperative force pattern characterization and mechanical visualization of sinus floor dynamics, and offering new perspectives on surgical strategies. Patients who required simultaneous TSFE and implant placement underwent preoperative planning. Under surgical supervision, the robotic system executed controlled sinus floor microfracture and membrane elevation using OD drills, with force-feedback parameters during TSFE continuously recorded. Postoperative evaluation included CBCT assessment of sinus augmentation, implant positioning, and patient-reported outcomes via visual analog scale. Statistical analysis employed descriptive statistics and Pearson's correlation (p<0.05). All 17 patients (18 implants) demonstrated 94.4% survival at 6 months postoperatively. The force-feedback curve exhibited two distinct phases: a critical peak followed by a sharp drop at the sinus-floor breakthrough point and a gradual rise followed by a steep decrease as the graft entered the sinus cavity. Cortical bone density positively correlated with force-feedback (p<0.05). Patient-reported outcomes reflected minimal postoperative swelling, high satisfaction levels, and strong procedural acceptance. Force-feedback-based implant robotics combined with OD is an innovative and reliable approach for TSFE. By integrating real-time mechanical vision with dynamic force analysis, the technology enables precise identification of cortical microfracture points through abrupt force transitions and millimeter-level visualization of drill displacement, effectively overcoming limitations of traditional blind techniques while enhancing procedural safety and predictability. Preliminary data published in COIR.