Case Series: Robot-Assisted Endodontic Microsurgery In Complex Anatomical Scenarios

A robotic system was successfully used in four complex endodontic microsurgery cases, preserving nearby vital structures. This demonstrates that autonomous robot-assisted endodontic microsurgery is a safe and viable option, even in challenging anatomical areas. Four molars (#3, #14, #19, #30) were diagnosed with chronic periapical periodontitis, causing persistent pain and swelling. CBCT showed teeth #3 and #14 near the maxillary sinus and teeth #19 and #30 near the inferior alveolar nerve. Data from CBCT and intraoral scans were used in the robotic system (Yakebot) to design the surgical path. Spatial alignment techniques were used to calibrate and register the robot and the patient. The surgeon controlled the robot for osteotomy and root-end resection. All patients demonstrated satisfactory healing within 1 to 6 months, with the periapical radiolucent area decreasing in radiographic examination. This report highlights the successful use of a robotic system in four complex cases, preserving vital anatomical structures. The robot's precision and stability make it ideal for complex tasks, reducing the technical sensitivity. Compared to the dynamic navigation system, it minimizes the reliance on hand-eye coordination. The stability of the robotic arm is much higher than that of a free hand. Additionally, surgeons can monitor and adjust the drill's three-dimensional position through a visual interface, enabling real-time adjustments to the robotic arm's trajectory program. Robot-assisted endodontic microsurgery is a safe, feasible procedure that reduces human error and technique sensitivity. It offers a valuable alternative for challenging anatomical cases.