Comparative accuracy analysis of robotic and static guided implant surgery: a retrospective clinical study

This study aimed to evaluate the accuracy of robot-assisted implantation by comparing it with guide-assisted implantation in different surgical contexts, including immediate implantation, multi-tooth implantation, maxillary sinus lift, and bone defect. Patients receiving implantation with static guide-assisted implant procedures or robot-assisted procedures were classified into the guide group (30 patients, 31 implants) and robot group (30 patients, 32 implants), respectively. Pre- and post-operative CBCT scans were processed with software for 3D reconstruction. Deviations between the original plan and actual implant placement at the apical level, cervical level, and implant angulation were projected into mesio-distal and bucco-lingual directions respectively, and were measured for analysis along with depth discrepancy. Comparing with guide group in this study, the robot group enjoyed smaller angular deviations in both bucco-lingual direction (1.289° ± 1.067 vs. 0.483° ± 0.334, P<0.01) and mesio-distal direction (1.652° ± 1.421 vs. 0.509° ± 0.426, P<0.01). Deviation analysis also demonstrated the advantage of robot system in controlling deviation at cervical (B-L: 0.461 ± 0.310mm vs. 0.183 ± 0.190mm, P<0.01; M-D: 0.441 ± 0.231mm vs. 0.121 ± 0.125mm, P<0.01) and apical distance (B-L: 0.508 ± 0.330mm vs. 0.164 ± 0.154mm, P<0.01; M-D: 0.476 ± 0.346mm vs. 0.135 ± 0.124mm, P<0.01). No important difference was noted in depth accuracy (0.426 ± 0.205, 0.335 ± 0.029, P>0.05). Notably, the precision of robotic implant placement remained consistently high across various procedures, including conventional, immediate, bone defect, class IV bone, sinus elevation, and multiple-tooth placements, with no important variation. Compared to guide-assisted techniques, the robotic implantation system offers superior accuracy in clinical implanting contexts. Its integration allows surgeons to focus more on planning and evaluation workflow, reducing manual effort and potentially lowering labor costs. Full name of the registry: Chinese Clinical Trial Registry. Trial registration number: ChiCTR2500109094. This study was retrospectively registered at Chinese Clinical Trial Registry (www.chictr.org.cn) on 11th Sept 2025.