Semi-active Robotic Over Free-hand Techniques for Evaluation of Dental Implant Placement Accuracy

INTRODUCTION: Accurate three-dimensional positioning of dental implants is necessary for attaining optimal prosthetic outcomes and long-term implant success. Conventional free-hand implant placement is highly operator dependent and associated with greater positional deviations, whereas semi-active robotic systems offer real-time guidance and mechanical constraint to enhance surgical precision. To comparatively evaluate the accuracy of dental implant placement using a semi-active robotic assistance system versus the conventional free-hand technique in a randomized controlled clinical trial. MATERIALS AND METHODS: This prospective parallel-arm randomized controlled trial included 200 implant sites allocated equally to a semi-active robotic group and a free-hand group. Preoperative cone-beam computed tomography (CBCT)-based virtual planning was performed for all cases. Implant placement accuracy was assessed postoperatively by superimposing pre- and postoperative CBCT scans to measure coronal deviation, apical deviation, and angular deviation. Secondary outcomes, such as surgical time, intraoperative complications, and postoperative pain, were considered. Statistical analysis was performed using appropriate parametric and nonparametric tests with significance set at P < 0.05. RESULTS: The semi-active robotic group demonstrated significantly lower coronal, apical, and angular deviations compared with the free-hand group (P < 0.001). Although surgical time was significantly longer in the robotic group, intraoperative complications and postoperative pain scores were comparable between groups. CONCLUSION: Semi-active robotic guidance significantly improves implant placement accuracy without increasing short-term patient morbidity, supporting its clinical utility in precision-driven implant dentistry.