Evaluation of accuracy and membrane perforation in robotic-assisted implant surgery for transalveolar sinus floor elevation: a retrospective case series

Abstract

BACKGROUND: The potential of the robotic system for transalveolar sinus floor elevation (TSFE) with simultaneous implant placement has not been verified. This study aimed to assess implant placement accuracy and membrane perforation in robotic computer-assisted implant surgery (r-CAIS) for TSFE. METHODS: Patients who underwent r-CAIS for TSFE were enrolled in this study. Positioning markers were placed in the patient's oral cavity, and cone-beam computed tomography (CBCT) was performed. Subsequently, the surgical plan was generated using robotic software. After the markers were registered with the robotic arm, TSFE and implant placement were performed using the robotic arm and crestal approach sinus (CAS) kit drills under the control of the surgeons. Deviations between the planned and placed implants were assessed using preoperative and postoperative CBCT data. In addition, perforation of the Schneiderian membrane was evaluated intraoperatively using the Valsalva maneuver and postoperatively using CBCT images. RESULTS: Ten patients were enrolled, and no adverse events occurred during the surgery. The mean global coronal, global apical, and angular deviations were 0.55 ± 0.20 mm (95% confidence interval [CI]: 0.41 to 0.69 mm), 0.56 ± 0.23 mm ( 95%CI:0.40 to 0.73 mm), and 1.38 ± 0.83° ( 95%CI: 0.78 to 1.97°), respectively. No membrane perforation was observed during or after the surgery. CONCLUSIONS: Within the limitations of this study, r-CAIS for TSFE showed high accuracy and a low membrane perforation rate.