Dental implant placement accuracy with robotic surgery compared to free-hand, static and dynamic computer assisted techniques: Systematic review and meta-analysis.

Background: This systematic review and meta-analysis compared the accuracy of robotic-assisted dental implant placement (r-CAIS) with conventional freehand, static computer-assisted (s-CAIS), and dynamic computer-assisted (d-CAIS) techniques. Methods: A comprehensive search was conducted in PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 2000 to January 2024. Studies meeting PICOST criteria, including clinical and in vitro studies, were included. Data on coronal, apical, and angular deviations were extracted for meta-analysis. The risk of bias (RoB) was assessed using the QUIN RoB and JBI RoB tools. Results: A total of 134 models and 100 patients with edentulous and partially edentulous arches were included. Eight studies (four in vitro, four in vivo) were reviewed, demonstrating that r-CAIS offers superior accuracy compared to freehand, s-CAIS, and d-CAIS techniques. Among the studies, two in vitro and two in vivo studies had a low RoB, while others had a high RoB. The meta-analysis of five studies showed significant improvements in coronal, apical, and angular deviations with robotic systems. Conclusion: Robotic-assisted systems showed greater accuracy than traditional non-robotic systems. However, this finding should be interpreted with caution due to the limited number of clinical studies and potential funding biases. Moreover, the high cost of robotic systems presents challenges for routine clinical implementation. Future research should focus on cost-effectiveness and seek broader clinical validation.