‘Precision Without Proof? A Systematic Appraisal of Robotic-Assisted Dental Procedures: A Narrative Review.

Author

Dr. B. LakshmanaRao, Dr. Vikas Punia , Dr. V. Dal Singh , Dr. D. Srikanth , Dr. M. Vaishnavi Devi


Abstract

 Background: Robotic systems have moved from laboratory prototypes to cleared clinical devices in dentistry within a decade, led by implant surgery but now extending to endodontics, tooth preparation, autotransplantation, periodontal and orthognathic surgery. Evidence is scattered across specialties and dominated by geometric accuracy endpoints.

Objective: To systematically map and appraise the evidence on robotic-assisted procedures across dental disciplines, with emphasis on accuracy, efficiency, safety, clinical outcomes and level of translational readiness.

Methods: Reported in accordance with PRISMA 2020. PubMed/MEDLINE was searched on 6 November 2026 with 19 discipline-specific strings (610 hits). Systematic reviews, meta-analyses, randomized and non-randomized clinical studies, case series/reports and in vitro/technical studies evaluating a robotic system in any dental procedure were eligible. Risk of bias was assessed using the RoB 2, ROBINS-I, QUIN, and AMSTAR 2 domains, and certainty was rated using GRADE. A narrative synthesis by discipline was performed; pooled estimates were extracted from existing meta-analyses.

Results: Forty-seven records were included (23 evidence syntheses, 24 primary studies). Implantology has the most mature evidence: four independent meta-analyses converged on pooled clinical deviations of 0.60–0.69 mm (coronal), 0.70–0.72 mm (apical) and 1.60–1.68° (angular), with a network meta-analysis of 11 RCTs ranking robotic surgery highest for single-tooth sites. Higher autonomy was associated with greater accuracy in the largest meta-analysis, but operative time was consistently longer. In other disciplines, robots reduced tooth-structure loss in calcified-canal access, improved socket congruence in autotransplantation (angular error 3.81° vs 9.54° freehand) and achieved crown-preparation RMSE of 0.18 mm, but evidence is limited to in vitro work and single-patient reports.

Conclusions: Robotic implant placement is accurate, with low-to-moderate certainty of superiority over static and dynamic guidance. All other applications remain at the feasibility stage. Patient-reported outcomes, long-term survival, cost-effectiveness and safety reporting are the critical evidence gaps.


Keywords

Robotics; Robotic surgical procedures; Computer-assisted implant surgery; Digital dentistry; Systematic review



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