Comparing the accuracy and treatment time of a robotic and dynamic navigation system in osteotomy and root-end resection: An in vitro study

Aim: To compare the accuracy and treatment time of a robotic system (RS) and a dynamic navigation system (DNS) in osteotomy and root-end resection in an in vitro study. Methodology: In this study, four identical mandibular models were created using three-dimensional (3D) printing, each model including 18 teeth. In the surgical procedures, teeth #35, #33, #32, #42, #43 and #45, along with the mesiobuccal roots of teeth #36 and #46, were specifically selected for operation on each model. Cone-beam computed tomography (CBCT) and intraoral scans were performed on all models. DentalNavi software was used to plan a drilling path and depth as well as design surgical accessories. In the RS, osteotomy and root-end resection were performed with robotic assistance, whereas in the DNS, these procedures were performed using dynamic navigation. Post-operative CBCT scans were obtained. Global platform deviation, global apex deviation, angular deflection, and time were compared to evaluate the accuracy and treatment time of the surgeries. The treatment time was defined as the registration time and drilling time. Statistical analyses were performed using the Shapiro-Wilk and independent sample t-test. Results: The global platform deviation, global apex deviation and angular deflection in the RS group were significantly smaller than those in the DNS group (p <.05). The registration time in the RS group was significantly longer than that in the DNS group (p <.001), whereas the drilling time was significantly shorter (p <.001). The overall surgical time was significantly longer in the RS group than in the DNS group (p <.001). Subgroup accuracy analysis revealed that in both the anterior and posterior tooth regions, the RS group exhibited significantly smaller apical and angular deviations than the DNS group (p <.001). Additionally, in both the anterior and posterior tooth subgroups, the total time for the DNS group was significantly shorter than that for the RS group in the anterior tooth area (p <.01). Conclusions: RS showed higher accuracy and shorter drilling time in osteotomy and root-end resection compared to DNS. The RS holds promise as a reliable technological advancement in endodontic microsurgery. However, future endeavours should prioritize the reduction in registration time.