An alternative radiation-free method for assessing the accuracy of robotic computer-assisted implant surgery: a cross-sectional study

Objectives: This study aimed to assess the accuracy of implant placement performed using robotic computer-assisted implant surgery (r-CAIS) by comparing postoperative measurements obtained via intraoral scanning (IOS) with those derived from cone-beam computed tomography (CBCT). Methods: The study employed a cross-sectional design. All patients received a preoperative CBCT and IOS for surgical planning and registration. All the surgeries were performed using r-CAIS. Postoperative CBCT and IOS datasets were acquired for each patient and superimposed on the preoperative datasets to assess deviations between planned and actual implant positions. Paired t-tests were used to analyze differences between the two assessment modalities, with statistical significance defined as P < 0.05. Agreement between the two methods was evaluated using intra-class correlation coefficients (ICCs) and Bland–Altman analyses. Results: Thirty-four implants in twenty-seven patients were included. Global coronal, global apical, and angular deviations measured using the IOS method were 0.59 ± 0.23 mm, 0.66 ± 0.24 mm, and 1.28 ± 0.69°, respectively, compared with 0.59 ± 0.24 mm, 0.63 ± 0.25 mm, and 1.19 ± 0.70° measured by the CBCT method. No statistically significant differences were observed between the two modalities (P > 0.05, respectively). ICCs for global coronal, global apical, and angular deviations were 0.911, 0.886, and 0.856, respectively. Bland–Altman analyses further confirmed excellent agreement between the two methods. Conclusions: Both IOS and CBCT methods demonstrated comparable accuracy and good agreement in r-CAIS. Clinical significance: Postoperative IOS method may serve as a reliable and radiation-free alternative to CBCT for assessing implant placement accuracy in r-CAIS in patients with a single missing tooth or two consecutive missing teeth. In future, multicenter randomized controlled trials with larger sample sizes are warranted to further validate these findings.