Robotics in oral and maxillofacial surgery

Robot-assisted surgery for dental implant placement: A narrative review

OBJECTIVE

To determine the current status and accuracy of robotic computer-assisted implant surgery (CAIS) applications by examining the associated clinical and experimental outcomes.

DATA AND SOURCES

PubMed, Medline, and Cochrane Library databases were searched for relevant studies published between January 2000 and November 2023, and focusing on robotic CAIS in dental implant surgery. All search results were then manually reviewed to identify only the pertinent articles. Only in vitro and clinical studies were included in this narrative review, with implant placement accuracy considered the main outcome.

RESULT

Based on our inclusion and exclusion criteria, we included 21 studies (with 1085 implant sites); of them, 8 were clinical studies, 12 were in vitro studies, and 1 included both an in vitro study and a case series. The ranges of the mean implant shoulder, apical, and angular deviations were respectively 0.43-1.04 mm, 0.53-1.06 mm, and 0.77°-3.77° in the clinical studies and 0.23-1.04 mm, 0.24-2.13 mm, and 0.43°-3.78° in the in vitro studies, respectively.

CONCLUSION

The accuracy of robotic CAIS in dental implant procedures appears to be within the clinically acceptable ranges. However, further relevant clinical trials validating the existing evidence are needed.

CLINICAL SIGNIFICANCE

Robotic CAIS can achieve clinically acceptable implant placement accuracy. This innovative technology may improve the precision and success rates of dental implant procedures, with benefit for surgeons and patients.

Robotic-Assisted Pelvic Reconstruction After Metastatic Renal Cell Carcinoma Resection: A Case Report

CASE

A 76-year-old man presented with metastatic renal cell carcinoma (RCC) in the right acetabulum with pelvic compromise. The patient had right hip pain and difficulty with ambulation, as such he elected to undergo tumor resection with subsequent reconstruction of pelvic defect. Given the size and location of the anticipated pelvic defect, robotic-assisted hip arthroplasty was used to execute prosthetic component placement and anatomic pelvic reconstruction.

CONCLUSION

Advances in technology, such as robotics and 3D navigation, have application in orthopaedic oncology surgery, especially for reconstructions after pelvic resections. The goal of this case report is to describe the utility of this technology in a case of metastatic RCC.

Application of supraomohyoid neck dissection via retroauricular hairline incision in patients with oral cancer

OBJECTIVE

To explore the application of supraomohyoid neck dissection via retroauricular hairline incision in patients with oral cancer, thereby providing a basis for the surgical treatment of patients with oral cancer in clinical practice.

METHODS

A total of 68 patients with oral cancer who met the inclusion criteria and exclusion criteria were included in our hospital from August 2018 to June 2020. According to the random number table method, they were divided into the experimental group (34 cases), in which patients underwent supraomohyoid neck dissection via retroauricular hairline incision, and control group (34 cases), in which patients received neck dissection.

RESULTS

The operation time was significantly longer and the intraoperative bleeding was significantly less in the experimental group compared with those in the control group (both P < 0.05). No significant differences in postoperative drainage, number of detected lymph nodes and length of hospital stay were detected between the two groups. One month after surgery, the scores of pains, muscle strength, range of motion and daily activities were significantly higher in the experimental group than those in the control group (all P < 0.05). Three months after surgery, the scores of pains, muscle strength, range of motion and daily activities were higher compared with those at one month after surgery in both groups, and these scores in the experimental group were higher than those in the control group (all P < 0.05). In addition, the scores of shoulder function, language, deglutition, chew, work, entertainment, activity of daily living, facial features, pain and degree of satisfaction to the scars in the experimental group were significantly higher than those in the control group one month after surgery (all P < 0.05).

CONCLUSION

Supraomohyoid neck dissection via retroauricular hairline incision can reduce the amount of intraoperative bleeding in patients with oral cancer, is beneficial to the recovery of shoulder joint function, improves the patient's quality of life and the degree of satisfaction to the scars, reduces the occurrence of related complications. It has relatively high safety and is worthy of clinical application and promotion.