Non-Cochrane · intervention · PM42762524
Robotic Computer-Assisted Dental Implant Surgery Versus Free-Hand and Guided Techniques: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Ainoosah Sultan, Al-Gabri Redhwan Saleh, Alaryani Omar M, et al. · Clinical and experimental dental research · 2026 · PubMed · doi:10.1002/cre2.70460
Findings
9 findings
| Population | ||||
|---|---|---|---|---|
| Patients undergoing dental implant placement | Robotic computer-assisted implant surgery (r-CAIS) | Free-hand implant surgery (FHIS) | Angular deviation (degrees) Postoperative imaging: immediate to 1 week; 3 months in one trial · China and India | MD -4.56 [-6.25, -2.86] Low Downgraded: risk of bias, inconsistency 5 studies |
| Patients undergoing dental implant placement | Robotic computer-assisted implant surgery (r-CAIS) | Free-hand implant surgery (FHIS) | Apical global deviation (mm) Postoperative imaging: immediate to 1 week; 3 months in one trial · China and India | MD -1.10 [-1.31, -0.89] Moderate Downgraded: risk of bias 5 studies |
| Patients undergoing dental implant placement | Robotic computer-assisted implant surgery (r-CAIS) | Free-hand implant surgery (FHIS) | Platform global deviation (mm) Postoperative imaging: immediate to 1 week; 3 months in one trial · China and India | MD -0.64 [-0.71, -0.57] Moderate Downgraded: risk of bias 5 studies |
| Patients undergoing dental implant placement | Robotic computer-assisted implant surgery (r-CAIS) | Dynamic computer-assisted implant surgery (d-CAIS) | Platform global deviation (mm) Postoperative imaging: immediate to 1 week; 3 months in one trial · China | MD -0.10 [-0.27, 0.07] Moderate Downgraded: imprecision 2 studies |
| Patients undergoing dental implant placement | Robotic computer-assisted implant surgery (r-CAIS) | Dynamic computer-assisted implant surgery (d-CAIS) | Angular deviation (degrees) Postoperative imaging: immediate to 1 week; 3 months in one trial · China | MD -0.77 [-1.33, -0.21] High 2 studies |
| Patients undergoing dental implant placement | Robotic computer-assisted implant surgery (r-CAIS) | Dynamic computer-assisted implant surgery (d-CAIS) | Apical global deviation (mm) Postoperative imaging: immediate to 1 week; 3 months in one trial · China | MD -0.13 [-0.44, 0.18] Moderate Downgraded: imprecision 2 studies |
| Patients undergoing single-tooth dental implant placement (maxilla and mandible; anterior, premolar and molar sites) | Robotic computer-assisted implant surgery (r-CAIS) | Static computer-assisted implant surgery (s-CAIS) | Angular deviation (degrees) 3 months postoperative (intraoral scan) · Clinical RCT in China | MD -1.50 [-3.89, 0.89] Low Downgraded: imprecision 1 study · 30 participants |
| Patients undergoing single-tooth dental implant placement (maxilla and mandible; anterior, premolar and molar sites) | Robotic computer-assisted implant surgery (r-CAIS) | Static computer-assisted implant surgery (s-CAIS) | Platform (coronal) global deviation (mm) 3 months postoperative (intraoral scan) · Clinical RCT in China | MD 0.00 [-0.36, 0.36] Low Downgraded: imprecision 1 study · 30 participants |
| Patients undergoing single-tooth dental implant placement (maxilla and mandible; anterior, premolar and molar sites) | Robotic computer-assisted implant surgery (r-CAIS) | Static computer-assisted implant surgery (s-CAIS) | Apical global deviation (mm) 3 months postoperative (intraoral scan) · Clinical RCT in China | MD -0.50 [-1.18, 0.18] Low Downgraded: imprecision 1 study · 30 participants |
Included primary studies 14
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chen 2025 Accuracy, Safety, and Efficiency in Robotic-Assisted vs. Freehand Dental Implant Surgery: A 6-Month Follow-Up Randomized Controlled Trial. PMID:39899324 | 2025 | 2 other reviews | not stated | not extracted yet |
| Shi 2024 Improved positional accuracy of dental implant placement using a haptic and machine-vision-controlled collaborative surgery robot: A pilot… PMID:37872750 | 2024 | 2 other reviews | not stated | not extracted yet |
| Yang 2024 Comparative analysis of dental implant placement accuracy: Semi-active robotic versus free-hand techniques: A randomized controlled… PMID:39161058 | 2024 | 2 other reviews | not stated | not extracted yet |
| Shi 2025 Comparison of Implant Precision with Robots, Navigation, or Static Guides. PMID:39586816 | 2025 | 1 other review | not stated | not extracted yet |
| Wei 2025 The Accuracy of Autonomous Robotic Surgery vs. Dynamic Navigation in Implant Placement: An Open-Label, Double-Arm, Randomized Controlled… PMID:40836378 | 2025 | 1 other review | not stated | not extracted yet |
| Yang 2025 Accuracy and safety of implant placement with a novel semi-autonomous robotic-assisted surgical system: A translational research study. PMID:39580315 | 2025 | 1 other review | not stated | not extracted yet |
| Chen 2025 Accuracy, Safety, and Efficiency in Robotic‐Assisted vs. Freehand Dental Implant Surgery: A 6‐Month Follow‐Up Randomized Controlled Trial DOI:10.1111/clr.14413 | 2025 | this review only | not stated | not extracted yet |
| Dash 2026 Semi-active Robotic Over Free-hand Techniques for Evaluation of Dental Implant Placement Accuracy DOI:10.4103/aam.aam_149_26 | 2026 | this review only | not stated | not extracted yet |
| Dash 2026 Semi-active Robotic Over Free-hand Techniques for Evaluation of Dental Implant Placement Accuracy. PMID:41992684 | 2026 | this review only | not stated | not extracted yet |
| Shi 2024 Improved positional accuracy of dental implant placement using a haptic and machine‐vision‐controlled collaborative surgery robot: A pilot… DOI:10.1111/jcpe.13893 | 2023 | this review only | not stated | not extracted yet |
| Shi 2025 Comparison of Implant Precision with Robots, Navigation, or Static Guides DOI:10.1177/00220345241285566 | 2024 | this review only | not stated | not extracted yet |
| Wei 2025 The Accuracy of Autonomous Robotic Surgery vs. Dynamic Navigation in Implant Placement: An Open‐Label, Double‐Arm, Randomized Controlled… DOI:10.1111/clr.70024 | 2025 | this review only | not stated | not extracted yet |
| Yang 2024 Comparative analysis of dental implant placement accuracy: Semi‐active robotic versus free‐hand techniques: A randomized controlled… DOI:10.1111/cid.13375 | 2024 | this review only | not stated | not extracted yet |
| Yang 2025 Accuracy and safety of implant placement with a novel semi-autonomous robotic-assisted surgical system: A translational research study DOI:10.1016/j.prosdent.2024.10.026 | 2025 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Human patients undergoing dental implant placement | Patients receiving single-tooth implants in anterior, premolar and molar sites of maxilla and mandible (n=7 RCTs, 529 implants) |
| Intervention | Robotic computer-assisted implant surgery (r-CAIS): semi-autonomous, collaborative or fully autonomous systems | r-CAIS: THETA semi-active (n=4), Yakebot and YaZhi task-autonomous (n=2), unspecified semi-active (n=1) |
| Comparison | Free-hand implant surgery (FHIS); dynamic computer-assisted implant surgery (d-CAIS); static computer-assisted implant surgery (s-CAIS) | FHIS (n=5); d-CAIS (n=2); s-CAIS (n=1) |
| Outcomes | Primary: positional trueness (platform global deviation, apical global deviation, angular deviation). Secondary: operative time, postoperative pain (VAS), postoperative edema, intraoperative and postoperative complications, early implant retention rate | Platform, apical and angular deviation (n=7; pooled for all 3 comparisons); operative time (n=4; not pooled); pain (narrative); edema (narrative); intraoperative and postoperative complications (narrative); early implant retention (n=7; not pooled); GRADE-rated operative time and early retention narratively |
| Study designs | RCTs | RCTs (n=7) |
| Timing | Not specified | Trueness immediately postoperative to 3 months; clinical follow-up 1 week to 6 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | No | no |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Critically Low | no |