Robotic Computer-assisted Implant Surgery (rCAIS): The Future of Implant Surgery?

Abstract

Robotic computer-assisted implant surgery (rCAIS) represents one of the recent advances in digitally guided implant placement. By combining virtual implant planning with robotic guidance or task execution, these systems aim to improve the transfer of the planned implant position to the surgical field. Unlike static guided surgery or dynamic navigation, rCAIS introduces a physical component of trajectory control, which may reduce operator-dependent deviation during osteotomy preparation and implant placement. Current clinical and preclinical evidence suggests that rCAIS can achieve high levels of trueness and precision in conventional and immediate implant placement, full-arch rehabilitation, tilted implants, and zygomatic implant surgery. Its potential value appears greatest in situations where small deviations may compromise anatomical safety, prosthetic outcomes, or esthetic results. Robotic systems may also contribute to more standardized surgical workflows and may have educational value for training clinicians in spatial planning and trajectory control. Nevertheless, the clinical adoption of rCAIS remains limited by workflow complexity, registration requirements, additional chairside time, equipment cost, restricted tactile feedback, and the need for reliable emergency management protocols. Crucially, current robotic systems remain strictly dependent on clinician-led diagnosis, case selection, treatment planning, intraoperative supervision, and patient communication. Therefore, rCAIS should be regarded as an advanced adjunct to clinical expertise rather than an autonomous replacement for the surgeon. This review summarizes the current status, clinical indications, potential benefits, and limitations of rCAIS, and discusses when robotic assistance may provide meaningful added value in modern implant dentistry.