The development of a robotic system for zygomatic implant placement

Al-Jarsha, Mohammed Yahya Mansoor (2025) The development of a robotic system for zygomatic implant placement. PhD thesis, University of Glasgow.

Abstract

Oral rehabilitation with zygomatic implant placement is a predictable treatment option to restore the function of lost maxillary dentition. It is particularly indicated in cases of severe resorption of the maxilla and also after maxillectomies.

Today, the placement of almost all dental implants including zygomatic implants is achieved with the aid of a physical or a digital guide. Static guides are widely used to physically guide the placement of dental and zygomatic implants. Dynamic navigation technology provides digital guidance through monitoring of a computer screen during the implant osteotomy preparation and implant placement. Robotic-assisted implant dentistry can be regarded as a combination guide in the sense that it provides haptic physical guidance in addition to the digital real-time monitoring of the drilling stages on screen.

On the other hand, robotic placement of dental and zygomatic implants also relies on digital guidance principles, but the drilling and implant placement is not performed by a human operator. This technique has shown to produce a highly predictable accuracy in conventional dental implants and also demonstrated promising results with zygomatic implants. A deeper analysis of the possible sources of error involved in the digitally guided zygomatic implant placement techniques would inform the surgeons and may lead to better treatment outcomes in relation to placement accuracy. Such level of analysis would also benefit operators performing digitally guided conventional dental implant placement as it has not been done with this type of implants either.

Chapter 1: reviews the literature in relation to the importance of accurate implant positioning, the revolution of digital planning and guiding protocols, including robotic-assisted and robotic-guided approaches.
Chapter 2: is presented as a published journal article. This chapter analysed the registration error; one of the major human-related sources of error for the digital guidance protocol. This analysis served to optimise and standardise the registration process for the next stages of the project, by selecting the configuration of registration markers expected to produce the best registration accuracy
Chapter 3: is presented as a published journal article. This chapter investigated the precision of drill calibration; another major human-related sources of error for the digital guidance protocol. The results served to optimise and standardise the drill calibration process for the next stages of the project, by selecting the best single drill that is expected to produce the best drill calibration accuracy.
Chapter 4: describes the processes involved in the initial development and testing phases of the integrated robotic system.
Chapter 5: is presented in the traditional chapter format. This chapter includes the final phases of in vitro testing of the newly developed integrated robotic system in this project. This blindly-analysed comparative study investigated the application error (i.e., execution error); the last major human-related source of error for the digital guidance protocol. The control groups involved operator placement under digital guidance (i.e., dynamic navigation) while the test group involved task-autonomous robotic placement using the new system.

In conclusion, this project investigated (in vitro) the accuracy of a newly developed dynamically guided robotic system to achieve zygomatic implant placement. The results demonstrated that the robotic system is highly accurate with clinically acceptable margin of errors. The translation into clinical application would require further developments mainly pertaining to the automation of the preparatory and within-procedure checks as the process was time-consuming when compared to manual placement. The project also contributes to our knowledge of the magnitude of the possible human-related sources of error in placing zygomatic implants under dynamic navigation guidance and suggests solutions to minimising them whether in vitro or in clinical scenarios.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: R Medicine > RK Dentistry
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Supervisor's Name: Naudi, Dr. Kurt, Ayoub, Professor Ashraf and Robertson, Dr. Douglas
• Date of Award: 2025
• Depositing User: Theses Team
• Unique ID: glathesis:2025-85135
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 30 May 2025 06:07
• Last Modified: 01 Jun 2025 20:53
• Thesis DOI: 10.5525/gla.thesis.85135
• URI: https://theses.gla.ac.uk/id/eprint/85135

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