Robot-Assisted Dentistry: What the Evidence Supports and Which Outcomes Are Still Missing

Abstract

Dentistry has rapidly adopted digitally planned workflows, supported by cone-beam computed tomography, intraoral scanning, and virtual planning, expanding computer-assisted implant surgery through static guides, dynamic navigation, and robotic guidance. However, dental robotics is used inconsistently, and conflating robotics with navigation or automation can obscure key mechanistic and safety differences. This narrative review aimed to provide a clinically grounded synthesis of dental robotics across specialties, with emphasis on workflow dependencies, outcome patterns, and translational constraints. A structured literature search was conducted up to March 2026 using PubMed, Embase, Scopus, and Web of Science. Evidence was synthesized thematically, prioritizing clinical outcomes like accuracy, complications, peri-implant parameters, survival, patient- or provider-reported outcomes, workflow data, and implementation considerations. The most mature clinical evidence concerns robot-assisted implant placement, in which high agreement between planned and achieved positions was observed. Yet, accuracy should be interpreted as workflow performance influenced by imaging, planning, registration, tracking stability, and intraoperative conditions. Comparative data suggest the clearest gains versus freehand placement, while early adoption may increase operative time due to added setup and verification steps. Outside implantology, robotics follows distinct trajectories, including robotic orthodontic archwire bending, aligner-related automation, and transoral robotic surgery in maxillofacial practice, underscoring the need to appraise domains using different outcome hierarchies. Restorative and prosthodontic applications are emerging, ranging from robot-guided tooth preparation for crowns, onlays, and veneers to laboratory robotics for manufacturing, yet these remain largely industrial. Across domains, a recurring limitation is the mismatch between commonly reported geometric accuracy endpoints and underreported clinically decisive outcomes, which include complications, patient-reported outcomes, long-term maintenance, and economic value. Cost remains a major barrier, and formal cost-effectiveness evidence is limited.

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