Risk Scrutiny and Future Opportunities of Robot-Assisted Implant Surgery: A Narrative Review.

INTRODUCTION AND AIMS: Robot-assisted implant surgery (RAIS) signifies a major advancement in computer-guided implant technology. In comparison to traditional hand-guided placement, RAIS enhances the precision and standardization of implant positioning. However, the increased technical complexity introduces potential error sources at various stages of the digital workflow. This review aims to systematically evaluate the potential risks associated with RAIS and explore relevant management strategies and future technological advancements.

METHODS

This review adhered to the Scale for the Assessment of Narrative Review Articles guidelines. A structured literature search was performed across the PubMed, Embase, and Web of Science databases, covering publications from January 2000 to May 2026. Studies reporting clinical outcomes, accuracy, technical performance, safety, complications, and workflow-related issues of RAIS were included. Evidence was narratively synthesized according to predefined thematic domains and appraised using Evidence-Based Medicine principles.

RESULTS

Robot-assisted dental implant surgery demonstrates significantly enhanced implant placement precision compared to conventional freehand surgery and navigation-guided surgery. Nonetheless, risks remain throughout the workflow, including imaging and planning errors, registration inaccuracies, inappropriate patient selection, system failures, tracking interruptions, thermal and mechanical injury, patient movement, and limitations in complex clinical scenarios. Additional concerns include system compatibility and instrument-related infection risks. Implementation of standardized operational workflows, systematic training protocols, and technological optimizations may mitigate these risks to some extent.

CONCLUSION

Despite the considerable potential of RAIS to enhance surgical precision and standardize operations, it remains in a developmental stage with inherent limitations. Future efforts should prioritize technological advancements and rigorous clinical trials to establish long-term safety and efficacy.

CLINICAL RELEVANCE: Establishing the evidence base for potential risks associated with RAIS and its clinical relevance allows clinicians to optimize patient selection, improve operational workflow management, and develop targeted risk control strategies, thus enhancing the safety, predictability, and clinical value of this technology.