Robotic Surgical Systems in Oral and Maxillofacial Surgery: A Systematic Review and Meta-Analysis.

Abstract

<h4>Background</h4>Relevance. In recent years, robotic surgical technologies have been firmly integrated into the practice of many surgical specialties. However, their adoption in dentistry and maxillofacial surgery remains limited. This is largely due to the unique anatomical features of the facial region and the exceptionally high demands for precision and equipment adaptability. At the same time, the growing interest in minimally invasive and highly accurate surgical interventions underscores the need for a scientific evaluation of the effectiveness of such technologies. Objective. This study aimed to systematically review the available clinical evidence on the use of robot-assisted surgical systems in oral and maxillofacial procedures, focusing on their accuracy, safety, and clinical feasibility.<h4>Material and methods</h4>The review was conducted in accordance with the PRISMA methodology. Studies involving patients who underwent implant or other maxillofacial surgical procedures using robotic systems were included. A systematic search was performed via the Cochrane Library platform, which simultaneously searches MEDLINE (PubMed) and Embase databases. The following keywords were used: (MeSH descriptor: [Robotics] explode all trees OR MeSH descriptor: [Robotic Surgical Procedures] explode all trees OR "robotic surgery":ti,ab,kw OR "robotic assisted":ti,ab,kw OR "robot":ti,ab,kw) AND ("maxillofacial surgery":ti,ab,kw OR "dental implant":ti,ab,kw OR "oral implantology":ti,ab,kw OR "oral surgery":ti,ab,kw). The level of evidence was assessed according to the GRADE, RoB 2.0, and ROBINS-I scales. Dual screening and data extraction were independently performed by two reviewers. The review protocol was prospectively registered in the PROSPERO database (CRD420251137197).<h4>Results</h4>A total of 18 studies met the inclusion criteria. In nearly all studies, robotic systems demonstrated high implant placement accuracy (mean deviations less than 1 mm and 3°), substantially outperforming conventional techniques. The safety profile was consistently favorable. In transoral oncologic surgery, robotic systems showed comparable or superior functional outcomes. However, most studies were limited in sample size and follow-up duration, necessitating cautious interpretation of the results.<h4>Conclusions</h4>Robot-assisted technologies in implantology and maxillofacial surgery have the potential to enhance precision and safety. Nevertheless, the overall certainty of evidence (GRADE) is rated as moderate to low. Larger-scale studies are required to confirm these findings.