Accuracy, Efficiency, and Patient‐ and Surgeon‐Reported Outcomes of Static Versus Robotic Computer‐Assisted Implant Surgery: A Randomized Clinical Trial

OBJECTIVES: To assess implant placement accuracy, efficiency, and patient- and surgeon-reported outcomes of static computer-assisted implant surgery (sCAIS) and robotic computer-assisted implant surgery (rCAIS) in single-tooth posterior edentulism. METHODS: In this randomized clinical trial, 36 patients requiring posterior single-tooth implant restoration were allocated to sCAIS (n = 18) or rCAIS (n = 18). Preoperative planning for all patients was performed using cone-beam computed tomography (CBCT) data. The DICOM datasets were imported into planning software to conduct virtual implant planning in accordance with prosthetic-driven and bone-supported principles. Implant placement accuracy was assessed by superimposing CBCT-based preoperative planning with postoperative cone beam computed tomography, measuring linear (coronal, apical) and angular deviations. Surgery time and patient-reported experiences (anxiety, intraoperative discomfort, postoperative pain) and surgeon-reported feedback were recorded for each group. RESULTS: The rCAIS group demonstrated significantly superior accuracy, with lower coronal (0.70 ± 0.44 mm vs. 1.02 ± 0.37 mm, p = 0.018), apical (0.75 ± 0.41 mm vs. 1.11 ± 0.40 mm, p = 0.009), and angular deviations (1.20° ± 0.44° vs. 2.38° ± 1.03°, p < 0.001). However, rCAIS required significantly longer surgery time (49.53 ± 12.96 min vs. 24.38 ± 6.51 min, p < 0.001) and resulted in greater intraoperative patient discomfort (3.00 ± 1.60 vs. 1.67 ± 1.87, p = 0.019). Surgeons reported easier access to the surgery site with sCAIS (p < 0.01), whereas the complexity of the surgical procedure and primary implant stability of both groups were comparable. CONCLUSION: The rCAIS provides superior implant placement accuracy compared to sCAIS but is associated with longer procedures and increased patient discomfort. The sCAIS offers reliable implant placement with simpler operation and greater adaptability. Clinical decision-making should balance the benefits of accuracy with patient comfort, efficiency, and resource considerations. TRIAL REGISTRATION: ClinicalTrials.gov (NCT06059573) and the Chinese Clinical Trial Registry (ChiCTR2300078795).