Can you help achieve "dental implant freedom"? Deciphering the Implant Dentistry Surgery Robot

"Science and Technology Innovation Board Daily" (Shanghai, reporter Jin Xiaomo) news, in order to achieve "dental implant freedom", in recent years, there have been news in various provinces and cities that will collect dental implant consumables. However, according to the previous investigation by the reporter of the "Science and Technology Innovation Board Daily", the reason why dental implants are expensive is more important is that implant doctors, especially excellent implant doctors, are scarce.

So, will a surgical robot that can assist doctors with implant operations be a problem-solving idea? A few days ago, the reporter of the Science and Technology Innovation Board Daily conducted a survey on this topic.

You can only start a simple cultivation business for 5 years

To know what functions the implant implant surgery robot can perform, you first need to understand how general implant surgery is performed.

Dr. Ji Guoping, president of Shanghai Hengzheng Dental Department and vice president and secretary general of Shanghai Private Dental Medical Committee, told reporters that the key basis for ensuring the success of an oral implant surgery is the precise implant location, which in turn includes the determination of the preoperative implant position and the operation during the operation. Both require doctors to have a wealth of experience, and the current auxiliary tools that can be used are oral CT and guide plates.

Among them, the function of oral CT is similar to the doctor's high-definition eye, which can help doctors see the patient's oral internal environment and obtain three-dimensional data of the alveolar bone; the guide plate is a customized simple mold, the doctor designs the guide plate in the design software according to the situation of oral CT "seeing", which can bite with the teeth, and at the same time make the implant location into holes, and then 3D print it into shape.

During the operation, the guide plate will be fixed in the patient's mouth, and the doctor only needs to "draw a gourd" on the patient's alveolar bone according to the hole position reserved on the guide plate, and carry out holes and implants, which can basically complete the operation.

It's easy to say, but it's still a complex system to operate.

"For example, when determining the implant location, you need to consider the relationship between teeth and teeth, how deep is it appropriate to make a hole in the alveolar bone? What is the thickness of the implant chosen? Ji Guoping said that the implant should not only be planted straight, but also consider the location and direction of the implant, which should be conducive to the later restoration, which is a comprehensive consideration of aesthetics, function, cleanliness, force and other factors, and after a failed implant, and then think about the secondary implant, the complexity and difficulty of the operation will be greater.

Ji Guoping further introduced that a dentist can carry out simple implants after graduating from formal colleges and universities, at least five years of professional training, and through systematic dental implant professional training; with at least 200 simple implants experience, can gradually carry out slightly complex dental implant surgery.

In the interview, Ji Guoping mentioned a detail: he is a doctor of stomatology at Jiaotong University and has more than 20 years of experience in practicing medicine, even so, before the epidemic, Ji Guoping would go overseas for training 2-3 times a year at his own expense. The difficulty is evident.

Surgical robots can play an auxiliary role to some extent

Therefore, according to logic, if there is a surgical robot to assist the dentist to operate, can the difficulty of the operation be reduced appropriately?

At present, Shanghai Shecheng Medical Device Co., Ltd. oral implant robot is in the approval stage, preliminary data show that the robot's surgical accuracy of less than 0.3 mm (the average surgical accuracy of the manual is about 2 mm), which can shorten the operation time by about 70%, and shorten the doctor's training time from five to eight years to half a year.

"The application of surgical robots can ensure the quality of surgery while reducing the doctor's mental tension and fatigue caused by long hours of work." Yao Jun, founder and CEO of Shecheng Medical, said that especially in the most common dental implant area of the posterior tooth area (about 70% to 80% of the implant teeth are in this area), the operating space and vision are limited, which is very challenging for doctors, and the surgical robot is dexterous and lightweight, which has more advantages.

At Shecheng Medical, a reporter from the Science and Technology Innovation Board Daily saw a dental implant robot in research. Yao Jun introduced to the "Science and Technology Innovation Board Daily" reporter how the surgical robot works: the robot first needs to "see" the location that needs to be planted; secondly, the mechanical arm should be able to align the position and give the punching force.

The robot mainly replaces the traditional guide plate and upgrades the traditional dental treatment in an automated way.

How does the robot see the position of the teeth? In fact, this is a coordinate concept.

Similar to the concept of three points in geography that can determine a position, surgical robots also use this way to "see": one is a tracking marker, which is like a signal flag, during oral CT shooting, during surgery, its "flagpole" part will be contained in the patient's mouth; one is an optical positioning device, which will continuously track the "signal flag"; and the other is the location of the tooth that needs to be implanted.

"In the same way as the traditional surgical method, the patient takes a CT first, and the doctor determines the location of the implant based on the CT data; in this way, a relative position relationship is determined between the implant and the signal flag - if one is found, the other can be found." This location relationship is identified by a special software system and informed to the robot. Yao Jun explained.

In the actual operation process, the robot's optical positioning device, played the role of the eye, it will stare at the "signal flag", when the robot "sees" the "signal flag", the software system will automatically find the location of the implant according to the aforementioned position relationship, and tell this information to the mechanical arm, so that the mechanical arm can find the location of the implant and assist the doctor in surgical operations.

It is reported that although the technical details are different, the current oral implant surgery robots all use this technical concept.

The track is still niche

According to the State Drug Administration, as of now, a total of three oral implant surgery robots (including software) have been approved for listing in China, which are from: Yake Wisdom (Beijing) Technology Co., Ltd., Suzhou Decaire Medical Technology Co., Ltd., and Beijing Baihui Weikang Technology Co., Ltd.

Among them, Decaire Medical has only been approved to list the oral implant surgery navigation system (first approved in 2016), without hardware, so it cannot be regarded as a surgical robot in the true sense; the "oral implant surgery navigation and positioning equipment" of BoHuiweikang and Yake Wisdom are two robot products including software and hardware, which were approved in March 2021 and September 2021 respectively.

Overall, oral implant surgery robots are still a minority in China.

As for the several robots, who is better to use?

Yao Jun told the "Science and Technology Innovation Board Daily" reporter that this mainly depends on the ability of each robot to "combine medicine and industry". For example, if the robot's robotic arm is too bulky, it will occupy a larger position in the clinic, thus affecting the doctor's operating space, but if the weight of the robotic arm is not enough, it is difficult to stabilize, and then it is easy to be unstable during the planting process;

For another example, the visual chip of the optical positioning device has a certain tracking field of view and focal range, if the positioning device is occluded, the operation will be interrupted, if the distance between the positioning device and the "signal flag" deviates from the focal range, the accuracy of the positioning device will become worse. If these problems occur, the doctor must first "serve" the good robot, and waste the effort.

Ji Guoping also told the "Science and Technology Innovation Board Daily" reporter that for doctors, in the actual surgical process, whether the surgical robot can assist doctors to achieve more minimally invasive, more accurate and more complex implant surgery, and whether the cost is cheap enough will directly determine its market space.

At present, oral implant robots still need doctors to make surgical plans, in the future, or highly qualified doctors can formulate or review surgical plans, while dentists with low experience can complete implant surgery and accumulate experience with the assistance of surgical robots. Yao Jun believes that this improves the planting efficiency of doctors as a whole.