Modern technology is actively being introduced into all areas of our lives. And dentistry is no exception. It is possible that soon, with the help of new technologies, it will be possible to grow new teeth to replace lost ones, dental fillings will be placed by a robot, and it will be possible to protect children from tooth decay even before their first tooth erupts.
The incredible possibilities of robots and AI in the field of dentistry
Improving new technologies in the field of AI, the development of robotics contributes to the introduction of revolutionary solutions in the field of dentistry, which can help practitioners in carrying out various procedures. In dentistry, robotics has advantages over traditional methods. These systems, along with navigational guidance, provide increased precision in dental treatment as well as streamlined workflows, resulting in improved quality of care. Robotic-assisted dentistry has evolved from traditional navigated surgery to more sophisticated systems that will prove indispensable for maintaining oral health and repairing oral lesions using nanomaterials, nanorobots, new diagnostic methods, and treatments. Although these therapeutic interventions are changing the way we look and understand today, robotic systems are already being used in dental procedures and are helping practitioners with implant treatments. Indeed, other areas of dentistry that could benefit from the use of robotic systems and artificial intelligence include endodontics, general procedures in restorative dentistry, orthodontics, and periodontics. When considering implants, several problems are associated with the risks of damage to various tissues. In addition, trauma during implant placement can also cause infection and lead to chronic complications. In addition to injuries and illnesses, implant failure is also a risk, with approximately 5% to 10% of dental implants failing. Implant failure can be caused by a lack of experience on the part of the physician, the location of the implant, bone characteristics, and medical complications associated with the patient. With the help of robotics and navigational surgery, doctors can achieve more successful implant placement procedures and reduce the risk of failure.
Robots placing implants
How a robot performed the first self-surgery in China
In 2017, a robot dentist at a clinic in Xi'an, China, successfully performed dental surgery on a live person for the first time. Under supervision, but independently and without the participation of the medical staff, it installed two artificial teeth on the patient. Both implants were printed on a 3D printer. The operation, which lasted one hour, was a success. The nursing staff at the surgery was not actively involved in the procedure but acted as an observer. The patient was first given a CT scan and a 3D digital model of all teeth and jaw; then, a particular labeling system was used to guide the robot. The error in placing the implants was less than 0.3 mm, which even an experienced dentist can tolerate in this type of surgery. In this version, the robot followed a set of pre-programmed commands, carrying out the specified procedures in order and under the supervision of specialists. However, a certain degree of autonomy still existed: the robot adjusted to the patient's movements - and made corrections to the trajectory of the instrument. Specialists were driven to create this kind of robot by the lack of qualified implantologists and the desire to lower the percentage of surgical errors. The novelty is more than urgent as the latest data showed that China has at least 400 million people needing dental implants and a lack of qualified doctors. That is, demand exceeds supply many times over, and the mass introduction of such technology, at least in the long term, could solve the problem. The developers believe that using robots will solve the problem of the lack of qualified dentists in the country. About a million implants are placed annually in China, but many patients have to return to the doctor because of surgical errors. In addition, using robots will make dental procedures less invasive and help reduce healing time. Experts believe that robotic surgery, albeit with minimal human involvement, allows for greater precision. Robots can be applied to perform complex surgical interventions that would otherwise be inaccessible. There are, of course, specific risks and unfortunate outcomes. For example, according to a retrospective study of 14 years of such practices in the United States, there have been 144 patient deaths associated with using machines. But this does not mean surgery using robots is less safe than surgery without them because a certain percentage of deaths are always present. In this case, the number of unsuccessful outcomes represents only a fraction of all robotic surgeries. Nevertheless, this direction is developing; the technology continues to improve to minimize the risks of failed operations.
U.S. developments
Continuing the Chinese trend, in March 2017, the U.S. Drug and Food Administration (FDA) approved the use of a robotic system called Yomi manufactured by Neocis to assist dentists in dental implant surgeries. Yomi is a full-fledged surgical assistant that uses tactile robotic technology to accurately and error-free place dental implants. Yomi's automated tactile devices can guide the dentist's hand throughout the implant procedure, providing dynamic adjustments that consider the dentist's individual experience. With Yomi, the doctor can feel when he is acting correctly. If he begins to deviate, he feels resistance. It lets the surgeon know exactly which direction to move for optimal implant placement. The unique tactile control allows the dentist to visualize the entire implant process. The surgeon controls the whole process and directly interacts with the instruments and the patient. Yomi also complements the clinical expertise of the dental staff by helping to provide patient-centered treatment.
The advantages of Yomi:
- conducting surgery in one day (without the need for an inpatient stay),
- easy-to-use pre-planning software,
- complete arch implantation in 90 minutes, in 2.5 hours on both arches,
- unsurpassed accuracy and precision,
- patented tactile guidance technology,
- patented implant planning software,
- planning of all details for perfect implant positioning before surgery,
- physical control of the implant placement,
- virtual visualization of the dentition and improved aesthetic planning;
- prevention of errors during preparation, drilling deeper than necessary to avoid damaging tissues, nerves, and sinuses,
- hands-free and in complete control of the operation,
- the doctor does not need a surgical template but remains accurate.
Microrobots
Navigated surgery and robotics provide consistency, superior workflow efficiency, and increased patient safety, all leading to improved success rates that hold promise for all dental specialties. Since endodontic procedures require the utmost precision and accuracy, micro-robots can improve the quality and reliability of therapy. As with dental implants, treatment results vary depending on the experience and expertise of the dentist. However, endodontic microrobots offer the opportunity to improve the quality of endodontic treatment and reduce errors during the procedure. For example, Advanced Endodontic Technology uses micromachine technology, in which the microrobot is placed on the tooth that needs treatment and is computer-controlled and monitored. At the same time, the procedure is performed in the root canal. In this way, the micromachine provides automated precision probing, drilling, cleaning, and filling to assist the doctor in delivering error-free therapy. While navigational surgery, robotics, and micro-robots are being introduced into dental treatment, other possibilities for robotics in the dental field exist thanks to nanotechnology. Nanotechnology refers to the design, creation, and engineering of nanobots. Nanobots are microscopic robotic machines that are close to the size of a nanometer, can consist of thousands of mechanical parts, and can be used to interact with or manipulate human cells. Nanobots under development are expected to change medical diagnosis, treatment, and drug delivery methods.
Nanodentistry
The application of nanotechnology in dentistry, also known as nano dentistry, opens treatment possibilities in restorative dentistry, orthodontics, and periodontics. In restorative dentistry, nanorobots can be used for oral cavity preparation, restoration, and even renaturalizing teeth. Because of their size, nanorobots work at the atomic, cellular, and molecular levels to perform basic tasks. They can help dentists treat complex cases at the microscopic level quickly and precisely. Nanotechnology can also help bone replacement and antibiotic delivery via nanoencapsulation, ensuring continued oral health with dental robots to kill pathogenic bacteria. In addition, nano dentistry can offer alternative methods for administering anesthesia and manipulating tissues to aid in complex restorative and periodontal procedures.
Do patients need robotic dentists?
On the one hand, it would seem unequivocal, yes! Researchers state that people are willing to trust unique robots to perform some dental procedures. And this is also clear from the reasons for developing an autonomous robot in China. The burden on patients can overwhelm the health care system, and not many people get the treatment they need on time. Delays in medical operations can ultimately lead to a deterioration in their health. Robots can help in this regard. They can shorten surgery times, so more people can get treatment on time. The greater precision and high quality of the procedures offered by robotic assistants add another argument in their favor. That said, not many people may feel comfortable thinking of having their procedures performed by robots. Regardless of how precise their movements are, there can be a fear of system failure. Dental patients are still wary of the idea of having robots perform procedures on their teeth and gums. Researchers at Florida A&M University Embry-Riddle conducted a 2018 survey with more than 500 respondents. Participants described their concerns about robotic technology in dentistry. Respondents were asked to rate which of 10 procedures they would be willing to entrust to a robot: dental hygiene cleaning, mouth guard shaping, tooth extraction, root canal preparation, gum surgery, teeth whitening, braces fixation, and fillings. Respondents responded that they were willing to trust robots to perform the most straightforward and least invasive procedures, such as hygienic cleaning and whitening. While many were not yet ready for the more complex activities such as root canal preparation, gum preparation, and filling, many were not prepared to let a robot in. Participants often noted that today's robots are not sophisticated enough to perform complex invasive surgeries. They believe the robot's design is still too superficial and should only perform simple procedures. The only factor that can change a patient's mind is price. Many agreed when respondents were asked whether they would be willing to have a procedure performed by a robot if it were half the cost of a conventional system. Thus, 32% of participants were initially against robotic cleaning and enamel whitening. However, with a 50% discount, 83% already agreed to these procedures. The results of this survey showed a high level of distrust in users' attitudes towards new technologies. It will take time and accumulate successful practice before robotic technologies in medicine are perceived as something usual. Notably, the practitioners commenting on the results of this survey were also skeptical about the idea of automated technology in dentistry. They also noted that they fear the robot will not respond if a person suddenly becomes painful or uncomfortable. A robot can be taught many procedures, but it will never understand attentive human communication. But it is impossible to teach empathy and understand a person's feelings without obvious diagnostic signs. The surgical patient is highly vulnerable, completely trusting the doctor. The doctor must be able to reassure and assure that everything will go well, even before the procedure begins.
Will robots ever replace dentists?
According to a New Scientist Live poll, more than half of the British are afraid of artificial intelligence. Pew Research data show that more than 70 percent of Americans have the same concern. They believe it could increase unemployment as robots replace them in their jobs. People also fear that robots will dominate them. Of course, this raises the question in the minds of practicing dentists: will robots dominate them and handle everything on their own? So far, robotic dentists have done whatever humans tell them to do. And in the future, the digital dentistry space will grow, but it will depend on humans to use and guide them. The knowledge that humans pass on to robots helps them achieve their goals. Without them, they will not be able to perform complex tasks independently. Robots have been used in medicine for decades, but it is still not the case that they can completely replace a doctor. Nevertheless, they are an excellent tool for improving the accuracy of procedures, such as filling root canals, fixing fillings, crowns, bridges, and implants.
The future of robotic technologies
Robotics, microbots, and nanotechnology have the potential to support dentists and positively impact the entire field. However, dentists have been slow to adopt this new technology compared to their medical counterparts. For example, dentistry appears to be more than a decade behind in the widespread adoption or integration of new technology. It is important to note that as each of these developments in artificial intelligence and robotics in health care moves forward, experts will be better able to explain the benefits of these advances, rather than the technology, to increase the rate of adoption and reduce any concerns about the use of artificial intelligence and robots in the medical space. Given that the overall goal of dental care is to provide optimal patient care, it is worth considering these applications and their potential to improve the quality of dental care. Robotics and artificial intelligence technologies can provide practicing dentists with valuable real-time information, allowing for more thorough examinations, accurate diagnoses, and supporting clinical decision-making throughout dental procedures. The pursuit of advances in dentistry never ends, and the use of robotics for dental treatment may soon become standard practice for all dentists. Thus, robots in dentistry improve accuracy, reproducibility, and reliability; however, due to the lack of available systems, the amount of research on robotic dentistry is limited. In addition, there is a lack of knowledge about the programming and control of automatic systems. As a result, good coordination between dentists and engineers is essential for research in this field. Robotics in dentistry shows promise in material testing, orthodontics, prosthetics, oral and maxillofacial surgery, and implantology. Aside from complex operating systems and high costs, the most significant limitations of robotic dentistry are the fundamental manipulative and sensory abilities of robots and their lack of training capabilities. In addition, robotic technology will not be widely adopted until people stop being wary of unattended treatments and hygiene. It is unlikely that there will be fewer dentists in the future. The patient likes interacting with a real doctor.