Print ISSN: 2321-6379

Online ISSN: 2321-595X

R evi e w A r tic le

Robotics: A Next-Generation Technology in

Prosthodontics
G S Chandu1, Nithin Thomas Mathews2, Jyoti Sarathe2, Apurva Ramteke2, Monika Giri2
Professor and Head, Department of Prosthodontics Crown and Bridge and Implantology, Rishiraj College of Dental Sciences and Research
1

Centre, Bhopal, Madhya Pradesh, India, 2Postgraduate Student, Department of Prosthodontics Crown and Bridge and Implantology, Rishiraj
College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India

Abstract
The use of robots is increasing in a number of medical specialties, including dentistry, to minimize manual labor and improve the
accuracy of procedures. Artificial intelligence and robotics are next-generation technologies that are opening new avenues of
growth and exploration for prosthetic dentistry. This article focuses on the applications and advances of robotics in prosthodontics
to date. Robotic interventions in prosthodontics are primarily used for the design and fabrication of complete dentures and to
support surgical procedures related to dental implantology. In both cases, significant advances have been made that allow
procedures to be performed with high success rates and a higher degree of accuracy. The use of robots significantly reduces the
time required for each procedure. However, the use of such sophisticated and uniquely designed robots for various prosthetic
treatments must be strictly supervised by a qualified dentist. Clinical judgement and professional competence are essential.

Key words: Dental implants, Prosthetic dentistry, Robots, Teeth arrangement, Yomi system

INTRODUCTION word “robota,” meaning forced labor is the origin of the

word “robot.” In his 1950 science fiction novel I robot,
Prosthodontics has been constantly changing and proving author Isaac Asimov first introduced the interdisciplinary
that it can adapt to changing requirements. Education, field of engineering and science known as robotics.
research, and practice of prosthetic dentistry is influenced The Robot Institute of America describes a robot as “a
by the development of newer concepts, technologies, reprogrammable, multifunctional manipulator designed
and materials. One of these developments has been the to move materials, parts, tools, or specialized equipment
introduction of robots in prosthetic dentistry.[1] through various programmed motions to accomplish a
variety of tasks.” Robots can not only increase worker
As a result of advances in laboratory technology, biomaterial productivity by taking on repetitive, tedious, and dangerous
science, clinical procedures, and multidisciplinary research, tasks that humans cannot do, but they can also perform
prosthodontics has undergone continuous change. Probably, tasks that humans are incapable of doing.[1]
more than any other dental specialty, prosthodontics has
demonstrated the ability to evolve in response to changing Robotic systems are not intended to replace human
needs, and it will likely continue to do so.[2] surgeons but are designed as intelligent surgical tools. They
help improve the accuracy, standard, and safety of surgical
Playwright Karel Capek first used the word “robot” in procedures. Their ability to provide a communication link
his 1921 play Rossom’s Universal Robot. The Czech between preoperative surgical plans and the operating room
is perhaps their most valuable capability. Even though all
Access this article online the necessary technologies have been developed and can
be easily adapted, robotics in dentistry is still in its infancy.
Month of Submission : 06-2023 Robots are mainly used in dental implantology and partial
Month of Peer Review : 06-2023 and full dentures for tooth arrangement in prosthodontics.
Month of Acceptance : 07-2023
Month of Publishing : 08-2023 With the advancement of robotics and artificial intelligence
www.ijss-sn.com
theory and the urgent needs of prosthodontics and
Corresponding Author: Dr. G S Chandu, Department of Prosthodontics Crown and Bridge and Implantology, Rishiraj College of Dental
Sciences and Research Centre, Bhopal, Madhya Pradesh, India.

7 International Journal of Scientific Study | August 2023 | Vol 11 | Issue 5

 Chandu, et al.: Robotics in Dentistry

orthodontics, a new type of medical robot has emerged, DIFFERENT APPLICATIONS

such as a robot in prosthodontics. Robots in prosthetics
can perform the following tasks: Making full or partial A Tooth Arrangement Robot for Complete Denture
dentures and performing dental implantation. The The most important step in the manual, traditional fabrication
software of the expert system for prosthetics incorporates of complete dentures is to insert the artificial teeth into a
the extensive knowledge and skills that experienced dental cushion in the correct position and direction. This
dentists and dental technicians have acquired over the work can only be done effectively by specialized dentists and
years. trained technicians. Robotic fabrication of denture systems
has now replaced the traditional method. The size of the
The fabrication of full or partial dentures as well as teeth, the positioning and alignment of the individual teeth
dental implants is then made possible by robotics in in relation to each other, and the curvature of the dental arch
prosthetics. Robotics in prosthodontics is a completely differ significantly in complete dentures. The flexibility of
new application for this technology. Research on a robot is an advantage as it can be configured to fabricate
robots in prosthetics will also represent a theoretical complete dentures.[3]
and technological advance. In addition to realizing
the quantification of full or partial dentures, dental The Canadian company CRS Robotics Corporation
implantology, and the development of prosthodontics, manufactured a robotic system with a single manipulator
their successful application will also represent an advance (Figure 1) and 6 degrees of freedoms (DOFs). This system
in relative fundamental theory.[3] was then modified to fabricate full dentures (Zhang et al.,
2001; Song et al., 2001).

ROBOTS IN THE DENTAL INDUSTRY The main components of the system include a CRS robot,
an electromagnetic gripper, a computer, a central control
Dental Patient Robots system with robot control software for planning and
It was discovered that dental patient robots, also known as executing movements, a prosthetic base, a light source, and
phantom heads because they only have a simple functional a photosensitive adhesive (Wang and Li, 2001).[3] Robotic
cephalic region and a tooth arrangement, are very different arm of the typical CRS robot system is shown in Figure 2.
from real patients. Robotic dental patients were first
proposed in Japan.[3] The robotic system’s three-dimensional virtual tooth-
arrangement software helps create the patient’s medical
Show Hanako history data, expert-drawn jaw, and dental arch curves
In order to create a lifelike robot that behaved exactly like according to the patient’s mandibular arch parameters,
a human in its gestures and responses, Showa University and dental arch curve adjustments. Once the designed
collaborated with the robotics company TMSK in the dentitions are displayed in three dimensions, a virtual
nation’s capital. This helped the dental students learn more observation environment is provided and each tooth
effectively.[4] position can be changed interactively. The robot control
software handles the calibration of the tooth arrangement,
Geminoid DK the initial positioning of the robot, the generation of
The first robot in a series based on characters from control data for the tooth arrangement, and the general
countries other than Japan is called Geminoid DK. These control of the robot. The maximum load capacity of this
remote-controlled robots, known as geminoids, can copy robot system is 3 kg; the maximum speed is 4.35 m/s; and
different head motions and facial expressions by using the positioning repeatability is 0.05 mm. In the production
cutting-edge motion capture technology.[4] of a complete prosthetic system for patients, this system
was used after its modification. The system is based on the
Simroid Robot use of a unique photosensitive substance that hardens when
The Nippon Dental University Kokoro created the illuminated. In this system, standard teeth are selected and
Simroid robot, which is used to instruct dentists. It is an implanted in fixed positions by a robot. However, it was
improvement over the 2007 robot Simuloid, which was less found that the system had difficulty accurately gripping
effective. This robot was created to give dentists emotional and manipulating the artificial teeth.
feedback, particularly regarding pain and discomfort. It
also responds to questions and commands and rates and As a result, better robotic systems with more DOF were
evaluates the patient’s treatment.[4] developed. An advanced system with 84 DOF and 14

International Journal of Scientific Study | August 2023 | Vol 11 | Issue 5 8

 Chandu, et al.: Robotics in Dentistry

independent tooth manipulators on the dental arch curve

was developed as a result of further research (Zhang et al.,
2008). The manipulators could move along the tooth tail in
either direction to change the position of the tooth on the
dental arch. The tooth could be adjusted in position along
the X, Y, Z, lingual, rotational, and near-far-mid axes using
a tooth arrangement helper with 6 DOF (three rotations
and three movements).[5]

This robot can assume any position in the area of the

artificial teeth, which solved a number of problems with
the previous robot. The fact that this system is driven by
84 independent motors complicates its control, which
reduces its efficiency.[3] Figure 1: Single manipulator tooth-arrangement robot system
for complete denture
Subsequently, 14 independent manipulators, a tooth arc
generator, and a sliding path mechanism were used to
create a significantly improved robotic system for the 50
DOF tooth arrangement as shown in Figure 3 (Zhang et al.,
2011; Zhang et al., 2010). The dental arch curve generated
by the dental arch generator corresponds to that in the
patient’s oral cavity.

The dental arch generator is controlled by the glide path

mechanism. The 14 independent manipulators can move
along their own tails to compensate for the rotation of
each tooth, just like the 84 DOF robotic system. These
manipulators each have 3 DOFs, two rotations and one
movement, so they can position each tooth in the Z,
lingual and near-far-mid directions. Two parallel, rotating
vertical rods are located under each manipulator to provide
the additional 3 DOFs needed to adjust the tooth in the Figure 2: Robotic arm of the typical CRS robot system
X, Y and rotational directions. This type of adjustment
has helped reduce the system’s motor requirements to
50, improving system efficiency. This 50 DOF robotic
system for tooth adjustment is simpler and easier to
control than previous generation systems and produces
a complete denture in as little as 30 min. The system’s
repeatable positioning accuracy is 0.07 mm for a single
manipulator and 0.1 mm for the entire robotic system.[3]
The robotic system for total denture fabrication has made
great strides in efficiency, but the process still relies heavily
on manual labor. The main obstacles to widespread use of
the system are its high cost and lack of knowledge about
its operation.[3] Virtual prototype for tooth-arrangement
robot of Cartesian type is shown in Figure 4.
Figure 3: 50 degrees of freedom multimanipulator tooth-
ROBOTS FOR DENTAL IMPLANT SURGERY arrangement robot system

Robotic surgery for dental implants, once found only in quality and safety of surgical procedures. Ecole des Mines
science fiction, is now a reality. Robotic systems are not de Paris in France and Umea University have developed
intended to replace human surgeons, but to be used as a robotic workbench for dental implants that covers the
intelligent surgical tools that help improve the accuracy, entire surgical spectrum from preoperative planning to

9 International Journal of Scientific Study | August 2023 | Vol 11 | Issue 5

 Chandu, et al.: Robotics in Dentistry

Figure 4: Virtual prototype for tooth-arrangement robot of Cartesian type

the operating room. The robot is expected to perform

the following tasks in implantology: preoperative 3D
reconstruction, path pre-planning and intraoperative image
navigation in real time. The structure of the robot should
accommodate flexible, image-guided insertion angle and
position adjustment in the limited working space.[1]

Developed by Neocis Inc. in the USA and approved by

the FDA in 2017, the Yomi robotic system for dental
implantology is the first robotic system for dental
implantology available on the market.
Figure 5: Yomi dental implantology robotic system
Preoperative planning and surgical navigation are
the two main components of robotic dental surgical
systems (Figure 5). Based on the data provided by
the patient computed tomography, surgeons have a
different perspective in the preoperative planning system.
An infrared light-based navigation camera is used by
the surgical navigation system to determine where to place
the surgical tool. These robots, which continuously track
the patient’s movements and take control of the drill as the
dentist approaches the tissue, can help the surgeon achieve
good accuracy. To help the surgeon avoid potential errors,
the system continuously monitors the patient.

With the help of monitoring and real-time 3D graphics,

the dental procedure can be planned immediately and
performed without delay in the dental clinic. Benefits
Figure 6: World’s first fully automated dental implant robotic
of using these robots include faster healing times and surgery
generally safer procedures for dentists as they drill with
greater precision. On September 22, 2017, a robotic implant surgery shown in Figure 6. The entire procedure
dentist placed two dental implants in a woman in Southern was supervised by human doctors who did not directly
China, performing the first ever fully automated dental intervene.[1]

International Journal of Scientific Study | August 2023 | Vol 11 | Issue 5 10

 Chandu, et al.: Robotics in Dentistry

Figure 7: Measurement system for mastication force after dental implantology

therapy. The Dento Munch robotic simulator is an example

of a dental masticatory robot. It is a 6 DOF robot for dental
test simulations. It consists of the compliance module and
artificial jaws. The jaws have been recreated to resemble
a human lower and upper jaw with artificial teeth. They
can be applied to dental components such as individual
teeth, crowns, bridges or an entire denture to simulate
the wear of materials and test the effectiveness of the
bridge.[1] Measurement system for mastication force after
dental Implantology is shown in Figure 7.

The Mouth Training Robot

Robots from the Waseda-Yamanashi (WY) series have
Figure 8: Implant surgery system constructed by the University been created for the training of temporomandibular joint
of Duesseldorf
(TMJ) disorder patients. During a training session for
opening the mouth, this robot is used to open and close the
Robot-assisted Surgical Template Fabrication patient’s mandible. The WY-5 and WY-6 versions are the
Compared to traditionally manufactured surgical guides, most sophisticated. The WY-5 robot measures the biting
robotic-assisted surgical guide manufacturing has led to force coming from the patient by using three translational
better clinical outcomes. Robotically fabricated surgical components of the force. A doctor robot with two DOFs
guides can fully control the trajectory of the implant, are (for open/close and forward/backward movements) or
less expensive, minimally invasive, and reduce the likelihood three DOFs (for open/close, forward/backward, and
of human error in clinical practice.[1] right/left movements) remotely controls the robot. The
WY robot incorporates muscular EMG measurements to
Dental Masticatory Robots track any changes in the patient’s jaw muscle and evaluate
A robot that can perform at least some specific human robotic therapy.[1]
masticatory functions is called a “masticatory robot” There
are numerous instruments and devices for measuring human Waseda Jaw (WJ) Series Robots
masticatory movements. These devices and machines are In order to comprehend the patient’s mastication
not sufficient to simulate the full range of complicated movement and resistance forces during jaw opening and
movements and functions that occur during mastication. closing training, the WJ robot is used as a patient robot.
This paved the way for realistic and controllable robotic TMJ dysfunctions may also be assessed for and treated with
replication of jaw movements for a variety of applications, the aid of this robot. These robots implement artificially
including dental education, jaw simulation, and speech produced clenching and grinding trajectories and have

11 International Journal of Scientific Study | August 2023 | Vol 11 | Issue 5

 Chandu, et al.: Robotics in Dentistry

three DOFs, two artificial TMJs, and two TMJs. Eleven improve polyvinylsiloxane’s flow, reduce the number of
artificial muscle actuators (AMA) that each consist of a set voids, and thus provide more precision in the recorded
of DC motor, encoder, wire, and force sensor power the impression and better model pouring, nanofillers are
robot. The AMA was created to mimic the forces generated incorporated into the material. Nano robots can also be
during muscle contraction. The motor pulls the opposite used in cosmetic dentistry for dentition re-naturalization
end of the tendon, which is attached to one end of the procedures. They remove outdated amalgam fillings and
robotic mandible.[1] recreate teeth using biological materials that are identical
to the original teeth.[1] Implant surgery system constructed
Robots for Treating TMJ Disorders by the University of Duesseldorf is shown in Figure 8.
Waseda University in Japan created the oral-rehabilitation
robot known as Waseda Asahi Oral-rehabilitation robot
No. 1 (WAO1). It is made up of a body with a headrest, ROBOTIC ADVANTAGES
two 6 DOF arms with plungers, a control box, a computer,
1. Greater accuracy and precision.
and an automatic massage trajectory generation system with
2. Stable and durable, allowing for continuous use without
virtual compliance control. By pressing or rubbing a plunger
rest.
whose motion is automatically computer-controlled, this
3. Capable of correctly processing and evaluating
robot system massages the patient’s face. The WAO1 is the quantitative data introduced into the system.
first robot that massages a patient’s facial tissues, mastication 4. A reduction in surgical errors.
muscles (masseter and temporalis), and saliva-producing oral
structures, such as the parotid gland and duct. As a result, it
may be used to treat TMJ disorder and dry mouth.[1] ROBOTIC DISADVANTAGES
Speech Robots 1. Lack of situational judgement renders them unable to
This was created in 2005 at the Canadian province’s use any qualitative data.
university. The two TMJs: one at each end of the jaw are 2. Robotic operations require more resources and have
driven by two 3-DOF parallel manipulators. It has been challenging learning curves.
designed to examine how jaw movements affect how we 3. There is a high demand for dexterity.
perceive and comprehend face-to-face communication.[1]

Humanoid Practice Robot FUTURE REQUIREMENTS

The ethical difficulty of using human subjects for clinical
Research into the use of robots in prosthetic dentistry has
training in dental education is a major barrier. Humanoid
advanced, but it is not yet finished. In order to optimize the
practice robots were introduced to address this problem.
robotic systems with accuracy within the constrained space of
These robots can be mounted on a dental chair and are
the oral cavity, more high-quality research and improvisation
full-body models. Through computer control, they behave
are required, according to the state of the art of robot
like actual patients and can mimic the gestures and speech
application in prosthodontics. To grasp and precisely position
of a real patient. When the students receive dental training,
the artificial teeth, a tooth-arrangement robot also needs
they may end up performing ineffective operational improvements in sensor and control techniques as well as a
procedures, and these reactions, such as pain response, highly effective and coordinated control algorithm. Future
emesis reflex, cough reflex, and irregular pulse, simulate research for dental implantology robots must concentrate on
accidents that may happen during treatment. Simroid is a real-time acquisition, feedback of drilling depth and implant
type of humanoid training robot.[1] force, and registration between intraoperative navigation
image and preoperative reconstruction image. One of
Microrobotized Dental Implant Surfaces
the key technologies for controlling the robot’s motion in
In comparison to conventionally treated implant surfaces,
prosthodontics is human-computer interaction. A type of
microrobotized dental implant surfaces can be used to
software for human-computer interaction should be created
achieve a higher bone-to-implant ratio and improved
to provide operators with humanization input and feedback
biomechanical fixation between the bone and implant.[1]
to streamline the operation.
Nanorobots
Producing robots at or close to the microscopic scale of a CONCLUSION
nanometer, 1 nm is equal to one millionth of a millimeter,
is known as nanorobotics. Nanoimpression material with Although still in its infancy, the use of robots in prosthetic
nano-filler is available for use in prosthetic dentistry. To dentistry is no longer speculative. To maximize the

International Journal of Scientific Study | August 2023 | Vol 11 | Issue 5 12

 Chandu, et al.: Robotics in Dentistry

benefits of this great innovation, high-quality research artificial intelligence in the diverse field of prosthetic
is needed in this era of rapidly evolving ideas and dentistry will be an everyday reality and the subject of
technologies. In the coming years, robotic assistance in intense discussion.
prosthetic dentistry will continue to be a hotly debated
topic. Under the guidance of an experienced dentist,
the use of sophisticated and customized robots helps to
REFERENCES
improve the accuracy and precision of various prosthetic 1. Mahule A, Shaikh A, Avinash S, Jaykumar G, Vandana G. Robots in
treatments. However, it is impossible to completely Prosthodontics: A scientific fiction or reality? Int J Res Technol 2021;9:16-22.
2. Kumar CP, Amrutha MA, Shahid MA. Trends in prosthodontics: An
eliminate human intervention. Clinical judgement and
overview. J Adv Med Dent Sci Res 2016;4:35-40.
professional expertise are essential. Based on their 3. Sreelekshmi S, Varghese K, Abraham JP, Jaysa JJ. Applications of robotics
experience and skill, artificial intelligence cannot replace in prosthodontics-a review. Int J Innov Res Adv Stud 2017;4:38-41.
an experienced dentist. In addition to doctors, patients 4. Kumar PY, Dixit P, Kalaivani V, Rajapandian K. Future advances in robotic
dentistry. J Dent Health Oral Disord Ther 2017;7:278-80.
must also be convinced to accept this technology for the 5. Jiang JG, Zhang Y, Wei C, Tianhua H, Liu Y. A review on robot in
benefit of humanity. Within a short time, the use of this prosthodontics and orthodontics. Adv Mech Eng 2015;7:1-11.

How to cite this article: Chandu GS, Mathews NT, Sarathe J, Ramteke A, Giri M. Robotics: A Next-Generation Technology in
Prosthodontics. Int J Sci Stud 2023;11(5):7-13.

Source of Support: Nil, Conflicts of Interest: None declared.

13 International Journal of Scientific Study | August 2023 | Vol 11 | Issue 5