Dental Dean Update – Robotics in Dentistry

The dental robot in surgery four will now see you. 

The Faculty of Dental Surgery Triennial Conference takes place 22 to 23 October this year and the early bird offer ends soon. I would be surprised if any Faculty members are not yet aware of the conference and triennial dinner. If you want to book your place, go to our dedicated booking platform 2026 Dental Triennial Conference | RCSEd. I would encourage you to book quickly as the conference places, triennial dinner tickets and hotel accommodation are all on a sell-out trajectory.

The theme of the conference is 'Digital Intelligence in Dentistry: from innovation to clinical impact'. One aspect that is very important to our College is robotics. In fact, it is so important that our College has been involved in robotics for decades. We even have a museum display with a series of inter-generational robots. Robots have transformed not only patient outcomes, but the working arrangements for surgical teams along with the training environment. The College also has a dedicated robotics group which has a large remit, covering all aspects, including dentistry.

Like surgery, dentistry has continually evolved in tandem with technology. The advent of the rotary dental hand-piece, digital radiography, CAD/CAM technology and much more have transformed dentistry over the years. Artificial intelligence is everywhere, and we rightly make good use of this technology both in our personal as well as professional lives. As artificial intelligence increasingly beats the human on precision, speed, outcomes and cost, the case becomes unequivocal. Humans are also prone to make the occasional observational or mechanical error, which is invariably eliminated with digital technology. Dentistry is now also embracing the next transformative change, robotics. As a tech-geek, I am fascinated by the journey we are currently on in dentistry and am intrigued to find out where it will take us.

On a complete tangent, one aspect of filmography that has always frustrated me is that dentistry is invariably portrayed by a predatory, sadistic or hapless clinician. The patient is invariably in distress or are physically harmed by the dentist. This is in direct contrast to machinery in other areas of fiction and science fiction, for example, in The Matrix or Maximum Overdrive where the machines take over to control the humans. But I digress. Robotic systems are already in use in dentistry and will continue to grow and develop in the years to come. Manufacturing in dentistry like all other medical disciplines embraces machine learning, artificial intelligence and robotics. Implants, prosthodontics, orthodontics, endodontics and surgical planning are just some of the areas where the technology has been used so far. Furthermore, we have all witnessed the digital transformation in our dental laboratories in recent years. No longer do our exceptionally skilled technological colleagues work solely with plaster, acrylic, cobalt-chrome and porcelain but much of their work is driven and at times delivered by digital technology and at times robots.

Artificial intelligence either through machine learning, deep learning or natural language processing is the backbone of robotic platforms which can be designed to improve clinical accuracy whilst reducing human error at the same time. The fully autonomous robotic dentist is not likely to eliminate the need for the human touch anytime soon, but the semi-autonomous and robotics-assisted digital workflows will continue to evolve.   

Urology, general surgery, cardiothoracic surgery and neurosurgery have been early adopters of robotics. All these specialties have sought to augment the human aspects of care by maximising the improvements in precision, procedural repeatability and data-driven decisions through robotic technology. And as robotics evolve, reshaping the delivery of dental care is on the horizon through increasing automation, digital integration and minimally invasive operative dentistry. Who would have thought that some of the technical aspects of dentistry that have traditionally been labour intensive could be robot-guided and laser-beam accurate. Whilst this blog is designed to focus on the opportunity that robotic dentistry presents, there are inevitable questions about training, both at undergraduate and postgraduate levels, in both traditional dentistry as well as training in tandem with robots, the moral case and accessibility of such technology in remote and less developed locations. Taking time to understand the current roles and remit of robotics in dentistry is key for considering how robotics will change dentistry in time to come. 

Robotic dentistry began in 2001 with orthodontic archwire bending. All very new age at the time. Robotics in dentistry has advanced over the last two decades and now involves the use of automated (predefined roles) and autonomous (the ability to make decisions and adapt to a changing environment) systems, sometimes paired with computer-assisted technology to partially or fully undertake dental procedures either directly or indirectly. Systems invariably integrate artificial intelligence, machine learning and computer visioning based on 3D imaging, also known as CAD/CAM digital workflows. More advanced systems employ haptic feedback and navigation software. The future of these technologies lies in advanced robotic arm gadgetry. We all tend to think of robots as industrial machines working in synchronicity on assembly lines. I remember the snappy Fiat Strada advert in the early 1980s “hand-built by robot”. Unlike the choreographed robotic arms dancing throughout the advert as the cars took shape with the occasional spark from welding components together, most dental robotic systems currently work behind the scenes rather than in competition with humans.

In terms of categorising dental robotics, the current groups are diagnostic, laboratory and prosthodontic, orthodontic, surgical and simulation, with each grouping evolving at different speeds. Intriguingly, robotic-assisted implant surgery is perhaps one of the most advanced applications for dental robotics at present. Interestingly when researching this article, my favourite search engine asked me “are you a robot?” but again, I digress from the subject. There are now commercially available systems in Europe and Asia which have made the leap from bench to clinic. Using a preoperative CBCT scan to create a virtual surgical plan, these systems either utilise fully automated robotic arms or navigation assisted surgery platforms to guide the clinician during implant insertion to ensure the planned implant trajectory is delivered using haptic feedback. Who knows, in future, robotic implant surgery may become the industry standard for complex full-arch cases, for anatomically difficult regions of the head and neck, or for patients who have had radiotherapy where precision is essential.

As an academic orthodontist who has been an active participant in the digital revolution, I have often joked that clinicians will be replaced by machines. Lingual fixed appliance systems already employ robotic wire bending based on digital treatment planning and 3D printed brackets. The poor manufacturing tolerances between bracket and archwire with labial fixed appliance systems are much improved and the delivery of more precise biological forces becomes more predictable as a result, improving overall treatment efficiency. Such technology is now also being employed for customised labial fixed appliance systems. 

The revolution in clear aligner therapy is everywhere and new manufacturers continually enter the marketplace using automated robotic production of aligners with remarkable overall precision. This coupled with AI-guided treatment monitoring and automated analysis of tooth movement, smart aligners incorporating sensors, and potentially even robotic bracket placement to overcome the errors with direct and indirect bonding. Miniaturised robotics may also become something for the future in the delivery of localised and targeted orthodontic forces with hitherto unknown levels of minimal yet individual tooth control. I fully expect that robotic orthodontics will be a key aspect of diagnosis, treatment planning and treatment delivery in the future. 

Within endodontics, the subject of robotics has come to life. Quite literally. The need to navigate the tiny and highly variable root canal systems of teeth means that even the most skilled clinicians have difficulties when working with calcified canals or procedural problems such as ledges, perforations and instrument separation. Using robotic systems incorporating advanced 3D imaging and artificial intelligence, it is possible to improve canal detection, instrument navigation, determination of working length and much more. Whilst the prospect of ‘roboticendodontics’ is more future than present, the incorporation of navigation systems as used in maxillofacial surgery or neurosurgery offers scope for microscopic procedures to preserve healthy tooth tissue.

In the field of prosthodontics, the robots are slowly taking over the dental laboratories behind the scenes. Whilst out of public view, this is one of the most widespread uses of robotics in dentistry. With CAD/CAM milling machines, robotically controlled polishing, automated manufacturing and prosthodontics is being transformed. Dental restorations that once upon a time required considerable manual input are now being increasingly digitally designed and robotically manufactured. And with a surprising level of accuracy. Crowns, bridges, veneers, dentures, and many other prostheses are now being produced with consistently high quality but with reduced production times. The adaptation of 3D printing to dentistry has upscaled this further. Robotically controlled additive manufacturing processes can generate restorations on a layer-by-layer method with resin, ceramic and metal powder. Who would have thought of the ‘smart laboratory’ with fully integrated digital design software and robotic manufacturing processes, all with minimal intervention by humans but delivering high quality. There is even scope for same-day production at the chairside in the years to come.

Oral and maxillofacial surgery has become a robotic-intensive area with CAD/CAM technology being used for many complex procedures. As an early user of 3D visualisation for orthognathic surgery planning, our unit is now entirely digital using a variety of robotic technology behind the scenes. With colleagues adapting this technology for oncology, bone grafting, TMJ surgery and much more, the future of precision and predictability for many procedures lies in the hands of robotic technology.

Operative dentistry is a key area for integrated artificial intelligence and robotic platforms to come together. With artificial intelligence systems for the analysis of radiographic images, caries patterns and supporting clinical decision-making, the prospect of predictive treatment planning for even the humble dental cavity becomes a potential reality.

What about the dentist of the future? It goes without saying that future colleagues will need to be taught all about robotic dentistry at university. With digital workflows becoming increasingly the norm, robotic interfaces, AI diagnostics, virtual planning and other robotic procedures will slowly integrate into our undergraduate curricula. Our students of today are already comfortable with simulation using haptic feedback systems and will adapt to virtual reality, augmented reality and mixed reality systems. 

Whilst some dentists will be naturally worried about the march of the robots, dentists will still be needed for much of the repair, retrieval and replacement work. I see robotics as helping us shift to technology-based delivery. Moving in time with robotics will allow dentists to focus on other key areas that we do not currently explore for our patients, biogenetic variability for example using salivary biomarkers as part of patient-centred care.  Maybe this will become the subject for a future blog but in the meantime, robotics is reshaping dentistry, quite literally.
 
The dental clinic of the future may have a different look, feel and smell when compared to the current dental practice environment. The ultimate goal will however remain the same. Helping patients towards good oral health and excellent quality of life is key. 

If you would like to get in touch, please email dental@rcsed.ac.uk.