La Alfonso X el Sabio University (UAX) This marks a turning point in oral implantology by performing robotic surgery in which six implants were placed simultaneously in a completely edentulous patient. This is a case of a full arch without teeth, which greatly complicates the system's orientation and increases the technical challenge for the team.
This intervention positions UAX as the first European university The project involved performing a robotic surgery to place six implants in a patient with no teeth, integrating the procedure into a real-world teaching environment. The case combines high clinical complexity, the use of cutting-edge technology, and the active participation of postgraduate students in oral surgery and implantology.
A pioneering case of six implants in a toothless patient
The operation was carried out in the UAX Dental ClinicsIn Madrid, within the framework of the Master's Degree in Oral Surgery and Implantology at the institution. The patient presented with a completely edentulous mouth, that is, without any teeth, which made it a particularly challenging scenario for a robotic full arch surgery.
In this context, the team managed to place six dental implants simultaneously, configuring a full-arch rehabilitation without relying on traditional dental references. The university emphasizes that it is the first case of this type In Europe, in the university environment, the total absence of teeth requires adapting the technology and planning in a very meticulous way.
The intervention has been led by the teaching team of the master's program, with the participation of professors and advanced students, which has allowed the students to witness and, in part, collaborate in a procedure already considered a milestone in university robotic implantology.
The Yakebot DRS-02-RA-Pro robot: extreme precision in implantology
For this case, the following was used: DRS-02-RA-Pro robotDeveloped by the Chinese company Yakebot, this system is one of the world's most advanced platforms for dental implant surgery. It is capable of achieving a positioning accuracy of up to 0,09 millimeters through a dynamic navigation system and real-time tracking of the surgical field.
The robot integrates digital case planning with CBCT imaging data and continuous patient position tracking. In this way, it can execute the surgical plan with a high degree of accuracy even when bone quality is complex or when, as in this case, there are no natural teeth to serve as a spatial reference.
According to available data, this platform is routinely used in China, where it has already been used for various purposes. more than 10.000 patients With around 200 units in operation and over 20.000 successful clinical applications globally, the temporary arrival of this system in Spain has allowed for the replication of this technological level within a European university setting.
In the UAX intervention, the combination of the precision of the robotic arm, the planning software and the constant supervision of the clinical team made it possible to replicate in the patient's mouth what had been planned virtually, minimizing the margin of error and increasing the safety of the procedure.
How does the robot orient itself in a toothless mouth?
One of the most complex aspects of the case was the total absence of dental referencesIn an edentulous mouth, the robot cannot rely on natural teeth to know at all times where it is within the work area, so the team had to design an artificial reference system.
To solve it, the professionals placed temporary markers in the bone, which were subsequently recorded using a new CBCT scan. Specifically, three reference markers and an additional one to carry the recording device were used, thus creating a series of “dummy teeth” that serve as orientation points for the robotic system.
Two infrared cameras simultaneously read the position of markers attached to the patient and those on the robotic arm. Through a triangulation process, the system determines the exact location of the surgical field in real time. In this way, the robot "learns." where is the patient's mouth before starting the milling and placement of the implants.
Once the entire system is calibrated, the preoperative CBCT, digital planning, and the new CBCT with markers are integrated. This data integration allows for a highly accurate transfer of the virtual plan to the real-world environment, a crucial step when working with a patient who is edentulous and has a full arch to be rehabilitated.
Minimally invasive surgery: less bleeding and faster recovery
The use of this robotic platform allowed for a minimally invasive surgeryThis reduces the need for large flaps and limits trauma to the soft tissues. In many cases, the planning and control of the system facilitate flapless techniques, that is, without raising a gingival flap.
This more conservative approach translates into less intraoperative bleedingThis results in less inflammation and a generally faster and more comfortable postoperative recovery for the patient. Furthermore, the precision in bone bed preparation promotes better primary implant stability, a key factor for the long-term success of osseointegration.
Among other notable advantages, the robot allows for a reduction in the surgical time per implantThe procedure can take around 15-20 minutes once the team is familiar with the technique. The system also helps avoid critical anatomical structures, such as the inferior alveolar nerve or the maxillary sinus, thanks to its safety features and constant monitoring of the position of the drills and implants.
Compared to conventional manual surgery, this technology brings greater consistency to the procedure, reducing some of the variability associated with fatigue, experience, or even the physical condition of the operating professional, something especially relevant in long or highly complex interventions.
Advantages over conventional guided surgery and navigation
Those in charge of the case emphasize that the robotic assistance systems They represent a step beyond traditional guided surgery or dynamic navigation without a robotic arm. Unlike conventional surgical splints, where the plan is fixed from the outset, the robot allows for real-time adjustments during the procedure.
This means that the clinical team can modify the milling sequenceThe system allows you to change the type of bur, adjust the entry height, or vary the access angle based on what you observe at any given moment. It continues to control the position and trajectory within safe parameters, but offers a margin of adaptation not available in static guided surgery.
In parallel, the robot's interface provides a real-time, X-ray-like visualization of the surgical environment, displaying the relationship of the drills and implants to the internal anatomical structures. The surgeon also has access to waveforms or signals from continuous calibration which allow checking the level of precision at all times, which for safety reasons is usually kept below 0,3 millimeters.
This combination of rigid control where necessary and flexibility when adjustments to the plan are required makes robotic surgery a tool with remarkable potential for complex cases, especially in complete rehabilitations and situations with compromised bone.
A project with a long history: from guided surgery to robotics
The development of this milestone at UAX did not arise from nothing, but is part of a prolonged learning curve by the responsible team. Professor Pablo Xing, one of the key figures in this project, became interested in robotic surgery several years ago after learning about the first cases performed in China.
Since then, he has followed a progressive career path that includes training in guided surgery and navigated surgery in Spain and, subsequently, specific stays in China to delve deeper into the operation of the DRS-02-RA-Pro robot. Currently, the professor travels regularly to the Asian country to continue refining the technique and maintain direct contact with the teams that have accumulated the most experience with this technology and to learn about other milestones in robotic scoliosis surgery.
This training path also shapes the way teaching is understood: robotic surgery is not conceived as an isolated starting point, but as an advanced phase that requires prior mastery of conventional, guided, and navigated surgery. Even so, for teams accustomed to working with these digital tools, the leap into robotics It feels more natural and acceptable.
In the specific case of six-implant surgery in edentulous patients, UAX has progressed from single and sectoral implant cases to total rehabilitation without teeth, relying on bone markers, double CBCT and especially demanding planning before entering the operating room.
A teaching environment connected to real clinical practice
The intervention took place in a real clinical university settingwhere students have had the opportunity to closely observe the procedure and even participate in certain phases under supervision. This approach aligns with UAX's educational model, based on experiential learning and direct contact with clinical practice from the early stages of training.
For students of the Master's program in oral surgery, periodontics and implants, to be able to prepare and collaborate in a case of full arch robotic surgery In a real patient, this represents a significant added value. Not only do they become familiar with the technology, but they also become aware of the need to stay up-to-date with the emergence of new devices and techniques every few years.
The institution emphasizes that the introduction of this robot at the university, even if temporary, is part of a broader commitment to integrate robotics, artificial intelligence and digitization in training programs. The goal is for future dentists and surgeons to learn not with outdated tools, but with systems that reflect the real trends in the healthcare sector.
In addition to the educational impact, the university emphasizes that its clinics have a high volume of care, attending to around 1.500 patients daily and performing hundreds of implants and orthodontic treatments per month, which allows combining teaching and research activity with intensive clinical practice.
Digitized university clinics and a benchmark in Europe
The case of robotic surgery with six implants in an edentulous patient reinforces the position of the UAX Dental Clinics as a leading center in Europe for advanced healthcare training and digital dentistry. These facilities are integrated within the university's Healthcare City, located on the Villanueva de la Cañada campus.
This healthcare complex includes the Veterinary Teaching HospitalThe university also boasts a Veterinary Simulation Center, a Virtual Simulation Hospital, and a Pharmacy Simulation Classroom, in addition to dental clinics. Thanks to these resources, UAX can replicate real-world work environments and offer students training that closely mirrors what they will later encounter in the job market.
The university's strategy involves quickly aligning its training programs with the new trends in the sectorIncorporating the latest technology in both clinical infrastructure and academic content, the temporary loan of the DRS-02-RA-Pro robot for Expodental aligns with this collaboration between industry and academia.
With this intervention, UAX consolidates its role as one of the European centers that is most committed to the digitalization of dentistry, combining massive patient care, intensive teaching activity and early adoption of solutions based on robotics and advanced digital planning.
Robotic surgery involving six implants in a completely edentulous patient, performed at UAX, illustrates how the high-precision technologyDetailed digital planning and an educational model connected to real-world practice can converge in a single clinical case. The result is a minimally invasive procedure, with greater control and less variability, which has become a benchmark both clinically and academically within the European field of implantology.
