In conventional clinical practice, the accuracy of dental implant placement relies heavily on the operator's experience and skills (Chen et al. 2025b). With the advancement of digital dentistry, computer-assisted implant surgery (CAIS), including static surgical guides and dynamic navigation, has become a vital modality for improving surgical predictability. However, current CAIS techniques still possess inherent limitations. Static guides lack the capacity for real-time intraoperative adjustments to manage unforeseen anatomical variations (Chen, Wang 2025b), whereas dynamic navigation systems impose steep learning curves, requiring substantial training to achieve proficiency, demand a high level of hand-eye coordination, and remain susceptible to human hand tremors (Tao et al. 2022). Consequently, for cases involving complex anatomies or demanding extreme precision, there is an urgent clinical need for more stable and automated technological support.

As an advanced evolution of CAIS, rCAIS has recently entered clinical application. By integrating high-precision spatial tracking systems with robotic arms, rCAIS translates preoperative virtual planning into physically constrained kinematic movements (Wu et al. 2019). Compared with traditional techniques, rCAIS demonstrates significant advantages in mitigating human operational errors and rigidly controlling insertion trajectories. It is now being applied across various clinical scenarios, ranging from single-tooth replacements to complex full-arch rehabilitations (van Riet et al. 2021). As summarized in Fig. 1, the development from freehand surgery to static guided surgery, dynamic navigation, and robotic-assisted surgery reflects a progressive shift from manual execution and template-based guidance toward real-time navigation and robot-assisted physical trajectory control.

Despite its substantial potential, contemporary research on rCAIS remains predominantly confined to in vitro experiments and small-sample clinical studies, necessitating high-quality evidence to validate its long-term clinical outcomes (Wu et al. 2024). Furthermore, challenges such as cumbersome registration protocols, high costs, and the absence of haptic feedback limit its applicability in complex surgical procedures such as bone augmentation. Therefore, at its current stage, rCAIS should be objectively positioned as an extension of traditional digital technologies rather than an autonomous surgical modality intended to replace the clinician; its core value lies in assisting surgeons to reduce the influence of physiological limitations in manual execution (Luo et al. 2025).

This review further evaluates the clinical advantages and limitations of rCAIS and discusses its practical clinical positioning and future development directions in modern implant dentistry.