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Received July 5, 2024, accepted December 13, 2024, date of publication Feburary 27, 2025.

Review 

Protocol for a Systematic Review on the Application of 
Robotics in Orthodontic Treatments

Guillermo Cano-Verdugo1, Myriam Angélica De la Garza-Ramos1*, Omosebi Temitope Olabisi2, Yinli Liu3, 
Georgina Mayela Núñez-Rocha4, María Natividad Ávila-Ortíz4 and Karina Janett Hernández-Ruiz4

1 Universidad Autónoma de Nuevo León, Facultad de Odontología, Monterrey, Nuevo León, México.
2 Lagos State University Teaching Hospital: Ikeja, Lagos State, Nigeria.
3 Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit 
Amsterdam, The Netherlands.
4 Universidad Autónoma de Nuevo León, Facultad de Salud Pública y Nutrición, Monterrey, Nuevo León, México.

* Corresponding Author Email: myriam.garzarm@uanl.edu.mx

ABSTRACT

Background and Objective: Robotics have multiple uses in dentistry, especially within the field of orthodontics, though the 
possible applications of these innovative systems are still not well defined. The objective of this systematic review protocol will 
focus on describing the steps to outline the role of robotics in orthodontic treatments and define its functionality and range 
within clinical applications.

Methods: To achieve this, peer-reviewed studies focusing on the employment of robotic systems in various aspects of orth-
odontic treatment will be incorporated, while literature reviews will be not considered. Data will be explored through Scopus, 
PubMed, Google Scholar and DOAJ. Potential for bias will be established using the ROBINS-E and certainty assessment with 
GRADE guidelines.

Results: The main results of the articles included will be tabulated in an Excel spreadsheet, and a detailed narrative summary 
and interpretation of the data will be produced and displayed based on its use in surgical and non-surgical orthodontic treatments.

Conclusion: This systematic review protocol aims to offer important perspectives on the application of robotic systems in 
orthodontic procedures, contributing to advancement in clinical practices and technological integration. The results may assist 
practitioners in adopting robotic systems to enhance treatment precision, efficiency, and overall patient care. The literature search 
will encompass studies from various regions worldwide. This study is self-funded and has been registered on the PROSPERO 
database under the registration number CRD42023463531.

Keywords—Robotics, Orthodontics, Clinical application, Surgical orthodontics, Orthodontic wire bending, Systematic 
review, Dental technology, Innovative orthodontics.

Copyright © 2025. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY): Creative Commons - 
Attribution 4.0 International - CC BY 4.0. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright 
owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduc-
tion is permitted which does not comply with these terms.

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33 J Global Clinical Engineering Vol.7 Issue 1: 2025

Cano-Verdugo, De la Garza-Ramos, Omosebi, Liu, Núñez-Rocha, Ávila-Ortíz, Hernández-Ruiz: Protocol for a Systematic 
Review on the Application of Robotics in Orthodontics Treatments

INTRODUCTION

The term “robot” originated in 1920 from Czech novel-
ist Karel Čapek, while “robotics” represents an intelligent 
fusion of perception and action, spanning multiple fields 
like engineering and computer science.1,2 In recent years, 
robotics has profoundly impacted various facets of modern 
life, from industrial manufacturing to healthcare, including 
significant advancements in dentistry. Emerging literature 
highlights robotics’ capability to engage, investigate, and 
work alongside humans, transforming oral health services 
and assistance.3,4

The robotics industry has increasingly focused on 
autonomous technologies, enabling minimally invasive 
procedures in dental operations. A notable milestone 
occurred in 2017 with a robot’s successful completion 
of full dental treatment, marking robotics' integration 
into diverse dental specialties.5 While relatively new in 
orthodontics, robots are poised to streamline routine 
tasks, thereby enhancing orthodontists’ workflow.6

Exploring the role of robotics in orthodontics is essential 
for redefining how treatments are conducted. Integrating 
robotic technology has the potential to enhance patient 
outcomes by optimizing treatment duration, reducing hu-
man error, and improving precision in procedures such as 
wire bending.7,8 Additionally, incorporating robotics into 
orthodontic practice could help streamline workflows 
by addressing challenges related to efficiency and stan-
dardization. By automating repetitive and labor-intensive 
tasks, orthodontists may be able to dedicate more time 
to diagnosis and personalized patient care.9,10

Moreover, robotics could contribute to expanding ac-
cess to orthodontic treatment and improving its overall 
quality. In regions with limited orthodontic specialists, 
robotic systems might help increase treatment capac-
ity, ensuring faster and more precise care. Recognizing 
the significance of robotics in this field is fundamental 
to enhancing clinical efficiency and optimizing patient 
outcomes, ultimately reducing complications and ex-
pediting recovery. Currently, four primary categories of 
medical robots have been documented—robotic surgical 
systems, wearable robotic devices, assistive robots, and 
medical robots—highlighting their growing influence in 
healthcare services.11,12

To clarify the methods to be employed, a protocol for 
systematic review will be conducted to offer the scientific 
community accurate data on the implementation of robot-
ics in orthodontics. This protocol addresses the current 
scarcity of literature by summarizing the role and scope of 
robotics in clinical practice within the orthodontics field.

METHODS

Statement Adherence

The PRISMA recommendations13 will be followed 
in the elaboration of this review and this protocol is 
registered at the PROSPERO site with record number 
CRD42023463531, accessible at https://www.crd.york.
ac.uk/prospero/display_record.php?RecordID=463531.

Research Question 

What are the steps for developing a systematic review 
on the role and scope of robotics in clinical orthodontic 
practice?

Inclusion Criteria, Data Variables, and Data Sources 

An exhaustive search will be conducted in Scopus, 
DOAJ, PubMed, Google Scholar, ResearchGate: Academic 
networking platform and ProQuest Dissertations & Theses 
Global, excluding searches for unpublished or non-peer-
reviewed literature. No restrictions based on age or 
language will be imposed for the publications. Eligibility 
criteria and data items will be stablished according the 
PICO tool14; detailed information will be displayed in Table 
1, while Table 2 outlines the search strategy according to 
the data source.

Data Collection Process

The selection of documents will be carried out through 
a multi-step screening process, starting with the title, 
followed by the abstract, and ultimately the full text. Ad-
ditionally, a manual search will be conducted by reviewing 
the reference lists of relevant manuscripts and documents 
that meet the inclusion criteria. During the review, several 
challenges may arise, such as inconsistencies in applying 
the inclusion and exclusion criteria, differing interpreta-
tions of data, or issues with retrieving relevant articles 
from certain databases. To address these challenges, the 

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=463531
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=463531


Cano-Verdugo, De la Garza-Ramos, Omosebi, Liu, Núñez-Rocha, Ávila-Ortíz, Hernández-Ruiz: Protocol for a Systematic 
Review on the Application of Robotics in Orthodontics Treatments

J Global Clinical Engineering Vol.7 Issue 1: 2025  34

search process will be performed concurrently by two 
independent authors, each reviewing the same data source. 
In case of disagreements, a third unbiased reviewer will 
be consulted to resolve discrepancies and reach a final 
consensus.

Data collection will be carried out by the researcher 
who will search the database and will be validated by O.T.O. 
and M.A.G.R. for consensus. Data collected by the authors 
will be arranged in an Excel worksheet and divided into 
the following sections: origin and journal impact level, 
authors, publication year, and country of study, type or 
name of the robotic technology, use in orthodontics (surgi-
cal or non-surgical), purpose of the study, study results, 
conclusions drawn, strength and drawbacks (Table 3).15 

TABLE 1. Eligibility criteria and data variables included within 
the study.

PICO 
Element

Inclusion and Exclusion 
Criteria

Data Variables

P 
(Problem)

Inclusion: All activity 
related to orthodontic 
practice 

Exclusion: Activities 
unrelated to orthodontics

Pertains to the dental 
specialty that the study 
concentrates on

I
(Intervention)

Inclusion: Implementation 
of devices for functional 
purposes in orthodontics

Exclusion: Original articles 
focused on Artificial 
intelligence applications in 
orthodontics

Focuses on the utilization 
of automated systems 
that support orthodontic 
procedures practitioners

O 
(Outcome)

Inclusion: Benefits and 
drawbacks of utilizing 
robotics in orthodontics 

Exclusion: Studies that 
do not show practical 
outcomes on the 
implementation of robotic 
technology in orthodontics

Results in employing 
innovative technological 
tools to aid orthodontic 
treatments

S 
(Study type)

Inclusion: Research 
studies, including 
published and unpublished 
original articles, doctoral 
dissertations, and master’s 
theses

Exclusion: Any documents 
not falling within the 
defined inclusion criteria

Studies considered to be 
included within results 
synthesis 

TABLE 2. Search strategy.

Source Search Strategy

PubMed: 
U.S. National 

Library of 
Medicine

(“robot technology” OR “robot-assisted” OR 
“robotic systems” OR “automation in robotics” 
OR “robotization” OR “robotic applications”) 

AND (“orthodontics” OR “orthodontic treatments” 
OR “dental alignment” OR “braces therapy” OR 

“orthodontic procedures”)

Google 
Scholar 

search engine  
“robot-assisted” AND “orthodontics” AND “dentistry” 

Scopus: 
Abstract 

and Citation 
Database

“robot-assisted” AND “orthodontic procedures”

DOAJ 
Directory of 
Open Access 

Journals  

“robotic systems” AND “dental orthodontics”

ResearchGate: 
Academic 

networking 
platform

“robot-assisted technology” AND “orthodontic 
treatments”

ProQuest 
Dissertations 

& Theses 
Global: 
Global 

database of 
academic 
theses and 

dissertations

“robotics applications” AND “orthodontic care”



35 J Global Clinical Engineering Vol.7 Issue 1: 2025

Cano-Verdugo, De la Garza-Ramos, Omosebi, Liu, Núñez-Rocha, Ávila-Ortíz, Hernández-Ruiz: Protocol for a Systematic 
Review on the Application of Robotics in Orthodontics Treatments

Evaluation of Potential Bias in the Study and 
Assessment of the Reliability of the Evidence

To avoid potential issues with missing data or low-
quality studies, the potential risk for bias will be established 

trough the ROBINS-E tool, and individual and overall 
analyses will be performed. In the absence of data, the 
decision for article inclusion will be determined through 
collective agreement. For the certainty assessment, the 
GRADE approach will be applied to evaluate the quality 
of the evidence both individually and collectively.16,17

FIGURE 1. PRISMA flow selection diagram.

TABLE 3. Table format that will be employed for data extraction.

Origin and 
journal impact 

level

Authors, 
publication year, 
and country of 

study

Type or name 
of the robotic 

technology

Use in 
orthodontics 

(either surgical or 
non-surgical)

Purpose of 
the study

Study results
Conclusions 

drawn
Strengths Drawbacks

1st included 
manuscript

2nd included 
manuscript

# included 
manuscript



Cano-Verdugo, De la Garza-Ramos, Omosebi, Liu, Núñez-Rocha, Ávila-Ortíz, Hernández-Ruiz: Protocol for a Systematic 
Review on the Application of Robotics in Orthodontics Treatments

J Global Clinical Engineering Vol.7 Issue 1: 2025  36

Approaches for Data Synthesis

A descriptive synthesis of the data will be carried out, 
organizing the information according to the use of robots 
in surgical and non-surgical orthodontic treatments. 
Heterogeneity will be assessed based on design of study 
and the specific application of robotics in orthodontics.9  

RESULTS

This section will present the results after data collection 
and analysis. The flow selection will be represented with 
PRISMA flow diagram (2020 version)18 for new systematic 
reviews, which include searches of databases, registers, 
and other sources, where identification, screening, and 
included manuscripts will be presented (Figure 1). The 
findings will be based on the use of robotics in surgical 
and non-surgical orthodontics.

Tables and figures will summarize key metrics and 
outcomes to facilitate comparison and interpretation. The 
risk of bias and certainty of evidence for each included 
study will be detailed.

DISCUSSION

This study aimed to summarize the methods employed 
for a systematic review of robotics applications in or-
thodontics. As a results, we obtained a comprehensive 
overview of the current methods and techniques used in 
orthodontics that incorporate robotics. The systematic 
review is expected to review how robotic technology is 
applied in orthodontic procedures, potentially providing 
insights into its effectiveness, precision, and impact on 
treatment outcomes. Additionally, it may highlight the 
challenges, benefits, and prospects of robotics in ortho-
dontics, helping guide further research or development 
in this field.

This approach aligns with other researchers who have 
developed protocols for systematic reviews, aiming to 
clarify the methods used in emerging fields. By establish-
ing clear and structured methodologies, these protocols 
help ensure that systematic reviews provide solid, reliable, 
and complementary research. This approach strengthens 
the evidence base and enhances the understanding of 

robotics applications in orthodontics, supporting future 
advancements in the field. Such systematic frameworks 
contribute to a more rigorous and standardized assessment 
of the technologies and techniques employed, ultimately 
benefiting clinical practice and ongoing research.19–21

While this review primarily focuses on robotics in 
orthodontics, it is important to consider complementary 
technologies that may synergistically enhance robotic 
applications. Artificial intelligence (AI), for instance, has 
the potential to revolutionize orthodontic treatments by 
improving diagnostic accuracy, treatment planning, and 
patient monitoring. AI can work in tandem with robotic 
systems, enabling more precise movements and personal-
ized treatment strategies based on patient data. 

Additionally, 4D printing, a technology that adds a 
temporal dimension to traditional 3D printing, could 
significantly impact orthodontic care by creating dynamic, 
self-adjusting devices that respond to the patient’s ana-
tomical changes over time. Integrating robotics with AI 
and 4D printing can provide a more holistic and future-
proof approach to orthodontic treatments, enhancing 
both treatment outcomes and efficiency.

We will interpret the results in the context of existing 
literature, highlighting the implications for clinical practice 
in orthodontics. The advantages and limitations of using 
robotics in orthodontics will be critically evaluated. Ad-
ditionally, this section will address the study’s strengths 
and weaknesses, potential biases, and the generalizability 
of the findings.

CONCLUSION

This protocol is expected to contribute to elucidating 
a systematic review detailing robotics applications in 
orthodontics. It is anticipated that this protocol has been 
scientifically grounded, aiming to yield generalizable and 
valuable results to the scientific community.

AUTHOR CONTRIBUTIONS

Conceptualization: G.C.-V. and M.A.G.-R., Methodology: 
G.C.-V., O.T.O. and Y.L.L., Software: O.T.O. and Y.L.L., Vali-
dation: G.M.N.-R. and M.N. Á.-O., Formal Analysis: G.C.-V. 



37 J Global Clinical Engineering Vol.7 Issue 1: 2025

Cano-Verdugo, De la Garza-Ramos, Omosebi, Liu, Núñez-Rocha, Ávila-Ortíz, Hernández-Ruiz: Protocol for a Systematic 
Review on the Application of Robotics in Orthodontics Treatments

and K.J. H.-R., Investigation: G.C.-V., M.A.G.-R. and K.J.H.-R., 
Resources: M.N.Á.-O. and G.M.N.-R., Data Curation: O.T.O. 
and Y.L.L., Writing—Original Draft Preparation: G.C.-V. and 
M.A.G.-R., Writing—Review & Editing: G.C.-V., M.N.Á.-O. and 
G.M.N.-R., Visualization: Y.L.L. and K.J.H.-R., Supervision: 
M.A.G.-R. and M.N.Á.-O., Project Administration: G.C.-V., 
Funding Acquisition: M.N.Á.-O. and G.M.N.-R.

ACKNOWLEDGMENTS

The authors would like to express their gratitude 
to Frida Priscilla Bañuelos-Ruiz, DDS., and María José 
Mora-Reyna, DDS., for their support in the development 
of this protocol.

FUNDING

This research received no external funding.

DATA AVAILABILITY STATEMENT

Not applicable.

CONFLICTS OF INTEREST

The authors declare they have no competing interests

ETHICS APPROVAL AND CONSENT TO PARTICIPATE 

Not applicable.

CONSENT FOR PUBLICATION

Not applicable.

FURTHER DISCLOSURE

A section of the present manuscript has been uploaded 
to the Open Science Framework (OSF) portal and is 
available for access at the following link: https://osf.io/
tn6s2/?view_only=ac2622dc1b934089906da26d435
2aa49. This repository provides access to relevant details 
of the research and can be consulted by those interested 
in exploring the methods and findings prior to formal 
publication.

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