a measurement setup is proposed that, for the first time, is capable of capturing the combination of high forces and subtle movements exerted during tooth removal procedures in high detail and in a reproducible manner by using robot technology. The outcomes of a design process from a collaboration between clinicians, mechanical and software engineers together with first results are presented in this proof of concept.Clinical relevance - by measuring all aspects of tooth removal in a single setup a strong database can be build that will deliver the data needed to gain scientific understanding of what makes (un)successful tooth removal. It gives a unique opportunity to model the procedure, evaluate techniques, understand and predict adverse events as well as to create new evidence-based teaching methods.@en

The need for a training modality for tooth extraction procedures is increasing, as dental students do not feel properly trained. In this study, a prototype of a training setup is designed, in which extraction procedures can be performed on jaw models and cadaveric jaws. The prototype was designed in a way that it can give real-time feedback on the applied forces in all three dimensions (buccal/lingual, mesial/distal, and apical/coronal), torques, and angular velocity. To evaluate the prototype, a series of experimental extractions on epoxy models, conserved jaws, and fresh frozen jaws were performed. Extraction duration (s), angular velocity (degrees/s), average force (N), average torque (Nm), linear impulse (Ns), and angular impulse (N ms) were shown in real-time to the user and used to evaluate the prototype. In total, 342 (92.9 % ) successful extractions were performed using the prototype (n= 113 epoxy factory-made, n=187 epoxy re-used, n=17 conserved, n=25 fresh frozen). No significant differences were found between the conserved and the fresh frozen jaws. The fresh frozen extraction duration, linear impulse, and angular impulse differed significantly from the corresponding values obtained for the epoxy models. Extractions were successfully performed, and the applied forces, torques, and angular velocity were recorded and shown as real-time feedback using the prototype of the dental extraction trainer. The feedback of the prototype is considered reliable.@en