Objectives: To develop and validate a questionnaire on dental students' self-efficacy with tooth removal, suitable for measuring the effectiveness of training methods. Methods: To prepare and validate this questionnaire, we used the Association of Medical Education in Europe (AMEE) stepwise guide for developing questionnaires for educational research. In the validation process, our study group conducted two pilot studies, the first for an exploratory factor analysis and the second for a confirmatory factor analysis. In addition, the questionnaire was tested for convergence with the neuroticism subscale of the NEO-Personality Inventory. Results: After an exploratory factor analysis, which used a total of 137 responses on 33 items, 15 items were left for confirmatory factor analysis. A total of 118 responses were available for the confirmatory factor analysis. Model fitness was tested using tests for exact fitness and fit indices such as the goodness of fit index (GFI), root mean square error of approximation (RMSEA) and standardised root mean squared residual (SRMR). An acceptable fit was found for 11 items divided over three factors: ‘self-perceived skill’, ‘tension’ and ‘dedication’. These 11 items did not converge with the neuroticism scale. Conclusion: This study showed the development steps and initial validation of a psychometric instrument, the Amsterdam Self-Efficacy Scale for Tooth Removal (ASES-TR), consisting of 11 items for testing dental students' self-efficacy in performing tooth removal procedures.

Surprisingly little is known about tooth removal procedures. This might be due to the difficulty of gaining reliable data on these procedures. To improve our understanding of these procedures, machine learning techniques were used to design a multiclass classification model of tooth removal based on force, torque, and movement data recorded during tooth removal. A measurement setup consisting of, among others, robot technology was used to gather high-quality data on forces, torques, and movement in clinically relevant dimensions. Fresh-frozen cadavers were used to match the clinical situation as closely as possible. Clinically interpretable variables or “features” were engineered and feature selection took place to process the data. A Gaussian naive Bayes model was trained to classify tooth removal procedures. Data of 110 successful tooth removal experiments were available to train the model. Out of 75 clinically designed features, 33 were selected for the classification model. The overall accuracy of the classification model in 4 random subsamples of data was 86% in the training set and 54% in the test set. In 95% and 88%, respectively, the model correctly classified the (upper or lower) jaw and either the right class or a class of neighboring teeth. This article discusses the design and performance of a multiclass classification model for tooth removal. Despite the relatively small data set, the quality of the data was sufficient to develop a first model with reasonable performance. The results of the feature engineering, selection process, and the classification model itself can be considered a strong first step toward a better understanding of these complex procedures. It has the potential to aid in the development of evidence-based educational material and clinical guidelines in the near future.

Objectives: To provide dental practitioners and researchers with a comprehensive and transparent evidence-based overview of physical robot initiatives in all fields of dentistry. Data: Articles published since 1985 concerning primary data on physical robot technology in dentistry were selected. Characteristics of the papers were extracted such as the respective field of dentistry, year of publication as well as a description of its usage. Sources: Bibliographic databases PubMed, Embase, and Scopus were searched. A hand search through reference lists of all included articles was performed. Study selection: The search timeline was between January 1985 and October 2020. All types of scientific literature in all languages were included concerning fields of dentistry ranging from student training to implantology. Robot technology solely for the purpose of research and maxillofacial surgery were excluded. In total, 94 articles were included in this systematic review. Conclusions: This study provides a systematic overview of initiatives using robot technology in dentistry since its very beginning. While there were many interesting robot initiatives reported, the overall quality of the literature, in terms of clinical validation, is low. Scientific evidence regarding the benefits, results and cost-efficiency of commercially available robotic solutions in dentistry is lacking. The rise in availability of open source control systems, compliant robot systems and the design of dentistry-specific robot technology might facilitate the process of technological development in the near future. The authors are confident that robotics will provide useful solutions in the future but, strongly, encourage an evidence-based approach when adapting to new (robot) technology.

Objectives: To provide dental practitioners and researchers with a comprehensive and transparent evidence-based overview of the characteristics of literature regarding initiatives of robot technology in dentistry. Data: All articles in which robot technology in dentistry is described, except for non-scientific articles and articles containing secondary data (reviews). Amongst others, the following data were extracted: type of study, level of technological readiness, authors’ professional background and the subject of interaction with the robot. Sources: Bibliographic databases PubMed, Embase, and Scopus were surveyed. A reference search was conducted. The search timeline was between January 1985 and October 2020. Study selection: A total of 911 articles were screened on title and abstract of which 161 deemed eligible for inclusion. Another 71 articles were excluded mainly because of unavailability of full texts or the sole use of secondary data (reviews). Four articles were included after hand searching the reference lists. In total, 94 articles were included for analysis. Conclusions: Since 2013 an average of six articles per year concern robot initiatives in dentistry, mostly originating from East Asia (57%). The vast majority of research was categorized as either basic theoretical or basic applied research (80%). Technology readiness levels did not reach higher than three (proof of concept) in 55% of all articles. In 84%, the first author of the included articles had a technical background and in 36%, none of the authors had a dental or medical background. The overall quality of literature, especially in terms of clinical validation, should be considered as low.

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.