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6Analysis of movements in tooth removal procedures using robot technology95IntroductionIn 1934, George Christiansen simplified tooth removal as removing a calcified substance from a bony socket lined by a fibrous membrane [1]. In his detailed paper, he provided expert instructions on what ideal movements in tooth removal should look like. In 1952, expert opinions on movements strategies from ‘authorities in the field of exodontia’ were summarized by Donald Kitzis [2]. Expert opinions, such as the aforementioned, regarding optimal tooth removal strategies lack, to date, a strong scientific background. This lack of scientific development is remarkable, since tooth removal is one of the most common and oldest surgical procedures worldwide. In contrast to movement patterns, some literature is available in which forces exerted during tooth removal are measured and analyzed. Scientific attempts to objectify these forces, however, are often restricted in their design. They are either limited to a small selection of teeth in vivo [3, 4], animal studies [5] or measured in an laboratory setting using a single tooth [6]. A scientific gap seems to exists in our knowledge of tooth removal [7]. In an effort to bridge this gap, the authors recently reported on forces and torques measured in experiments on fresh frozen cadavers [8]. The lack of scientific understanding of tooth removal has serious consequences for the education of dental students and most previous work in this field state to do so for educational reasons [6, 9]. It is well known that students often feel unprepared before performing their first tooth removal on patients [10]. Preclinical training models are largely absent and, if used, rarely valued as representative [10]. Up until today, direct practice on patients, without significant preclinical training, is the most widely used training modality. However, in well-developed countries where preventive dentistry prevails, the opportunities to practice these procedures on patients are reducing. This situation potentially leads to less confident young dentists and more unnecessary referrals to oral and maxillofacial surgeons [11]. To benefit, amongst others, the development of new educational material, it is necessary to improve our knowledge of these complex procedures. Previous research aimed at analyzing forces in tooth removal, but research initiatives analyzing motion patterns are missing in literature [7]. The purpose of this study is to capture the full range of motions and angular velocities in a series of tooth removal experiments on fresh frozen cadavers. As explained in previous work describing a ‘proof of concept’, we Tom van Riet.indd 95 26-10-2023 11:59