Open Access Open Badges Research article

Clinical validation of robot simulation of toothbrushing - comparative plaque removal efficacy

Tomas Lang1, Sebastian Staufer1, Barbara Jennes1 and Peter Gaengler2*

Author Affiliations

1 ORMED Institute for Oral Medicine, University of Witten/Herdecke, Alfred-Herrhausen-Str. 45, 58455 Witten, Germany

2 Faculty of Health, Department of Dentistry, University of Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany

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BMC Oral Health 2014, 14:82  doi:10.1186/1472-6831-14-82

Published: 4 July 2014



Clinical validation of laboratory toothbrushing tests has important advantages. It was, therefore, the aim to demonstrate correlation of tooth cleaning efficiency of a new robot brushing simulation technique with clinical plaque removal.


Clinical programme: 27 subjects received dental cleaning prior to 3-day-plaque-regrowth-interval. Plaque was stained, photographically documented and scored using planimetrical index. Subjects brushed teeth 33–47 with three techniques (horizontal, rotating, vertical), each for 20s buccally and for 20s orally in 3 consecutive intervals. The force was calibrated, the brushing technique was video supported. Two different brushes were randomly assigned to the subject. Robot programme: Clinical brushing programmes were transfered to a 6-axis-robot. Artificial teeth 33–47 were covered with plaque-simulating substrate. All brushing techniques were repeated 7 times, results were scored according to clinical planimetry. All data underwent statistical analysis by t-test, U-test and multivariate analysis.


The individual clinical cleaning patterns are well reproduced by the robot programmes. Differences in plaque removal are statistically significant for the two brushes, reproduced in clinical and robot data. Multivariate analysis confirms the higher cleaning efficiency for anterior teeth and for the buccal sites.


The robot tooth brushing simulation programme showed good correlation with clinically standardized tooth brushing.

This new robot brushing simulation programme can be used for rapid, reproducible laboratory testing of tooth cleaning.

Toothbrushing; Plaque control; Cleaning efficacy; Robot simulation; Randomized clinical trial; Oral hygiene