Augmented, virtual and mixed reality in oral and maxillofacial surgery: A review of surgical training, navigation and patient-centered applications

Objectives. Augmented reality (AR), virtual reality (VR), and mixed reality (MR)-collectively termed extended reality (XR)-are increasingly applied in oral and maxillofacial surgery (OMFS), a discipline that combines anatomical complexity with high demands for precision and aesthetics. This review synthesises the current applications, reported performance, and limitations of AR, VR, and MR across four domains of OMFS: surgical training and simulation, preoperative planning, intraoperative navigation, and patient communication. Methods. A narrative, thematically structured review of peer-reviewed studies applying AR, VR, or MR to OMFS and closely related surgical fields was conducted, with findings organised by application domain and appraised against the metrics most often reported. Results. In training, immersive VR and haptic simulators provide risk-free, repeatable, objectively assessed practice and yield outcomes that are non-inferior and often superior to conventional methods. In planning, immersive three-dimensional visualisation improves spatial understanding and supports waferless, guide-based, and patient-specific workflows. In navigation, AR and MR overlay the surgical plan onto the operative field, with reported overlay or registration errors typically in the sub-millimetre to low-millimetre range. In patient communication, patient-specific VR, AR, and MR visualisations improve understanding and satisfaction and reduce anxiety during informed consent. Conclusions. XR offers tangible benefits across the OMFS pathway, yet evidence is constrained by small heterogeneous studies, registration and ergonomic challenges, novelty bias, and limited long-term clinical data. Robust validation, cost-effectiveness analysis, and standardised reporting are needed before routine adoption.