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Comparing Mixed Reality and Two-Dimensional Imaging in Mandibular Fracture Classification: A Prospective Randomized

Valerian Dirr¹, Leyla Halter¹, Maximilian Ries¹

¹Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.

Journal of Clinical Medicine

|May 4, 2026

Summary

Mixed reality (MR) shows promise for oral and cranio-maxillofacial (OCMF) surgery education, enhancing user satisfaction and learning. However, it did not improve mandibular fracture classification accuracy compared to traditional 2D imaging.

Keywords:

dental education mandibular fractures medical education mixed reality virtual reality

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Area of Science:

Medical Education Technology
Oral and Maxillofacial Surgery
Medical Imaging

Background:

Oral and cranio-maxillofacial (OCMF) surgery demands precise anatomical knowledge and accurate interpretation of imaging, particularly for fracture care.
Mixed reality (MR) technology offers potential benefits for spatial understanding in anatomy-based fields, but its efficacy in teaching mandibular fracture classification is not well-established.

Purpose of the Study:

To evaluate the effectiveness of mixed reality (MR) compared to conventional 2D imaging for teaching mandibular fracture classification to medical and dental students.
To assess user perceptions of usefulness, ease of use, learning, and satisfaction with MR versus 2D imaging in OCMF education.

Main Methods:

A randomized controlled trial involving 40 medical and dental students at the University of Zurich.
Participants were assigned to classify unilateral mandibular fractures using either MR or conventional 2D imaging.
Outcomes included perceived usefulness, ease of use, learning, user satisfaction (via questionnaire), classification accuracy, and time to classification.

Main Results:

No significant difference in overall fracture-classification accuracy was observed between the MR and 2D imaging groups.
While both groups demonstrated learning effects over time, the 2D group completed classifications more quickly.
MR participants reported higher satisfaction and perceived learning benefits, whereas the 2D group found the method easier to use.

Conclusions:

Mixed reality (MR) enhances user satisfaction and perceived learning in OCMF fracture classification education but does not improve diagnostic accuracy over 2D imaging.
MR may serve as a valuable complementary tool in OCMF education, rather than a complete replacement for conventional imaging techniques.