Virtual reality (VR) has emerged as a promising tool for dental education. In addition to reducing material consumption, VR systems enable objective, data-driven performance evaluations through integrated feedback mechanisms. The study aims to determine whether repeated practice on a VR simulator leads to measurable improvements in specific surgical skills. This prospective cross-sectional study investigated the impact of repeated virtual reality (VR) simulator training on osteotomy performance. Participants included 32 dental students (ST) in the 5th semester and seven oral and maxillofacial surgery (OMFS) residents (RE) from a university hospital in Germany. Each participant completed an initial assessed osteotomy of tooth 38 on a VR simulator after a brief introductory task. They then performed four independent practice rounds before completing a final assessed osteotomy. Performance parameters such as bone removal, procedure duration and adjacent tooth damage, were recorded. A post-training questionnaire assessed subjective perceptions, prior experience, and video game familiarity. Both students and residents showed statistically significant improvements in procedure time (ST: p < 0.001; RE: p = 0.004) and reduction of iatrogenic bone damage (p < 0.001) after training. Students demonstrated a steeper learning curve for time reduction (p < 0.001) and lingual bone preservation (p < 0.001), whereas residents improved more notably in avoiding damage to adjacent teeth (p < 0.001). Participants with prior video game experience completed tasks more quickly (p < 0.001) and with less adjacent bone removal (p < 0.03) during the final exercise. Residents rated the training more favorably overall, especially regarding perceived skill improvement, realism of tooth removal and desire for further VR-based practice. VR-based training significantly enhances technical performance in simulated oral surgery tasks, regardless of prior clinical experience. Its integration into dental education can support individualized learning, objective evaluation, and efficient skill improvement. Future studies should investigate the long-term retention of skills and real-world clinical transferability.

Virtual reality

Dental education

Oral surgery

Simulation training

Osteotomy

Skill acquisition

Hand-eye coordination

© 2025 The Authors. Published by Elsevier Ltd on behalf of European Association for Cranio-Maxillo-Facial Surgery.