## 1 Introduction  
### Background of the Study  
Successful surgery requires medical professionals who possess knowledge and skills, diverse clinical experience, proficiency in utilizing medical equipment and technology, and the ability to establish accurate surgical plans. To train such professionals, many dental and medical educational institutions provide education in areas such as theory, practice, clinical skills, communication, equipment handling, and planning. Among these, practical training, clinical education, and surgical planning are critical methods for enhancing the surgical performance of medical professionals. Through practical and clinical training, learners can acquire essential surgical skills and experience while understanding how theoretical knowledge is applied in medical settings. Surgical-planning education, on the other hand, involves learning to simulate surgical procedures using 3D computer-aided design (CAD) tools, covering approaches, precise site setting, necessary resection size, suturing, and other surgical processes. This training helps learners strengthen their surgical skills, teamwork, clinical response, problem-solving abilities, and surgical-planning capabilities [1; 2; 3; 4; 5; 6]. However, there are several issues with the practical and clinical training provided by educational institutions, as well as the use of 3D CAD tools for surgical planning. Practical and clinical training face challenges such as limited environments and models, insufficient practice opportunities, and a lack of patient diversity. Due to the restricted use of specific environments and models, it is difficult to improve the ability to respond to various situations. Additionally, the lack of time, resources, and educators hinders learners from receiving adequate training opportunities. Furthermore, the limited diversity of patient types makes it challenging to enhance skills in managing and interacting with specific types of patients [1; 7; 8]. Three-dimensional CAD tools face challenges such as high initial installation costs, limitations of a 2D user interface (UI), and accuracy variations based on user proficiency. Due to features such as medical data processing, 3D model conversion, and various post-processing functions, 3D CAD tools used for surgical planning are often expensive, making it difficult for educational institutions to purchase them in large quantities. Additionally, because 3D models are displayed on a 2D UI, it can be challenging to perceive depth, potentially reducing the accuracy of surgical planning. Furthermore, many functions in these tools require a high level of proficiency, leading to differences in surgical-planning accuracy depending on the user.  
In response, medical education institutions are exploring ways to improve practical and clinical training and address the limitations of 3D CAD tools, conducting related research in collaboration with companies and research institutions. In particular, studies on practical and clinical training or surgical planning using virtual reality (VR) and augmented reality (AR) technologies are actively underway, with the effectiveness of research results applying VR and AR being validated [3; 4; 5; 6; 9; 10; 11]. VR enables the cost-effective replication of various environments and scenarios, and the display of 3D models in virtual space allows for intuitive navigation and manipulation. This makes surgical planning easily achievable even with minimal proficiency, while its user-friendly and straightforward UI facilitates the seamless utilization of various features [3; 4; 6]. In the case of AR, it allows for intuitive navigation and manipulation of augmented 3D models in real-world environments, achieving high educational effectiveness. Additionally, it provides real-time surgical guidelines or navigation information during surgery, enhancing accuracy [4; 5; 6].