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The literature commonly provides augmented\/mixed reality (AR\/MR) solutions for assisting maxillofacial osteotomies and repositioning without any interactive guide. This work proposes a new MR application, useful for osteotomy and repositioning, providing interactive, fast, and intuitive feedback to the surgeon, who is then supported in performing the bone fragment resection and replacement frame by frame. The proposed application speeds up the surgery and reduces under\/overshooting errors. Moreover, the idea of integrating osteotomy and repositioning assistance in the same MR application is rarely found in the literature. It is an entirely novel approach to craniomaxillofacial surgery. The MR application has been designed with a three-button menu. The \u201cApp Start\u201d calibrates the app, the \u201cOsteotomy Mode\u201d visualises the holograms of the cutting lines and drilling points, and the \u201cRepositioning Mode\u201d visualises the step-by-step real-time feedback to precisely support the surgeon placing the osteotomised bone fragment towards the final pre-planned position. The MR app has been developed in Unity and deployed on Microsoft HoloLens V2. A laboratory test bench was realised to validate the accuracy of the proposed MR-based approach. The validation protocol consists of two tasks to test the osteotomy and repositioning modes using a 3D-printed skull phantom. For osteotomy, the accuracy is 0.89\u00a0mm (genioplasty), 1.24\u00a0mm (maxillary osteotomy), 1.33\u00a0mm (orthognathic surgery), and 2.89\u00a0mm (mandibular angle osteotomy). For repositioning, the accuracy is 0.6\u00a0mm (anteroposterior deviation), 0.7\u00a0mm (mediolateral deviation), and 0.6\u00b0 (angular deviation).<\/jats:p>","DOI":"10.1007\/s10055-023-00867-z","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T08:02:08Z","timestamp":1697529728000},"page":"3221-3237","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["An innovative mixed reality approach for maxillofacial osteotomies and repositioning"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0450-2510","authenticated-orcid":false,"given":"Agnese","family":"Brunzini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9082-8407","authenticated-orcid":false,"given":"Alida","family":"Mazzoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5621-687X","authenticated-orcid":false,"given":"Mario","family":"Pagnoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0962-5982","authenticated-orcid":false,"given":"Marco","family":"Mandolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"issue":"3","key":"867_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/app11031228","volume":"11","author":"J Ackermann","year":"2021","unstructured":"Ackermann J, Liebmann F, Hoch A, Snedeker JG, Farshad M, Rahm S, Zingg PO et al (2021) Augmented reality based surgical navigation of complex pelvic osteotomies\u2014a feasibility study on cadavers. 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