Artificial intelligence in oral and maxillofacial surgery: a scoping review of clinical applications, ethical challenges, and legal considerations

Artificial intelligence (AI) is increasingly used in oral and maxillofacial surgery (OMS) for imaging, planning, and robotic/navigation support, yet ethical and legal governance remains unsettled. We conducted a PRISMA-ScR scoping review to map clinical applications and associated risk domains. PubMed/MEDLINE, Scopus, and Web of Science were searched for English-language articles published from January 2015 to July 2025. Eligible records reported a clinical AI application in OMS or analyzed ethics/legal issues relevant to OMS; purely technical papers without clinical linkage, non-indexed sources and conference abstracts, non-English items, and records without an abstract were excluded. Two reviewers screened studies independently with consensus on inclusion. Of 2158 records, 99 met eligibility. Ethical discussions most often addressed accuracy/reliability, transparency/explainability, and bias/fairness. External multicenter validation and calibration were uncommon, prospective decision-impact or effectiveness studies were rare, and no large randomized trials were identified. Recurrent ethical–legal themes included informed consent for AI involvement, fairness auditing, privacy and data protection, allocation of responsibility for decision-support versus autonomous functions, and post-deployment monitoring for performance drift. AI shows encouraging technical performance in OMS, but patient benefit will require stepwise, monitored integration, standardized reporting, prospective studies, strengthened consent processes, fairness and privacy safeguards, and clear professional and manufacturer accountability.