Skeletal Stability and Complications of Bilateral Sagittal Split Osteotomies and Mandibular Distraction Osteogenesis: An Evidence-Based Review

Purpose: To provide all evidence-based review comparing the skeletal stability and complications of bilateral sagittal split osteotomics (BSSOs) and mandibular distraction osteogenesis (MDO) in the treatment of mandibular hypoplasia Materials and Methods: A Medline search from January 1957 to December 2007 was performed wherein articles were retrieved on the basis of a set of inclusion and exclusion criteria. Data on mean skeletal stability and complications for the 2 techniques were retrieved from these articles Results: Based on the articles about stability, patients undergoing BSSO or NIDO with all advancement or lengthening between 6 and 10 mill showed a similar mean skeletal relapse of 15.0% and 17 1%, respectively, within postoperative months 6 to 12. Greater skeletal relapse was reported for BSSO patients with high mandibular plane angles compared with normal mandibular plane angle patients (29.6% vs 11.3%). Based oil the articles about complications, patients who underwent MDO showed a lower incidence of persistent inferior alveolar nerve disturbance (2.9%) andcondylar resorption (1.4%) compared with BSSO patients, in whom the incidence of these conditions wits 27.8% anti 6 1%, respectively. Conclusion: Both BSSO and MDO showed similar relapse rates for mandibular advancements between 6 and 10 mm. Both techniques may also share similar risk factors for skeletal relapse BSSO has a higher incidence of persistent neurosensory disturbances and condylar resorption than NIDO Randomized controlled. trials of these 2 techniques are still lacking. CD 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67.-2344-2353, 2009