A randomized clinical trial was conducted to compare bilateral sagittal split
osteotomy (
BSSO) with
distraction osteogenesis (DO) for the advancement of the mandible, with a focus on patient discomfort,
postoperative pain, the need for
analgesics, and occurrence of
infection. All patients were non-syndromal, had a class II hypoplastic mandible, and had not undergone previous mandibular surgery. A total of 66 patients were allocated randomly to the
BSSO group (32 patients) or the DO group (34 patients). Sixty-three patients were eligible for evaluation, 29 in the
BSSO group and 34 in the DO group. Patients in the DO group experienced more
pain after 6 days postoperative, and were administered more
analgesics after 5 days postoperative than patients in the
BSSO group (P=0.030 and P=0.045, respectively). The operating time was significantly shorter for the
BSSO group than for the DO group (78 min vs. 100 min, P=0.024). All postoperative
infections (12 in total) emerged in the DO group (P=0.005). All patients in the DO group had a second surgery in
day care to remove the distractor, while two patients in the
BSSO group needed plate removal. It is concluded that patients experienced more
pain after DO, needed more
analgesics postoperatively, and had more
infections in comparison to the
BSSO group.