to the best of my knowledge, it is thus:
1. BSSO is more predictable, requires less patience compliance/resources/surgeon oversight (i.e traditional jaw surgery options are "one and done", DO for the jaws is two surgeries and requires a lot of patient-surgeon face to face interaction for a number of weeks)
2. DO is a lot more expensive, requires specialized hardware
AFAIK of the surgeons who do regularly use DO methods, they only use them on adults when the retrognathism/microgenia is so pronounced that they literally do not have the space to perform a BSSO safely, so they distract first and then finish with BSSO and genio etc.
