Objectives: The present study was performed to compare between two different fixation techniques and evaluate the histopathological changes which occur in temporomandibular joint (TMJ) of the dogs after surgically induced unilateral subcondylar fracture. Methods: Twenty- One healthy beagle male dogs with a mean age of 30 months were used in the present study. One of these animals was sacrificed to study the normal histology of the dog TMJ. The rest of the animals (20 animals) were operated on to induce a displaced unilateral subcondylar fracture then, the animals were randomly equally divided into 2 groups. After surgery, 5 dogs of each group were sacrificed at 2 months after surgery (Short-Term), while the remaining 5 were sacrificed at 4 months after surgery (Long-Term). The heads were separated and fixed, oscillating saw was used to articulate the entire TMJ. Specimens were decalcified, then the specimens were washed, grossed and sectioned in a sagittal plane. Tissue sections of 4 um thick were cut and stained with Hematoxylin and Eosin to be studied microscopically. Results: In group I animals, at 2 months after surgery, there was a marked hypertrophy of the articular fibrous covering of the condylar head, while at 4 months after surgery, the articular fibrous covering appeared thinner than normal, with marked decrease in thickness of the articular cartilage layer. In group II, at 2 months after plate insertion, the articular fibrous covering became hypertrophic, and the articular cartilage was markedly reduced but it was of a uniform thickness, while at 4 months after subcondylar fracture and plate fixation, no significant changes could be detected either in thickness or structure of the articular fibrous covering. Conclusion: Based on this study, it is obvious that the plate fixation group gave the most favorable results, when compared with maxillomandibular fixation (MMF) group.

The use of miniplates for stabilizing bones after orthognathic surgeries, has become increasingly popular for their effectiveness in ensuring stability and promoting swift recovery. However, the post-surgical fate of these miniplates remains a subject of contention among surgeons. Some advocate for their removal, while others suggest leaving them in place. The aims of this study, is to evaluate the incidence, causes, and potential risk factors associated with the removal of miniplates in orthognathic surgeries. A comprehensive meta-analysis was conducted by reviewing studies from various databases like PubMed, Google Scholar, Research Gate, Embase, and Scopus, focusing on publications from 1989 to 2023. Ten studies encompassing a total of 1603 patients which conformed to the inclusion criteria were selected and included in the meta-analysis. With M:F ratio range from 4:1 to 109:141. Total number of miniplates inserted was 5595, and total number of miniplates removed were 294 (5.3%). The most common reasons for miniplates removal were, infection was reported in 161 cases (2.9%), followed by miniplates exposure (34 cases, 0.6%) and palpable plates (23 cases 0.4%). Other indications included pain, patient’s preference, and temperature sensitivity. Relatively less common reasons that resulted in miniplates removal include, sinusitis, second surgery and dental pathology. The mean duration of miniplates removal was 5.5 months with the majority of miniplates (56.1%) were removed from the mandible compared to maxilla. In conclusion, this meta-analysis underscores the importance of miniplate removal in cases where hardware causes diverse complications and physical discomfort. The primary reasons for miniplates removal were infections and plates exposure, with the mandible being the most common site for removal. These findings emphasize the need for continued monitoring to assess the fate of miniplates in orthognathic surgery and provide valuable insights for future clinical decision-making.