Regenerative Potential of Botox Combined and Uncombined with Platelet-Rich Plasma in Treating Induced Osteoarthritis of Temporomandibular Joint in Albino Rats

Abstract

Objectives: One of the common therapeutic approaches for osteoarthritis is intra-articular injection due to the benefit of local drug delivery as well as instant pain relief. The aim of this study was to investigate the regenerative potential of intraarticular injections of Platelet-Rich Plasma (PRP), Botox and Botox + PRP (combined) in treating induced temporomandibular joint (TMJ) osteoarthritis in albino rats. Design: Osteoarthritis was induced in rats by injection of 2mg monosodium iodoacetate in both sides of TMJ. After confirmation of osteoarthritis by enzyme-linked immunosorbent assay (ELISA), the rats were randomly divided to three groups. The right side acted as the experimental treatment group and was injected weekly with either Botox (5 IU/kg diluted in 50 μL saline), 50 μL PRP, or their combination, while the left side acted as control. Tissues were assessed at two and four weeks post-treatment histologically, radiographically and biochemically (using qRT-PCR and ELISA). Results: The treated sides showed statistically significantly higher mean bone area percentages, in addition to lower statistically significantly mean IL-1β and MMP13 levels than the untreated sides. The highest mean bone area % was recorded in the PRP group followed by the combined group of Botox+ PRP. The treated sides recorded a higher mean joint space than the untreated sides that is statistically significant in the Botox group (p<0.001) and statistically non-significant in the PRP and Botox+ PRP group. Conclusion: This study confirms the regenerative potential of PRP alone and in combination with Botox, which implies that the use of PRP alone or combined with Botox for treatment of TMJ osteoarthritis cases may enhance the healing potential of the condition.