Inflammatory and degenerative effects of induced osteoarthritis/rheumatoid arthritis models on temporomandibular joint of rats.

OBJECTIVE: The present study compared three models of induction of osteoarthritis (OA) and rheumatoid arthritis (RA) in the temporomandibular joint (TMJ) of rats. DESIGN: The induction method was by injection of complete Freund's adjuvant (CFA) + type II bovine collagen (CII). Twenty-four adult male rats were divided into four groups (n = 6): G1: Sham, 50 µL of 0.9% sodium chloride at the base of the tail and in each TMJ; G2: OA, 50 µL CFA+CII in each TMJ; G3: RA+OA, 100 µL of CFA+CII at the base of the tail and 50 µL CFA+CII in each TMJ; G4: RA, 100 µL of CFA+CII at the base of the tail. All injections were repeated 5 days later. Twenty-three days after the first injection, the animals were sacrificed and the TMJs were submitted to histomorphometric analysis and measurement of cytokines. The Kruskal-Wallis and Dunn tests were used (alpha=0.05). RESULTS: The total thickness of the condylar cartilage increased in G2 in relation to the other groups, G3 and G4 reduced in relation to G1; and G2 and G4 reduced in relation to G2 and G3. The levels of IL-1ß, IL-6 and TNF-α increased in the three induction models compared to G1. The level of IL-10 increased in G2 compared to the other groups and reduced in G3 and G4 compared to G1. CONCLUSION: CFA+CII induced inflammation and degeneration compatible with RA (advanced chronic stage) when injected in the tail, and compatible with OA (acute stage or early disease) when injected only in the TMJ.

Edema and hematoma after local anesthesia via posterior superior alveolar nerve block: a case report.

Although rare, complications can occur with anesthetic procedures. The posterior superior alveolar nerve (PSAN) block anesthetic technique has a high success rate, but positive aspiration can cause bruising, transient diplopia, blurred vision, and temporary blindness in approximately 3% cases. When edema occurs, it is occasionally massive, especially in the infratemporal fossa, and the resulting hematoma is usually unsightly. A 20-year-old woman presented with massive edema followed by hematoma in the upper right jaw immediately after PSAN block administration, which subsequently spread to the oral mucosa. The patient did not report any complications during the anesthetic procedure. However, after the injection was administered, the patient experienced anesthetic sensations, which rapidly evolved to facial edema. There was mild pain, but without intraoral or extraoral bleeding. The patient was prescribed medicines and instructed to perform contrast therapy. Although hematomas and edema are rare, they are difficult to prevent. The choice of local anesthetic and appropriate application of the anesthetic technique can minimize their occurrence.

The effect of association of aspirin and omega 3 in rat temporomandibular joint with induced arthritis.

This study aimed to evaluate the effects of omega-3 (ω3) polyunsaturated fatty acids, in association with aspirin (AA), on the morphology of cytokine release in the temporomandibular joint (TMJ) of rats induced with rheumatoid arthritis (IR) by injecting 100 µL of complete Freund's adjuvant with bovine type II collagen at the tail base. Thirty-two adult male rats were divided into treatment groups: Sham, treated with 0.9% sodium chloride (NaCl) p.o.; IR-control, treated with 0.9% NaCl p.o.; IR-ω3 treated with ω3 PUFAS (85 mg/kg/day p.o.); and IR-ω3 + AA treated with ω3 (85 mg/kg/day p.o.) + AA (20 mg/kg/day i.p.). After maintained treatment for seven days, the animals were euthanized. Bilateral TMJs from each rat were removed and one was subjected to histological immunoassays and enzyme-linked immunosorbent assays to assess interleukin (IL)-1ß, tumor necrosis factor-α, and IL-10 levels. Data analysis was performed using the Kruskal-Wallis and Dunn tests. In the IR-ω3 and IR-ω3 + AA groups, the TMJ was greater than in the IR-control group (P < 0.0001). The addition of AA did not improve the effects of ω3 (P = 0.0698). Similarly, the addition of AA conferred no additional effects on the cytokine levels (P > 0.05); however, it increased the proteoglycan density, compared with ω3 alone. We found that ω3 exhibited anti-inflammatory activity in arthritic rats, and the addition of AA increased proteoglycan density, but did not affect cytokine expression.

Omega 3 polyunsaturated fatty acids: Potential anti-inflammatory effect in a model of ovariectomy and temporomandibular joint arthritis induction in rats.

OBJECTIVE: To evaluate the effect of polyunsaturated fatty acid-type omega 3 (ω3) on the temporomandibular joint (TMJ) of ovariectomized rats (OVX) with rheumatoid arthritis (RA). DESIGN: Rheumatoid arthritis was induced using complete Freund's adjuvant and type II bovine collagen injected at the base of the tail. Twenty-four adult female rats were treated by gavage and divided into four groups: G1: Sham, treated with 0.9% NaCl; G2: OVX, treated with 0.9% NaCl; G3: OVX+RA treated with 0.9% NaCl; G4: OVX+RA+ω3 treated with omega 3 (300 mg/kg/day). The induction of rheumatoid arthritis in groups G3 and G4 was performed 21 days after OVX, treatments were started 15 days after the induction of rheumatoid arthritis, maintained for 7 days, and killed. Bilateral TMJs were removed and assigned to morphometric analysis by micro-computed tomography and immunoassay to assess levels of cytokines IL-1ß, IL-6, TNF-α, and IL-10. RESULTS: Higher levels of inflammatory cytokines were found in the G2 and G3 (P < 0.05) and anti-inflammatory cytokines in the G1 and G4. TMJ analysis by micro-computed tomography showed a higher percentage of bone volume (median - interquartile deviation) in G1 (96.2-1.1) than in the G2 (91.5-2.0, P = 0.0374) and G3 (85.1-5.2, P = 0.0001) but showed no statistically significant differences with the G4 (93.1-1.7, P = 0.79). CONCLUSIONS: Omega 3 successfully reduced TMJ damage in rats caused by ovariectomy and induced rheumatoid arthritis, and is a promising alternative for bone repair and attenuation of inflammatory processes.

The effect of a hydroxyapatite impregnated PCL membrane in rat subcritical calvarial bone defects.

OBJECTIVE: The present study evaluated the effect of polymeric-nanofibers membranes impregnated with microparticulate hydroxyapatite (HA) in the subcritical calvarial bone defects (SCBD) healing. DESIGN: PCL membranes with and without HA were obtained by electrospinning. SCBD were perforated (3.3mm) in left and right sides of 36 rat calvarias. The right-side SBCD of 18 animals was filled with HA mixed with blood clot and blood clot at the contralateral side. The remaining animals received PCL+HA membrane at the right-side SCBD and PCL membrane at the contralateral side. Animals were killed after 30, 60 and 90days after surgery. Bone defect volume (in mm3) was measured by tomography (CBCT). Qualitative histological analysis and SBCD area (in mm2) were measured. Quantitative data were submitted to Kruskal-Wallis/Dunn tests. RESULTS: Reduction of SBCD volume was observed in all treatments but PCL. Association with HA significantly improved bone healing induced by PCL and blood clot. PCL+HA induced the lowest SBCD volume at 60 and 90days. Complete bone healing was not observed even at 90days in SCBD treated with blood clot. In every period, more bone formation was observed for SCBD treated with membranes. CONCLUSIONS: We concluded that both PCL membrane and HA were able to improve bone healing.

The influence of altered occlusion on pro-inflammatory cytokine levels in the TMJ synovial tissues of rats.

OBJECTIVE: The aim of this study was to evaluate whether altered occlusion affects both the condylar cartilage thickness and the cytokine levels of the TMJs of rats. DESIGN: Thirty adult-male rats (n=30) were randomly assigned to three experimental conditions: a control group that underwent sham operations with unaltered occlusion; an FPDM group that underwent functional posterior displacement of the mandible that was induced by an incisor guiding appliance; and an iOVD group in which the increased occlusal vertical dimension was induced in the molars. The rats were subjected to the FPDM or iOVD model for 14 days and then killed. Both the right and left TMJs were removed and randomly assigned to examination with staining or immunoassay techniques. Toluidine blue staining was used to measure the thicknesses of the four layers of the articular cartilage (i.e., the fibrous, proliferating, mature, and hypertrophic layers). ELISA assays were used to assess the concentrations of the pro-inflammatory cytokines IL-1α, IL-1ß, IL-6, and tumour necrosis factor (TNF-α). The measurements of the articular cartilage layers and cytokine concentrations were analyzed with ANOVA and Tukey's tests and Kruskal-Wallis and Dunn tests, respectively (α=5%). RESULTS: The thickness of articular cartilage in the FPDM group (0.3±0.03mm) was significantly greater than those of the control (0.2±0.01mm) and iOVD (0.25±0.03mm) groups. No significant difference was observed between the control and iOVD groups. The four articular cartilage layers were thicker in the FPDM group than in the control and iOVD groups, and the latter two groups did not differ one from each other. Both the FPDM and iOVD groups exhibited higher cytokine levels than did the control (p<0.05) group. Compared to the FPDM group, the iOVD group exhibited significantly higher levels of IL-1ß and TNF-α. CONCLUSION: Both models induced inflammation in the TMJ and caused significant structural changes in the TMJ and surrounding tissues.