الفهرس 
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Abstract
TMJ-OA is indeed a degenerative condition of the joint which causes both the hard and soft tissues of the TMJ to gradually deteriorate. TMJ-OA is still challenging to identify and treat [1].
Hyaluronic acid is the main hydrodynamic component of synovial fluid. Intra-articular HA injection is now the osteoarthritis treatment that has received the most widespread approval [2]. New applications of Botox in medicine, such as the treatment of osteoarthritis, have recently attracted growing interest [3].
Aim:
The present study was conducted to investigate the regenerative potential of intra-articular injections of Botox, Hyaluronic Acid, and their combinations in treating CFA-induced TMJ-OA in rats.
Material methods:
30 young adult male Albino rats weighing 250–300g were used in this study. Rats were divided randomly into 3 groups. Animals in group I (Control) received three injections of saline on Days 7, 14, and 28. Animals in group II (osteoarthritic) received a single dosage of CFA and left without treatment. group III (treatment) was subdivided into 3 subgroups. In each subgroup, animals received 3 doses of high molecular weight hyaluronic acid in subgroup A, Botox in subgroup B, and combination of both in subgroup C on days 7, 14, and 28. The animals were killed after 35 days, and the TMJs were dissected, evaluated histologically, and tested for tumor necrosis factor alpha using immunohistochemistry.
Results
H&E results:
Our histological analysis of the TMJ of rats using hematoxylin and eosin stain in the OA group revealed that the thickness of the AD was increased. Both the AC thickness and chondrocyte number decreased. Clustering, hypertrophy, and apoptosis can all be seen in chondrocytes. By intra-articular injection of HMWHA, the TMJ retained its normal histological structure. There was no improvement in these osteoarthritic changes with intra-articular injection of Botox, but with their combinations, there was a slight improvement in the osteoarthritic changes.
Masson’s trichrome results:
In the OA group, histological analysis of the TMJ of rats using Masson’s trichrome stain revealed a lack of blue staining in some areas of the ECM, indicating a reduced collagen content. Intra-articular injection of HMWHA resulted in increased collagen fiber regeneration, which appeared as intense, diffuse blue staining. Botox intra-articular injections and their combination do not result in collagen fiber regeneration as in the HA group.
Toluidine blue stain results:
Our histological analysis of the TMJ of rats using toluidine blue stain in the OA group revealed a reduction in the proteoglycan content, which could be seen as faint metachromasia. Intra-articular injection of HMWHA led to regeneration of proteoglycan, which appeared as deep metachromasia compared with Botox and the combination of both.
Immunohistochemical results:
Immunohistochemical sections of the TMJ condyle from the CG and HA group revealed mild immuno-reaction of the TNF-α marker in chondrocytes and the ECM. In the OA and Botox groups, the TNF-α marker was highly immuno-reaction in chondrocytes and moderately expressed in the ECM. In the combination group, the TNF-α marker was highly immuno-rection in chondrocytes and the ECM.
Recommendations:
➢ In the future, we will need more experimental studies to prove the effectiveness of Botox in treating osteoarthritis or not.
➢ We recommend combining Botox with other materials to improve its efficacy in the treatment of osteoarthritis.