Cansu Gül Koca1, Bengisu Yıldırım1, Özlem Özmen2, Muhammed Fatih Çiçek1, Mehmet İğneci1, Özge Kırarslan1, Aras Erdil1

1Department of Oral and Maxillofacial Surgery, Uşak University Faculty of Dentistry, Uşak, Türkiye
2Department of Pathology, Burdur Mehmet Akif Ersoy University Faculty of Medicine, Burdur, Türkiye

Keywords: High-molecular-weight hyaluronic acid, lactoferrin, micro-computed tomography, matrix metalloproteinase-3, osteoarthritis, temporomandibular joint.


Objectives: This study aims to evaluate the efficacy of highmolecular-weight hyaluronic acid (HMWHA) and lactoferrin (LF) injections on temporomandibular joint (TMJ) cartilage and subchondral bone in mono-iodoacetate (MIA)-induced temporomandibular joint osteoarthritis model in rats.

Materials and methods: In this in vivo study, a total of 24 rats were divided into three groups as follows: saline group (Group 1), HMWHA group (Group 2), and LF group (Group 3) including eight rats in each group. The intra-articular injections were administered once a week for three weeks after osteoarthritis was induced. All animals were euthanized 28 days after induction of osteoarthritis, and TMJs were harvested for histomorphometric, immunohistochemical, and micro-computed tomography (CT) analysis.

Results: There was no significant difference between the HMWHA and LF groups in terms of the histomorphometric and immunohistochemical analysis results (p>0.05). According to the micro-CT analysis, the LF group had the highest mean bone volume fraction (74.9±0.5) and trabecular thickness (0.122±0.002), while the saline group had the lowest mean values (55.0±0.3 and 0.071±0.002, respectively) (p<0.001). There was no significant difference between the HMWHA and LF groups according to the micro-CT analysis (p>0.05). Both groups had better healing effects than the saline group in all analyses.

Conclusion: Lactoferrin has a healing effect at least as much as HMWHA in MIA-induced TMJ osteoarthritis. We suggest that LF may be evaluated in future clinical studies as a promising agent in the treatment of osteoarthritis.

Citation: Gül Koca C, Yıldırım B, Özmen Ö, Çiçek MF, Iğneci M, Kırarslan Ö, Erdil A. Comparison of the efficacy of intraarticular injections of hyaluronic acid and lactoferrin in monoiodoacetate-induced temporomandibular joint osteoarthritis: A histomorphometric, immunohistochemistry, and microcomputed tomography analysis. Jt Dis Relat Surg 2023;34(1):166- 175. doi: 10.52312/jdrs.2023.901

Ethics Committee Approval

The study protocol was approved by the Afyon Kocatepe University, Animal Research and Ethics Committee (date: 03.06.2020, no: AKUHADYEK-221-20). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.

Author Contributions

Provided input into the concept and design of the study: C.G.K., B.Y.; Provided the materials, analyzed the data, carried out literature review: C.G.K., B.Y., Ö.Ö., Ö.K., A.E.; Supervision of the study: C.G.K., Ö.Ö.; Collected and assembled the data: M.F.Ç., M.İ.; Wrote the article: C.G.K., B.Y., A.E.; All authors have critically revised the article, read and approved the final version at the time of submission.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.