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Abstract

Juvenile idiopathic arthritis is an inflammatory disease that can affect the temporomandibular joint (TMJ) and lower jaw growth. Better treatment options are needed, so this study investigated the effect of low-intensity pulsed ultrasound (LIPUS) on TMJ arthritis. Seventy-two 3-week-old male Wistar rats were in vivo microcomputed tomography (micro-CT) scanned and divided into eight groups (n = 9). These groups were Group 1—TMJ arthritis and immediate LIPUS treatment (20 min/day, 4 weeks); Group 2—immediate LIPUS treatment and no TMJ arthritis; Group 3—TMJ arthritis and no LIPUS; Group 4—no TMJ arthritis and no LIPUS; Group 5—TMJ arthritis and LIPUS treatment with a delayed start by 4 weeks; Group 6—Delayed LIPUS and no TMJ arthritis; Group 7—TMJ arthritis and no (delayed) LIPUS; and Group 8—no TMJ arthritis and no (delayed) LIPUS. Ex vivo micro-CT scanning was completed, and samples were prepared for tissue analysis. Synovitis was observed in the TMJ arthritis (collagen-induced arthritis [CIA]) groups, but the severity appeared greater in the groups without LIPUS treatment. Fibrocartilage and hypertrophic cell layer thicknesses in the CIA group without LIPUS treatment were significantly greater (p < 0.05). Proteoglycan staining appeared greater in the LIPUS groups. Immediate LIPUS treatment increased the expression of type II collagen, type X collagen, and transforming growth factor-beta 1 (TGF-β1) immunostaining, and CIA (no LIPUS) increased MMP-13, vascular endothelial growth factor, and interleukin-1 beta (IL-1β) immunostaining. LIPUS treatment prevented growth disturbances observed in the CIA groups (no LIPUS) (p < 0.005). Our results have contributed to the understanding of the uses and limitations of the CIA juvenile rat model and have demonstrated the effects of LIPUS on the TMJ and mandibular growth. This information will help in designing future studies for investigating LIPUS and TMJ arthritis, leading to the development of new treatment options for children with juvenile arthritis in their TMJs.

Impact Statement

Treatment options for children with juvenile idiopathic arthritis (JIA) in the temporomandibular joint (TMJ) are unsatisfactory. Low-intensity pulsed ultrasound (LIPUS) decreases arthritis-associated inflammation, reducing tissue damage, and it enhances tissue regeneration and mandibular growth. LIPUS has not been studied in an applicable juvenile animal model of TMJ arthritis, so its potential at improving treatment options for patients with JIA is unknown. This study demonstrates the positive impact of LIPUS on treating TMJ arthritis in this animal model and improving mandibular growth. This preclinical evidence will help in designing additional preclinical and clinical studies toward developing better treatment options for JIA.

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The Effect of Low-Intensity Pulsed Ultrasound on Temporomandibular Joint Arthritis in Juvenile Rats

Abstract

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