Purpose of the study is to compare clinically, radiographically and biochemically the effect of intra- articular injection of hypertonic dextrose with a stabilization appliance and the intra- articular injection of 2 ml of liquid phase concentrated growth factor with a stabilization appliance as a prolotherapy for temporomandibular joint anterior disc displacement without reduction.

Twenty four patients with anterior disc displacement without reduction will be selected from those attending the Prosthodontic Department, Faculty of Dentistry, Alexandria University and diagnosed clinically and by magnetic resonance imaging. Patients will be randomly assigned into 2 study groups each comprising 12 patients. Group I will receive an intra-articular injection of hypertonic dextrose in conjugation with a maxillary CAD/CAM full-arch hard clear acrylic stabilization appliance while group II will receive an intra-articular injection of LPCGF in conjugation with a maxillary CAD/CAM full-arch hard clear acrylic stabilization appliance.

Inclusion Criteria:

• Patients with painful TMJ.
• Patients with limited mouth opening (MMO <40mm).
• Patients with anterior disc displacement without reduction confirmed by MRI.
• Presence of full or nearly full complement of natural teeth.
• Patients with angle class I occlusion.
• Patients with RCP not greater than 2mm and with no open bite.

Exclusion Criteria:

• Patients who have anterior disc dislocation with reduction detected by MRI.
• Inability or unwillingness to undergo magnetic resonance imaging (MRI) such as implanted electronic devices.
• Patients having uncontrolled systemic disease, hematologic or neurologic disorders or inflammatory diseases.
• Patients under anticoagulant drug therapy.