Ultrasound Guided Versus Non-Guided Prolotherapy for Treatment of Internal Derangement of Temporomandibular joint.

Rationale for conducting the research:

The most critical cause for guided prolotherapy is to specify the accurate location of glenoid fossa and the disc space while prolotherapy procedure, and to adjust the needle insertion to according to articular eminence, mandibular condyle, and intra-articular space as anatomical variations. The vibration of ultrasound waves generates a heat so there is a thermal effective for prolotherapy effusion in the TMJ space.

Inclusion Criteria:

1. Patients with TMD - internal derangement with symptomatic clicking pain, according to RDC (Research diagnostic criteria for TMJD) sheet .
2. Muscles spasm causing TMDs.
3. Patients who failed to improve on conservative measures or highly hyperactivity patients.
4. Female and male patients age range from 20 to 60 years old.

Exclusion Criteria:

1. Patients who refused to be included in the research.
2. Patients with a systemically diseases or inflammation whether local or generalized.
3. Patients with bleeding disorders.
4. Patients with unknown dextrose allergy.

The data of volunteers will be shared with the doctors supervising the thesis research to assess the status and results of the scientific research