Group A (Study group):

This group includes thirty-four patients with temporomandibular joint disc displacement without reduction, who will receive the Rocabado approach exercise program 6×6 AND MANIPULATION

This group includes thirty-four patients with temporomandibular joint disc displacement without reduction who will receive TMJ Arthrocentesis

Rocabado's approach (Rocabado's 6 × 6 Exercises and manipulation). This program included 6 exercises to be performed 6 times a day, repeated 6 times, and three gliding exercises.

Will be used for measuring the Maximal interincisal opening, lateral movement will be measured.

Measuring Maximal Interincisal Opening :

1. Patient Positioning: The patient opens their mouth as wide as possible without discomfort.
2. Scale Placement: The range of motion scale is positioned so that the notch rests on the edge of the lower incisor.
3. Measurement: Rotate the scale until it contacts the upper incisor, and record the reading at the point of contact.

Measuring Lateral Excursion Movement:

1. Scale Alignment: Rest the range of motion scale against the lower incisors with the upper and lower teeth closed together.
2. Arrow Alignment: Align the arrow on the scale with an interproximal space between two upper teeth.
3. Measurement: Move the mandible laterally (side-to-side) and record the measurements on the lateral side.

Disability related to orofacial pain, which makes it a generic tool that one can use it for different types of orofacial pain conditions.

1. Preparation: Select a quiet and distraction-free environment.
2. Understanding the Scale: Rate each item on a scale from 0 (no limitation) to 10 (severe limitation).
3. Completing the Questionnaire: Carefully read each question and reflect on your jaw function over the past week.
4. Items to Rate: Assess difficulties in chewing, mouth opening, and emotional expression.
5. Time Required: Completion typically takes less than 5 minutes.
6. Post-Completion: Higher scores indicate greater functional limitations.

One of the pain rating scales,

1. Preparation: Ensure the VISUAL ANALOG SCALE line is accurately printed to scale (10 cm) with endpoints labeled:

   • 0 = No pain.
   • 10 = Worst imaginable pain.

2. Patient Instructions: Ask the patient to mark their current pain level on the line.

3. Score Measurement and Interpretation: Measure the distance in centimeters from the "no pain" end (0) to the patient's mark to determine the score out of 10. Higher scores indicate greater pain intensity (e.g., a mark at 6 cm corresponds to a pain level of 6/10).

4. Recall Period: Patients report either their current pain or pain experienced within the last 24 hours, depending on assessment context.