Temporomandibular joint (TMJ) disorders will continue to pose significant clinical challenges, often causing pain, restricted function, and reduced quality of life. One of the most prevalent TMJ internal derangements will be disc displacement without reduction (DDWOR), which will be characterized by an anteriorly displaced articular disc and symptoms like limited mouth opening and discomfort. While conservative treatments will usually serve as first-line management, arthrocentesis—a minimally invasive procedure—will likely prove effective for early-stage internal derangements by releasing adhesions and improving disc function. The standard double-puncture arthrocentesis technique, although effective, may be time-consuming and may pose challenges such as needle dislocation. To address these issues, a single-puncture technique using the SPA Type II needle will be developed to simplify the procedure by combining inflow and outflow in one needle, potentially reducing complications and operating time. This randomized controlled study will aim to compare the outcomes of single- versus double-puncture arthrocentesis on the disco-condylar complex using MRI. The study will involve 24 patients divided into two groups, and it will use pain scores, maximum mouth opening, lateral and protrusive movements, clicking, and MRI evaluation of the disco-condylar complex as outcome measures. By providing clinical insights into the efficacy of these techniques, the findings will guide clinicians in selecting optimal treatment approaches for TMJ disorders, ultimately improving patient outcomes and supporting the use of minimally invasive procedures.