09/05/2026
Briana’s TMJ Journey - A Complex Case Across Both Joints
Briana first came to Dr Christopher Lim four years ago with severe right‑sided TMJ dysfunction and degenerative joint disease. She underwent a right TMJ replacement, which restored her comfort and function extremely well.
Earlier this year, she re‑presented with left‑sided TMJ pain and dysfunction.
A minimally invasive arthroscopy was performed, where Dr Lim identified synovitis, mature fibrosis in the anterior recess, and anterior disc displacement. Adhesions were released, the disc was reduced, and medication was placed into the joint. She then completed physiotherapy.
Despite this, her symptoms remained intractable, and her pain increased after the procedure.
Clinical findings from her recent review:
• MRI showed chondral loss of the left condylar head
• The underlying issue appeared to be within the bony condyle, not the upper joint space
• Examination showed significant joint pain, limited opening to 30mm, and pain levels between 7–9/10
• No muscular pain was present
A CT scan later confirmed degenerative joint disease in the lower joint compartment, including erosion of the cortical bone — a condition that does not respond well to arthroscopy.
Management plan
Given her history and the success of her previous right‑sided replacement, and after four years of conservative management, Briana has chosen to proceed with a left TMJ replacement. She was offered non‑surgical options but made this decision independently, with a full understanding of the process and expected outcomes.
We will continue to keep you updated on her progress.
Dr Christopher Lim — Oral & Maxillofacial Surgeon
📞 AU: 02 9030 5699
📞 NZ: +64 22 465 8135
📧 admin@drchristopherlim.com.au
📍 Sydney & New Zealand
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