Comparison of the Clinical Effectiveness of Two Photobiomodulation Systems for Facial Nerve Dysfunction Following Temporomandibular Joint Surgery.

Objective

To compare the clinical effectiveness of two photobiomodulation systems for the management of facial nerve dysfunction following temporomandibular joint (TMJ) surgery.

Materials And Methods

Twenty-four patients who developed postoperative facial nerve dysfunction after TMJ surgery between May 2022 and April 2026 were randomly assigned to receive photobiomodulation using either the GRR Laser or the SiroLaser Advance Plus system. The treatment began on the first postoperative day and consisted of 15 treatment sessions, administered daily during the first 5 postoperative days and every other day thereafter. Facial nerve function was evaluated on postoperative Days 5, 7, 10, 30, and 60 using the House-Brackmann (HB) grading system, the Sunnybrook Facial Grading System, and the Facial Clinimetric Evaluation (FaCE) Scale.

Results

Both groups showed significant improvements in Sunnybrook and FaCE Scale scores throughout follow-up (both p < 0.001). No significant differences were observed between the groups in House-Brackmann grades at any follow-up time point (all p > 0.05). Linear mixed-effects model analyses demonstrated a significant main effect of time for both Sunnybrook and FaCE Scale scores (both p < 0.001), whereas neither the main effect of group nor the group × time interaction was statistically significant (all p > 0.05). However, change-score analyses from postoperative Day 5 to Day 60 showed significantly greater improvements in Sunnybrook (17.67 ± 3.42 vs. 13.75 ± 6.08; p = 0.036) and FaCE Scale scores (22.92 ± 11.51 vs. 18.64 ± 11.71; p = 0.040) in the GRR Laser group.

Conclusions

Both photobiomodulation systems were associated with progressive improvement in facial nerve function following TMJ surgery. Although change-score analyses showed greater improvements in Sunnybrook and FaCE Scale scores in the GRR Laser group, linear mixed-effects model analyses did not demonstrate a significant difference in the longitudinal recovery pattern between the two treatment groups.