Comparison of Two Photobiomodulation Systems for Facial Nerve Dysfunction Following TMJ Surgery

August 17, 2026 updated by: Mehmet Emre Yurttutan, Ankara University

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

This randomized clinical trial compared two photobiomodulation systems for the management of postoperative facial nerve dysfunction following temporomandibular joint surgery. Patients who developed clinically detectable facial nerve dysfunction after open temporomandibular joint surgery were randomly assigned to receive photobiomodulation using either the GRR Laser system or the SiroLaser Advance Plus system. Photobiomodulation was initiated on the first postoperative day and consisted of 15 treatment sessions. Facial nerve recovery was evaluated using the House-Brackmann Grading System, the Sunnybrook Facial Grading System, and the Facial Clinimetric Evaluation (FaCE) Scale during a 60-day follow-up period.

Study Overview

Detailed Description

This prospective, randomized, parallel-group clinical trial was conducted in patients who developed postoperative facial nerve dysfunction following open temporomandibular joint surgery. Eligible participants were randomly allocated in a 1:1 ratio to one of two active photobiomodulation treatment groups using a computer-generated block randomization sequence.

Participants assigned to the GRR Laser group received extraoral transcutaneous photobiomodulation using a dual-wavelength 650-nm and 904-nm laser/LED system. Participants assigned to the SiroLaser Advance Plus group received extraoral transcutaneous photobiomodulation using a 660-nm continuous-wave diode laser. In both groups, irradiation was applied along the anatomical projection of the clinically affected facial nerve branches on the operated side.

Photobiomodulation treatment was initiated on the first postoperative day. Treatment was administered daily during the first five postoperative days and every other day thereafter, for a total of 15 treatment sessions. Each treatment session lasted approximately 10 minutes.

Facial nerve function was evaluated on postoperative days 5, 7, 10, 30, and 60. Clinical assessments included the House-Brackmann Grading System and the Sunnybrook Facial Grading System. Patient-reported functional status and quality of life were assessed using the Facial Clinimetric Evaluation (FaCE) Scale. The first standardized outcome assessment was performed on postoperative day 5; therefore, this assessment represented the first standardized postoperative evaluation rather than a pretreatment baseline.

Study Type

Interventional

Enrollment (Actual)

24

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Ankara
      • Ankara, Ankara, Turkey (Türkiye)
        • Ankara University Faculty of Dentistry

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients who underwent open temporomandibular joint surgery.
  • Presence of clinically confirmed postoperative facial nerve dysfunction.
  • Willingness to comply with the follow-up protocol and attend scheduled follow-up visits.
  • Provision of written informed consent.

Exclusion Criteria:

  • Pre-existing facial nerve paralysis or facial nerve dysfunction before surgery.
  • History of central neurological disease.
  • Previous surgery involving the facial nerve.
  • History of head and neck malignancy and/or chemotherapy or radiotherapy that could potentially affect facial nerve function.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: SiroLaser Advance Plus Group
Participants received photobiomodulation using the SiroLaser Advance Plus system.
Extraoral transcutaneous photobiomodulation was delivered using the SiroLaser Advance Plus system in SoftLase mode. Irradiation was provided using a 660-nm continuous-wave diode laser with an output power of 25 mW through an 8-mm fiber-optic tip. Treatment was applied along the anatomical projection of the clinically affected facial nerve branches. Treatment began on the first postoperative day and consisted of 15 sessions using the same treatment schedule as the GRR Laser group.
Experimental: GRR Laser Group
Participants received photobiomodulation using the GRR Laser system.
Extraoral transcutaneous photobiomodulation was delivered using the GRR Laser system, a dual-wavelength 650-nm and 904-nm laser/LED system. Treatment was applied along the anatomical projection of the clinically affected facial nerve branches. Treatment began on the first postoperative day and consisted of 15 sessions, administered daily during the first 5 postoperative days and every other day thereafter. Each session lasted approximately 10 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Sunnybrook Facial Grading System Score
Time Frame: From postoperative day 5 to postoperative day 60
The Sunnybrook Facial Grading System was used to assess facial nerve function based on resting symmetry, voluntary facial movement, and synkinesis. The composite score ranges from 0 to 100, with higher scores indicating better facial nerve function. The change score was calculated as the postoperative day 60 score minus the postoperative day 5 score.
From postoperative day 5 to postoperative day 60

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
House-Brackmann Grading System
Time Frame: Postoperative days 5, 7, 10, 30, and 60
Facial nerve function was graded using the House-Brackmann Grading System, which classifies facial nerve function from Grade I (normal function) to Grade VI (complete paralysis), with higher grades indicating greater dysfunction.
Postoperative days 5, 7, 10, 30, and 60
Facial Clinimetric Evaluation (FaCE) Scale
Time Frame: Postoperative days 5, 7, 10, 30, and 60
The FaCE Scale is a 15-item patient-reported measure assessing facial movement, facial comfort, oral function, eye comfort, lacrimal control, and social function. Total scores are transformed to a 0-100 scale, with higher scores indicating better facial function and quality of life.
Postoperative days 5, 7, 10, 30, and 60

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Mehmet Emre Yurttutan, DDS, PhD, Ankara University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 12, 2022

Primary Completion (Actual)

June 22, 2026

Study Completion (Actual)

June 22, 2026

Study Registration Dates

First Submitted

August 13, 2026

First Submitted That Met QC Criteria

August 17, 2026

First Posted (Actual)

August 19, 2026

Study Record Updates

Last Update Posted (Actual)

August 19, 2026

Last Update Submitted That Met QC Criteria

August 17, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because no prospective data-sharing plan was established for this study.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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