Browse > Article
http://dx.doi.org/10.5051/jpis.2018.48.5.274

Early Wound Healing Score: a system to evaluate the early healing of periodontal soft tissue wounds  

Marini, Lorenzo (Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome)
Rojas, Mariana Andrea (Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome)
Sahrmann, Philipp (Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich)
Aghazada, Rustam (Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome)
Pilloni, Andrea (Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome)
Publication Information
Journal of Periodontal and Implant Science / v.48, no.5, 2018 , pp. 274-283 More about this Journal
Abstract
Purpose: Numerous indices have been proposed to analyse wound healing in oral soft tissues, but each has specific shortcomings. A new method of analysis, the Early Wound Healing Score (EHS), was evaluated in the present study. The aim was to assess more accurately early healing by primary intention of surgical incisions in periodontal soft tissues. Methods: Twenty-one patients were treated with different surgical procedures comprising 1 or 2 vertical releasing incisions as part of a surgical access flap. Twenty-four hours after surgery, early wound healing at the vertical releasing incisions was assessed using the EHS. This score assessed clinical signs of re-epithelialization (CSR), clinical signs of haemostasis (CSH), and clinical signs of inflammation (CSI). Since complete wound epithelialization was the main outcome, the CSR score was weighted to be 60% of the total final score. Accordingly, a score of 0, 3, or 6 points was possible for the assessment of CSR, whereas scores of 0, 1, or 2 points were possible for CSH and CSI. Higher values indicated better healing. Accordingly, the score for ideal early wound healing was 10. Results: Thirty vertical releasing incisions were assessed in 21 patients. At 24 hours after incision, 16 vertical releasing incisions (53.33%) received the maximum score of CSR, while 6 cases (20%) received an EHS of 10. None of the cases received 0 points. Conclusion: The EHS system may be a useful tool for assessing early wound healing in periodontal soft tissue by primary intention after surgery.
Keywords
Gingiva; Periodontal diseases; Soft tissue injuries; Symptom assessment; Wound healing;
Citations & Related Records
연도 인용수 순위
  • Reference
1 American Academy of Periodontology. Glossary of periodontal terms. 4th ed. Chicago (IL): American Academy of Periodontology; 2001.
2 Wikesjo UM, Selvig KA. Periodontal wound healing and regeneration. Periodontol 2000 1999;19:21-39.   DOI
3 Aukhil I. Biology of wound healing. Periodontol 2000 2000;22:44-50.   DOI
4 Hakkinen L, Uitto VJ, Larjava H. Cell biology of gingival wound healing. Periodontol 2000 2000;24:127-52.   DOI
5 Polimeni G, Xiropaidis AV, Wikesjo UM. Biology and principles of periodontal wound healing/regeneration. Periodontol 2000 2006;41:30-47.   DOI
6 Hiatt WH, Stallard RE, Butler ED, Badgett B. Repair following mucoperiosteal flap surgery with full gingival retention. J Periodontol 1968;39:11-6.   DOI
7 Werfully S, Areibi G, Toner M, Bergquist J, Walker J, Renvert S, et al. Tensile strength, histological and immunohistochemical observations of periodontal wound healing in the dog. J Periodontal Res 2002;37:366-74.   DOI
8 Susin C, Fiorini T, Lee J, De Stefano JA, Dickinson DP, Wikesjo UM. Wound healing following surgical and regenerative periodontal therapy. Periodontol 2000 2015;68:83-98.   DOI
9 Landry RG, Turnbull RS, Howley T. Effectiveness of benzydamyne HCl in the treatment of periodontal post-surgical patients. Res Clin Forums 1988;10:105-18.
10 Wachtel H, Schenk G, Bohm S, Weng D, Zuhr O, Hurzeler MB. Microsurgical access flap and enamel matrix derivative for the treatment of periodontal intrabony defects: a controlled clinical study. J Clin Periodontol 2003;30:496-504.   DOI
11 Hagenaars S, Louwerse PH, Timmerman MF, Van der Velden U, Van der Weijden GA. Soft-tissue wound healing following periodontal surgery and Emdogain application. J Clin Periodontol 2004;31:850-6.   DOI
12 Tonetti MS, Fourmousis I, Suvan J, Cortellini P, Bragger U, Lang NP, et al. Healing, post-operative morbidity and patient perception of outcomes following regenerative therapy of deep intrabony defects. J Clin Periodontol 2004;31:1092-8.   DOI
13 Huang LH, Neiva RE, Wang HL. Factors affecting the outcomes of coronally advanced flap root coverage procedure. J Periodontol 2005;76:1729-34.   DOI
14 World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310:2191-4.   DOI
15 Woodley DT. Reepithelialization. In: Clark RAF, editor. The molecular and cellular biology of wound repair. New York (NY): Plenum Press; 1996. p.339-54.
16 Politis C, Schoenaers J, Jacobs R, Agbaje JO. Wound healing problems in the mouth. Front Physiol 2016;7:507.
17 Martin P, Leibovich SJ. Inflammatory cells during wound repair: the good, the bad and the ugly. Trends Cell Biol 2005;15:599-607.   DOI
18 Larjava H. Oral wound healing: cell biology and clinical management. Chichester: John Wiley & Sons, Inc.; 2012.
19 Harrison JW. Healing of surgical wounds in oral mucoperiosteal tissues. J Endod 1991;17:401-8.   DOI
20 Kumar KR, Kumar J, Sarvagna J, Gadde P, Chikkaboriah S. Hemostasis and post-operative care of oral surgical wounds by hemcon dental dressing in patients on oral anticoagulant therapy: a split mouth randomized controlled clinical trial. J Clin Diagn Res 2016;10:ZC37-40.
21 Young EE, Lariviere WR, Belfer I. Genetic basis of pain variability: recent advances. J Med Genet 2012;49:1-9.   DOI
22 Pippi R. Post-surgical clinical monitoring of soft tissue wound healing in periodontal and implant surgery. Int J Med Sci 2017;14:721-8.   DOI
23 Cairo F, Rotundo R, Miller PD Jr, Pini Prato GP. Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. J Periodontol 2009;80:705-10.   DOI
24 Gale AJ. Continuing education course #2: current understanding of hemostasis. Toxicol Pathol 2011;39:273-80.   DOI