The Evaluation of Wound Healing Following Periodontal Surgery Varied Across Different Dental Specialties Using a Modified Early Wound Healing Index

We have previously developed a novel assessment for wound healing, called the modified early wound-healing index（mEHI）, following a modified papilla-preservation technique（mPPT）. The previous study showed better scores of mEHI in enamel matrix derivative group than those of recombinant human fibroblast growth factor group. However, the inter-rater reliability of the mEHI were not high. This study aimed to investigate the causes of low inter-rater reliabilities in mEHI by analyzing differences in the intraclass correlation coefficients（ICCs）between dental board-certified doctors （BDs）and non-board-certified doctors（non-BDs）of the Japanese Society of Periodontology. A total of 79 wound-healing sites following mPPT was evaluated using the mEHI by eight BDs and 12 non-BDs. The mEHI included incision, fibrin clot, step, redness, swelling, and dehiscence. The mEHI scores and the ICCs were compared between the BD and non-BD groups. Partial ICCs between the mEHI items were calculated, and the differences were statistically analyzed. The ICCs of fibrin clot, step, and redness were >0.45, and the incision line and step had low ICCs in both groups. The scores of fibrin clot and dehiscence were higher in the non-BD group than in the BD group. A significant negative partial correlation was noted between the incision line and fibrin clot, and between dehiscence and swelling in the non-BD group. In conclusion, the mEHI is a valuable tool in evaluating wound healing. However, assessments of fibrin clot and dehiscence were found to be influenced by periodontal treatment experience, contributing to the low inter-rater reliability of the mEHI.