Yahya et al used the Inflammatory Proliferative Remodeling (IPR) scale to monitor healing after surgical extraction of third molars. The authors are from Tel Aviv University, Beilinson Hospital, and a private clinic in Israel.
Patient selection: third molar surgical extraction
Parameters for inflammatory findings on days 3-5:
(1) bleeding (spontaneously or on palpation)
(2) granulation tissue
(3) hematoma
(4) tissue color
(5) incision margins
(6) suppuration
(7) edema on a VAS scale, from 0 to 10
(8) pain on a VAS scale, from 0 to 10
Parameters for proliferative features on day 14:
(1) re-epithelialization
(2) tissue color
(3) scar
(4) suppuration
(5) pain on a VAS scale, from 0 to 10
Parameters for remodeling at 6 weeks:
(1) scar
(2) tissue color
(3) pain on VAS scale, from 0 to 10
|
Parameter |
Finding |
Points |
|
bleeding day 3-5 |
no |
0 |
|
|
yes |
1 |
|
granulation tissue, day 3-5 |
no |
0 |
|
|
yes |
1 |
|
hematoma, day 3-5 |
no |
0 |
|
|
yes |
1 |
|
tissue color, day 3-5 |
like opposite side tissue |
0 |
|
|
redder or whiter than other side |
1 |
|
incision margins, day 3-5 |
complete flap closure; fine fibrin line |
0 |
|
|
incomplete flap closure; necrosis |
1 |
|
suppuration, day 3-5 |
no |
0 |
|
|
yes |
1 |
|
edema day 3-5 |
0 to 5 |
0 |
|
|
6 to 10 |
1 |
|
pain day 3-5 |
0 to 5 |
0 |
|
|
6 to 10 |
1 |
|
re-epithelialization 2 weeks |
complete |
0 |
|
|
partial |
1 |
|
tissue color at 2 weeks |
like opposite side tissue |
0 |
|
|
redder or whiter than other side |
1 |
|
scar at 2 weeks |
no scar or < 2 mm in width with regular contour |
0 |
|
|
scar > 2 mm, irregular contour |
1 |
|
suppuration at 2 weeks |
no |
0 |
|
|
yes |
1 |
|
pain at 2 weeks |
0 to 5 |
0 |
|
|
6 to 10 |
1 |
|
scar at 6 weeks |
no scar or < 2 mm in width with regular contour |
0 |
|
|
scar > 2 mm, irregular contour |
1 |
|
tissue color at 6 weeks |
like opposite side tissue |
0 |
|
|
redder or whiter than other side |
1 |
|
pain at 6 weeks |
0 to 5 |
0 |
|
|
6 to 10 |
1 |
where:
• Tissue color and pain are in all 3 measures.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum total score: 0
• maximum total score: 16
• Subscores for each section can be caluclated.
Specialty: Otolaryngology
