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30.08.2023 | Research

Separation effect, pain perception during functional activity and gingival inflammation of elastomeric and Kansal separators—a split mouth study

verfasst von: Keerthipati Thejasri, Gowri Sankar Singaraju, Anand Marya, J. S. Yamini Priyanka, Shajin Shaik, Prasad Mandava

Erschienen in: Clinical Oral Investigations | Ausgabe 10/2023

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Abstract

Introduction

An effective space opening for band placement with minimal pain and gingival inflammation is a prime requisite during fixed orthodontic procedures. The study aimed to compare the effectiveness of two types of separators, elastomeric and Kansal, in the amount of space opening, pain perception elicited, and gingival inflammation.

Methods

A random split-mouth study was designed with 30 subjects undergoing fixed orthodontic treatment. Two different separators (Elastomer and Kansal) were placed alternatively on the left and right sides around the mesial and distal sides of the first molars in the mandibular arch of each subject. After 3 days, the amount of separation after 3 days was assessed with a leaf gauge on both mesial and distal sides. The subjective pain perception by visual analog Scale (VAS) at different points and during different functions for each of the 3 days was evaluated. A self-filled chart was utilized to be performed by the patients. Gingival index was used to assess the inflammatory changes.

Results

The most significant amount of separation (0.28 mm) was found with elastomers on the mesial side and is statistically significant (p < 0.001) compared to the mesial side (0.18 mm). The Kansal separators produced equivalent separation on mesial (0.19 mm) and distal sites (0.17 mm). The highest pain score was found after 24 h with elastomeric separators (median-40) for chewing and biting and the least for sleep (median-30). There is a statistical difference of pain perception between elastomers and Kansal separators at different points for the given function (p < 0.001). Both the separators resulted in mild gingival index of score less than 1 (0.70 ± 0.65, 0.97 ± 0.720, and there was no statistically significant difference between the two types of separators.

Conclusion

Both the separators produced adequate separation after a minimum 3 days. Kansal produces minimum discomfort and pain compared to elastomeric separators. Mild gingival inflammation was observed with both the separators.

Davidovitch M, Papanicolaou S, Vardimon AD, Brosh T (2008) Duration of elastomeric separation and effect on interproximal contact point characteristics. Am J Orthod Dentofacial Orthop 133(3):414–422CrossRefPubMed

Fricker JP (1997) A 12-month clinical comparison of resin-modified light-activated adhesives for the cementation of orthodontic molar bands. Am J Orthod Dentofac Orthop 112(3):239–243CrossRef

Millett DT, Hallgren A, Robertson M (1999) Bonded molar tubes: a retrospective evaluation of clinical performance. Am J Orthod Dentofacial Orthop 115(6):667–674CrossRefPubMed

Vardimon AD, Matsaev E, Lieberman M, Brosh T (2001) Tightness of dental contact points in spaced and non-spaced permanent dentitions. Eur J Orthod 23(3):305–314CrossRefPubMed

Dentaurum GmbH & Co (2020) 2020 Orthodontics Catalog. Edition 22. https://www.dentaurum.de/files/989-781-00.pdf. Accessed 26 Jun 2020

Angle EH (1907) Treatment of malocclusion of the teeth and fractures of the maxillae. Angle’s System 1907:21–24

Kesling HD (1959) United States Patent Office No. 2,897,598

Hansen JD, Tzou TZ (1959) United States Patent Office No. 2,897,598

Dragiff DA (1969) Table clinic separators. J Clin Orthod 3(12):664–671

10.

McGann BD (1991) A nickel titanium separating spring. J Clin Orthod 25(5):315–321PubMed

11.

Coolidge ED (1937) The thickness of the human periodontal membrane. J Am Dent Assoc 24(8):1260–1270

12.

Yang Y, Tang W (2017) Analysis of mechanical properties at different levels of the periodontal ligament. Biomed Res 28(20):8958–8965

13.

von Böhl M, Maltha JC, Von Den Hoff JW, Kuijpers-Jagtman AM (2004) Focal hyalinization during experimental tooth movement in beagle dogs. Am J Orthod Dentofacial Orthop 125(5):615–623CrossRef

14.

Becker T, Neronov A (2012) Orthodontic elastic separator-induced periodontal abscess: a case report. Case Rep Dent 2012:463903

15.

Wilcock A, Kansal S, Singh G, Raghav P, Kumar P, Kumar A (2014) The Kansal separator: In search of “a better mouse trap.” Arch Cran Oro Fac Sc 2(1):100–103

16.

Bondemark L, Fredriksson K, Ilros S (2004) Separation effect and perception of pain and discomfort from two types of orthodontic separators. World J Orthod 5(2):172–176PubMed

17.

Steiner CC (1953) Cephalometrics for you and me. Am J Orthod 39(10):729–755CrossRef

18.

Little RM (1975) The irregularity index: a quantitative score of mandibular anterior alignment. Am J Orthod 68(5):554–563CrossRefPubMed

19.

Tweed CH (1953) Evolutionary trends in orthodontics, past, present, and future. Am J Orthod 39(2):81–108CrossRef

20.

Löe H (1967) The gingival index, the plaque index and the retention index systems. J Periodontol 38(6):610–616CrossRef

21.

Briggs M, Closs JS (1999) A descriptive study of the use of visual analogue scales and verbal rating scales for the assessment of postoperative pain in orthopedic patients. J Pain Symptom Manage 18(6):438–446CrossRefPubMed

22.

Daokar ST (2016) Separators in orthodontics: a review. OJN 6(1):37–40

23.

Kumar A, Kansal S, Thareja V, Singh G, Kumar P (2014) The biomechanics of Kansal separator: a “2 in 1” self-secured orthodontic spring separator. J Orthod Sci 3(1):12–16CrossRefPubMedPubMedCentral

24.

Cureton SL, Bice RW (1997) Comparison of three types of separators in adult patients. J Clin Orthod 31(3):172–182PubMed

25.

Nalbantgil D, Cakan DG, Oztoprak M, Arun T (2009) Perception of pain and discomfort during tooth separation. Aust Orthod J 25(2):110–115PubMed

26.

Juneja A, Bagga DK, Sharma R, Sharma P (2011) A comparative evaluation of separation effect and perception of pain using two different orthodontic separators. J Ind Orthod Soc 45(4):183–188CrossRef

27.

Kapoor P, Singh H, Ghai GS, Ghai GK (2013) Perception of pain and discomfort from three types of orthodontic separators. Indian J Dent Sci 5(4):9–11

28.

Bangar C, Wagh S, Murthy KK, Parhad S (2016) Clinical evaluation of self-secured spring separator. Int J Contemp Med Res 3(1):69–72

29.

Sharma SK, Barthunia N, Pandit A, Singh A (2017) Perception of discomfort and amount of separation from two types of orthodontic separators: a prospective study. Int J Oral Health Med Res 4(3):35–38

30.

Tripathi T, Singh N, Rai P, Khanna N (2019) Separation and pain perception of elastomeric, Kesling and Kansal separators. Dental Press J Orthod 24(2):42–48CrossRefPubMedPubMedCentral

31.

Al-Balbeesi HO, Huraib SM, AlNahas NW, AlKawari HM, Abu-Amara AB, Vellappally S, Anil S (2016) Pain and distress induced by elastomeric and spring separators in patients undergoing orthodontic treatment. J Int Soc Prevent Communit Dent 6(6):549–553CrossRef

32.

Collins SL, Moore RA, McQuay HJ (1997) The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain 72(1–2):95–97CrossRefPubMed

33.

Aldrees AM (2015) Intensity of pain due to separators in adolescent orthodontic patients. J Orthodont Sci 4(4):118–122CrossRef

34.

Ngan P, Kess B, Wilson S (1989) Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop 96(1):47–53CrossRefPubMed

35.

Giannopoulou C, Dudic A, Kiliaridis S (2006) Pain discomfort and crevicular fluid changes induced by orthodontic elastic separators in children. J Pain 7(5):367–376CrossRefPubMed

36.

Sandhu GPS, Kanase A, Naik CR, Pupneja P, Sudan S (2013) Separation effect and perception of pain and discomfort from three types of orthodontic separators. J Ind Orthod Soc 47(1):6–9CrossRef

37.

Kumar BD, Chandra S, Singh RN, Shahi AK, Sharma S, Singh B (2022) Separation effect and perception of pain and discomfort from Kesling and elastomeric orthodontic separators: an in vivo study. J Contemp Dent Pract 23(5):508–512CrossRefPubMed

38.

Karobari MI, Assiry AA, Mirza MB, Sayed FR, Shaik S, Marya A, Venugopal A, Alam MK, Horn R (2021) Comparative evaluation of different numerical pain scales used for pain estimation during debonding of orthodontic brackets. Int J Dent 4(2021):6625126

39.

Kumari L, Nayan K (2019) A comparative study of separation effect of four different types of seperators. Indian J Orthod Dentofacial Res 5:130–132CrossRef

Titel: Separation effect, pain perception during functional activity and gingival inflammation of elastomeric and Kansal separators—a split mouth study
verfasst von: Keerthipati Thejasri
Gowri Sankar Singaraju
Anand Marya
J. S. Yamini Priyanka
Shajin Shaik
Prasad Mandava
Publikationsdatum: 30.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 10/2023
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-023-05215-8

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Separation effect, pain perception during functional activity and gingival inflammation of elastomeric and Kansal separators—a split mouth study