Separation and pain perception of Elastomeric, Kesling and Kansal separators

Abstract

Introduction: Various types of separators have been advocated, but the ideal separator should produce optimum separation with minimal pain and discomfort. Objective: The objective of this study was to evaluate and compare the amount of separation achieved by three different types of separators (Elastomeric, Kesling and Kansal), and to assess the associated pain and discomfort. Methods: A random single-blind split-mouth study was conducted on 108 patients seeking fixed orthodontic treatment, in which two different separators were used on each side in both the arches for a single patient. After five days, the amount of separation was measured with a feeler gauge. Visual Analogue Scale (VAS) scoring was performed by the patient on each day, to evaluate pain perception. Discomfort was evaluated by questionnaire filled by the patient at the time of separator removal. Results: The greatest amount of separation was seen with the elastomeric separators, while the smallest separation was seen with Kansal separators. VAS scoring showed maximum pain at day 1 with all the three separator types. Highest pain was perceived in the Elastomeric separators group, followed by Kesling and Kansal separators, respectively. Statistically significant difference was found in VAS score of Elastomeric separators, when compared to both Kesling and Kansal, on day 1 and 2 (p= 0.001). Analysis of the questionnaires revealed that a greater number of patients experienced discomfort with elastomeric separators placement (69.4%), which was statistically significant (p< 0.01) when compared to the other two types of separators. Answers to the other questions were comparable, except for the need for medications, which was reportedly highest with elastomeric separators. Conclusion: Kesling separators produce adequate separation with minimal discomfort and pain, compared to Elastomeric and Kansal separators.

Analgesic effect of photobiomodulation after placement of elastomeric separators: randomized controlled clinical trial

“…Separation methods should involve easy placement with little or no discomfort. Elastomeric separators are more efficient than other separators, but generate a higher level of pain (Qamruddin, 2016;Tripathi, 2019). Pain involved in the placement of separators affects functions such as chewing and the eating pattern and the discomfort may lead to a need for medication (Sousa, 2014;Marini, 2015;Tripathi, 2019).…”

Separation Effect, Pain Perception During Functional Activity and Gingival Inflammation of Elastomeric and Kansal Separators- A Split Mouth Study

“…The amount of separation was found to be statistically signi cant ( P < 0.001) with a maximum on the mesial side ( 0.28mm) of elastomeric separators and with a distal side reading 0.18mm after 3 days of separation in the present study. In a study conducted on elastomers after 5 days of separation 30 , it is noted that there is no distinction between the mesial(0.42-0.44 mm) and distal sides( 0.41-0.42mm) of elastomers as well between the mesial (0.22mm) and distal side( 0.22mm) m as Kansal separator. Interestingly, the studies conducted after 7 days [25,31] noted that the amount of separation is almost equal on mesial and distal sides with elastomers.…”

Laserterapia de baixa intensidade no manejo da dor provocada por separadores elastoméricos: uma revisão integrativa

“…Diversos estudos sugerem que a dor provocada pelos separadores elastoméricos se inicie quatro horas após a instalação e alcance o pico de forma gradual nas primeiras 24 horas. A redução da sensação dolorosa pode começar por volta das 72 horas após a instalação, quando se iniciam os processos de reparo tecidual, normalizando após cinco ou sete dias 1,3,5,6,20,22,23 .…”

“…Durante o tratamento ortodôntico, alguns pacientes podem experimentar diversas mecânicas de movimentação dentária que causam dor e desconforto. A sensação dolorosa tem sido frequentemente associada ao tratamento ortodôntico na visão de até 90% dos pacientes e pode ser entendida como a principal causa de desistências de tratamento 1,2 .…”

“…Quando há pouco espaço interdental e existe a necessidade de colocação de bandas ortodônticas, os separadores elastoméricos podem ser uma ferramenta útil para separar os dentes. Entretanto, a inserção destes separadores no espaço interdental causa tensão nas estruturas dentárias de suporte e dor induzida por moléculas inflamatórias, como prostaglandinas, leucotrienos, bradicininas e outras citocinas pró-inflamatórias 1,2 .…”