Separation and pain perception of Elastomeric, Kesling and Kansal separators

Tripathi, Tulika; Singh, Navneet; Rai, Priyank; Khanna, Neha

doi:10.1590/2177-6709.24.2.042-048.oar

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…This study concludes that the larger the interdental space, the greater the pain at 24 h [53]. This differs from the present study, in which we obtained a negative correlation between space and pain, indicating that the larger the interproximal space, the less pain the patient experiences.…”

Section: Discussioncontrasting

confidence: 99%

Comparison of the Effects of Ketorolac and Acetaminophen on RANK-L Levels in the Gingival Crevicular Fluid during Orthodontic Tooth Movement: A Pilot Study

Rodríguez-Montaño,

Ponce-Gómez,

Lomelí-Martínez

et al. 2024

Applied Sciences

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Background: Patients usually present pain due to the release of different inflammatory mediators such as prostaglandin E2 and RANK-L. Analgesics such as acetaminophen and ketorolac can inhibit RANK-L expression and this can affect orthodontic treatment by decreasing bone remodeling and slowing orthodontic dental movement. Several studies have reported a decrease in dental movement after administering some non-steroidal anti-inflammatory drugs. Proposal: The objective was to evaluate the RANK-L levels and a possible modulation by administering acetaminophen and ketorolac in patients starting orthodontic treatment. Methodology: A double-blind, randomized clinical trial was carried out with 24 subjects divided into three study groups: calcined magnesia as a placebo, acetaminophen, and ketorolac. Gingival crevicular fluid was obtained at four time points: before pharmacological intervention, at 24 h, at 48 h, and on the 5th day. RANK-L concentrations were evaluated through ELISA analysis. Also, interproximal space generated by the elastic separator at the end of the study was recorded in the different study groups using the visual analog scale. Results: An increase in RANK-L at 24 h was observed in the placebo group compared to the ketorolac and acetaminophen groups. However, no significant differences were observed in the interproximal space at day 5 in the three study groups. Conclusion: Patients who do not take analgesics at the start of orthodontic treatment have higher levels of RANK-L. Therefore, the use of ketorolac or acetaminophen could decrease bone remodeling and interfere with orthodontic dental movement.

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Section: Discussioncontrasting

confidence: 99%

Comparison of the Effects of Ketorolac and Acetaminophen on RANK-L Levels in the Gingival Crevicular Fluid during Orthodontic Tooth Movement: A Pilot Study

Rodríguez-Montaño,

Ponce-Gómez,

Lomelí-Martínez

et al. 2024

Applied Sciences

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“…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).…”

Section: Discussionmentioning

confidence: 99%

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

Ortega

Gonçalves

Schalch

et al. 2022

RSD

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Objective: Pain resulting from the positioning of elastomeric separators is a strong reason for abandoning orthodontic treatment. So, this study aims to verify the analgesic effects of photobiomodulation (PBM) in participants submitted to orthodontics with elastomeric separators. Methods: Participants were individuals who received separators on the mesial and distal surfaces of the first molars. They were randomly separated into two groups: an experimental group that received photobiomodulation (PBM) (n=22) and a placebo group (n=22). After the positioning of the separators, the PBM group received one application of PBM (2 J of energy applied in 20 seconds per point, adding up to 12 J per molar (6 J on the vestibular surface and 6 J on the lingual surface) over the cervical portion and the apical third of the tooth. Pain was measured one hour after placement, with the aid of a visual analog scale (VAS). Statistical analysis involved the Mann-Whitney, Fisher’s Exact and chi-square tests. Results: Reports of severe pain only occurred in the placebo group. However, a larger percentage of the individuals in the PBM group reported feeling moderate pain compared to this same intensity in the placebo group. No significant differences among groups were found with regards to reports of mild pain and no pain. An association was found between pain and the female sex in both groups. Conclusion: Significant difference was found in severe pain sensitivity when PBM was applied after the positioning of elastomeric separators, favoring the irradiated participants. Thus, PBM may be a useful tool in orthodontic treatment. Clinical Trials Reference Number (www.ClinicalTrials.gov), NCT03939988.

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“…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 .…”

Section: Revisão De Literaturaunclassified

“…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 .…”

Section: Introductionunclassified

“…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 .…”

Section: Introductionunclassified

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

Lima¹,

Ribeiro²,

Lopes³

et al. 2021

R. Fac. Odontol. Porto Alegre

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Introduction: The use of elastomeric separators during orthodontic treatment can cause pain and low-level laser therapy has been used to manage this outcome. Objective: To present the evidence on the effect of low-level laser therapy in the management of pain caused by the use of elastomeric separators. Methods: An integrative review of clinical studies was carried out in the PubMed, Web of Science, Scopus, BVS, SciELO and clinicaltrials.gov databases using a PICo strategy developed with descriptors, including studies published in the last ten years, without language restriction. 68 articles were tracked and 12 were reviewed. Literature review: Considering laser therapy, most studies used gallium and aluminum arsenide (Ga-Al-As), with a wavelength between 808nm and 940nm, as well as power between 40.6mW and 200mW. The visual analog scale (VAS) was used by most studies to measure the pain. Two studies did not find significant differences in low-level laser therapy in pain caused by elastomeric separators, eight studies found significant differences between the intervention, control and placebo groups (when used) and two studies were not fully conclusive and pointed out partial statistical differences between the groups in question. The application techniques were too heterogeneous in the studies included in this review and do not allow a quantitative synthesis. Conclusion: The low-level laser therapy can demonstrate beneficial effects in reducing pain caused by elastomeric separators. However, it is not yet possible to determine the best application technique.

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Separation and pain perception of Elastomeric, Kesling and Kansal separators

Cited by 7 publications

References 17 publications

Comparison of the Effects of Ketorolac and Acetaminophen on RANK-L Levels in the Gingival Crevicular Fluid during Orthodontic Tooth Movement: A Pilot Study

Comparison of the Effects of Ketorolac and Acetaminophen on RANK-L Levels in the Gingival Crevicular Fluid during Orthodontic Tooth Movement: A Pilot Study

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

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

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