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

Abstract

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. 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 3days, the amount of separation after 3days 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 3days was evaluated. A self-filled chart was utilized to be performed by the patients. Gingival index was used to assess the inflammatory changes. The most significant amount of separation (0.28mm) was found with elastomers on the mesial side and is statistically significant (p < 0.001) compared to the mesial side (0.18mm). The Kansal separators produced equivalent separation on mesial (0.19mm) and distal sites (0.17mm). The highest pain score was found after 24h 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. Both the separators produced adequate separation after a minimum 3days. Kansal produces minimum discomfort and pain compared to elastomeric separators. Mild gingival inflammation was observed with both the separators.