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

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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.

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Data availability

All data related to the study can be provided on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Orthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India

    Keerthipati Thejasri, Gowri Sankar Singaraju, Shajin Shaik & Prasad Mandava

  2. Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia

    Anand Marya

  3. Center for Transdisciplinary Research, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, 600077, India

    Anand Marya

  4. Department of Orthodontics, Vydehi Dental College and Research Center, Bangalore, Karnataka, India

    J. S. Yamini Priyanka

Authors
  1. Keerthipati Thejasri
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  2. Gowri Sankar Singaraju
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  3. Anand Marya
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  4. J. S. Yamini Priyanka
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  5. Shajin Shaik
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  6. Prasad Mandava
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Contributions

KT is the main researcher who has performed the study, data collection, and analysis; PM is the guide and head of the unit involved in the supervision of the research study and contributed to manuscript preparation. SGS made significant contributions to the conception, assessor of the scores and clinical management of the cases. AM is involved in the design of the study, editing, and critical review of the manuscript. SS and JSYP contributed to the review of literature and clinical management steps in the study. The final manuscript was read and approved by all the authors.

Corresponding authors

Correspondence to Anand Marya or Prasad Mandava.

Ethics declarations

Ethics approval and consent to participate

The Institutional Ethical Committee Clearance and Declarations Regd.No. D178408011; Ref No. NDC/IECC/ORTHO/DISS/12–18/04 dated 05–12-2018).

Informed consent

Written informed consent was obtained from the patient and their legal guardians regarding their participation in the research project. The patients and their parents/legal guardians were also requested to provide written consent regarding the use of the patient images in the manuscript to which they agreed.

Conflict of interest

The authors declare no competing interests.

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Thejasri, K., Singaraju, G.S., Marya, A. et al. Separation effect, pain perception during functional activity and gingival inflammation of elastomeric and Kansal separators—a split mouth study. Clin Oral Invest 27, 6015–6026 (2023). https://doi.org/10.1007/s00784-023-05215-8

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