Pain and distress induced by elastomeric and spring separators in patients undergoing orthodontic treatment

Abstract

Aims and Objectives:The objective of the present investigation is to evaluate patients’ pain perception and discomfort, the duration of pain and the level of self-medication over time during tooth separation, and the effectiveness of elastomeric and spring types of orthodontic separators in Saudi population.Materials and Methods:The study group consisted of 30 female adolescent patients who had elastomeric/spring separators as part of their orthodontic treatment. A self-administrated questionnaire comprising 16 multiple choice questions and another with visual analog scale were used to record the patient's pain perceptions at 4 hours, 24 hours, 3 days, 5 days, and 7 days from the time of insertion. The level of pain and discomfort during these time periods were assessed by a visual analog scale. After a separation period of 7 days, the amount of separation was measured with a leaf gauge. Type and frequency of analgesic consumption was also recorded. The Statistical Package for the Social Sciences (SPSS) version 20 (IBM SPSS -Chicago, IL: SPSS Inc.,) was used for statistical analysis.Results:The data showed significant increase in the level of pain at 4 hours, 24 hours, and 3 days from separator placement. The elastomeric separators produced significantly more separation than the spring separators and also caused maximum pain during the first 3 days after insertion. However, there was no significant difference between the score of pain between two separators at all time intervals.Conclusion:Both elastomeric and spring separators showed comparative levels of pain and discomfort during the early phase of separation. Elastomeric separators were found to be more effective in tooth separation than spring separators. However, further studies are necessary to substantiate this preliminary observation.

Separation and pain perception of Elastomeric, Kesling and Kansal separators

“…The amount of pain was found to be greater during the first 24 hours of separator placement, similar to previous studies. 9 , 12 , 24 , 25 The intragroup comparison revealed that the pain with elastomeric separator was so intense at the time of placement that the pain reduction on each day, for the entire research period, was statistically significant. On the other hand, Kesling and Kansal separators showed significant pain reduction only until day 3, which means that lesser residual pain persists after the third day of placement, leading to better patient comfort.…”

“…The placement of separators causes pressure, tension, soreness and pain, which can be detrimental to the patient’s attitude towards further orthodontic procedures. 10 - 12 The separator-associated pain also interferes with functions like chewing or dietary pattern, leading to discomfort and need for medication. A subjective method for pain assessment is the Visual Analogue Scale (VAS), which has been extensively used in various studies for assessment of pain intensity.…”

Pain characteristics and countermeasures to improve intraoperative pain for patients with temporomandibular joint disorder during treatment of orthodontics

“…In addition, it is believed by Banerjee et al (2018) that the patients' circulatory system could be regulated effectively to promote their heart rate to be normal through parasympathetic excitation and sympathetic suppression. It is believed in the study of Al-Balbeesi et al (2016) that there would demonstrate certain difference in the clinical manifestations of pain after placing the bow wire in orthodontic treatment for patients with temporomandibular joint disorder syndrome, and appropriate orthodontic force control could improve the pain effect effectively. Besides, Minghui et al (2017) further proposed that there was no difference in the degree of periodontal pain after placing the first two bow wires, but the duration of pain after placing the second bow wire was shorter, during orthodontic treatment.…”

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 .…”

“…Quando separadores elastoméricos são inseridos nos espaços interdentais, inicia-se uma cascata de eventos inflamatórios que resultam em respostas teciduais com liberação de mediadores inflamatórios associados a dor. O aumento de prostaglandina E2 tem sido associado à dor inicial e o aumento de interleucina-1 tem sido associado ao pico de dor em 24 horas após a colocação dos separadores elastoméricos 5,6 .…”