RESUMO
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.
RESUMO
Introduction The objective of this observational study is to compare the dental and skeletal changes that occur following the release of incisor locking in class II division 2 patients in the decelerating phase of the adolescent growth spurt. Materials and methods Lateral cephalograms of 17 subjects with skeletal class II and division 2 malocclusion, taken at the pre-treatment (T1) and post-leveling and alignment (T2) phases, were analyzed. All these patients were treated with non-extraction methods in the initial stage. A total of 25 skeletal and dental parameters, which included linear and angular measurements, were evaluated. Statistical analysis A paired t-test was used to compare the difference in the dimensional values between (T1) and (T2) points of the time period. The results were considered statistically significant at Bonferroni adjusted p<0.002. Results A statistically significant positional change was noted in the condylar position both in the vertical and sagittal directions, resulting in sagittal changes of the mandible in the forward direction. The deep bite was relieved by vertical changes in the dental structures in both the posterior and anterior segments. Growth changes in the vertical direction were also noted but not conclusive. Conclusions There was a definite horizontal shift of the mandible, improving maxillo-mandibular relations following the unlocking of the bite in class II division 2 patients. This shift is mostly attributed to the condylar repositioning in the forward and downward directions.