Nalbantgil Didem, Cakan Derya Germec, Oztoprak M Oguz, Arun Tülin
Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.
Aust Orthod J. 2009 Nov;25(2):110-5.
To evaluate patients' perceptions of pain and discomfort during tooth separation and to compare the effectiveness of brass wire and elastomeric separators.
The participants were 87 adults with a mean age of 22.1 +/- 1.9 years. Elastomeric and brass wire separators were inserted mesial and distal to upper right (elastomeric separators) and upper left first molars (brass wire separators) in each subject. After seven days, the amount of tooth separation was measured with a leaf gauge, and pain perception and discomfort were evaluated with a visual analogue scale and questionnaire.
The elastomeric separators produced significantly more separation than the wire separators. There was a statistically significant difference in the subjects' perceptions of pain and discomfort at rest and during chewing between the different separators (p < 0.001). In general, the brass wire separators caused the greatest pain and discomfort immediately after insertion. Pain from the wire separators subsided over seven days, whereas elastomeric separators caused the greatest pain on the first two days after insertion. Eating was negatively influenced by the separation in 61 per cent of the subjects on the first day. On the other hand, other daily activities were affected minimally.
The different levels of pain and discomfort caused by these separators, together with their advantages and disadvantages, can help the clinician to choose an appropriate separator. Patients should be warned that pain due to separation may affect their chewing, social life, school work and sleeping. Analgesics and soft food are recommended following placement of separators.
评估患者在牙齿分离过程中的疼痛和不适感受，并比较黄铜丝分离器和弹性分离器的效果。
研究对象为87名平均年龄22.1±1.9岁的成年人。在每位受试者的右上第一磨牙（使用弹性分离器）和左上第一磨牙（使用黄铜丝分离器）的近中及远中放置弹性分离器和黄铜丝分离器。7天后，用叶片规测量牙齿分离量，并用视觉模拟量表和问卷评估疼痛感知和不适情况。
弹性分离器产生的牙齿分离量明显多于金属丝分离器。不同分离器在静止和咀嚼时，受试者对疼痛和不适的感知存在统计学显著差异（p<0.001）。一般来说，黄铜丝分离器在插入后立即引起的疼痛和不适最强烈。金属丝分离器引起的疼痛在7天内逐渐减轻，而弹性分离器在插入后的前两天引起的疼痛最强烈。第一天，61%的受试者的进食受到分离的负面影响。另一方面，其他日常活动受到的影响最小。
这些分离器引起的不同程度的疼痛和不适，以及它们的优缺点，有助于临床医生选择合适的分离器。应告知患者，分离引起的疼痛可能会影响他们的咀嚼、社交生活、学业和睡眠。建议在放置分离器后使用镇痛药并食用软食。
