Comparative Evaluation of Molar-Premolar Separation, Stability, and Patient Pain Perception Using Four Orthodontic Separators: An In Vivo Study

Abstract

Orthodontic separators play a crucial role in fixed orthodontic treatment by creating space between adjacent teeth for band placement. This in vivo study comparatively evaluates four types of orthodontic separators elastomeric, dumbbell, Kesling, and brass wire based on three key parameters: separation effect, intraoral stability, and patient pain perception. A total of 60 adult volunteers participated, with each separator type placed in different quadrants of the oral cavity. The separation effect was measured using a JAIBROS Feeler Gauge, stability was assessed by recording dislodged separators, and pain perception was evaluated using the Visual Analog Scale (VAS). Statistical analysis, including ANOVA and Bonferroni tests, revealed that dumbbell separators achieved the highest mean separation (0.26 ± 0.12 mm), while brass wire separators produced the least (0.2007 ± 0.06 mm). Stability analysis indicated that Kesling separators had the highest loss rate (11.7%), whereas dumbbell separators were the most stable (1.6% loss). Pain perception was highest with Kesling separators (VAS score: 5.03 ± 0.956) and lowest with dumbbell separators (VAS score: 1.30 ± 0.462). The findings suggest that dumbbell separators are the most effective in achieving optimal separation while minimizing patient discomfort, making them a preferred choice in clinical orthodontic practice.