Objectives: The aim of the study was to evaluate the experience of pain and the expression of interleukin-1beta (IL-1ß), substance P (SP) and prostaglandin E2 (PGE2) in gingival fluid (GCF) after placement of orthodontic elastic separators. Methods: 18 children (mean age 10.8 y) attending the department of orthodontics for treatment were included. Molar elastic separators were inserted mesially to the first upper or lower molars, the antagonist molar serving as control. GCF was collected from 2 distal sites (DB-DP) from each molar, by means of durapore strips, before (Day -7, Day 0) and after placement of separators (Day 0-60sec, Day 0- 1h, Day 1 and Day 7). Pain intensity was recorded using a visual analogue scale (VAS). The contents of IL-1ß, SP and PGE2 were determined by ELISA in GCF samples of 8 patients. Results: 72% of the patients reported pain at the moment the separators were inserted (VAS mean= 20). After 1h and the first evening as well as the following morning, 17% and 40% of the patients reported pain, respectively. At Day 7, no pain was reported. After 1h and 24h, mean GCF IL-1ß levels were significantly elevated at treatment teeth compared to control teeth. (10.04 pg vs 4.65 pg and 10.79 pg vs 4.63 pg, respectively) and dropped to baseline values at Day 7. The GCF levels of SP and PGE2 for the treatment sites were significantly higher at Day 1 and Day 7 than the control sites (p<0.005 and p<0.05, respectively). All three mediators remained at baseline levels throughout the experiment for the control teeth. Conclusions: Pain is common in young patients after a simple procedure such as placement of molar separators. Crevicular fluid component analysis may be useful for assessing cellular response to minor orthodontic force in vivo. Supported by the Swiss National Science Foundation.

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