IPR (Interproximal reduction) – TIPS FOR SUCCESS

Clear aligners work on basic orthodontic principles. They are used for the correction of crowded teeth, gaps or rotation, while achieving the desired results in an organised and planned fashion. These customised trays are “nearly invisible” and move the teeth in the desired direction. 

This is achieved through wearing a series of clear aligners, each for 22 hours a day, 1 to 2 weeks at a time (one stage), which move the teeth per stage until their optimal alignment has been reached.

Sometimes there just is not enough room to move the teeth into. In this case you can gain some space by carefully “polishing” away a fraction of a millimetre of the enamel layer of the tooth.

The aim of IPR is to create space for ideal tooth alignment during orthodontic treatment, to give teeth a suitable shape whenever problems of shape or size require attention.

Here are some points to remember:

  • Conduct a thorough assessment of the patients tooth morphology and enamel thickness
  • Assess the patient for any present contraindications to the procedure
  • Gain informed consent from the patient
    • Fully inform the patient about the associated costs, risks and benefits of the procedure
    • Include any alternatives and their implications
  • Draft a plan of action both mentally and physically
  • Prepare the appropriate working materials beforehand
  • Use a method with which you are most comfortable
  • Protect the soft tissue around the tooth
  • Always review the exact amount of documented IPR required
  • Avoid creating ledges near the cervical regions

  • Always check that reduction on stripping is in the correct contact area of the tooth as the tooth may be rotated during the treatment plan
  • As teeth are more often than not triangular shaped, IPR is often only needed at the contact points of the teeth, stripping areas should be paralleled
  • The stripped area should be fluoridated after polishing

Over multiple interproximal regions, this can amount to significant ‘room for manoeuvre’ to achieve a result that will satisfy you and your patients.