IPR (Interproximal Reduction)

Topics covered

How to perform:

IPR stands for interproximal reduction. It is the process of creating very small amounts of space between pairs of teeth in order to allow the teeth to move as needed during treatment.

  A red triangle on the treatment plan represents IPR, or interproximal reduction.

View our IPR video tutorial:

Download a printable version of the below tutorial here.

This information is taken from a demonstration delivered by Dr. Willis Pumphrey, DDS in 2010. It is intended to serve as a general guide and is in no way a comprehensive instruction manual for performing IPR. As always, doctors must rely on their own best judgement.

The ABCs of IPR

  • Avoid the tongue, lips, and cheeks. Protect the patient's soft tissue with a mirror and cheek retractor.
  • Brace yourself with a finger rest. Use a finger or thumb rest to stabilize the handpiece and align the disc. Then, line up the handpiece with the contact area. Use the handpiece to blanch the gums.
  • Check for fully-broken contact using unwaxed dental floss. Keep track of IPR performed by using your IPR tracking chart.

Parts needed

Before you do anything check your treatment plan

Check the treatment plan included in the box with the aligners. Here, the recommended amounts and locations of IPR for each step is marked on the tooth charts and listed in red beneath each one. Keep a record when you perform IPR; write down which teeth you reduced and by how much.

Performing IPR

0.1mm on an anterior tooth

Parts needed:

Instructions:

 

Cut diamond strip in half. You will only need one half of the strip per procedure. 

Gently move the strip backwards and forwards between the teeth along the contact area in a sawing motion. It takes roughly 8-12 motions, but ultimately depends on the patient.

  

Flip the strip over, and perform this action again, about 8-12 times. Rinse the area.

  

Take the 0.1mm gauge and place in between the two teeth to verify the correct amount of space. If the gauge does not t in between those teeth, continue to file between the tooth surfaces until the desired result is reached.

0.2mm on an anterior tooth

Parts needed:

The single-sided diamond disc that you will utilize to perform this procedure depends on the tooth that you wish to reduce and the direction of movement. You can determine this by checking the tooth charts on your treatment plan.

Instructions:

Line up the disc parallel to the contact area.

Turn the drill on and move the disc along the contact area. Stop at the height of the interdental papilla, or when you feel the contact break. 

 

If needed, use floss to ensure that the contact has broken. You may also use a diamond strip to file down any sharp corners or rough surfaces left from the disc.

  

You may use a diamond strip to file down any sharp corners or rough surfaces left from the disc.

Rinse the area, then take the 0.2mm gauge and place in between the two teeth to verify the correct amount of space.

0.2mm on a posterior tooth

Parts needed:

The single-sided diamond disc that you will utilize to perform this procedure depends on the tooth that you wish to reduce and the direction of movement. You can determine this by checking the tooth charts on your treatment plan.

Instructions:

 

Have a dental assistant hold back the patient's lips and cheeks, to prevent them from getting cut. Have the assistant hold the tongue down with a mirror or retractor. If needed, extend the neck of the drill so that the disc does not interfere with the anterior teeth during the procedure.

Line up the disc parallel to the contact area. Turn the drill on and move the disc along the contact area, from facial to lingual. Stop at the height of the interdental papilla, or when you feel the contact break.

 

If needed, use floss to ensure that the contact has broken. You may also use a diamond strip to file down any sharp corners or rough surfaces left from the disc.

 

Take the 0.2mm gauge and place in between the two teeth to verify the correct amount of space.

0.3mm on a posterior tooth

Parts needed:

Instructions:

 

Have a dental assistant hold back the patient's lips and cheeks, to prevent them from getting cut. Have the assistant hold the tongue down with a mirror or retractor. If needed, extend the neck of the drill so that the disc does not interfere with the anterior teeth during the procedure.

Line up the disc parallel to the contact area. Turn the drill on and move the disc along the contact area, from facial to lingual. Stop at the height of the interdental papilla, or when you feel the contact break.

 

Rinse, then use the 0.3mm gauge to verify the correct amount of space.

Common questions about IPR

Is there a limit on the amount of IPR done?

There is a limit on the amount of IPR we would do on any one tooth during the course of a treatment, excluding if a revision was submitted and the doctor asked for more IPR.

Our standard protocol is 0.3mm mesial of the canines and 0.6mm distal of the canines as a maximum.  Any more than that will need specific instructions from the doctor.  Revisions will have a reduced amount of IPR because it is hard to know for sure if the previous IPR request was completed or not.  Usually if no IPR is requested by the technician is because the setup did not need it to achieve the final goal.

IPR Kit

ClearCorrect offers an IPR kit that contains all the tools you will need in order to perform IPR during your case. The kit costs $249.95, and will arrive to you in a fancy red box within 5-7 days of purchase. You can also refill your IPR kit through the ClearCorrect Online Store, so you'll never be unprepared during your next patient visit. 

The IPR Kit includes:

  • Diamond disc, coated on upper surface - 0.10mm
  • Diamond disc, coated on lower surface - 0.10mm
  • Diamon disc, coated on both surfaces - 0.15mm
  • 5-pack mosquito burs, 0.16mm
  • 5-pack needle burs, 0.10mm
  • Set of 15 stainless steel diamond strips
  • Set of six IPR gauges: 0.1mm, 0.2mm, 0.25mm, 0.3mm, 0.4mm, 0.5mm

To order, please visit the ClearCorrect Online Store.

 

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ClearCorrect is a medical device manufacturer and does not practice dentistry. The treating physician is solely responsible for prescribing and administering orthodontic treatment. Clear aligner therapy is unpredictable. ClearCorrect does not guarantee a successful treatment outcome. Individual results will vary.

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