For information regarding insufficient space, refer to the following:
Insufficient space is when there is not enough room in the arch to align the teeth. For further information, also refer to insufficient pressure.
When you prescribe your case, you can plan to create space with extraction, arch expansion, proclination or IPR, depending on how much space is required. However, despite prediction and planning, there may be some instances where insufficient space will still be an issue.
For example, when teeth crowd each other there may be tight contacts between them. Tight contacts between teeth are common and exist naturally due to the patient's dentition. The teeth are so crowded, they press up against each other, and literally put each other under pressure. You can try to relieve this pressure by creating space (for instance, by performing IPR).
If there's enough pressure, the surrounding teeth may just move in to fill the space you’ve created. If this happens, you may need to create more space than originally intended. If this is not caught and addressed, it can prevent treatment from going forward as planned because the rest of the movements no longer have sufficient space to straighten out. This can result in treatment going off track and the aligners no longer fitting.
You can check for tight contacts by running floss between the teeth. If the floss has a hard time popping in and out, then you know that you have a tight contact. (If the floss pops in and out easily, then you have light to moderate contact.) With tight contacts preventing tooth movements, your solutions are:
- Hand stripping/IPR
- Revise treatment to request expansion or IPR
TIP: Always rack the amount of IPR being done. We offer an IPR tracking chart for this purpose.
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