For information on IPR (Interproximal Reduction), refer to following:

• Definition
• Additional Information
• Performing IPR

Definition

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.

IPR is used to create space between teeth by reducing the proximal surfaces of the teeth, when needed or called for in the treatment plan, during clear aligner treatment.

IPR can also be used to break Tight contacts

Before you do anything check your Treatment Plan 

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

 Check the treatment plan included in the box with the aligners. Here, the 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.

Additional Information

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.

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.

Performing IPR

The following is a step by step instructional video on how to perform IPR:

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.

When performing IPR its recommended in the following increments:

• 0.1mm on an anterior tooth
• 0.2mm on an anterior tooth
• 0.2mm on a posterior tooth
• 0.3mm on a posterior tooth

0.1mm on an anterior tooth

To perform 0.1mm on an anterior tooth, perform the following steps:
NOTE: You will need the following parts: 

• Medium diamond strip (view item)
• IPR gauges

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



2.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.



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



4. Take the 0.1mm gauge and place in between the two teeth to verify the correct amount of space.

NOTE: If the gauge does not fit in between those teeth, continue to file between the tooth surfaces until the desired result is reached.

0.2mm on an anterior tooth

To perform 0.2mm on an anterior tooth, perform the following steps:
NOTE: You will need the following parts: 

• Upper or lower-coated diamond disc (view item)
• IPR gauges
• Optional: Fine or extra-fine diamond strip (view item)

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.

1. Line up the disc parallel to the contact area.



2. 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.



3. 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.



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



5. 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

To perform 0.2mm on an posterior tooth, perform the following steps:
NOTE: You will need the following parts: 

• Upper or lower-coated diamond disc (view item)
• IPR gauges
• Optional: fine or extra-fine diamond strip (view item)

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.

1. 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.



2. 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.



3. 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.



4. 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

To perform 0.3mm on an posterior tooth, perform the following steps:
NOTE: You will need the following parts: 

• Double-sided diamond disc (view item)
• IPR gauges

1. 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.



2. 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.



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