As dentists, we almost always recommend orthodontic treatment from a functional perspective. Patients often invest in orthodontic treatment from an aesthetic perspective.
Since aesthetics is a luxury segment, it's worth considering how you plan your delivery protocol (and your treatment pricing). It's essential to provide patients with an extraordinary experience that doesn't differ greatly from a normal consultation, but still gives the patient the feeling that embarking on an aligner treatment is something special. This ensures a greater likelihood of a positive approach to both the treatment and the dental practice.
IPR after 4 weeks with clear aligners
Part of the patient experience when dispensing aligners can be the performance of IPR.
Many patients have a need for IPR.
When planning clear aligner IPR, we always recommend that the first IPR is performed after 4 weeks at the earliest.
As I've written about before, there are several good reasons to wait 4 weeks before bonding attachments/engagers. So in that way, the timing of IPR at 4 weeks fits well with this procedure.
After 4 weeks, the patient has shown us that he or she is able to tolerate using their clear aligners. Furthermore, the patient has shown their level of compliance.
Avoid problems with IPR
Imagine having performed 0.5 mm. IPR between all the teeth in the front of a patient's lower jaw. After 4 weeks, the patient comes back and says she hasn't used her aligners much and doesn't want to continue the treatment because she can't stand having the aligners in her mouth....
Avoid losing time, money and reputation
How would you feel about a patient who does not want to continue with the treatment and you have removed 0.5 mm of enamel in all the spaces in the mandibular front?
One is that it's quite difficult to close the gaps again. Another is that it's difficult to charge for it, because if you do, this type of patient is likely to spread a bad reputation about the dental practice online and offline.
If the patient regrets
It is extremely rare that patients can't bear to wear their aligners. However, there are a few patients who can't come to terms with wearing the aligners. Even if it's negligible, it's a shame to spend time and energy trying to solve a problem that could have been completely avoided if you had exercised proper care in your treatment planning.
Mobility makes IPR easier
After 4 weeks, the teeth have started to become mobile, making it somewhat easier to perform IPR. With the right mechanical IPR instruments, it's now easy to achieve the ideal amount of IPR in just a few minutes.
Inform the patient that you will need to reshape the spaces between the teeth slightly and that it may feel a bit uncomfortable as it causes some vibration in the teeth. In rare cases, sensitivity to cold may occur during and for a short period after IPR has been performed.
Follow the instructions in the digital setup or CliniCheck.
Clinical tips for performing IPR
At AlignerService, we recommend the use of mechanical files that are calibrated so that the thickness matches the amount of IPR to be performed (Ex. 0.1 mm. 0.2 mm. 0.3 mm. etc.). This could for example be the Dentatus IPR tips for a Profin contra-angle handpiece. These are currently the only tips that are calibrated for any aligner system. This eliminates the need for measuring tools and serves as one of the most predictable and efficient IPR systems on the market.
Remember to polish the enamel surfaces after IPR. For this, we prefer soflex discs or the 0.1 millimeter Dentatus IPR tip.
After polishing, apply fluoride varnish.
Alternatively, a fluoride gel can be placed in the aligner.
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Jesper Hatt DDS
Phone: +41 78 268 0078
AlignerService helps dentists create realistic, safe and predictable treatment plans with clear aligners.
Currently, we help approximately 1500 dental practices in 19 different countries. AlignerService is a preferred partner of ClearCorrect.
In addition AlignerService clear aligner experts work with Invisalign, SureSmile and Spark.