This is a step by step guide on how to perform IPR fast, easy and predictable on your clear aligner patients.
Step by step
Start by using a perforated red metal strip to loosen the contact points - a single pull through the contact point is usually enough.
We recommend using the Dentatus IPR tips in a Profin PDX or EVA contra-angle handpiece. The Dentatus tips are the only calibrated tips on the market.
Start with the 0.1 mm. tip and move upwards step by step until you have reached the amount of IPR you need.
Use the 0.1 mm. tip to polish the surfaces at the end.
Apply fluoride varnish (My personal favourite is Fluorprotector S from Ivoclar)
To be as effective as possible, I use each tip for all the intervals they are needed before switching to the next tip. Remember to keep an eye on when to stop ( i.e. if there is a difference in the amount of IPR in the different approximal spaces)
Fast and predictable
With the method and equipment shown, it is possible for us to achieve 0.3 mm. IPR in 7 different locations in less than 5 minutes.
Since the Dentatus tips are calibrated, there is no need to measure the spaces created. Which makes the system fast and predictable to use.
Morphology
The wide plate of the IPR tip makes it easy to ensure that the full length of the teeth is properly corrected. So there are no small overhangs or inaccuracies that can prevent the teeth from moving according to the treatment plan.
The morphology is not worsened by using a wide tip. Because if you need 0.5 mm. IPR, the teeth will almost always be more square - no matter which IPR system you use. Here you just have to adjust the surface of the teeth after performing the desired amount of IPR.
Surface rounding
A quick way to round the surfaces facially and orally is to use a red "American football shaped burr". Simply insert the tip perpendicularly into the space between the teeth and pass it up through the approximal space in one sliding motion.
Equipment
Since we work for dentists in 15 different countries, we do not have an overview of which dental depots are distributors of Dentatus tips. Therefore, we have made an agreement with the Dentatus factory, so you can order the equipment shown directly from Dentatus through us. Simply download the order form below and send it to helle@alignerservice.com and we will arrange for Dentatus to send your ordered items immediately.
Risk during IPR
I think it is essential to remember that teeth are mobile when we perform IPR.
When the teeth are able to move, it can potentially give an erroneous picture of how much IPR is performed. If you use the typical instruments, you have to constantly measure whether you have achieved the desired amount of IPR. When the measuring instrument is pressed between the teeth, the teeth can move, giving us an impression that the amount of IPR we want has been performed.
When using measuring instruments, it is therefore important to find the balance between pressing the measuring disc between the teeth and letting it slide without resistance.
Problems arise if too little enamel is removed and a posterior open bite occurs as a result. Now you have to perform more IPR. But as there is only 0.6 mm of enamel in the approximal spaces on the incisors in the lower jaw, it starts to get a bit challenging. Because it is impossible to know where too little IPR was performed.
If we get through the enamel and into the dentin, there is a pronounced risk of approximal caries. I want to avoid that risk by doing the right amount of IPR the first time and thereby decrease the risk of a posterior open bite and the need for refinements. I find this easiest with the tips shown from Dentatus.
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Many kind regards
Jesper Hatt DDS
Phone: +41 78 268 00 78