With the increased popularity of aligner therapy and its improving effectiveness in contemporary orthodontics, interest in enamel interproximal reduction (IPR) has grown, as it is being considered as one of the major space-gaining orthodontic procedures.
Upon submitting the prescription form, if we select all three ways to create space in a nonextraction crowded condition, IPR will be the default, last consideration. If space was not sufficient after dental arch expansion and anterior dental proclination , IPR will be indicate. This is a nonreversible clinical procedure and has to be indicated with care .
Enamel interproximal reduction (IPR), extractions, increase in arch perimeter with distalization, buccal arch expansion, or incisor protrusion are important therapy strategies to solve dental crowding
IPR is an adjunct clinical procedure involving the reduction, anatomic recontouring, and protection of proximal enamel surfaces of permanent teeth
The procedure of IPR entails approximately 0.3–0.5 mm removal of the outer enamel on the interproximal surfaces of teeth. It mainly allows gaining space to relief mild to moderate dental crowding and facilitate tooth movement and alignment when extraction is undesirable
Enamel reduction in the premolar and molar area can provide up to 9.8 mm of additional space for the realignment of mandibular teeth
Other claimed advantages include reduction in treatment time , providing greater contact point areas therefore greater stability and reduction of open gingival embrasures (black triangles) , and achieving treatment objectives without compromising the integrity of periodontal and dental tissues
the actual procedure of enamel reduction can be performed using several techniques: discs, strips, or burs, and is largely dependent on clinicians’ skills and comfort
IPR is contraindicated in cases in which this procedure was done in previous orthodontic treatment, in cases with thin and slender dental anatomy, or in cases where there is poor oral hygiene or other enamel defects such as dental imperfect
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