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    How to simplify interproximal reduction

    How Komet USA’s DISCtance™ IPR System offers a new and improved option for interproximal reduction procedures.

    Interproximal reduction (IPR) involves the selective removal of enamel from the contact surfaces of teeth, usually incisors. A viable alternative to tooth extraction, IPR is particularly suitable for adult patients undergoing braces or aligner therapy.

    IPR is an indispensable component of successful orthodontic treatment, and it has a range of indications. These include correcting tooth size discrepancies in the upper versus the lower arch, eliminating crowding, and increasing the stability of orthodontic-treatment results by lengthening the contacts between teeth, especially in the lower incisors. The most common uses for the procedure are to correct a Bolton Discrepancy, to help upright teeth, to relieve crowding and to reshape teeth to close black triangles:

    Bolton Discrepancy: The mesiodistal widths of the teeth are measured to determine if there is a discrepancy between the size of maxillary and mandibular teeth. Often, small lateral incisors, large lower incisors or oversized premolars can create less-than-optimal inter-arch relationships. Small reductions can be made to several teeth to balance these discrepancies, allowing the doctor to achieve a Class I canine and molar relationship with ideal overjet and overbite.

    To help upright or “lingualize” teeth: Performing IPR on flared upper and/or lower incisors, followed by closing the resultant space on round wires, can improve esthetics and anterior coupling.

    To relieve crowding: IPR can aid the alignment of moderate to severe crowding by creating extra space to move or rotate teeth. IPR is also extremely helpful in aligner cases.

    To reshape teeth to close black triangles: Fan-shaped teeth that are wider at the incisal aspect are oftentimes associated with “black triangles,” small spaces that form between the interdental papilla and the base of the contact in incisors, effectively ruining an otherwise perfect orthodontic finish. Much like a carpenter sanding two pieces of wood in order to form a tight joint, teeth can be reshaped to create longer and more esthetic contacts.

    A variety of options is available for performing IPR, including interproximal strips, IPR strip systems (Fig. 1), mosquito burs, reciprocating IPR systems (Fig. 2) and rotary discs (Fig. 3). Some methods can be unpredictable, time-consuming, uncomfortable for the patient, and awkward for the doctor. Specialized rotary discs (used with a slow-speed handpiece) offer the fastest and most comfortable option. 

    Fig. 1Fig. 2Fig. 3

    Fig. 1                                                                             Fig. 2                                                                             Fig. 3

    Next: See one IPR system in action

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