Chairside “Pre-IPR” Invisalign: Performing IPR Before the Scan and ClinCheck to Convert a Complex Case into a Moderate One

Introduction

• Dr. Amanda from Straight Smile Solutions introduces an alternative workflow for Invisalign IPR.
• This approach was developed after a real-world question from a doctor and technician review.
• Chairside Pre-IPR focuses on completing IPR before the scan or ClinCheck setup.
• The goal is to improve predictability, efficiency, and treatment outcomes.

Chairside Pre-IPR Workflow (Point Form)

• Why Chairside Pre-IPR
  • Ideal when IPR is clearly needed due to:
    • Bolton discrepancies
    • Space requirements without proclination or expansion
    • Avoiding extractions or sequential distalization
  • Especially useful in cases with:
    • Crowns or veneers
    • Missing teeth
    • Non-adjacent contacts where Invisalign will not auto-prescribe IPR
• Traditional vs Chairside IPR
  • Traditional method:
    • Invisalign recommends exact IPR locations and amounts
    • The doctor must execute precisely after the trays begin
  • Chairside Pre-IPR method:
    • IPR is done before scanning
    • The scan captures the actual space created
    • Aligners are designed to close the existing space
• Clinical Advantages
  • Higher accuracy and predictability
  • Less stress about hitting exact decimal measurements
  • Invisalign closes the space regardless of minor over- or under-reduction
  • Reduced risk of refinements related to IPR inaccuracies
• Accuracy Considerations
  • Exact measurements are less critical than balance and symmetry
  • Avoid uneven reduction that could cause anterior collisions
  • If needed, additional IPR can always be added later
• Alternative Workflow Option
  • Scan first → identify need for IPR → create a duplicate (“dummy”) case
  • Perform IPR → rescan → submit final case
  • ClinCheck now focuses only on space closure, not space creation
• Impact on Case Complexity
  • Pre-IPR simplifies tooth movement requirements
  • Converts many complex Invisalign cases into moderate ones
  • Improves efficiency for both doctor and lab setup

Conclusion

Chairside Pre-IPR is a practical, efficient Invisalign strategy that enhances control and predictability. By completing IPR before the scan or ClinCheck, doctors allow aligners to work with real space rather than theoretical estimates, often simplifying treatment plans and improving outcomes.