Note: Please join our IPR webinar on July 11th where we will be giving away a free FitStrip® Kit, value $199! Visit https://www.straightsmilesolutions.com/media/ to register.
IPR stands for interproximal reduction. It is the process of creating very small amounts of space between teeth to improve crowding, midlines, or overjet.
This blog is intended to serve as a general guide and is in no way a comprehensive instruction manual for performing IPR. As always, doctors must rely on their own best judgement. When you create your treatment plan, be mindful of interproximal restorations, bridges, crowns, implants, and veneers that may be damaged if modified with IPR.
Before you do anything, check your treatment plan for the staging and localization of your IPR. Some doctors prefer to stage all of the IPR at the beginning of treatment, while others prefer for the teeth to align first (round-tripping).
1. Garrison IPR Fit Strip Kit with IPR gauge and 2 serrated saws
*remove the single sided if you have them
2. Unwaxed Dental Floss
3. Fluoride (optional)
Isolate the tongue, lips, and cheeks. Protect the patient’s soft tissue with a mirror and cheek retractor.
· Tie one end of the floss to the Strip handle for safety and let it hang outside of the patient’s mouth.
· Check for fully broken contact using unwaxed dental floss. Keep track of IPR performed by using an IPR Chart.
Start with the serrated saw locked in the straight position to open the contact. For anterior teeth, you can use the handle, if you prefer.
Once you open the contact, gently work your way up the sequence of files in the locked and straight position, and STOP when you are at least 1 file smaller than the size you actually need. Gently move the strip backward and forward between the teeth along the contact area in a sawing motion. It takes roughly 8-12 motions, but the precise number is ultimately dependent upon each individual patient.
Verify the size with the IPR gauge. Note: not all IPR gauges are calibrated. We recommend using only the Garrison Dental Fit Strip Gauge for ideal accuracy.
Once you obtain the size of the space that is 1 size smaller than you need, curve the strip and lock it in the curved position. Then, work your way BACKWARD down the file sequence from coarse to fine around the contacts in order to round them. Measure the space again. The finishing and polishing process will remove a very small amount of enamel too, so it’s important to save at least -.1mm for finishing and polishing.
Make the gauge one size smaller than you need, and place it in between the two teeth to verify the correct amount of space. If the gauge does not fit in between those teeth, continue to file between the surfaces of the teeth until the desired result is reached.
The Fit Strip IPR kit is the only one that actually locks in the curved position to prevent hand fatigue.
Is there a limit to the amount of IPR that can be done?
Yes, there is a limit to the amount of IPR we would do on any one interproximal space during the course of a treatment, except if a revision was submitted and the doctor asked for more IPR. As a rule, we recommend no more than 0.5mm per interproximal space.
Instructions for cleaning and sterilization:
1. The FitStrip should be brushed clean with water and soap or a cleaning solution of your choice.
2. The FitStrip is suitable for ultrasonic baths if appropriate clamping implements are used to prevent instruments from touching.
3. Avoid excessive touching of the strip, and ensure all debris is removed prior to use. Each strip must be washed and disinfected before every use.
4. Strips can be vapor-sterilized in an Autoclave with steam at 273°F (134°C) for 5 minutes.
StraightSmile Solutions® supports doctors with all orthodontic treatments, including but not limited to functional appliances, braces, hybrid treatment, habits, lab selection, airway and of course- aligners! Our goal is to find you the right solution for your case and your treatment philosophy and budget. We support you with everything you need: case selection, treatment planning, team training, staging, compliance, operations, outcomes, and retention. We also help to train doctors and teams with hands-on courses that are both digital and destination. For more information visit www.straightsmilesolutions.com. Disclaimer: StraightSmile Solutions® is unable to support any direct-to-consumer operations or doctors at this time.