In a recent survey, we asked ClearCorrect providers to share their tips & tricks for performing IPR. As you'll see, we got a wide variety of responses, some of them contradictory. Everybody has their own preferred techniques.
Today, we're passing on some of the responses we got. Nothing here should be taken as official advice or recommendations from ClearCorrect or its employees—use your professional judgement to evaluate what's best for you and your patients.
Tools for performing IPR
Based on our responses, the most popular tools for performing IPR are diamond strips, followed by burs and diamond discs.
Doctors who prefer strips said:
- “Floss first then diamond strip.”
- “I usually underprepare the IPR so that the reduction gauge is difficult to fit between the teeth. If needed, more can be done later, often with a finishing strip, so that a closed contact can be reliably achieved.”
- “I generally do IPR with manual strips every six weeks until contacts are not tight. I don't think this is better I am just more comfortable with this.”
- “Pre-wedging prior to IPR and starting with strips prior to discs.”
“IPR first with hand strips. Also, I find it easier to IPR when teeth are aligned first in the contact areas.”
- “Start with the thin stainless steel strips and switch to the thicker carborandum strips as contacts become less tight.”
- “I like to use a long finishing diamond to do IPR because I think it gives me more ability to maintain ideal proximal tooth contours.”
Doctors who prefer burs said:
- “I find it’s easier to do IPR with burs as opposed to discs and strips. The smallest bur that I have found for 0.3mm is the mosquito interproximal from Neo Diamond. #1416f”
- “I prefer a mosquito diamond to discs for IPR. I feel like I can shape it better.”
- “I use ContacEZ high speed mosquito bur 1.6mm x 5mm length.”
- “Mosquito burs are much easier to use and safer than discs, especially posteriorly.”
- “I use a Brasseler mosquito bur from the cervical incisal to prevent lodging and make sure contact is completely broken.”
- “I have stopped using the discs and use the mosquito bur to open the contact at the correct angle then I also use it to provide the correct proximal contours. Then I use the strips to finish to final IPR spacing and polish.”
- “A high speed air turbine and bur seems to be the quickest and most controlled method.”
Doctors who prefer discs said:
- “Start with low speed and stay in clear vision and control of the procedure. I use loupes 3x or microscope to do it.”
- “It’s important to reduce straight (not angulated) and to carry the separation through the contact areas.”
- “I use a slow speed straight hand piece with a VisionFlex disc. Fast and smooth and has many uses. You must be very careful.”
- “Have different sized discs.”
- “Just remember to use a guard on the wheel.”
- “Use reciprocating files when extremely crowded and then rotary diamonds.”
- “Use Brasseler perforated diamond disc - tissue guarded mandrel is an absolute must use.”
And some doctors prefer other tools:
- “Always use diamond floss.”
- “Use a combination of diamond discs on the slow speed hand piece with a soft tissue guard. Measure the amount of reduction done. Finish the IPR with hand strips. Check with an explorer to make sure that there is not a ledge left. Before starting any case involving IPR, inform the patient that it is needed.”
- “I use a Komet, USA IPR kit with a reciprocating hand piece and safe tips. Then I finish with diamond strips to smooth and finish and contour. The gauges to confirm amount removed are integral as well.”
- “I routinely perform IPR with a high speed hand piece and tapered carbide bur in conjunction with fixed appliance treatment. IPR occurs after separation of the contact points, and is performed on molars, bicuspids, and cupids as needed.”
- “Use a high speed with a needle fine diamond. Check with the spacer key. Then round off the edges with the Diamond to restore anatomy. Done.”
- “Get the electric wiggle saw. I do not know the name. Safe and effective.”
- “On an extremely tight contact, I will place a separator for a few minutes prior to IPR. When I remove it and perform IPR, the patient is more comfortable and the strips do not break as often.”
- “I use an oscillating hand piece made by Komet. It's easy to use and relatively comfortable for patients.
General thoughts on IPR
Some doctors prefer to perform IPR after aligning teeth, some from posterior to anterior and some prefer to perform IPR after arch expansion to allow access. Here are a few general tips from providers:
- “Measure, re-measure, recheck before IPR, and also during the process.”
- “Under IPR rather than over IPR.”
- “The trick is to have the ClearCorrect technicians expand the arches to create more access to the area that is supposed to get IPR. I do use a mosquito nose diamond from SS White. It’s called a piranha diamond very fine, ISO FG# 392-016.”
- “Do the posterior first, then anterior later.”
- “Use a steady hand to be sure you don't open up too much space. I've used local anesthesia before on very sensitive patients.”
- “Always use a gel topical anesthesia on the soft tissue, acts as a lubricant as well as anesthetic. And separate the teeth with a soft flexible wedge. It eases access and protects the soft tissue.”
- “I like to use topical fluoride after IPR, trying to re-mineralize the cut enamel.”
Thanks to all of the providers who answered our survey. We hope you found something useful here.
Check out our Help Center for more helpful information on treating your patients with clear aligners and don't miss our upcoming advanced training webinar on IPR or our advanced training series of webinars on various topics related to clear aligner treatment.
Until next time…