IPR Tips & Tricks

Pre-IPR Evaluation by the Doctor

• Decide if the recommended IPR should be performed at this appointment or postponed to a future visit.
• Identify which tooth surfaces need to be contoured.
• Choose the appropriate tools and techniques for the procedure, such as abrasive strips or single/double-sided discs.
• Remember that doctor has control over timing, location and amount of IPR performed

Pre-IPR Staff Preparation

• Upon seating the patient for new aligners, review the treatment setup or plan to determine if IPR is advised during this session.
• Ensure that the patient or their guardian comprehends what the IPR entails.
• Arrange all instruments as specified by the doctor.
• Confirm and note the exact locations and dimensions for the IPR 

Conducting IPR

• Avoid performing IPR in areas where there is already spacing.
• Always verify tooth contacts before proceeding:
  • Use dental floss to check for tight contacts; presence indicates good aligner compliance and the treatment can proceed.
  • Absence of contact suggests possible non-compliance; in this case, instruct the patient to continue wearing the current aligners for an additional 1-2 weeks and reassess at the next visit.
• For use with a slow speed disc, ensure safe and clear access to the IPR sites:
  • Consider using a disc guard for difficult-to-reach areas.
  • Start with the back teeth and move forward.
  • Use a low RPM initially to achieve the correct angle, then increase RPM for effective reduction.
  • Have an assistant direct a stream of air/water at IPR location to clear debris.
  • Regularly monitor both the front and back sides of the teeth to prevent excessive reduction.
  • Apply gentle pressure; allow the abrasive instruments to do the work.
• To achieve the specified amount of IPR:
  • Use abrasive strips for 1 mm of reduction: 0.08mm (extra fine), 0.10mm (fine), or 0.13mm (medium).
  • Use a one-sided disc for 2 mm, and a double-sided disc (0.15-0.2mm thick) for 3 mm, by moving it back and forth until the desired spacing is achieved.
• After reduction, pause to check if the contact is completely eliminated.
• Ensure complete separation during the reduction; you will notice less resistance and slight blanching of the gum.
• Verify the new space with an IPR gauge.
• Refine the tooth shape post-IPR:
  • Angle the reduction properly to maintain the tooth's aesthetic.
  • Inspect the contoured surfaces for any irregularities using an explorer or floss.
  • Smooth any sharp edges with diamond burs or abrasive strips.
• Record the details of the IPR performed, including the extent and specific locations. Following these guidelines will help ensure a smooth and efficient treatment session as you prepare to provide the patient with their next set of aligners.