Abstract
Abstract Interproximal reduction (IPR) is the deliberate removal of part of the dental enamel from the interproximal contact areas, which decreases the mesiodistal width of a tooth. This enamel may be removed for various reasons, but most commonly to create space during orthodontic treatment or to correct tooth-size discrepancies. Several authors have also encouraged its use as a method by which post-orthodontic stability might be enhanced, particularly in the lower anterior region. With the increased use of removable aligners for orthodontic treatment in which non-extraction therapy is often advocated, the use of IPR becomes a valuable tool to relieve crowding without over-expanding the dental arches. It is possible that inaccurate IPR could result in the over-reduction of enamel, the creation of ledges and notches in the proximal surfaces, increased tooth sensitivity or damage to the surrounding soft tissues. However, carefully conducted IPR performed within the recommended guidelines may be used as a safe method to gain space for the relief of crowding, to correct tooth-size discrepancies and to improve aesthetics and long-term stability in selected orthodontic patients.
Highlights
Interproximal reduction (IPR) is the deliberate removal of part of the dental enamel from the interproximal contact areas, which decreases the mesiodistal width of a tooth.[1]
Interproximal reduction (IPR) is a technique that has been used in orthodontic practice since the 1940s
Its use is common in circumstances in which space is required to relieve crowding, especially when extractions are not wanted or not indicated. It is useful in these circumstances and can decrease treatment time compared with extraction therapy since the amount of tooth reduction achieved in one session corresponds exactly to the amount of crowding
Summary
Interproximal reduction (IPR) is the deliberate removal of part of the dental enamel from the interproximal contact areas, which decreases the mesiodistal width of a tooth.[1]. Its first reported use was to correct tooth-size discrepancies when aligning anterior teeth.[3] A ratio based on the mesiodistal widths of teeth in the lower arch in relation to the upper arch was created,[4] which determined how well the buccal segments would interdigitate (‘overall’ Bolton’s analysis) and Australasian Orthodontic Journal Volume 33 No 2 November 2017 whether the size of the anterior teeth would support the creation of a Class I canine relationship with acceptable overbite and overjet (‘anterior’ Bolton’s analysis). After a detailed space analysis, in cases in which there are discrepancies between the upper and lower dentitions, the teeth that are oversized may be narrowed by performing IPR. Cases in which a Bolton’s discrepancy is more likely include the circumstance when the patient has diminutive upper lateral incisors; when there are missing teeth; or when there are large, small or unusually shaped teeth in either arch.[4]
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