49
Fig. 14: Demonstration of the IPR procedure.
Fig. 15: The progress can be checked with
the IPR gauge.
Fig. 16: Composite engagers placed on the
teeth.
some of the patient’s teeth to create space
for movement or to help idealize tooth
position and occlusion. In the treatment
plan, the location and intensity of the
stripping is indicated.
Figure 13 is an example of the treatment
plan for a specific phase. I find diamond
disks are the most efficient method, but
diamond separating strips can be used
for the minor stripping cases. I would
also suggest getting the IPR gauge. This
is a collection of tabs in various thick-
nesses you use to confirm the reduction
requested in the patient’s treatment plan.
While performing IPR, I like to use a
wave wedge to protect the papilla and an
Optragate.
Figure 14 shows the diamond disk in use
with the wave wedge. These are great aids
to protect the soft tissue while using any of
the abrasive instruments. The proximal surface is adjusted with
disks, strips and Soflex disks until the IPR gauge slides in snuggly,
as seen in Figure 15. Usually, when the next set of retainers is ready
to be used, you will be asked on the treatment plan to confirm
closure of the contact area where you performed IPR.
The size and position of the engagers you place are controlled
by a separate set of trays. The engager template is only included
in your case package when engagers are part of the treatment
plan. To place engagers, it is a very simple procedure and the
template ensures accuracy. If you are comfortable bonding a
composite, you can place an engager. You can use the etching
material, bonding agents and composites you presently have in
your office to complete this procedure. You can see an example
Fig. 17: Patient progress with ClearCorrect.
of engagers in Figure 16 (they are minor bumps that the patient
accommodates to quickly). Figure 17 shows patient progress
utilizing ClearCorrect.
The combination of quick and easy full-arch scans and the
precision of the movements the ClearCorrect aligners perform
allows one to incorporate orthodontics in their normal treatment
options for their patients. Many times, it is not just a matter of
grinding away teeth and placing porcelain on them; it is amatter of
using orthodontics to create a more favorable environment prior
to prepping.
For questions or more information, Dr. Gardell can be reached at
.
