How to and how not to...

Some hints and tips to make everyone's life a little easier.

IPR - Best practice

IPR (interproximal reduction) is a procedure where, by reducing the proximal surfaces of the teeth, a very small amount of space between the dentition is created to allow the teeth to move during treatment. IPR is often recommended when treating patients with clear aligners.

There are a number of important things to keep in mind when you perform IPR.

Know before you go

- The amount and location of IPR will be recommended by 3Dalign, but those recommendations are not absolute.

- IPR is always at the discretion of the clinician and it’s up to you to make any necessary changes.

- Don’t do IPR where there’s already space.

Confirm interpoximal space created by using an IPR thickness gauge.

Using attachments

Attachments are composite shapes added to the teeth to engage the aligner and assist with movements. They act like small handles for moving teeth. Attachments are often recommended when treating patients with clear aligners.

There are a number of important things to keep in mind when you need to place attachments.

- Review the treatment plan sent with the case or the treatment setup to see if attachment placement is recommended at this appointment.

- Acid etch only the area beneath the attachment.

- Trim the template(s) if desired.

- Remove the template and any composite flash

Tips for good impressions

A high-quality impression is the foundation of a successful case. Whether for a submission or a revision, accurate impressions are vital to ensuring that treatment is effective and time-wasting delays are avoided.

The most common problem that we find is a double impression, which usually happens during a 2-step impression.

The easiest solution is to switch to a simpler, more reliable 1-step impression material.

Another big issue is distortion of the most distal teeth in the impression. It can be hard to see back there, and sometimes the posterior teeth get shortchanged.

There are a couple of ways to avoid this problem:

Make sure that you're using a correctly-sized tray. It should extend past the last tooth in the arch without touching the gums.
Before inserting the tray containing light body, add some light body directly to the occlusal and distal portion of the last tooth in the arch, ensuring that the last tooth is completely covered with material.

Wear Schedules

We would recommend that the patient only removes the aligners to eat and clean. It is important to get across the issue that as long as the aligners are not being worn the teeth are moving back to their original position.

Treatment Guide