History
- Murray L. Ballard advocated for stripping lower anterior teeth in 1944.
- John J. Sheridan introduced the Air Rotor Stripping technique in the 1980s.
- IPR can be used as an alternative to tooth extraction or expansion.
- Zachrisson stated that IPR can improve the esthetics of anterior teeth.
- Modern diets of soft and processed foods have led to increased dental crowding.
Application
- IPR is an irreversible procedure.
- Indications for IPR include mild to moderate crowding, black triangles, retention enhancement, and correction of the Curve of Spee.
- IPR is contraindicated for patients with high caries risk, poor oral hygiene, periodontal diseases, multiple restorations, excessive crowding, hypersensitivity to cold, and large pulp chambers.
Amount
- Up to 50% of proximal enamel can be stripped without causing problems.
- Sheridan recommended 2.5mm of space from IPR of five anterior contacts and 6.4mm from IPR of eight posterior contacts.
- It is recommended to remove no more than 0.5mm - 0.75mm from each proximal side of anterior teeth.
Techniques
- IPR can be carried out using abrasive metal strips, diamond coated disks, or air-rotor stripping burs.
- Metal strips are suitable for rotated teeth.
- Diamond disks should be used carefully to avoid enamel undercuts or contact with soft tissue.
- Squared-off tips should be used with air-rotor burs to prevent furrows.
- Burs may produce a rough finish on enamel.
Side-Effects
- Excessive heat during IPR can damage the dental pulp.
- IPR has been associated with caries and periodontal disease, but the association is debated.
- Topical fluoride application or wearing a fluoride varnish-infused retainer can help limit side-effects.
- A study showed that fluoride application after IPR reduced the risk of caries.
- Observational studies found no signs of gingival recession or thinning of the labial gingiva in most patients who underwent IPR.