How to Perform Interproximal Reduction (IPR)

Interproximal Reduction (IPR) is a process of removing enamel from the mesial-distal aspects of the teeth to reduce the width so that teeth can be aligned.

In the video and outline below, we will review the equipment and steps needed to perform interproximal reduction (IPR). 

Required Tools & Supplies

To perform IPR, you'll need the following tools: 

  • Scaler
  • Mirror and Explorer
  • Diamond IPR Strip
  • Mosquito IPR Bur
  • High-speed handpiece
  • IPR gauge

Print the IPR Summary

It is helpful to have the sheet printed out with the instructions of where IPR will be done and how much IPR is at each location.

IPR with High-Speed Handpiece

For IPR that is greater than .5mm, it is helpful to use a bur at high speed to complete the procedure.

  1. Lay the patient back
  2. Visualize the contact
  3. When approaching the contact, it is important to hold the handpiece and bur parallel to the contact of the tooth.
  4. Once the posterior IPR is complete, take your mirror and visualize the contacts to ensure it is broken all the way through.
  5. It is also helpful to take an explorer or scaler to double-check that no ledges are present between the contacts.
    • Any ledges will prevent complete space closure.

IPR with Diamond Strips

Once the posterior IPR is complete, we can begin with the anterior IPR.

The preferred method of anterior IPR is using diamond strips. Each strip is about a tenth of a millimeter.

  • TIP: Because each diamond strip is 0.1mm, folding it back on itself will give you an easy way to measure 0.2mm of IPR.

  1. Take the strip and slide it between the contact.
  2. Once broken through, move the strip back and forth until the contact is completely broken through.
  3. Turn the strip around in the other direction and repeat the process for the adjacent tooth.
  4. Proceed to the other contacts and repeat the process.
    • It is important to move the strip gingivally to ensure you have broken through the contact completely.
  5. Once the IPR is complete, clean the contacts with a cotton roll.

Check IPR with Gauge

  1. Using your IPR gauge, find the thickness of the IPR you just completed.
  2. Use the gauge to measure and ensure that adequate IPR has been performed
    • If additional IPR is needed, take the strip or the high-speed and go back and repeat the process until enough IPR has been accomplished.
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