Stephanie
Chief Complaint:
Teeth becoming more crowded
It looks like Stephanie is progressing well. After checking the contacts with floss we discovered several areas with tight contacts. Using the “sequential/incremental” method to execute interproximal reduction (IPR), we elected to perform IPR at these tight contacts. The tight contacts were at contacts 22-23, 23-24, 24-25, 25-26, 26-27. The IPR prescription approximation called for a total of 0.3mm IPR at each of these contacts.
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At a prior visit, 0.10mm of IPR was performed and recorded in the patient’s charting records. For this sequential appointment we will perform an additional 0.10mm of IPR at each of the “tight” contact sites listed above. This will leave 0.10mm in “reserve” for future IPR. In the event that the indicated contacts were not tight, as evidenced by flossing, no additional IPR would be performed. In this manner we will check the contacts at each sequential monitoring visit and perform the IPR in small increments.
The IPR is performed with a slow speed hand piece using a straight shaft lab diamond coated disc. We will use a disc that is 0.10mm in thickness. The disc can then serve as the measurement gauge of the IPR cut.
It is very important to use a good finger rest, and think carefully about the rotation of the disc so that soft tissue is always protected. It is best to use “variable” speed to slowly work through the contact from the incisal/occlusal to the gingival. Proper technique requires that the disc be held parallel to the long axis of the tooth to reduce the possibility of cutting inadvertently into the adjacent tooth.
The cut interproximal surfaces were polished with Sof-lex discs as the contact is accessible. Once again floss is used to check the contacts for any interproximal ledges that might result from not taking the cut fully through the proximal tooth structure.
Stephanie was given her next aligners #13,#14,#15, with instructions to wear them 24/7 and change each aligner after two weeks of wear. Stephanie is doing well, her teeth are tracking nicely and she is scheduled to return for a monitoring visit in 6 weeks.
