During your Invisalign consultation and/or throughout the course of treatment there are several procedures that you may hear mentioned, that should be explained to you in advance. These procedures help the dentist predict movement of your teeth and ensure you receive the best result possible.
Interproximal reduction is often necessary during Invisalign treatment in order to predict and deliver a successful outcome. Interproximal reduction, known as IPR, is the removal of enamel on the interproximal portion of the teeth. IPR is often necessary in order to create space within a moderately crowded arch without the need to remove teeth. It may also indicated when correcting a tooth discrepancy or reducing the appearance of dark interproximal triangles. Accurate reduction can be recreated from the digital file to inside the patient’s mouth. If too much reduction is performed, spaces will be created in the patient’s mouth that were not prescribed, resulting in prolonged treatment, mid-course correction, or refinement. Interproximal reduction is performed incrementally throughout treatment. It is a simple procedure accomplished with the use of diamond strips, slow speed diamond discs, and small finishing burs. It is extremely important to use caution when performing interproximal reduction with diamond discs. They have a high torque and can cause unnecessary iatrogenic trauma to the tissues if not properly isolated. Incremental gauges of 0.1mm provided by Invisalign, are used to indicate interval thickness. All IPR should be tracked along with exact location and thickness in the patients chart and kept as part of their dental record. Flossing the area in which the IPR was performed at each visit with ensure there is adequate space to accomplish the movement indicated. The smallest amount, 1/100th mm of space, can be enough to move a tooth to the desired position.
Attachments or buttons are auxiliary tools used as anchors to help grip the tooth/teeth and aid in more advanced movements. They are composed of a composite resin and are bonded to the teeth temporarily. The composite resin is usually translucent or a similar shade that closely matches your natural tooth structure. These attachments are not removed with the aligners daily, so there will be a small amount of material you can feel when your aligners are not in place. During your initial visit or soon after the dentist will use a template to attach the buttons to your teeth in the exact location in which the aligners will engage. Sometimes the attachments/buttons will be removed during treatment and placed in a different location. These auxiliary tools aid in movements such as extrusion, intrusion, and rotation to name a few. Once your treatment is complete, the attachments are polished off, leaving no damage to the tooth structure. It is important to understand the placement of the attachments if necessary during the course of your treatment, so you are aware prior to and during your treatment. You should monitor the attachments to ensure they are engaging the aligners properly and maximizing tooth movement throughout your treatment.