My orthodontist is suggesting extractions but I have been told to look into IPR. I know only a small amount of tooth is removed during the "tooth shaving" so I'm wondering would that create as much space as extracting 2 premolars?
Thanks for any input
IPR to replace extractions?
Moderator: bbsadmin
Re: IPR to replace extractions?
short answer: IPR will NOT create the equivalent space of having 2 premolars extracted.
i actually asked this same question last year when i got my braces on as well! IPR is generally used for light to moderate crowding. if you have severe and in some cases, maybe even just moderate crowding, there's no getting around extractions. it's not just to relieve some issues of crowding, but your ortho is also thinking about other ways your teeth may move which may include making room for teeth to rotate or to work on the torque (angle) on the teeth as well.
my suggestion would be to bring it up at your next appointment with your ortho. a number of factors goes into deciding whether or not they would suggest extractions. Ask about IPR and how much of a difference that would make vs extractions. in addition, make sure you are asking for their OBJECTIVE medical opinion. hopefully that helps!
i actually asked this same question last year when i got my braces on as well! IPR is generally used for light to moderate crowding. if you have severe and in some cases, maybe even just moderate crowding, there's no getting around extractions. it's not just to relieve some issues of crowding, but your ortho is also thinking about other ways your teeth may move which may include making room for teeth to rotate or to work on the torque (angle) on the teeth as well.
my suggestion would be to bring it up at your next appointment with your ortho. a number of factors goes into deciding whether or not they would suggest extractions. Ask about IPR and how much of a difference that would make vs extractions. in addition, make sure you are asking for their OBJECTIVE medical opinion. hopefully that helps!
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SinkFullOfDinner
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Re: IPR to replace extractions?
Your ortho will know if IPR can free up enough space. That's a big enough issue that I'd be sure to get multiple consultations.
I was told by my ortho that it's ok to remove up to 0.5mm of enamel per side, so that adds up to a total of 1.0mm per tooth or between two teeth. Depending on how many teeth are involved, they can actually free up quite a bit of space. They usually strip incrementally, not all at once. So far, they've hit my top and bottom twice and it's involved all but two spots from molar to molar on top, and all but four on the bottom. Since it's been incremental, it's really been no big deal and they can still do a bit more if needed before they limit out. I had one consult suggest extraction and two that said they could accomplish what they needed with IPR. Obviously I went with the latter! But if the majority (and one I trusted most) had recommended extractions, I would have gone that path. Whatever the best plan calls for.
I was told by my ortho that it's ok to remove up to 0.5mm of enamel per side, so that adds up to a total of 1.0mm per tooth or between two teeth. Depending on how many teeth are involved, they can actually free up quite a bit of space. They usually strip incrementally, not all at once. So far, they've hit my top and bottom twice and it's involved all but two spots from molar to molar on top, and all but four on the bottom. Since it's been incremental, it's really been no big deal and they can still do a bit more if needed before they limit out. I had one consult suggest extraction and two that said they could accomplish what they needed with IPR. Obviously I went with the latter! But if the majority (and one I trusted most) had recommended extractions, I would have gone that path. Whatever the best plan calls for.