Avoid IPR by Widening Arch?

Question

Can IPR be avoided by widening or reshaping the arch of top and bottom teeth during refinement? I already had over 4 mm of IPR total done during the initial express treatment to address protrusion and crowding that did not work as well as expected and would like to avoided any further IPR. Is this an valid option I could let my ortho know? My arch is of a V shape now. Can it be changed to a U shape - in other words are there any limitations of arch widening with Invisalign?

Michael J. Thomas, DDS · Answer

No days its done automatically in the Clinchek or program built into your treatment. If you do a refinement then for sure have them widen the arch first and do IPR second. They may be able to do the IPR in a different place other than where you've had the IPR before. .4 and .5mm is really the most we like to do. but there's still ample enamel left after that is done..Be sure and get a flouride treatment when your treatment is finished to harden your enamel....

Robert Waxler, DMD, MS · Answer

No orthodontist wants to do a lot of expansion (unstable), or a lot of IPR (too much can damage the teeth) or extraction of teeth.....nonetheless these are the major ways space is created for crowding and reduction of protrusion...Bottom line you have to get the space somehow so every option is a trade-off. You need to go over this with the doctor

Kent Lauson, DDS, MS · Answer

Although Invisalign aligners can get some widening, it is mostly alveolar in nature. However, you can get massive true bone widening through the use of dentofacial orthopedic appliances such as a Schwarz appliance. Only a small percentage of orthodontists use these techniques on adults, and they do so with slow activations, one to two a week. Over a 4-6 month period as much as 8mm of expansion can occur giving you that wide U shaped archform. This can not only eliminate the need for IPR but can eliminate extractions in most cases. After the expansion takes place, Invisalign can take over and get you the great result you want, a beautiful Movie Star like smile.

Gabriela Hricko, DDS · Answer

Hi-- Invisalign is very good at reshaping arch forms as long as the tooth movement is not too great. Invisalign is good at this type of dental expansion. This expansion also gives patients a broader smile which is nice and many of my patients want this for their smile.

Doug Depew, DMD, MS - Account Suspended · Answer

Typically refinement is limited to small movements.  And IPR is a primary way to accomplish that. Your doctor would need to specify that he/she wants arch shaping rather than IPR.  And that is only if it is appropriate for YOUR case.  For some situations it would not be advisable because of concerns for post-treatment stability and available bone to handle the re-shaping.  So having a discussion about it with your doctor before any new impressions are sent to the lab would be a good idea.

	Good luck.

Avoid IPR by Widening Arch?

Answers (5)