Information provided by KOMET USA.

	Interproximal reduction (IPR) involves the selective removal of enamel from the contact surfaces of teeth, usually incisors. A viable alternative to tooth extraction, IPR is particularly suitable for adult patients undergoing braces or aligner therapy.

	IPR is an indispensable component of successful orthodontic treatment, and it has a range of indications. These include correcting tooth size discrepancies in the upper versus the lower arch, eliminating crowding, and increasing the stability of orthodontic-treatment results by lengthening the contacts between teeth, especially in the lower incisors. The most common uses for the procedure are to correct a Bolton Discrepancy, to help upright teeth, to relieve crowding and to reshape teeth to close black triangles:

The mesiodistal widths of the teeth are measured to determine if there is a discrepancy between the size of maxillary and mandibular teeth. Often, small lateral incisors, large lower incisors or oversized premolars can create less-than-optimal inter-arch relationships. Small reductions can be made to several teeth to balance these discrepancies, allowing the doctor to achieve a Class I canine and molar relationship with ideal overjet and overbite.

To help upright or “lingualize” teeth:

 Performing IPR on flared upper and/or lower incisors, followed by closing the resultant space on round wires, can improve esthetics and anterior coupling.

 IPR can aid the alignment of moderate to severe crowding by creating extra space to move or rotate teeth. IPR is also extremely helpful in aligner cases.

To reshape teeth to close black triangles:

 Fan-shaped teeth that are wider at the incisal aspect are oftentimes associated with “black triangles,” small spaces that form between the interdental papilla and the base of the contact in incisors, effectively ruining an otherwise perfect orthodontic finish. Much like a carpenter sanding two pieces of wood in order to form a tight joint, teeth can be reshaped to create longer and more esthetic contacts.

	A variety of options is available for performing IPR, including interproximal strips, IPR strip systems (

), mosquito burs, reciprocating IPR systems (

). Some methods can be unpredictable, time-consuming, uncomfortable for the patient, and awkward for the doctor. Specialized rotary discs (used with a slow-speed handpiece) offer the fastest and most comfortable option. 

Fig. 1                                                                             Fig. 2                                                                             Fig. 3

	The newly introduced DISCtance™ IPR system (Kit 4671) from Komet USA (

) features a range of specially designed stripping discs that ensure the amount of enamel is easily, efficiently, and precisely removed (usually 0.15/0.20/0.30 mm). 

	The DISCstance IPR kit contains three 0.15-mm-thick, fine-grit IPR discs in three coating versions: the RS15FV.HP.200 is coated on the upper side; the RS15FH.HP.200 is coated on the underside; and the RS15F.HP.200 is coated on both sides. The kit also includes the medium-grit 0.20-mm-thick RS20M.HP.200 and 0.30-mm-thick RS30M.HP.200 discs, which are coated on both sides. Using diamond discs with sequentially increasing thickness simplifies precise removal of the required amount of enamel. 

	Please note: The diamond-grit sizes for the DISCstance instruments were created based on an optimal ratio of the efficiency of substance removal and the resultant surface polishability of the tooth. Commonly used discs are generally too coarse for this application, often leading to iatrogenic plaque accumulation. 

Fig. 4                                                                                                        Fig. 5                    

	The DISCtance™ IPR System also addresses three issues associated with traditional rotary discs: durability, rigidity and precision. 

 The diamond-coated DISCtance discs keep their flat shape longer than traditional discs. 

Some traditional discs are too flexible, leading to durability issues, or they are too rigid, which can increase ledging and decrease control. The DISCtance discs are specially designed for optimal control, making them neither too flexible nor too rigid.

 Traditional discs only come in one thickness, and that thickness varies between discs; these stand-alone discs do not comply with recommended IPR specifications. The DISCtance IPR System includes five different discs for superior precision, and the thickness of each disc is based on frequent specifications in popular aligner systems.

	The patient is a 30-year-old female undergoing aligner therapy for mild, generalized spacing. The digital setup indicated that the patient would have black triangles between her maxillary and mandibular central incisors, so 0.2 mm of IPR was planned in both locations. She presented at the midpoint of treatment, with spaces closed, and with the predicted black triangles visible (

Fig. 6                                                                                    Fig. 7          

	 IPR was undertaken to lengthen the contacts between these incisors and eliminate the black triangles once space closure was completed.

: To avoid ledging and for best results, always make sure incisors are properly aligned before performing IPR

 Break initial contact with a medium-grit diamond strip (DS25, Komet USA). This also ensures that rotary diamond discs do not jam (

Place the 0.15-mm disc (RS15FH.HP.200) buccally and guide it slowly through the contact starting at the occlusal-most aspect. Approaching from the buccal will help reduce the likelihood of ledging the teeth.

Fig. 8                                                                           Fig. 9

 To ensure the removal of the appropriate amount of enamel, assess and measure the enamel to be removed with a thickness gauge (

). Continue to use the gauge throughout the procedure to confirm the desired amount of interproximal reduction.

 Follow with the diamond discs incrementally in ascending order of thickness until the required amount of enamel has been removed. In this case, continue with the IPR disc RS20M.HP.200 to achieve the desired substance removal of 0.2 mm. Note: Be sure to cool the area with water during use, and work with a disc guard (

Fig. 10                                                                 Fig. 11           

 Once IPR is complete, finish each contact with an interproximal strip, contour interproximal and incisal edges as necessary with the specially designed mosquito bur (8392.FG.016, Komet USA), and follow up with fluoride treatment to protect the enamel.

 exhibit the final result. Once contacts are closed, black triangles are eliminated. 

                                                     Fig. 12                                                                   

	Mastering the technique of IPR is often essential in providing patients with the best possible orthodontic outcome. While there are several methods for performing IPR, rotary discs offer the best combination of quality, simplicity, and efficiency. The new DISCtance™ IPR System offers some key improvements above and beyond traditional discs, including a stiffer and more resilient disc that remains durable over time, and the three different thicknesses enhance precision and ease of use. 

Articles

How Komet USA’s DISCstance™ IPR System offers a new and improved option for interproximal reduction procedures.

How to simplify interproximal reduction

	Functional and esthetic requirements in conjunction with material strength dictate the amount of tooth reduction required for a specific case.

	Recently, dentistry has seen a shift from gold-based metallic restorations to milled materials (e.g., 

 [Ivoclar Vivadent] and zirconia) due to lower production costs. Because both lithium disilicate and zirconia can be 

conventionally cemented or bonded to tooth structure (zirconia requiring a metallic primer for maximum bond strength), the reduction requirements may vary depending on the choice of cement.

	For conventional cementation, high-strength ceramics generally require the same amount of tooth reduction as traditional porcelain-fused-to-metal crowns. Generally, 1.5 to 2.0 mm of space is recommended for occlusal and incisal clearance so these crown materials can perform well in high-stress functional areas without the risk of fracture. Furthermore, rapid, efficient tooth reduction minimizes biologic trauma to the tooth and dental pulp during the preparation process. 

 (Komet USA LLC) have been specifically designed for ultra-fast, effective removal of tooth structure, offering measurably greater tooth reduction without sacrificing operator control (Figs. 1-3). This is achieved by using a new diamond-grit size of 230 micrometers (versus the average 181-micrometer particle size of standard super-coarse diamonds), uniformly sized at an optimal depth to produce an efficient cut without instrument clogging.

	Following gross reduction with Deep Purple diamonds, a fine-grit finishing diamond instrument is recommended for finishing and smoothing the preparation for a more intimate fit of the restorative material. Note: Identically matched Komet

 8856 finishers correspond in size and configuration with Deep Purple diamonds. 

Read more: Komet USA launches Deep Purple™ diamonds for efficient crown prep

	Up next: Crown preparations for high-strength ceramics

	 Crown preparations for high-strength ceramics 

	Uniformity of tooth reduction is important to the successful fabrication of indirect dental restorations. With the various types of materials available, it is important to understand preparation requirements so the proper amount of tooth structure is removed 

according to the functional and esthetic requirements of the restorative material. The following technique outlines the proper steps for tooth preparation prior to indirect restoration with a high-strength ceramic.

	Create vertical depth cuts into the middle and incisal one-thirds of the tooth, following the angle of the facial plane in the incisal one-third. The diameter of the instrument (856XC.FG.016) at the tip is 1.6 mm; therefore, the diamond should produce a depth cut to approximately one-half its total diameter (approximately 0.8 mm) (Fig. 4). Note: As a safety option, Komet USA’s 

 enable the user to reliably achieve and maintain the minimum layer thickness for all-ceramic restoration preparations.

Click here to see the depth-marking diamonds in action!

	To “erase” the depth cuts, “paint” with the bur in a horizontal plane (Fig. 5).

	Place depth cuts in the cervical plane to approximately one-half the depth of the end of the bur. This leaves a rounded shoulder finish line with a 90-degree cavosurface angle (Fig. 6).

	Up next: More tips on how to achieve great results with diamond instruments

	The two-plane labial reduction is shown from the facial aspect. A three-quarter view shows the refinement of the two-plane reduction, with the bur positioned parallel to the cervical one-third plane of reduction (Figs. 7-8).

	Use the 856XC.FG.016 tapered-cylinder diamond to place 1.0-mm depth grooves on the incisal edge (Fig. 9 ), and reduce the incisal edge to form an acute angle to the facial surface (Fig. 10).

	Cut a depth groove by applying the 856XC.FG.016 rounded-cylinder diamond on the lingual surface, taking care to follow the natural contour of the tooth. The cervical plane formed by preparation of the cingulum should diverge 10 to 15 degrees from the cervical plane on the labial surface (Fig. 11).

	With a football-shaped diamond (5379.FG.023), eliminate the depth groove in the lingual concavity only (middle and incisal one-thirds of the lingual surface) (Fig. 12).

	Reduce the cervical third of the lingual surface and blend the finish line to both proximal aspects with the 856XC.FG.016. Note: Remember to keep the depth uniform in the axial direction (Fig. 13).

	Verify the lingual reduction by asking the patient to close in centric occlusion: Observe the uniformity of lingual reduction as the patient moves forward in protrusive with light incisal contact (Fig. 14).

	Use a 46-micron, round, tapered-cylinder finishing diamond (8856.FG.016) to refine and smooth the axial walls on all aspects of the preparation, followed by the incisal edge (Fig. 15).

	Apply a 46-micron football-shaped finishing diamond (8379.FG.023) to finish the lingual concavity of the preparation (Fig. 16). 

	Figure 18 shows a labial view of the completed all-ceramic crown preparation. Note the uniform thickness of the finish line circumferentially as well as the overall smoothness of the transitional line angles. The preparation should be as smooth as possible to increase accuracy of fit and ease of delivery. The final result is a combination of structural strength and esthetic beauty-the “ideal” dental restoration in every sense of the word.

A technique showcasing the Deep Purple™ diamond instruments from Komet USA LLC. and how they can simplify process the of tooth reduction.

How to perform rapid tooth reduction with diamond instruments

	Designed for simplified storage, cleaning, disinfection and sterilization of dental burs, diamonds and 

 feature silicone plugs that hold the instruments securely in place, preventing them from falling out even in the event of sudden movement. 

The blocks feature a unique design that eliminates the use of outer screws, thereby preventing screw failure. Komet stainless-steel bur blocks resist discoloration, even after repeated sterilization cycles, and they are suitable for all instrument-reprocessing methods, including ultrasonic baths and steam sterilization.

Related reading: Making life easier in the dental practice: Komet USA's bur conversion card

, varying in width and height to suit a range of requirements. When five or more are ordered, they can be laser marked according to individual requirements. The blocks also feature a long service life paired with a clearly structured layout that optimizes instrument organization and enhances practice efficiency. In addition, refill packs of the silicone plugs (9891) are available in a variety of colors.

Check out this video to see how Komet stainless-steel bur blocks can maximize efficiency: 

How Komet Ceramic Cutters make it easy to trim acrylics at chairside

For more information on the Komet® stainless-steel bur blocks, contact Komet USA LLC at 888-566-3887 or visit the company website at 

 Designed for simplified storage, cleaning, disinfection and sterilization of dental burs, diamonds and endodontic and sonic tips, Komet® stainless-steel bur blocks feature silicone plugs that hold the instruments securely in place, preventing them from falling out even in the event of sudden movement. 

How to maximize efficiency by using Komet® stainless-steel bur blocks during instrument reprocessing

Looking for a way to make things easier in your dental practice? 

 is offering a new conversion service that the company says will do just that.

Komet USA’s new conversion service offers an easy, fast method for converting existing burs, diamonds, and polishers to Komet® instruments. The program uses a specially designed conversion card (see below), which provides an efficient, user-friendly technique for doctors and lab technicians to identify and order the Komet equivalent of an existing instrument.

TECHNIQUE: How to remove instrument fragments	with KOMET Endo Rescue Kit

The service encourages users to simply place a bur or polisher on the card’s measurement grid, snap a picture using a smart phone or tablet, and send the image to 

’s product specialists expertly matches the instrument and returns the equivalent Komet diamond, carbide, or polisher - each one backed by a generations-long tradition of precision engineering, superior manufacturing, outstanding customer service, and direct delivery. 

KOMET helps deliver simpler root canal therapy

To receive your own conversion card, send a note to 

Looking for a way to make things easier in your dental practice? Komet USA is offering a new conversion service that the company says will do just that. Komet USA’s new conversion service offers an easy, fast method for converting existing burs, diamonds, and polishers to Komet® instruments. The program uses a specially designed conversion card (see below), which provides an efficient, user-friendly technique for doctors and lab technicians to identify and order the Komet equivalent of an existing instrument.

Making life easier in the dental practice: Komet USA's bur conversion card

According to Frank J. Milnar, DDS, AAACD, for the best results when working with zirconia, users should rely on instruments optimized for the high-strength material.

He says standard instruments often fail in these cases, requiring the operator to use multiple burs to adjust or polish a single restoration. In turn, if the instrumentation does not achieve a high luster on the restoration, the zirconia will be very unforgiving and antagonistic to the opposing dentition; therefore, a kit dedicated to high-strength ceramics offers the ideal solution.

 offers the instruments necessary for adjusting occlusion and reconfiguring the luster of zirconia restorations.

In this technique video from Dr. Milnar, the case demonstrates the placement of a full-contour zirconia crown using the LD0707 Cut, Finish and Polish kit from Komet USA.

How to get zirconia crowns right with the LD0707 kit from Komet [VIDEO]

Today's HOT How To features a technique demonstrating the use of KOMET USA's S6856XL.FG.021 extended-length diamonds to help ease crown preparations when gingival recession is present. Case presentations are performed by Christine M. Yonker, DDS, and Sergio Rubinstein, DDS, from Oral Rehabilitation Center in Skokie, Ill.

Problem solving, innovating and adapting instrumentation and technique to meet the challenges of each new case are among the hallmarks that distinguish a great dentist from a good dentist. All dentists, however, will agree that they are happiest when procedures are completed as expected and the need to solve problems doesn’t arise. Having the appropriate instruments and materials on hand for each individual case reduces the need to over-modify or potentially misuse traditionally used items for purposes that  weren’t originally intended.

An example of this is as simple as the rotary instruments used with dental handpieces. In dental school students learn about diamond and carbide burs-the types of rotary instruments best employed for particular purposes and the configurations and sizes that best create ideal preparations in typical cases. Then, the first atypical patient presents with limited interocclusal distance, and the dentist is unable to precisely position the bur parallel to the second molar, especially on the distal. This is when the dentist’s creativity is called upon. Sometimes one bur is used to cut a portion of the shank of another bur, which is then placed back into the handpiece and used for the tooth preparation. Using the shortened bur typically provides a satisfactory result.

In another scenario, however, a patient presents with moderate bone loss due to periodontal disease and requires a crown on a canine or central incisor. As tooth preparation begins, even after completing incisal reduction, we find we cannot reach our margin with the correct handpiece angulation or without the handpiece hitting either the edge of the tooth being prepared or the adjacent teeth. Again, the dentist’s creativity is summoned.

Either the handpiece must be angled in such a way, often awkwardly, to likely produce an undercut, or the bur must be pulled from the chuck in the head of the handpiece as far as feasible so the friction grip still retains the bur and operation can continue. The dentist simply hopes, however, that the bur stays in the handpiece while preparation continues.

These aren’t new issues in dentistry, and longer burs have been developed, but in practice, we need to determine whether the extended-length burs are actually long enough to avoid problematic situations.


	Developed to address crown preparation requirements in cases presenting gingival recession, the KOMET® S6856XL.FG.021 diamond features a 12 mm working length. This extra-long, perio-length diamond allows the operator to maintain ideal position and angle of the handpiece and avoid interference with adjacent teeth, thus permitting the precise preparation and refinement of optimal crown margins at the proper angle in patients who have longer, exposed crown lengths.

The KOMET® S6856XL.FG.021 diamond is a new addition to KOMET USA’s S-Diamonds®, which efficiently remove tooth structure during crown preparation procedures. KOMET S-Diamonds feature a diamond understructure on their working portions, which incorporate staggered plane surfaces to optimize material reduction, ensure maximal debris removal, facilitate cooling, and save operator time. Less loading of the KOMET S-Diamonds cutting surfaces enhance patient comfort.
	KOMET S-Diamonds are offered in a variety of configurations and lengths to accommodate individual crown preparation designs, including tapered chamfer, long chamfer, modified taper, modified taper shoulder, modified cylinder, modified parallel shoulder, modified tapered chamfer, modified parallel chamfer and parallel chamfer.

An egg-shape diamond for occlusal/lingual reduction and a round diamond also are available, as are kits containing a selection of KOMET S-Diamonds for modified tapered-chamfer preparations, tapered-chamfer preparations and modified tapered-shoulder preparations.


	The following cases demonstrate a variety of clinical applications of a diamond bur with increased length. The first case exemplifies insufficient length of diamond cutting surface relative to the length of the tooth. The second and third cases illustrate how adjacent teeth can interfere with the head of the handpiece, thereby preventing access to the margin of the prepared tooth.


	The patient doesn’t like the appearance of her existing crowns and veneers due to recession that has occurred over time. The treatment plan includes replacing the older, unesthetic crowns from tooth No. 6 to tooth  No. 11. To improve the appearance of the new crowns, the margins must be prepared slightly subgingivally (Fig. 1).

Once the crowns are removed and the preparations are refined, we find that the cutting surface of the regular-length diamond is inadequate in length relative to the length of the canine (Fig. 2).
	By changing burs and using the KOMET® 12 mm long diamond bur, the margin can be prepared subgingivally while providing sufficient length of cutting surface to accommodate the entire length of the tooth (Fig. 3).

The greater length allows the entire tooth to be prepared uniformly and produces a nice, clean margin in the desired subgingival location (Figs. 4-6).

The occlusal view demonstrates the margins on the canine are just as precise as the preparations on the shorter teeth as a result of having a longer length diamond bur (Fig. 7).


	This patient had a crown removed from tooth No. 11. Notice the apical position of the existing margin on tooth No. 11 as compared to tooth No. 10. The length of tooth No. 10 also is greater than that of an average, healthy lateral incisor. For a standard diamond bur to access the margin for refinement, the handpiece would have to approach the tooth from the distal. Because patients don’t have removable cheeks, a longer bur is needed to prevent the handpiece head from interfering with the incisal edge of the adjacent lateral incisor (Fig. 8).

The longer bur allows more freedom of movement while re-preparing and smoothing this tooth (Figs.  9-10) .


	This case is similar to Case 2. In this instance, a lower canine with an existing veneer requires replacement due to a transverse fracture in the porcelain (Fig. 11). Again, the standard–length diamond has limited capability to properly prepare this tooth because the incisal edge of the adjacent tooth interferes with handpiece positioning and movement. The bur is simply not long enough to reach the margin (Fig. 12).

In this case, the KOMET “perio-length” diamond bur produces enough clearance to permit access to the margin without the adjacent tooth restricting the path of the handpiece head (Fig. 13). 

A clean margin lays the foundation for a predictable outcome in the final porcelain restoration (Fig. 14).


	Dr. Christine M. Yonker received her dental degree from Indiana University School of Dentistry. She was an active participant in periodontal research that explored the inflammation that occurs on a cellular level. Dr. Yonker is in private practice and continues to work on publications for dental journals on a multitude of topics.
	
	Dr. Sergio Rubinstein completed his Periodontal-Prosthesis program at the University of Illinois College of Dentistry where he became an Assistant Professor for 12 years. He invented a device to prosthetically correct misaligned implants and lectures on a national and international level. Patients are referred to Dr. Rubinstein to manage and treat the most simple to the most complex cases, especially when it relates to function and esthetics

How To: Prepare atypical crowns with KOMET USA's extended-length diamonds

	Dental crowding is just one of countless conditions for which a patient seeks orthodontic care. Solutions for creating more space in these cases range from extractions or comprehensive treatments like arch development using fixed or removable orthopedic appliances, to more conservative options like interproximal reduction (IPR). While IPR is not the solution for every patient, it is particularly suitable for those whose malocclusion can be corrected by creating a small amount of space. In addition, IPR is effective for correcting Bolton tooth-size discrepancies, for keystoning an arch, and for simply creating the necessary space for clear aligner therapy.Traditional IPR procedures rely on diamond-impregnated strips or handpiece-powered discs to make the all-important initial cut and to follow through with the complete amount of reduction required. These methods, however, can be frustrating because of their inherent levels of unpredictability and the danger of injury to the patient. In addition, diamond-strip methods are time-consuming, uncomfortable for the patient, and often awkward for the dentist-particularly when making the initial opening reduction. Likewise, standard-shaped discs are unsatisfactory because of their 360° rotation and the required guards that encircle the discs. These guards obstruct the doctor’s vision, easily leading to tissue lacerations, inaccuracies or ledging of the adjacent teeth.

	A simple solutionThe IPR Starter Kit (LD0528) addresses the limitations of traditional IPR techniques, eliminating user frustration and patient discomfort and adding precision, safety and reliability to the procedure.

	Its contact breakers provide a simple and effective method for making an initial reduction of 0.18 mm, effectively eliminating the need for diamond strips or discs in this phase. Once that initial cut is made, the appropriate 0.20 mm instrument easily slides into the space created and is used to continue the reduction, followed as needed by the remaining discs to gradually and safely achieve the desired amount of interproximal reduction. Obstructed vision is no longer a difficulty thanks to the pairing of an oscillating handpiece with the OS instrument’s wedge shape and perforated design. The practitioner finally has unimpeded access to the interproximal areas, creating unparalleled safety and predictability in a procedure that, until now, has been inherently inconsistent.

	This case involves a 32-year-old female patient who sought an orthodontic evaluation of her crowded, misaligned teeth (Fig. 1). Her primary concerns were tooth crowding and esthetics, and she was unwilling to pursue conventional orthodontic treatment. A treatment plan was created to address these points as well as the additional clinical concerns of protruding lower incisors and gingival recession. Following three months of arch development consisting of removable mandibular and maxillary functional appliances, the patient was ready to begin Invisalign® treatment.

A wooden wedge was inserted into the interproximal area to protect the gingival tissue (Fig. 2). 

Note: This step is optional, but it is particularly useful to operators just becoming familiar with the system. 

The appropriate single-sided contact breaker was selected to initiate the first reduction at a position that provided straight-line access to the contact (Fig. 3). Note: If both interproximal surfaces are equally accessible, the tooth with the greatest height of contour should be selected for the initial reduction.

The instrument was positioned so that a finger rest was achieved, providing the user with a stable fulcrum to prevent impingement of the handpiece body on the teeth or oral structures. At rest prior to starting the KOMET OS30 handpiece, the instrument was centered at the contact point. 

Important: For every step in the reduction procedure, the instrument position remained perpendicular to the contact point and parallel to the long axis of the contact. 

The OS30 oscillating contra-angle handpiece was accelerated to full speed prior to engaging the contact. Note: The handpiece features four water ports that flood the instrument with water throughout the procedure.

Gentle, intermittent, apical pressure was applied until the contact was fully reduced (Fig. 4). The width of the cut was then verified (Fig. 5).

The single-sided OS20-FH honeycomb instrument was used to continue the reduction to the prescribed amount (Fig. 6). The flexible honeycomb construction facilitated anatomical recontouring, making it easy to maintain natural embrasure spaces. The width was verified at every step, and the steps were repeated for the seven contacts that required reduction.

The 4564 KOMET Composite Polishing System’s 3-in-1 strips were used to complete the procedure, starting with the medium-grit section of strip CS40 (Fig. 7).

The fine-grit section of the same strip was used (Fig. 8), followed by the ultra-fine grit section to finalize polishing (Fig. 9).

In-office topical fluoride was applied to all reduced interproximal areas per manufacturer instructions (Fig. 10). Fluoride gel was given to the patient for daily use at home.

	This case involved seven separate areas that required IPR, yet it took mere minutes to complete. The patient indicated there was no pain during the procedure and there was no frustration for the dentist. Following treatment, the patient’s teeth exhibited normal tooth contours and natural anatomy far beyond that possible with standard discs or strips (Fig. 11). Clearly, patients and doctors alike will benefit from a technique that is safe, effective, simple and remarkably precise. 

 Dental crowding is just one of countless conditions for which a patient seeks orthodontic care. Solutions for creating more space in these cases range from extractions or comprehensive treatments like arch development using fixed or removable orthopedic appliances, to more conservative options like interproximal reduction (IPR).