Zhang Y, Wang X, Wang J et al. IPR treatment and attachments design in clear aligner therapy and risk of open gingival embrasures in adults. Prog Orthod 2023; 24: 1.
A high rate of open gingival embrasures occurs after clear aligner therapy. Clinicians should be aware of the application of IPR and the design of attachments.
This study determined the prevalence of open gingival embrasures (OGE) in adults after clear aligner therapy and to investigate the risk of OGE associated with interproximal enamel reduction (IPR) treatment and attachment design, focusing on the amount and distribution in mandibular anterior teeth. Pre-treatment and post-treatment intraoral frontal photographs of 225 non-extraction patients were evaluated retrospectively. The amount of IPR and the number of attachments in the anterior teeth from subjects after screening were recorded according to the first version of clear aligner software (Clincheck) and clinical documents. The incidence of OGE in non-extraction patients after clear therapy between maxillary and mandibular central incisors was 26% and 40%, respectively. IPR was not associated with the occurrence of OGE but was associated with severity. The number of attachments in the anterior teeth or central incisors was significantly related to the incidence of OGE but was not associated with severity.
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Wadia, R. Clear aligner therapy - OGE & IPR. Br Dent J 234, 100 (2023). https://doi.org/10.1038/s41415-023-5465-x