There are not many things in dentistry that I find more traumatizing than IPR (interproximal reduction) for Invisalign. I hate it. You're probably mumbling to yourself, “Show me on the doll where IPR touched you, Josh.” Fine. I will. I will relive the entire trauma for your edification. The year was 2011. I had just taken my first Invisalign course and was ready to do my first case. I was treating a young adult who had some simple lower crowding. As part of the treatment plan, some minor IPR was required between the lower anterior teeth. My initial Invisalign training taught us to do this with an unguarded diamond disc. Yep…that’s where my trauma comes from. One slip of the hand, and I was driving my patient to the oral surgeon’s office to have that lip sewn up. To this day, it is one of my worst moments in dentistry.
I recently took a two-day Invisalign course with Dr. David Galler called Reingage. During his opening remarks, he commented on how all of us would “fear no IPR after this course.” He was right. I no longer fear IPR. It is all thanks to the GOST IPR Bundle from Strauss Diamond. GOST stands for Galler Ostreicher Spacing Technique. It was named after the two clinicians who came up with it, and it is a brilliant way of performing IPR safely and easily. It starts by using something like a Magic Strip set to start opening the space.
Once you get the contact opened up a bit with these hand strips, it’s time to jump to our discs. Slide the first disc (.15 mm) into the special slow-speed straight hand piece and apply the disc guard. Run that once through the contact and continue on until you’ve reached the desired space needed. Included in the GOST kit are .15 mm, .2 mm, .3 mm. and .4 mm discs. An additional .5 mm disc is available to order outside the kit if needed. The discs are specially designed for orthodontic-related IPR. They have a diamond on both sides in a stripe that is around the width of anterior contacts to protect the teeth from ledging. They simply polish down the contact and protect the rest of the interproximal surface. It’s almost foolproof!
The GOST Bundle includes the discs plus the hand piece and a motor. You might be thinking to yourself that you already have a straight hand piece. However, the 16:1 gear reduction on the straight hand piece included in the GOST kit gives the perfect torque for IPR while reducing heat production. Also included in the bundle is a nice electric micro motor that works optimally with the 16:1 straight hand piece. Thankfully, it also includes a disc guard is also so you don’t end up with a split lip like I did! A video on the Strauss Diamond website gives detailed instructions on using the bundle so you get the best results. The entire kit, including discs, disc guard, hand piece, and motor, is less than $600! And the discs can be used multiple times before you need to replace them. Talk about a great value!
Last week, I started an Invisalign case that required .4 mm of IPR from canine to canine. In the past, I would have HATED this. It would have taken forever, and I would definitely not have stripped enough, compromising the orthodontic result. With the GOST IPR Bundle, sure enough, I FEAR NO IPR. We knocked it out in five minutes, and it was easy on both the patient and me. Solo home run to left field for the GOST IPR Bundle from Strauss Diamond!
Joshua Austin, DDS, FAGD, FACD, writes the Pearls for Your Practice column in Dental Economics. After graduating from the University of Texas Health Science Center Dental School, Dr. Austin associated for several years. In October of 2009, he opened a solo general practice in a suburban area of San Antonio, Texas. Dr. Austin is involved in all levels of organized dentistry and can be reached at [email protected].