Enamel interproximal reduction and periodontal health

Enamel interproximal reduction (IPR), also known as stripping, is an orthodontic procedure used by many clinicians, especially in non-extraction cases. It aims to reduce the mesiodistal diameter of teeth by removing interproximal enamel. This therapeutic option allows to obtain space in the dental arch to achieve tooth alignment, in case of mild or moderate crowding, and to preserve the papilla avoiding the onset of black triangles. IPR is an irreversible procedure, and it requires an accurate case examination to avoid damage, such as demineralization of the enamel or periodontal complications, that can compromise both aesthetics and oral health. When performing IPR, orthodontists can change the contact point between the teeth and move it closer to the alveolar crest, thus improving esthetics by reducing the black triangles. However, there is also a risk for worsening periodontal health due to root proximity although, according to the literature, periodontal indices, such as clinical attachment loss (CAL) and bleeding on probing (BOP), seem to be not significantly affected by IPR.