Possibilities of interproximal enamel reduction approach digitalization during orthodontic treatment of teeth crowding

Abstract

Introduction. Interproximal reduction (reapproximation) of enamel is a minimally invasive manipulation that involves thinning of the enamel on the contact surfaces of the teeth, thus reducing the mesiodistal size of the tooth row unit, and providing conditions for optimizing the correction of its position in the treatment of mild and moderate crowding of teeth. Objective of the research. To evaluate the possibilities of using digital scanning functions held among dentitions and cast models for optimization of the interproximal enamel reduction (IPR) procedure performance and verification of the results for such intervention. Materials and methods. The analysis of literary data involved processing of scientific publications, which reflected the various possibilities and purposes of using digital scanning of dentitions and cast models during the interproximal reduction procedure. The search for publications was carried out exclusively in the PubMed Central database using the following keywords «interproximal enamel reduction» and «digital scan». Results and discussions. In none of the analyzed studies dedicated to the verification of correspondence between the planned and achieved interproximal enamel reduction, which was evaluated by digital scans of dentition or stone casts, the accuracy of different scanning techniques and systems was not compared, the veracity and precision of which may influence the variation of the obtained results. In addition, it is important to evaluate how valid are the results of the original scan and the subsequent graphic rendering of the images for the contact surfaces of the teeth registered using different scanning systems and technologies are. It is also advisable to verify changes in configuration and migration of contact points and planes based on intraoral scanning data after the interproximal enamel reduction procedure, taking into account the potential influence of these factors on changes in the state of periodontal tissues within the area of intervention. The development of approaches with navigational control of interproximal enamel reduction looks also perspective. Conclusions. Possibilities of using the functions of digital scanning among dentitions or cast models to optimize the performance of the interproximal enamel reduction procedure and to verify the results of such intervention include the following: 1) to assess the initial clinical situation and to objectify the scope of the future intervention based on the obtained intraoral scans; 2) to plan the stage of practical realization for the interproximal enamel reduction procedure, to mark safe intervention zones based on variations in enamel thickness on the contact surfaces of different teeth, and based on this, to model the navigation guide for the controlled implementation of interproximal enamel reduction; 3) to verify the actual amount of enamel reduction and its correspondence with previously planned based on the analysis of the results of repeated intraoral or extraoral scanning.