In earlier blog entries, I have written about what tooth stripping is, how we plan it using Invisalign or invisible lingual braces and a brief explanation of the decision on whether to do stripping in an orthodontic treatment. After several professional colleagues asked me how we do stripping in our Barcelona clinic, I decided to write down and photograph the step-by-step procedure and explain what material we use in this procedure.
Reasons to do stripping:
- Create space for aligning the teeth (in cases of crowded teeth)
- Guide the teeth to where we want them, while they are being aligned (significantly shortens treatment time)
- Make size of teeth compatible with length of dental arch
- Improve the relationship between arches (especially in the anterior)
- Esthetic purposes (closing or reducing gum pockets)
- Periodontal reasons (in periodontal patients, the roots of the teeth move closer together after stripping, producing an improvement in bone architecture and periodontal health)
- Other reasons (for example to help in extrusion with Invisalign, etc.)
Important note: when we do stripping it often helps to solve several of these problems at the same time.
Stripping technique is extremely important; after this procedure, the teeth must have the same anatomy as before, it must be difficult to notice that stripping has been done. Occasionally, we find iatrogenesis (harm from treatment) in patients where this procedure was carried out carelessly or using an inadequate technique; the professional altered the tooth anatomy, and there is no way for such teeth to come together, the tooth enamel is nicked, or teeth have squared profiles from not rounding and carefully polishing the edges as needed.
Procedure – Tooth stripping
The procedure starts with properly planning the right time to do the stripping, the teeth that are to be treated, and the amount of stripping to be done. This planning takes place through a proper orthodontic study. There are cases where stripping is done at the start, and cases where it is done during treatment; each case must be individually assessed.
In this case, the objective of stripping is to close the gum pockets, retract the lower incisors and improve the relationship to the upper arch.
The procedure begins with a fine, turbine drill that opens the points of contact between teeth; depending on the amount of stripping to be done, we use a finer or a wider drill. The image shows the first drill that we used; using this drill we can obtain a minimum of 0.3mm between the teeth (due to the width of the drill). Using this drill we also begin to shape the teeth more anatomically and to eliminate any remaining edges and ridges. The next drill we use is has the shape of a concave “mushroom”; with this drill we round over all the tooth surfaces that we have touched. Due to its shape, this drill is easy to use and helps leave the teeth with a more anatomical shape. Between this drill and the first one that we used, the teeth are left with their proper shape, and all that remains is to polish the surfaces we have touched in order to avoid nicks and roughness that might increase the risk of cavities. The next step is the final polishing and rounding of the teeth by using a 15-micron file with an oscillating contra-angle (back and forth movement). These files, also called pre-polish files, leave the tooth surface ready for final polishing, and have the big advantage that they are flexible and adapt to the curvature of the tooth. Lastly, we use the finest composite polishing discs and finest-grained polishing strips. Once the stripping is finished, we measure the space that we have created using special gauges for stripping, this way we know how much space we have created. Results 15 days after closing the spaces with chain. Depending on the tooth anatomy, we can repeat the procedure to close the pockets even further.
For further information please contact us by telephone (+34) 93 832 72 81.