Mastering interproximal stripping: with innovations in slenderization

Crowding and irregularity remain a consistent problem for children. Management of space problems continues to play an important role in a dental practice. It also represents an area of major interaction between the primary provider and the specialists. Proximal stripping is routinely carried out to avoid extraction in borderline cases where space discrepancy is less and in cases where there is a discrepancy between the mesio- distal width of maxillary and mandibular teeth to satisfy Bolton ratio. Proximal stripping is carried out using of metallic abrasive strip, safe sided carborundum disk, or with long thin tapered fissure burs with air rotor. The use of rotary cutting instrument can harm the pulp by exposure of mechanical vibration and heat generation (in some cases). Whereas, the large diameter of the disk obstructs vision of the working area. Also fracturing away a portion is a common problem with disk. Tapered fissure burs cut the tooth structure as the width of bur or overcutting may occur of the tooth structure due to high speed. The use of metallic abrasive strip is the safest procedure amongst the above. The strip can be placed in the anterior region without any difficulty but using it in the posterior region is difficult as, it is difficult to hold it with fingers while stripping the posterior teeth. To avoid this inconvenience here with a simple and economical way of fabricating strip holder from routine lab material is presented.

Proper management of space in the primary and mixed dentitions can prevent unnecessary loss in arch length. Diagnosing and treating space problems requires an understanding of the etiology of crowding and the development of the dentition to render treatment for the mild, moderate and severe crowding cases. Most crowding problems with less than 4.5 mm can be resolved through preservation of the leeway space, regaining space or limited expansion in the late mixed dentition. In cases with 5 to 9 mm of crowding, some can be approached with expansion after thorough diagnosis and treatment planning. Most of these cases will require extraction of permanent teeth to preserve facial esthetics and the integrity of the supporting soft tissue. Sequential proximal stripping is routinely carried out to avoid extraction in borderline cases where space discrepancy is less and reserved for treatment of mild tooth-size/arch-size discrepancies. How to cite this article: Sharma NS, Shrivastav SS, Hazarey PV. Mastering Interproximal Stripping: With Innovations in Slenderization. Int J Clin Pediatr Dent 2012;5(2):163-166.