In Vitro Study of Tooth Surfaces After Interproximal Enamel Reduction: Extraoral Scanner and SEM Analysis


  • Francesca Cremonini
  • Viviana Giannoccaro
  • Mario Palone
  • Paolo Albertini


Objective: To perform a morphological evaluation concerning the extent of interproximal enamel reduction (IPR) with different manual instruments in different types of teeth and a qualitative analysis of enamel surface characteristics at the contact point before and after IPR. Material and Methods: 40 freshly extracted, caries-free, and intact human teeth were used for the study (20 bicuspids and 20 incisors) and performed IPR just on the mesial surface. The morphological variation of contact point was evaluated by superimposed the stl file, obtained thanks to an extraoral scanner, at T0 and T1 for each tooth. Two types of strip were used, Intensiv Manual Ortho Strips Coarse/Medium and Steelcarbo Horico Strips. Teeth were then cut lengthwise, removed the most apical root portion and the mesial and distal halves were gilded and observed at different magnifications. Results: The morphological variation following stripping mainly depends on the extent of the stripping, while the diameter, the type of strip and the shape of the tooth itself do not appear to be relevant. The 500X and 1500X magnifications allowed to appreciate better the characteristics of the surface of the stripped enamel and the differences with the intact enamel. All teeth treated, independently from the kind of strip used, shows deep marks and grooves in the direction of stripping. In both cases, the enamel appears significantly damaged at great magnifications . Conclusion: Stripping always and inevitably leads to a change in the shape of the contact point and is directly correlated to the amount of stripping performed. The use of polishing after the removal of enamel interproximal is necessary in all cases.


Ballard ML. Asymmetry in tooth size: a factor in the etiology, diagnosis and treatment of malocclusion. Angle Orthod 1944; 14(3):67-70.

Bolton WA. Disharmony in tooth size and its relation to the analysis and treatment of malocclusion. Angle Orthod 1958; 28(3):113-30.

Peck H, Peck S. An index for assessing tooth shape deviations as applied to the mandibular incisors. Am J Orthod 1972; 61(4):384-401.

Di Fazio D, Lombardo L, Gracco A, D'Amico P, Siciliani G. Lip pressure at rest and during function in 2 groups of patients with different occlusions. Am J Orthod Dentofacial Orthop 2011; 139(1):e1-6.

Lombardo L, Toni G, Stefanoni F, Mollica F, Guarneri MP, Siciliani G. The effect of temperature on the mechanical behavior of nickel-titanium orthodontic initial archwires. Angle Orthod 2013; 83(2):298-305.

Zachrisson BU, Minster L, Ogaard B, Birkhed D. Dental health assessed after interproximal enamel reduction: caries risk in posterior teeth. Am J Orthod Dentofacial Orthop 2011; 139(1):90-8.

Germec-Cakan D, Taner TU, Akan S. Arch-width and perimeter changes in patients with borderline Class I malocclusion treated with extractions or without extractions with air-rotor stripping. Am J Orthod Dentofacial Orthop 2010; 137(6):734.e1-7.

Lombardo L, Stefanoni F, Mollica F, Laura A, Scuzzo G, Siciliani G. Three-dimensional finite-element analysis of a central lower incisor under labial and lingual loads. Prog Orthod 2012; 13(2):154-63.

Arman A, Cehreli SB, Ozel E, Arhun N, Cetinşahin A, Soyman M. Qualitative and quantitative evaluation of enamel after various stripping methods. Am J Orthod Dentofacial Orthop 2006; 130(2):131.e7-14.

Danesh G, Hellak A, Lippold C, Ziebura T, Schafer E. Enamel surfaces following interproximal reduction with different methods. Angle Orthod 2007; 77(6):1004-10.

Lucchese A, Porcù F, Dolci F. Effects of various stripping techniques on surface enamel. J Clin Orthod 2001; 35(11):691-5.

Frindel C. Clear thinking about interproximal stripping. J Dentofacial Anom Orthod 2010; 13(2):187-99.

Chudasama D, Sheridan JJ. Guidelines for contemporary air-rotor stripping. J Clin Orthod 2007; 41(6):315-20.

Fillion D. Vorund Nachteile der Approximalen Schmelzreduktion. Inf Orthod Kieferorthop 1995; 27:64-90.

Hudson A. A study of the effects of mesiodistal reduction of mandibular anterior teeth. AJO 1956; 42(8):615-24.

Grippaudo C, Cancellieri D, Grecolini ME, Deli R. Comparison between different interdental stripping methods and evaluation of abrasive strips: SEM analysis. Prog Orthod 2010; 11(2):127-37.

Mikulewicz M, Szymkowski J, Matthews-Brzozowska T. SEM and profilometric evaluation of enamel surface after air rotor stripping--an in vitro study. Acta Bioeng Biomech 2007; 9(1):11-7.

Perrini F, Lombardo L, Arreghini A, Medori S, Siciliani G. Caries prevention during orthodontic treatment: In-vivo assessment of high-fluoride varnish to prevent white spot lesions. Am J Orthod Dentofacial Orthop 2016; 149(2):238-43.

Arreghini A, Lombardo L, Mollica F, Siciliani G. Torque expression capacity of 0.018 and 0.022 bracket slots by changing archwire material and cross section. Prog Orthod 2014; 15(1):53.

Pisani L, Bonaccorso L, Fastuca R, Spena R, Lombardo L, Caprioglio A. Systematic review for orthodontic and orthopedic treatments for anterior open bite in the mixed dentition. Prog Orthod 2016; 17(1):28.

Gupta P, Gupta N, Patel N, Gupta R, Sandhu GS, Naik C. Qualitative and quantitative evaluation of enamel after various post-stripping polishing methods: an in vitro study. Aust Orthod J 2012; 28(2):240-4.

Piacentini C, Sfondrini G. A scanning electron microscopy comparison of enamel polishing methods after air-rotor stripping. Am J Orthod Dentofacial Orthop 1996; 109(1):57-63.

Lopez MA, Andreasi Bassi M, Confalone L, Gaudio RM, Lombardo L, Lauritano D. Retrospective study on bone-level and soft-tissue-level cylindrical implants. J Biol Regul Homeost Agents 2016; 30(2 Suppl 1):43-8.

Lopez MA, Andreasi Bassi M, Confalone L, Gaudio RM, Lombardo L, Lauritano D. Clinical outcome of 215 transmucosal implants with a conical connection: a retrospective study after 5-year follow-up. J Biol Regul Homeost Agents 2016; 30(2 Suppl 1):55-60.




How to Cite

Cremonini, F. ., Giannoccaro, V. ., Palone, M. ., & Albertini, P. . (2021). In Vitro Study of Tooth Surfaces After Interproximal Enamel Reduction: Extraoral Scanner and SEM Analysis. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 21, e0021. Retrieved from



Original Articles