Communication between the laboratory ceramist and the cosmetic dentist has always been the key to obtaining a superior result in both esthetic and functional aspects of restorative dentistry. An essential yet overlooked part of this communication is the role of the diagnostic wax-up.
The diagnostic wax-up, when used properly, can provide valuable information to the dentist, ceramist, and patient. It may help dentists determine the amount of reduction necessary to achieve the final result, keeping preparation as conservative as possible.
Another important role of the diagnostic wax-up is in the fabrication of provisional restorations or temporaries. An impression of the wax-up is taken with a putty material. In the mouth, the temporaries can be contoured and customized to the patient’s facial features. Occlusion and phonetics also can be evaluated, and when these, along with esthetics, are deemed satisfactory, an impression can be made to communicate the proper size, shape, length, and form to the lab.
Case Study
A young lady came into my office interested in enhancing her smile. She was not pleased with the size, shape, and color of her teeth. She knew from internet research that she wanted porcelain veneers.
In order to give the patient an idea of what the final outcome would be, I recommended a diagnostic wax-up. Once she had a chance to view the final outcome she immediately scheduled for the treatment to be initiated. She was very pleased with the result, as seen in her photos.
Figures
1. A pre-op facial picture of the patient
2. A close-up of her pre-op smile
3. The diagnostic model used to communicate proposed size, shape, and characteristics
4. The 3D diagnostic wax-up
5. Porcelain veneer restorations created by Burbank Dental Lab using Ivoclar Vivadent's IPS Empress Esthetic material.
6. A Ppst-op facial photo of the patient