Some clinicians use the DWU as a visual aid to show the proposed treatment outcome to the patient. This necessitates changing the plan from restoring the teeth with veneers to using crown restorations on the maxillary anterior teeth, or doing additional procedures on the mandibular anterior teeth to establish contact. The anterior veneers that you had planned or that the patient requested will not work in this situation, because you will need to add ceramic on the palatal aspect of the upper teeth to reestablish contact with the lower anterior teeth to achieve the desired function.

For example, if you are restoring the maxillary arch and opening the vertical dimension, the diagnostic wax-up may indicate that there is no longer anterior contact with the mandibular anterior teeth. Articulated castsĭuring the waxing process, it may be determined that the plan cannot be achieved from a functional perspective. It is used as a diagnostic aid to establish the desired esthetic changes (tooth position, alignment, inclination, proportion and morphology) and develop or confirm the occlusal scheme and function. Diagnosis and treatment planning with a diagnostic wax-upīy completing a DWU before discussing the proposed treatment plan with the patient, the clinician can confirm that the plan is achievable. The greater the room for interpretation, the more likely clinician and patient expectations will not be met. It should not be arbitrarily done based on the technician’s interpretation of minimal clinical information. The laboratory’s responsibility is to establish the tooth position, alignment, inclination, morphology and occlusal scheme based on clinician directions. The instructions written on the prescription form should reflect the needs and expectations of the patient and the clinician. The clinician is responsible for accurately communicating on the laboratory prescription the desired outcome the technician is to create with the wax-up. Since a diagnostic wax-up is an outcome-based diagnostic tool, it should accurately represent the desired result of treatment. Facebow transfer Why you should do a diagnostic wax-up

Guides, stents, templates and matrixes are made on the diagnostic wax-up, or a cast made from the wax-up, to aid in performing surgical and restorative procedures. I think of a wax-up as the foundation of the entire treatment plan, since it physically establishes the proposed outcome of esthetics and function. It is defined in the glossary of Prosthodontic Terms as “waxing of intended restorative contours on dental casts for evaluation and planning restorations a wax replica of a proposed treatment plan. How to successfully communicate the desires and expectations of the clinician and patient to the laboratory technician.What type of technique should be used (additive only or reductive stone followed by additive wax).When to complete the DWU (timing - 3 parts to this series).I will be providing my insights as to how this valuable diagnostic tool can be used in your practice to establish a clear visual representation of the desired patient outcome to facilitate treatment planning and communication. When talking to dentists, I am frequently asked about when or how to use diagnostic wax-ups (DWU), so I have decided to dedicate the next four articles to addressing multiple aspects of this topic.

Dental wax ups