In Lab Time
2 weeks

ADA Codes
D9950 Occlusal Analysis—Diagnostic Wax-Up
(for Diagnostic Casts see D0470)

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Diagnostic Data and Instruction

  • The diagnostic wax-up collects the objective data (both functional and esthetic) needed for developing the cosmetic change or reconstructive dental procedures and treatments.
  • A diagnostic wax-up begins with dental impressions of the teeth and gums, an occlusal record or bite registration, and for many cases, a facebow transfer for an articulator.
  • The models are then sent to the lab and the changes that the patient has discussed with the dentist can be made to the teeth on the model.
  • A diagnostic wax-up is a visual aid to help the dentist understand the tooth reduction requirements, which can cut the preparation appointment time in half.
  • Data and instructions that come with the diagnostic wax-up allow the dentist to plan the contouring in advance.
  • When the wax-up is finished it provides a tangible 3-dimensional model of the patient‘s new teeth.
  • The diagnostic wax-up can be used by the doctor to create fully representative temporaries.
  • After the dentist evaluates the temporaries for fit, the patient can try out the temporaries and evaluate how the new restorations look and function.
  • It is important for the patient to evaluate how the temporaries affect their speech and how their joints and muscles adapt to the new changes.
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Types of Diagnostic Wax-Ups

Additive/Reductive Diagnostic Wax-Up

  • The basic diagnostic wax-up aids in developing an overall treatment plan for restorative procedures.
  • The basic diagnostic wax-up is an important tool to communicate with the laboratory technician the direction the case will be developed. Of all the wax-ups, the basic diagnostic wax-up is the least costly in both time and money; however, it is the best tool for the visualization process.
  • Minimal waxing is used and placed in deficient areas only.
  • Models can be marked to depict necessary gingival crown lengthening.
  • Wax can then be flowed down or up in those areas to provide a good visual of the improvement.
  • Cusp tips can be added to improve centric stop areas, lingual contours added to improve anterior guidance functions, and incisal length added to achieve the desired length or position.
  • Many times it is necessary to reduce areas with a handpiece and bur to eliminate areas that are detrimental to the overall goal of proper plane of occlusion, stable centric ctops, and maximized anterior guidance function.

Full Contour/Case Presentation Diagnostic Wax-Up

  • The full-contour wax-up is used when improved esthetics and contours are included in the treatment plan.
  • In many instances, this is the wax-up of choice for large rehabilitation cases.
  • An advantage of the full-contour wax-up is the ability to create functionally correct provisions for the patient.
  • A judgment call can be made during the analysis phase o fo the full-contour wax-up when it is determined that finer details of the current situation are of less value in overall end result.
  • The full-contour wax-up is used if missing teeth are involved and implant placement determinants are necessary.
  • The case presentation wax-up is generally requested to show the patient the end result of the personalized treatment plan.
  • In order to create this type of wax-up, the teeth are prepared on the model as they would be in the mouth. Wax is built-up to proper contour and function.
  • Often pink baseplate wax is added to the tissue areas to complete the visual effect for the patient.
  • The case presentation wax-up is the least diagnostic of all wax-ups, unless done in tandem with a basic diagnostic wax-up.
  • It is as the name implies—for case presentation and, therefore, patient acceptance.
  • Although not common, provisionals can also be generated from this type of wax-up, provided the pink wax has not been added to the tissue areas.
  • The case presentation wax-up requires much more skill and time from the technician which is reflected in the price.
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