Kelly/Olivier

Visually Speaking

An Advanced Diagnostic Wax-UP

byLaura Kelly
AACD Accredited Member
featuring
Juan Olivier, CDT, MDT

Purpose: A diagnostic wax-up can

provide a valuable communication
tool for dentists, patients, and
laboratory technicians prior to
treatment. It also serves as a guide for
preparation and temporary design,
and is utilized as the final restorations
are being fabricated at the laboratory.
Diagnostic wax-ups can provide the
following:
A three-dimensional, visual
1
communication tool that dentists
can use to discuss with the patient
regarding the design of their
upcoming restorations.
A communication tool between
the laboratory technician and den-
tist prior to and during treatment,
where preparations, case design,
esthetics, and patient feedback
during the temporary stages are
discussed and modified as needed
prior to final restorations being
completed.
2
A guide for reduction and a tool
to fabricate temporaries. Patients
are able to test drive their new
smiles and dentists can modify the
temporaries, providing additional
information to the technician that
can enhance the final outcome of
the case.

Photography and wax-up provided by LK Dental

Studio, www.LKdentalstudio.com (San Ramon, CA).
Featured technician: Juan Olivier, CDT, MDT.

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Journal of Cosmetic Dentistry 2010
Summer 2010 Volume 26 Number 2
 Kelly/Olivier

Visually Speaking
4

5 6

1: Preoperative model with a surgi-

cal tissue template. The surgical
tissue template is utilized to
provide an ideal guide to tissue
position height and ideal sym-
metry for the diagnostic wax-up.
The template can transfer to the
patients mouth, providing a
guide for the dentist to adjust
tissue as needed.
2: After the surgical tissue template
is created, the new position of
the tissue is marked on the pre-
operative models. Preparation
on the model according to the
dentists preferences is begun.
3: Surgical tissue template is
7 placed in position over the
preparation model, and the
model is prepared and ready for
diagnostic wax-up.

Journal of Cosmetic Dentistry 2010

Summer 2010 Volume 26 Number 2 57
 Kelly/Olivier
Visually Speaking

4: Ivory-colored wax is utilized,

8 combined with modifiers and
incisal translucency, allowing
more realistic esthetics to be
provided at the diagnostic stage
for dentist and patient to discuss
and approve. Ideal golden
proportions, function, esthet-
ics, and patients desires can be
discussed at this stage.
5: Once the diagnostic wax-up is
completed, a Sil-Tech template
(Ivoclar Vivadent; Amherst;
NY) is created off of the
wax-up and is finished with a
re-line of a light-body wash to
capture additional details of the
morphology.
6: After duplicating the diagnostic
wax-up in stone, a preparation/
reduction guide is created. The
dentist can use this guide to
prepare the case and design for
final ceramics.
7: Colored wax is utilized to create
more natural-looking internal
effects and detailed diagnostic
wax-up.
8: Upon completion of the full-
contour diagnostic wax-up, the
technician creates an incisal
and facial cutback into the ivory
wax. Several different wax colors
9 and translucency are applied,
imparting a more realistic effect.
By adding internal effects, the
dentist and patient can discuss
their preferences regarding
internal effects and degree of
10
translucency. As a result of being
provided with a more color-
comprehensive diagnostic wax-
up, the patient can see a preview
of how the future ceramics may
look if they desire more
natural effects.
9: Front view of the completed
wax-up.
10: Occlusal view of the final
diagnostic wax-up, showing
detailed morphology and
enhanced esthetics created
completely with wax.

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Journal of Cosmetic Dentistry 2010
Summer 2010 Volume 26 Number 2

11: Lingual view of the upper ante-
rior wax-up.
12: Completed full upper and lower
advanced diagnostic wax-up.
Sources
Kataoka S, Nishimura Y. Natures morphol-
ogy: characteristics of lingual surface mor-
11
12
Kelly/Olivier
Visually Speaking
phology. Hanover Park (IL): Quintessence hensive esthetic treatment concept. Int J
Publishing Co.; 2002. Perio Rest Dent. 1996;16:560-9.
Magne P, Belser U. Bonded porcelain restora- Rieder CE. Use of provisional restorations to
tions in the anterior dentition: a biomi- develop and achieve esthetic expectations.
metic approach. Hanover Park (IL): Quin- Int J Perio Rest Dent. 1989;9:122-39.
tessence Publishing Co.; 2002. 198 p.
______________________
Magne P, Magne M, Belser U. The diagnostic
template: a key element to the compre-
v
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Journal of Cosmetic Dentistry 2010
Summer
Summer 2010
2010 Volume 2626
Volume Number 2 2
Number 59