What is a Wax-up and Why do we Need It?

Monday, 24 April 2017 13:49

A diagnosis wax-up can be compared to the project we use for building a house, before any actual work is done. In the case of dental treatments, a wax-up is basically wax representation on the study casts of the way the teeth will look like in the mouth after all the treatments are finished from an esthetic and functional point of view.  Wax is added on the casts, which modifies the shape, size, and the way the teeth touch each other, in order to simulate how they will be like at the end. (Figure 1 A, B).

Complex prosthetic rehabilitation treatments cannot be predictable without this wax project. Correlating the diagnostic wax-up with the patient is critical in order to avoid a result which seems optimal on the casts, but which can be inappropriate for the patient´s smile and functionality (Figure 2). 

The wax-up allows not only the doctor but also the patient to visualize the end result tridimensional and to anticipate the shape and function changes in a reversible way, most of the time, without preparing the patient´s teeth. Why do we say reversible? The wax-up can be transferred in the mouth (mock-up), with the help of a self-polymerization composite (it takes 6 minutes to settle) (Figure 3 A, B), through silicon moulds obtained by copying the wax-up casts (Figure 4). The patient has the possibility to check, for a period of up to two months the esthetics and functionality of the future dental restorations and to communicate with the clinician regarding how he feels, what he likes and what he doesn´t.

Actually, the patient has the opportunity to test-drive of the future teeth, thus the final result will not be a surprise in what esthetics and functionality of the future prosthetic restorations is concerned. After the test-drive if the patient doesn´t like the esthetics and/or function, the composite material from the patient´s unprepared teeth is removed, going back to initial situation, without having touched the dental tissue of the patient. The dental technician will copy the shape and dimension of the teeth after the mock-up test, onto the final ceramic restorations, the difference being the esthetics, because ceramics are more esthetic materials when compared to the composite used for the test-drive.

This simulation is very useful also for educating the patient regarding the recommended treatment protocol and for determining the ideal occlusion (the way the superior teeth bite onto the inferior ones). In an interdisciplinary approach, this wax-up facilitates communication among several dental specialists who are involved in the treatment. Also, this method is a very important communication instrument with the dental technician. 

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