Dentaltown March 2022 - 54
STEP
STEP
4
Design the smile (waxup).
An imperative step to cosmetic case
success is the diagnostic waxup. Along with
the diagnostic waxup, reduction guides
and putty matrix are fabricated to assist
with the case (Fig. 8). This is important
for several reasons:
* It allows the dentist to place a
mockup and to reduce the patient's
teeth only where necessary to
achieve the final result. (This will be
discussed in Step 5.)
* It also allows the treating doctor
to place provisionals that match
the diagnostic plan. This part of
the process allows you to test both
the functionality and cosmetics of
Fig. 8
the plan. If the diagnostic waxup
is not performed, and a functional
and cosmetic " test drive " of the
proposed design is not performed in
provisionals, then the " test drive " of
the desired plan happens only when
the final ceramics are inserted.
It cannot be stressed enough that you
should not skip this step! Nearly all issues
can be overcome by performing a diagnostic
waxup. If records were performed
improperly and an occlusal cant exists in
the diagnostic waxup, a new facebow record
can be performed, or the cant corrected in
the provisionals. The cosmetics are also
adjusted until the patient approves the plan.
5
Place a mockup and
prepare through it.
With a combination of additive waxup
and the lab reducing the preoperative model
only as necessary to add wax, the doctor
performs the same initial enamelplasty to
place the mockup (Fig. 9). With the mockup
in place, the practitioner reduces and prepares
directly into the mockup (Figs. 10 and 11).
This prevents over- or underreducing the
preparations and allows for the proper
amount of reduction to achieve the desired
end result.
By conserving as much enamel as possible,
bond strengths are increased in final
ceramics and long-term success of the case
can be increased.6-8
This technique also
allows for a uniform thickness of the ceramic,
which helps prevent shade variants.9
Once
the preparations are completed, a photograph
is taken with a preparation shade guide to
provide the lab (Fig. 12). This is a necessary
step so the lab can understand what effect
the color of the preparation may have on the
definitive ceramic. This will affect the lab's
decision on ingot selection for the ceramic.
Waxup
Preoperative model
Reduction model
Putty matrix
Reduction guides
54 MARCH 2022 // dentaltown.com
http://www.dentaltown.com
Dentaltown March 2022
Table of Contents for the Digital Edition of Dentaltown March 2022
Dentaltown March 2022 - Intro
Dentaltown March 2022 - Cover1
Dentaltown March 2022 - Cover2
Dentaltown March 2022 - 1
Dentaltown March 2022 - 2
Dentaltown March 2022 - 3
Dentaltown March 2022 - 4
Dentaltown March 2022 - 5
Dentaltown March 2022 - 6
Dentaltown March 2022 - 7
Dentaltown March 2022 - 8
Dentaltown March 2022 - 9
Dentaltown March 2022 - 10
Dentaltown March 2022 - 11
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Dentaltown March 2022 - Cover3
Dentaltown March 2022 - Cover4
Dentaltown March 2022 - SI_1
Dentaltown March 2022 - SI_2
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