Diagnostic Wax-Up Planning for Multiple Tooth Loss Rehabilitation

A case study detailing the planning and execution of a diagnostic wax-up for a patient with multiple lower tooth loss, focusing on increasing the occlusal vertical dimension (OVD) and restoring chewing, phonetics, and aesthetics.

Initial design of the diagnostic wax-up

Introduction

This clinical case involved the planning of a diagnostic wax-up for a patient with multiple lower tooth loss. The goal was to restore chewing, speaking, and aesthetic functions, beginning with the rehabilitation of the upper crowns. The dentist provided several references for the patient’s new smile plan, including photographs and an in-mouth record of the desired height to increase the occlusal vertical dimension (OVD).

Materials and Methods

  • STL File: Conventional impression with a plaster mold registered with a DOF bench scanner
  • Reference Images: Frontal and profile photographs of the smile, photos of the arches with a lip retractor
  • Height Record: In-mouth record of the desired height for OVD increase
  • Planning Objective: Increase the occlusal vertical dimension (OVD) and restore chewing, phonetics, and aesthetics.
Final model after the diagnostic wax-up

Processes

  1. Initial Analysis and Planning:
    Based on the scanned models, photographs, and the OVD height record, a preliminary analysis was performed to define the new occlusal plane and the ideal height for the vertical dimension increase.

  2. Diagnostic Wax-Up of Upper Elements:
    Using the collected references, a diagnostic wax-up of 13 upper elements was completed. This process established the new occlusal plane and optimal positions for chewing and speaking functions.

  3. Functional and Aesthetic Evaluation:
    Adjustments to the OVD were made using photographic references and the height record, ensuring a comfortable and visually harmonious rehabilitation.