J Dent Rehabil Appl Sci.  2023 Jun;39(2):89-95. 10.14368/jdras.2023.39.2.89.

Esthetic restoration of maxillary anterior fixed prosthesis using a digital diagnostic wax-up: a case report

• Oh E
• Park S
• Jang W
• Park C
• Yun K
• Lim HP
• Park S

• KMID: 2549276
• DOI: http://doi.org/10.14368/jdras.2023.39.2.89

Abstract

Recently, computer-aided design and computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of prosthesis. The diagnostic wax-up by using digital technology simplifies the laboratory process and provides clinical efficiency and convenience. In this case, Digital diagnostic wax-up was superimposed on extra-oral photo to consider the patient’s facial appearance and utilized to produce the final prosthesis. It can be more efficient and esthetic than a diagnostic wax-up that was made only on a model. The digital diagnostic wax-up that superimposed on extra-oral photo not only visualizes the predicted outcome of prosthodontic treatment but also improves satisfaction and facilitates the communication between patient and dentist. We report aesthetically and functionally satisfactory results that obtained after restoration.

Keyword

diagnostic wax-up; esthetic prosthesis; CAD/CAM

Figure

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  Fig. 1 Initial intraoral photographs. (A) Right lateral view, (B) Frontal view, (C) Left lateral view.

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  Fig. 2 Extra-oral photographs for esthetic analysis. (A) Frontal view. Right slanted incisal plane, discrepancy between facial midline and dental midline, low smile line, (B) Lateral view. Upper lip to E-line (+2 mm), 99° nasolabial angle.

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  Fig. 3 Initial radiograph. (A) Panoramic radiograph, (B) Standard radiograph.

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  Fig. 4 Intraoral scan after extraction.

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  Fig. 5 Digital diagnostic wax-up on CAD software. (A) Design in consideration of tooth ratio, (B) Tooth alignment.

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  Fig. 6 Superimposition of extra-oral photographs. (A) Superimposition of digital diagnostic wax up and extra-oral photographs, (B) Esthetic re-evaluation of diagnostix wax-up.

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  Fig. 7 Materials for counseling. (A) Digital diagnostix wax-up model, (B) 3D printed model.

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  Fig. 8 Preparation. (A) Putty index for reduction guide, (B) Impression taking with intraoral scan, (C) Intraoral photo of pre-fabricated provisional restoration.

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  Fig. 9 Definitive prosthesis. (A) Diagnostic wax-up library, (B) Intraoral photo of final restoration.

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  Fig. 10 Extra-oral photo of patient with final restoration. (A) Frontal view. Incisal plane parallel to inter-pupillary line, dental midline correspond to facial midline, average smile line, (B) Lateral view. Upper lip to E-line (-1 mm), 105° nasolabial angle

Reference

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