Planning for a brilliant restoration

An effective preview

A diagnostic wax-up is key in the development of cosmetically-optimised results in dentistry, for example the production of veneers.[i] There has been a recent uptick in demand for restorations of this manner, led in part by the ‘Zoom boom’ – where individuals are seeking out cometic work after years of analysing their reflections in online video calls.[ii]

Physical diagnostic wax-ups can improve the communication of a desired treatment between technicians and clinicians, whilst identifying an effective plan to achieve these aesthetically-driven outcomes.[iii]

There are generally considered to be two main approaches for a diagnostic wax-up. In the first method a stone cast of the existing dentition is modified in order to create an ideal contour, with the wax then added in the newly-made space around it. The second is a purely additive method; when the teeth are already in an ideal position, wax is simply shaped in the already existing spaces, without taking away from the pre-established structures.[iv]

Choosing between each process may depend on the availability of space in the dentition or patient preference. If an individual doesn’t wish to undergo surgery, for example, the additive method takes on a less invasive and, in turn, more ideal approach.[v]

When correctly applied, both techniques could create an effective and tactile model for the final look of a patient’s new teeth.

Clinician communication

As an essential component in the treatment planning process, technicians must ensure that accuracy is optimised before a wax-up is even created. After all, the model’s creation will rely intrinsically upon the laboratory prescription detailed by a clinician.[vi] Creating an open and communicative relationship with clients could help technicians establish the complete information they need when designing a wax-up.

As well as pre-establishing these needs, it’s important to communicate if and when they aren’t met fully. Some missing information may be assumed, but without directly checking with the initial clinician there is always an element of uncertainty. The most minor and seemingly insignificant assumptions could result in a poor wax-up – wasting both time and money.

Diagnostic wax-ups are used as an effective communication tool between clinician and technician, but they can also be presented to the patient.[vii] They are, of course, the individual receiving the eventual cosmetic treatment. Seeking their opinions in the wax-up stage is essential to working towards a final restoration that everyone involved is confident with. This relies once again on the relationship between the technician and the clinician – the latter commonly acting as an intermediary of the patient’s preferences and requirements.

Creating an accurate model

Whether the agreed approach is a reductive or an additive method, or a bit of both, it’s important that technicians ensure their diagnostic wax-up work is accurate and encourages ideal aesthetics.[viii] This requires technical skill to successfully create a visually appealing and mechanically-functional dentition.

The necessary psychomotor skills must be trained over time to allow technicians to fabricate such intricate models with accuracy. An effective strategy for developing these skills is dental carving, where technicians recreate dental morphological features in wax.[ix] By applying an existing knowledge of the dentition’s structure and that of single teeth to this practice, the techniques can be honed in order to consistently create reliable diagnostic wax-ups.

For many dental technician students, this will be taught early in their course, which could pose a challenge for the retention of the required dexterity.[x] Effective and regular practice allows professionals to maintain and improve upon their technique and knowledge, which could make the difference when designing and crafting a diagnostic wax-up for a client.

Professionals and students can utilise these skills effectively with the Kemdent^® Carving Blocks, specially designed for technicians. The small wax blocks are suitable for real-to-life tooth modelling and carving other models. They are also prepared for student use, allowing for the development of the finer psychomotor skills needed for the efficient and accurate creation of a diagnostic wax-up.

A diagnostic wax-up stands to be one of the most effective tools in a technician’s arsenal when working with clients. By utilising clear and consistent communication with a clinician, alongside some honed psychomotor skills, technicians can reliably create models that drive the outcome of a brilliantly aesthetic dentition.

For more information about the leading solutions available from Kemdent, please visit

www.kemdent.co.uk or call 01793 770 256

[i] Villalobos-Tinoco, J., Jurado, C. A., Rojas-Rueda, S., & Fischer, N. G. (2022). Additive wax-up and diagnostic mockup as driving tools for minimally invasive veneer preparations. Cureus, 14(7).

[ii] Norton, R. (2021). COVID-19 and cosmetic dentistry: the ‘Zoom boom’. Dental Nursing, 17(1), 18-19.

[iii] Chisnoiu, A. M., Staicu, A. C., Kui, A., Chisnoiu, R. M., Iacob, S., Fluerașu, M., & Buduru, S. (2023). Smile Design and Treatment Planning—Conventional versus Digital—A Pilot Study. Journal of Personalized Medicine, 13(7), 1028.

[iv] Villalobos-Tinoco, J., Jurado, C. A., Rojas-Rueda, S., & Fischer, N. G. (2022). Additive wax-up and diagnostic mockup as driving tools for minimally invasive veneer preparations. Cureus, 14(7).

[v] Villalobos-Tinoco, J., Jurado, C. A., Rojas-Rueda, S., & Fischer, N. G. (2022). Additive wax-up and diagnostic mockup as driving tools for minimally invasive veneer preparations. Cureus, 14(7).

[vi] Winter, R., (2017). Why You Should Do a Diagnostic Wax-Up. Spear. (Online) Available at: https://www.speareducation.com/spear-review/2017/12/why-you-should-do-a-diagnostic-wax-up [Accessed July 2023]

[vii] DRAFTA, S., PERIEANU, V., COSTEA, R., EFTENE, O., BURLIBASA, M., MANEA, R. M., … & MARU, N. (2022). Diagnostic Wax-Up-an extremely important method of communication between the dental office and the dental laboratory. Romanian Journal of Medical Practice, 17(2).

[viii] Chisnoiu, A. M., Staicu, A. C., Kui, A., Chisnoiu, R. M., Iacob, S., Fluerașu, M., & Buduru, S. (2023). Smile Design and Treatment Planning—Conventional versus Digital—A Pilot Study. Journal of Personalized Medicine, 13(7), 1028.

[ix] Kara, R., & Velibeyoğlu, M. B. (2022). The Effect of Tooth Carving Technique on Dental Technician Student Perception and Performance in Tooth Morphology and Manipulation Course. Journal of Health and Medical Sciences.

[x] Conte, D. B., Zancanaro, M., Guollo, A., Schneider, L. R., Lund, R. G., & Rodrigues‐Junior, S. A. (2021). Educational interventions to improve dental anatomy carving ability of dental students: A systematic review. Anatomical Sciences Education, 14(1), 99-109.