Rich Rosenblatt When doing a larger case, it takes a lot of planning. If I’m doing anterior restorations, I like to get an impression of the patient’s mouth, have an idea wax up made and then transfer that wax up to the mouth.
This lets the patient try out what the final will look like and we can adjust length, occlusion, phonetics and esthetics. It is a predictable way to minimize surprises in your final case. The key is getting a nice wax up with a putty matrix to transfer the wax up. I would strongly recommend avoiding a suck down because it does not give the detail of a putty matrix when transferring it to the mouth. In this specific case, I etched and bonded all the maxillary teeth and used bisacryl provisional material that would be bonded to the surface of his teeth.
I did not do any prepping. Bonding this to his teeth allowed him to see what the wax up looks like in his mouth and allows him to function at his new vertical dimension. We can adjust in the temps for the weeks that he is wearing it prior to the final case being done. When the case is stable and the patient is happy with the look, we just need to bio copy the case and recreate exactly what was in his mouth in the provisional phase. At the end of the day on a large case like this, the more ideal the wax up and the matrix copying that wax up, the less work you’ll have to do for the finals.
