Wax Pattern for Fixed

Dental Prosthesis
Dr. Ali Waqar Qureshi
Assistant Professor Prosthodontics
BDS, FCPS, CHPE.
Shifa College of Dentistry (SCD).
 Learning Objectives
After the end of this session the students should be able to:

• Describe lost wax techniques.

• Understand prerequisites of wax up.
• Understand materials used for wax up
• Describe the Wax pattern laboratory procedure/techniques for fixed
prosthesis.
• Explain the recommended sequence of wax up.
 INTRODUCTION – Indirect method –
Lost Wax Technique
• A large percentage of time and effort spent in fabricating metal or
pressed-ceramic fixed prostheses is devoted to producing a very
Impression
accurate wax pattern.

• From this pattern, the finished restoration is duplicated through the use
of the lost-wax process.

• The technique consists of obtaining an accurate impression of the

prepared tooth. Cast
 Cont’d

INTRODUCTION – Indirect method – Lost

Wax Technique Wax pattern on die
• Make a cast from the impression on which a wax pattern that
resembles the shape of the definitive restoration is shaped.

• A mold is then made around the wax pattern with a refractory

investment material.

The pattern is
• When the investment has set, the wax is vaporized in an attached with sprue to
electric furnace. a rubber crucible
former and invested
 Cont’d

INTRODUCTION – Indirect method – Lost

Wax Technique
• The hollow mold is then filled with molten casting alloy,
reproducing every detail of the wax pattern.

• The metal casting is retrieved, excess metal is removed,

and after polishing, the cast restoration is ready for
clinical evaluation.

Luted restoration.
 Cont’d

OPTICAL CAPTURE - Virtual

renderings of substructures.
• A virtual cast can be generated on which the crown can be designed.
The margin has been
delineated on the virtual die
(red line)
• The wax pattern can then be milled from a solid block of specially
formulated wax, or it can be printed.

The optical scan of the

• The margins of the resulting patterns are then readapted manually to occluded position (index)
ensure optimal adaptation, invested, and cast as described previously. used to properly relate the
definitive virtual cast to the
opposing cast.
 Cont’d

OPTICAL CAPTURE - Virtual renderings of

substructures.

Insertion of the opposing cast in relation to the molar and incisor

preparations.
 Cont’d

OPTICAL CAPTURE - Virtual renderings of

substructures.

Anatomic contour renderings are then morphed

 Cont’d

OPTICAL CAPTURE
Virtual renderings of substructures.
• After the anatomical areas are
morphed, the area that is to be
veneered is delineated.
 Cont’d

OPTICAL CAPTURE - Virtual renderings of

substructures.
• Virtual renderings of the completed substructure designs.
 Printing wax patterns.
• ProJet 1200 3D printer.
 Cont’d

Printing wax patterns.

• Printed pattern for a three-unit metal-ceramic fixed
dental prosthesis seated on its corresponding solid
cast.

• Printed patterns for crowns.

• Note the supporting struts to maintain positional

stability during the printing process.
 Solidification
• The solidifying metal (casting) shrinks when it cools to room temperature.

• Dimensional accuracy of the casting is achieved by balancing this shrinkage against precisely
controlled expansion of the mold.

• Wax is used to make the patterns because it can be conveniently manipulated and precisely
shaped.

• With heating, it can be completely eliminated from the mold after investing.
 Careful handling of the wax
• Every defect or void in the wax will appear in the casting.

• Most defects can be corrected easily in wax but not in a metal casting.

• Careful evaluation of the pattern, preferably under low-power (up to 10

times) magnification, is crucial to obtain a good casting.
PREREQUISITES
 PREREQUISITES
• The definitive die and cast may require small modifications before waxing is
started.

• Depending on the procedure, the dentist can increase the size of the die
slightly by applying a thin layer of painted-on spacer, which helps slightly
enlarge the internal diameter of the restoration.
 Cont’d

Correction of Defects
• Even a very small undercut on the die of a tooth preparation
makes wax pattern removal very difficult.
• Small dimples in the die (resulting from caries removal or loss
of a previous restoration) may be undercut in relation to the
path of placement of the planned restoration.
• Such areas are normally blocked out intraorally with glass
ionomer or restored with amalgam or another suitable
foundation material as part of the mouth preparation phase.
 Cont’d

Correction of Defects
• Blocking them out on the working die may be more
practical and convenient, as long as the defect does not
extend to within 1 mm of the cavity margin.

• Zinc phosphate cement is a suitable material, but other

commercial products (e.g., resin) are available for this
purpose.
 Provision of Adequate Space for the Luting
Agent
• A space should exist between the internal surface of the casting and the prepared
surface of the tooth everywhere except immediately adjacent to the margin.

• This provides room for the luting agent and allows complete seating of the
restoration during cementation.

• At the preparation margin, there should be a band of close adaptation (about 1 mm

wide) to prevent disintegration and dissolution of the luting agent.
 Cont’d

Provision of Adequate Space for the Luting

Agent
• The ideal dimension for the luting agent space is 20 to 40 µm for each wall,
so a complete crown should have an internal diameter between 40 and 80 µm
larger than the diameter of the prepared tooth.

• Through the use of available techniques in an appropriately standardized

manner, such a degree of casting adaptation can be obtained routinely,
independent of the geometry of the finish line.
 Cont’d

Provision of Adequate Space for the Luting

Agent
• If the luting agent space is too narrow:
• The restoration will not seat properly during cementation.
• Because of hydraulic pressure that develops when the viscous mass of luting agent cannot escape
through the narrow gap between crown and preparation.

• Conversely, if the luting agent space is too wide:

• The casting is loose on the tooth
• Resistance form is reduced
• The position of the crown is difficult to maintain accurately during evaluation and occlusal adjustment.
 Factors responsible to obtain precise amount
of space for the luting agent:
• Materials and techniques used in the indirect process particularly the choice
of:
1. Impression material.
2. Die material.
3. Investment.
4. Casting alloy.
 Increasing the Space for the Luting Agent
1. Increased thermal and polymerization shrinkage of the impression material.

2. Use of a solid cast with individual stone dies.

3. Use of an internal (initial) layer of soft wax in the wax pattern.

4. Use of die spacers.

 Cont’d

Increasing the Space for the Luting Agent

5. Increased expansion of the investment mold.
6. Removal of metal from the fitting surface by:
• Grinding
• Airborne-particle abrasion
• Etching with aqua regia
• Electrochemical milling
 Cont’d

Impression materials and Die system selection

• The dentist has little control over the polymerization shrinkage of impression materials.

• Die system selection has a direct influence on the size of the wax pattern.

• With some impression materials, using a multiple-pour system for fabrication of a solid
definitive cast and a separate die yields a die that is slightly larger than the prepared tooth.

• The pattern is, in effect, stretched during manipulation, which results in a proportionally
larger internal casting diameter.
 Cont’d

An internal (initial) layer of soft wax in the wax

pattern.
• An internal layer of soft wax is subject to slightly more compression by the
setting refractory investment material, which leads to a looser fit.
 Cont’d

Die spacers
• Spacers enlarge the die by coating the occlusal surface and vertical axial walls
with a thin layer of rapidly drying paint.
 Cont’d

Increased expansion of the investment mold

• To increase the expansion of the investment mold, the mold can be heated
to a slightly higher temperature during the wax elimination phase, and metal
can be removed from the internal surface of a cast crown through:
• Air abrasion.
• Etching.
• Milling procedures.
 Reduction of the Space for the Luting Agent

1. Reduced thermal and polymerization shrinkage of the impression material.

2. Use of resin or electroplated dies.
3. Use of alloys with a higher melting temperature range.
4. Reduced expansion of the investment.
 Cont’d

Resin and electroplated dies

• They are slightly smaller than stone dies and therefore result in a smaller
casting.
 Cont’d

Alloys with a higher melting temperature range.

• As alloys cool over a larger temperature range, the additional shrinkage that
takes place also results in a smaller casting.
 Cont’d

Reduced expansion of the investment.

• There are multiple ways to reduce investment expansion;
• Technique selection.
• Burnout temperature
• Water-to-powder ratio: If the investment is mixed with an adjusted water-to-powder
ratio, which results in less setting expansion, the size of the resulting casting is again
reduced.
Problems with fitting castings become apparent
at two stages of the indirect procedure:
1. When the casting is evaluated on the die
2. When it is cemented.
• Recognizing problems at each stage and correcting them before proceeding
is crucial.
 Difficulty with seating the casting on the die.
• This is generally caused by:
1. Wax distortion
2. The presence of flash (excess wax that was not removed before the
investing and casting procedure) extending cervical to the preparation
margin
3. Improper investment expansion (underexpansion)
4. Casting nodule.
• Modification of the investing and casting protocol solves these
problems by a change in just one variable in the protocol.
• Although many technicians advocate the routine use of die spacer.
 Die Spacer
• This material is similar to model airplane
paint, is applied to the die to increase the
cement space between axial walls of the
prepared tooth and the restoration.

• Applying die spacer is available in contrasting

colors to facilitate applying the required
number of coats.
 Cont’d

Die Spacer
• It is formulated to maintain constant thickness when painted
on the die.
• However, it should not coat the entire preparation.
• For adequate marginal adaptation, a band of about 1 mm
immediately adjacent to the preparation margin must be left
unpainted.
• Thinner is provided to replace the solvent, which tends to
evaporate.
• Use of thickened die spacer can result in an excessive
thickness of spacer.
 Marking the Margins
• The technician’s awareness of the precise location of the preparation margin is
crucial.
• By marking it with the side of a colored pencil tip, the technician can pinpoint this
location.
• The color should contrast with that of the wax that will be used (e.g., a red pencil
can be used for green wax).
• An ordinary lead pencil is not recommended because it can abrade the die, its darker
color can interfere with efforts to verify that the wax has been properly adapted at
the margin, and traces of the graphite (an antiflux) can prevent complete casting of
the margins.
 Cont’d

Marking the Margins

• The marked margins can be coated with low-viscosity cyanoacrylate resin
and immediately blown dry.
• Adds no more than 1 µm to the die.
• Although removing the excess with acetone is sometimes possible, care must
be taken not to create a thick layer of cyanoacrylate, which can result in an
unacceptable fit of the definitive cast restoration.
• For this reason, higher viscosity resins must be avoided.
 Cont’d

Marking the Margins

• Marking the preparation margin.
• Note that the side of the colored pencil tip is
used to keep line width to a minimum.
MATERIALS SCIENCE
 Inlay casting wax
• The name given for all wax used in forming the pattern for cast restorations.
• It is composed of several waxes.
1. Paraffin is usually the main constituent (40% to 60%).
2. Remaining balance consists of:
1. Dammar resin (to reduce flaking).
2. Carnauba.
3. Ceresin.
 Cont’d

Inlay casting wax

6. Candelilla wax (to raise the melting temperature)
7. Beeswax.
8. Synthetic wax is substituted for the natural material.
9. Dyes are added to provide color contrasts.

• Exact formulations are trade secrets.

 Category of Waxes - American National
Standards Institute (ANSI) and the American
Dental Association (ADA)
• Two types:
• Type I:
• A medium-hardness wax (generally used with the direct technique for making patterns in the
oral cavity).
• Waxes used with direct techniques must not flow appreciably at mouth temperature.
• Type II:
• A softer wax (generally used for the indirect fabrication of castings)
• Those used with indirect techniques must resist flow at room temperature to maintain their
newly shaped forms..
TECHNIQUE
 TECHNIQUE
• Incorrect midfacial contour is difficult to determine
from a direct view of a three-dimensional object.
• It is more easily seen (dashed red line) by sequential
evaluation of the profile of the pattern as it is
rotated.
 Cont’d

TECHNIQUE
• The finished wax patterns should be an accurately shaped anatomic replica
of the original teeth that meets all functional dynamic requirements.
• Information needed to shape the restoration correctly is derived from the
contours of the unprepared tooth surface, adjacent tooth surfaces, the
opposing occlusal surfaces, and reproduction of mandibular movement in
the dental laboratory.
• The dentist’s thorough knowledge of tooth anatomy and the ability to copy
three-dimensional structures accurately are needed as well.
 Cont’d

TECHNIQUE
• When waxing a restoration, the technician should refer to:
• A suitable model (e.g., diagnostic casts, unworn extracted teeth, a contralateral tooth) or
• A casts of unworn natural teeth.
• To evaluate occlusal form, breaking down the complex surfaces into
individual components is helpful.
• To evaluate axial contours, the practitioner should assess a series of two-
dimensional outlines by rotating the wax pattern.
 Cont’d

TECHNIQUE
• These outlines can easily be compared with an appropriate model, and any
aberrations can be corrected.
• The human eye excels at interpreting even very small differences in height
and width of objects (two dimensions) but is not in depth.
• Therefore, the practitioner must systematically look at cross sections through
the pattern and evaluate its silhouette.
• Rotation of the pattern and repeating this process from all angles of
observation speed up this intricate process.
 Cont’d

Armamentarium
• Bunsen burner
• Inlay wax
• Waxing instruments
• Cotton cleaning cloth
• Sharp colored pencil (in color
that contrasts with wax).
 Cont’d

Armamentarium
• Separating liquid.
• Occlusal indicator powder: zinc stearate or powdered wax.
• Zinc stearate may present a health hazard if inhaled; powdered wax is a safer
alternative.
• Soft toothbrush.
• Double-sided brushes (soft/rigid).
• Cotton balls.
• Fine nylon hose.
 WAXING INSTRUMENTS
• They can be categorized by the intent of their design:
• Wax addition
• Carving
• Burnishing.
• PKT instruments designed by Dr. Peter K. Thomas
specifically for the additive waxing technique
• No. 1 and No. 2 are wax addition instruments. Top to bottom: PKT Nos. 1 to 5 instruments

• No. 3 is a burnisher for refining occlusal anatomy.

• No. 4 and 5 are wax carvers.
 Cont’d

WAXING INSTRUMENTS
• Top to bottom: PKT Nos. 1 and 2 wax addition
instruments.
• The PKT No. 1 instrument is used for for large increments.
• The smaller No. 2 is used for lesser additions.

• PKT No. 3 burnisher.

 Cont’d

WAXING INSTRUMENTS
• PKT No. 4 wax carver.

• PKT No. 5 wax carver instrument.

 Cont’d

WAXING INSTRUMENTS
• PKT No. 7 waxing spatula.
 Cont’d

TECHNIQUE
• Wax is added by heating the shank of the instrument in the
Bunsen flame, touching it to the wax, and quickly reheating
its shank in the flame.
• Wax flows away from the hottest part of the instrument, so
that if the shank is heated, a bead of wax flows off the tip.
• PKT No. 1 for large increments and the smaller No. 2 is
used for lesser additions
 Cont’d

TECHNIQUE
• Add large amounts of wax, particularly in
forming the initial coping (the thimble-like layer
of wax that covers all prepared surfaces) by using
a No. 7 or 7A waxing spatula.
Dual Digital Wax Carving Touch Pencils
• Electric waxing instruments can also be used as
they enable precise control of the wax
temperature for proper manipulation.

Pro Waxer Duo

 Cont’d

TECHNIQUE
• Another advantage is that they minimize carbon
buildup, which easily results from overheating a waxing
instrument in a Bunsen flame.

• It is not possible to draw solidifying wax in the

required direction because the instrument remains hot. Ultra-Waxer 2.
 Cont’d

TECHNIQUE - Carving
• Wax carvers should be kept sharp and should never
be heated.
• In addition to the PKT instruments, the Nos. 1 2 No. 2 Ward Wax carver.
and 3 Hollenback and the No. 2 Ward carvers are
popular.
• When wax is carved, light pressure should be used
to obtain the desired smooth surface. No. 1/2 Hollenback.

No. 3 Hollenback.
 Cont’d

TECHNIQUE - Burnishing
• It is an alternate to carving for obtaining a smooth wax pattern of the
desired contour.
• Slightly warming a blunt instrument and rubbing the wax.
• The instrument should not be so hot that it melts the wax surface.
• The PKT No. 3 instrument is useful for burnishing the occlusal surfaces.
 Cont’d

TECHNIQUE - Burnishing
• The PKT Nos. 1 and 2 instruments can be used
for burnishing, as well as for wax addition.

• Another popular burnisher, the PFI Land

trimmer - available on special order from Hu- PFI Land trimmer (wax burnisher),
available from Hu-Friedy, Chicago.
Friedy Mfg. Co., Chicago), is based on the DPT6
Darby Perry trimmer.
 Cont’d

TECHNIQUE – Excess wax removal

• Burnishing is less effective than carving but it is easier to control.

• It leaves a smoother surface, which can be particularly important when

excess wax is trimmed near the margin.

• Careless (excessive) carving in this area can lead to abrasion of the die, which
results in a ledge at the margin of the finished casting.
 Waxing Posterior Teeth
• The recommended sequence:
1. Internal surface
2. Wax pattern removal and evaluation
3. Proximal surfaces
4. Axial surfaces
5. Occlusal surfaces
6. Margin finishing
 Cont’d

Waxing Posterior Teeth - Internal Surface

• The wax must reproduce all retention features of the
restoration.
• Apply die lubricant generously with a clean brush.
• Allow the lubricant to dry, and paint on a second
coat (repeat periodically as needed).
Lubricating the die
 Cont’d

Waxing Posterior Teeth - Internal Surface

• Waxing should not begin until the lubricant has been allowed to soak in
completely.
• Lubricant must be reapplied more frequently on dies that have been coated
with cyanoacrylate resin.
 Cont’d

Waxing Posterior Teeth - Internal Surface

• If pinholes have been prepared, fit in plastic pins
that match the bur used to prepare the hole.
• Seat the pins in the die.
• Use a heated PTK No. 7 instrument to flatten
their tops to provide retention in the wax.

Adapting plastic pins.

 Cont’d

Waxing Posterior Teeth - Internal Surface

• Flow wax onto the die from a well-heated, large
waxing instrument, making sure that any previous
application is partially remelted.
• A large instrument holds sufficient heat to partially
remelt previous wax increments and to prevent
folds or lines from developing in the fitting surface. Forming the initial copings:
A large instrument is used to keep
• Waxing is easier if the instruments are kept clean the wax sufficiently hot.
and only the shank is heated. Previous applications should be
remelted as additional wax is added.
 Cont’d

Waxing Posterior Teeth - Internal Surface

• When applying the initial layer, be sure that the wax is fully molten.

• If it is not, wax solidity may cause distortion. Very hot wax flows rapidly over
the die.

• Use cooler instruments for subsequent waxing of external anatomic details,

which allows small additions to be placed accurately.
 Cont’d

Waxing Posterior Teeth - Internal Surface

• Dipping the lubricated die in a pot of melted wax is
another method for making well-adapted internal
surfaces.
• This method works well for complete coverage
restorations.
 Cont’d

Waxing Posterior Teeth - Internal Surface

• Add sufficient wax with a large instrument to allow
the coping to be handled without deformation or
breakage.

• A large instrument keeps the wax hot more effectively

than does a small instrument. Forming the initial copings.
Wax is added to build up adequate
bulk for rigidity
 Cont’d

Waxing Posterior Teeth - Internal Surface

• Give the proximal areas extra bulk for strength and to help grip the coping
and prevent its distortion on removal from the die.
• The wax should cool between applications.
• At this point, no attempt should be made to contour the axial walls.
 Cont’d

Waxing Posterior Teeth - Internal Surface

• Trim the wax back to the margin so that the coping
can be removed and evaluated.
• Excess bulk can be removed safely with a carving
instrument.
• When only a thin excess layer remains, trimming is
performed most safely with a burnisher.
The wax is trimmed very carefully to the margin.
 Cont’d

Waxing Posterior Teeth - Internal Surface

• Careless use of a sharp carver at this stage may scratch the fragile margin of
the die or chip it.
• Therefore, a slightly warmed blunt instrument should be used and the
margins rubbed with a burnishing action.
• A carver can be used, but meticulous technique and great care are required.
Waxing Posterior Teeth – Wax pattern removal

• The wax should be allowed to cool thoroughly before

the coping is removed from the die.

• To remove the coping, the thumb and forefinger of one

hand maintain a constant light grip on the pattern while
Wax pattern removal.
pressure is applied against them with the thumb and A sheet of washed rubber dam
forefinger of the other hand, which also holds the die. increases friction and aids removal.
 Cont’d

Waxing Posterior Teeth – Wax pattern removal

• A small square of washed rubber dam increases

friction between the fingers and the pattern.
• If the pattern fails to move, excess wax may be
present beyond the margin, locking the pattern in
place.
Wax pattern removal.
The fingers of the left hand hold the die.
The right hand holds the pattern.
 Cont’d

Waxing Posterior Teeth – Wax pattern removal

• To pull the die from the pattern, the

fingers of the left hand squeeze the die.
 Waxing Posterior Teeth – Evaluation
• The objective of the first waxing step is a
perfectly adapted reproduction of the prepared
tooth surfaces.
• Identify the defects.
• Rotate the pattern under a bright light and look
for shadows formed by folds or creases.
Well-adapted pattern.
 Cont’d

Waxing Posterior Teeth – Evaluation

• A binocular microscope or a high-quality magnifying
loupe is helpful not only for this step but also
throughout the laboratory phase.
• Ten-power magnification is practical and helpful. Using
higher power interferes with maintaining orientation.

Poor adaptation. Folds and

creases indicate that the wax was
not hot enough when applied.
 Waxing Posterior Teeth – Proximal Surfaces

• The proximal surfaces of natural teeth are

not convex.
• They tend to be flat or slightly concave from
the contact area to the cementoenamel
junction.
• Any restoration must reproduce this feature.

Proximal surfaces gingival to the contact area are normally flat or

concave. Note the triangular shape of the posterior embrasure
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces

• Overcontouring often makes maintaining periodontal health difficult,

particularly if drifting of teeth has increased root proximity.
• Excessively concave or undercontoured proximal surfaces also make flossing
ineffective and must be avoided.
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• The size and location of the contact areas should be established before the
remaining proximal surfaces are waxed.
• Reference is made to the contacts between the contralateral teeth and
knowledge of anatomic form.
• Abnormally large proximal contact areas make plaque control more difficult,
which can lead to periodontal disease.
• Very small (point) contacts may be unstable and cause drifting.
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• Deficient contacts can also lead to food impaction;
although this is not a direct cause of chronic
periodontal disease, it can be very uncomfortable
and painful for the patient.

• Most posterior contact areas are located in the

occlusal third of the crown.
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• The maxillary first and second molars make contact in the middle third.
• The contact areas between mandibular teeth and maxillary molars are
generally central.
• Between maxillary premolars and molars, the contact areas are usually toward
the buccal surface (which makes the lingual embrasure larger than the
buccal).
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• Under no circumstances should a proximal contact area
in the restoration be concave.
• If overlooked during waxing or rendering, concavities
must be recontoured in the finished restoration.
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• Replace the wax coping on the lubricated definitive cast
or removable die.
• When a removable die system is used, care must be taken
to ensure that the locating pin or pins and stone surfaces
are absolutely free of excess wax or other debris that
could prevent complete seating of the die. Wax chips that accumulate on the
dowel pin or in the sleeve prevent a
• To ensure that proximal contacts are not deficient, die from seating.
relieve the adjacent proximal surface slightly by scraping. Periodic cleaning with a brush is
recommended.
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• Adjust the coping as necessary to be completely clear
of the opposing occlusal surfaces.
• The structure will be developed with the wax additive
technique later
• Add wax to the contact areas until they are the correct
To ensure that proximal contacts
size, properly located, and consistent with anatomic are not deficient, a slight amount
form. of stone is scraped from the
adjacent tooth before waxing.
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• Wax is added to the contact area to establish a
correctly located proximal contact.
• When this has been accomplished, shape the
proximal surfaces gingival to the contacts to
the correct contour.
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• A properly trimmed die is of great assistance in accomplishing this. The
unprepared tooth structure that was reproduced in the “cuff ” of the
impression now serves as an effective guide to orienting the waxing
instruments properly.
• Evaluation: The location of the contact area is checked once again.
• Where multiple restorations are being made, the proximal embrasure is
shaped symmetrically to provide adequate room for the free gingival tissues
of adjacent teeth.
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• The proximal surfaces should be flat or slightly
concave.
• Should be shaped to eliminate any directional
change between the root surface and the finished
restoration.
From the occlusal view, proper buccal
and lingual embrasure form have been
established
 Cont’d

Waxing Posterior Teeth – Proximal Surfaces –

Contact Areas.
• The cervical contour of the restoration should
be continuous, with the contour of the
unprepared tooth structure immediately cervical
to the preparation margin.
• The contact areas should be shaped so that the
gingival embrasures are symmetric.
 Waxing Posterior Teeth – Axial Surfaces.
• The buccal and lingual surfaces should be shaped to follow the contours of
the adjacent teeth.
• The location of the height of contour (or, alternatively, the survey line for
retainers for removable dental prostheses) is generally in the gingival third of
most teeth.
• Although on mandibular molars it is usually in the middle third of the lingual
surface.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces.

• Restorations are often made too bulky.
• Natural teeth are rarely more than 1 mm wider at their height of contour than at the
cementoenamel junction.
• This width should not be exaggerated when a tooth is re-created in wax.
• Emergence profile: The tooth surface gingival to its height of contour immediately
adjacent to the gingival soft tissues should be flat or concave.
• Creation of a convexity in this area or a shelf or ledge makes bacterial plaque
removal more difficult and has been shown to cause inflammatory and hyperplastic
changes in the marginal gingiva.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces

• In the past an excessive axial contour was considered necessary to keep food
from entering the gingival sulci.
• However, no evidence supports this concept.
• Healthy gingival tissue are associated with artificially reduced axial contours
(as when a prepared tooth is left unprotected for an extended period).
• Overcontoured axial surfaces result if axial reduction during tooth
preparation has been insufficient.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces

• Special care is needed where bone loss has
occurred as a result of periodontal disease,
particularly when this has caused exposure
of the root near the furcation.
• The axial contour should then be modified
to improve access for plaque removal.
As the cervical margin is placed near root furcations,
the axial contour is modified to improve access for
plaque control in patients with extensive bone loss.
Change in the outline form of the occlusal tables.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces –

Axial Contours.
• As the cervical margin is placed near root
furcations, the axial contour is modified to
improve access for plaque control in patients
with extensive bone loss.
• The contralateral teeth have normal axial
contour.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces –

Axial Contours.
• Modified contour allows better access for oral
hygiene.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces –

Axial Contours.
• Establish the location, position, and overall outline of the contour, using the
adjacent and contralateral teeth as a guide.

• Wax the axial surfaces gingivally to form a smooth, flat profile.

• There should be no change of direction from unprepared tooth structure to

the axial restoration contour.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces –

Axial Contours.
• Shape the middle third of the axial surface, using
the adjacent tooth as a guide.
• Add wax to join the axial and proximal surfaces,
and smooth them, paying particular attention to
the location and shape of the mesial and distal
transitional line angles.
• Waxing axial contours.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces –

Axial Contours.
• A Boley gauge may prove helpful.
• The line angles should correspond to those on
the contralateral teeth if those are intact.
• Evaluating the buccolingual dimension with a
Boley gauge. This instrument is also helpful in
assessing axial shape and height of contour.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces –

Axial Contours.
• Evaluate the shape of the tooth at its greatest convexity by looking at the
wax pattern and comparing its shape with that of the contralateral tooth.
• Each part of the outline should be carefully scrutinized.
• An outline that is too square or too round is modified.
• The buccal and lingual contours and the embrasures should all be assessed.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces –

Axial Contours.
• Initially, assessing individual components rather than the entire contour or
outline is helpful.
• Try to relate the shape under evaluation to a “neutral” reference point, such
as the midsagittal plane in viewing from the occlusal surface.
• With more experience, the practitioner will find it easier to review multiple
forms simultaneously.
 Cont’d

Waxing Posterior Teeth – Axial Surfaces –

Axial Contours.
• Each contact area has four embrasures: gingival,
buccal, lingual, and occlusal.
• All but the occlusal will have been completed by this
stage.
• The embrasures are normally symmetric about a line
drawn through the contact area.
• Symmetry of embrasures.
 Waxing Posterior Teeth – Occlusal Surfaces

• The cusps and ridges of the occlusal surfaces should be shaped to allow even
contact with the opposing teeth while the teeth are stabilized and forces are
directed along their long axes.
• Nonfunctional cusps (buccal cusps of the maxillary teeth, lingual cusps of
the mandibular teeth) should overlap vertically and horizontally, preventing
accidental biting of the cheek or tongue and keeping food on the occlusal
surface.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Point contacts between opposing teeth are preferable to

broad, flat occlusal contacts because wear of the
restorations is minimized and mastication of tough or
fibrous foods is improved.
• The occlusal surfaces of natural teeth consist of a series
of convexities with developmental grooves where the To develop accurate occlusal contacts,
convex ridges meet. wax is added in small increments,
and the articulator is closed while
• Occlusal waxing with the sequential wax addition the added wax is still soft.
technique.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Powder is used to verify the location and size of the

contact.

• Cones are used to determine the location of the

lingual cusp tips.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• The various features of the occlusal surface

are developed sequentially in wax.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Secondary occlusal features can be refined

by reflowing the wax and burnishing the
fissures.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Completed waxing with occlusal contacts

marked. (For the cusp–marginal ridge scheme).

First Premolar Second Premolar First Premolar Second Premolar

 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Completed waxing with occlusal contacts marked. (For the cusp–marginal

ridge scheme).

First molar distolingual cusp

First molar mesiolingual cusp First molar distobuccal cusp First molar mesiobuccal cusp
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• The opposing cusps should travel through pathways paralleling the grooves
in the occlusal table of natural teeth without tooth contact in excursive jaw
movements.
• The occlusal surfaces can be precisely developed with a wax addition
technique.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Sequence of occlusal wax addition.

• Step 1: placement of cones.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Sequence of occlusal wax addition.

• Step 2: superimposition of cuspal ridges.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Sequence of occlusal wax addition.

• Step 3: placement of cones, cuspal
ridges, and triangular ridges.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Sequence of occlusal wax addition.

• Step 4: placement of cones, cuspal
ridges, triangular ridges, and secondary
and marginal ridges.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces

• Sequence of occlusal wax addition.

• Step 5: finished occlusal waxing.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces -

Occlusal Scheme.
• Two occlusal schemes are generally recognized
1. Cusp–marginal ridge.
2. Cusp-fossa.
 Cont’d

Cusp–marginal ridge scheme

• The buccal cusps of the mandibular premolars and the mesiobuccal cusps of
the mandibular molars contact the embrasures between the maxillary teeth
(i.e., they each contact two teeth).
• The lingual functional cusps of the maxillary teeth contact the fossae of the
mandibular teeth in both schemes.
• Most adults with an Angle class I occlusion and unworn teeth have a cusp–
marginal ridge scheme.
 Cont’d

Cusp–marginal ridge scheme

 Cont’d

Cusp-fossa scheme.
• The mandibular functional cusps contact farther distally into the fossa of the
maxillary tooth and contact only one tooth.
• The lingual functional cusps of the maxillary teeth contact the fossae of the
mandibular teeth in both schemes.
• In natural dentitions, the cusp-fossa arrangement is found only when a slight
Angle class II malocclusion is present.
 Cont’d

Cusp-fossa scheme.
• Recommeded over the cusp–marginal ridge when occlusal reconstruction is
undertaken because:
1. Food impaction is prevented.
2. Centric relation closure forces are nearer the long axes of the teeth.
3. Improved stability results from the tripod contacts for each functional cusp.
• When the mesiodistal relationships of opposing teeth favor it, the cusp-fossa
scheme is optimal.
 Cont’d

Cusp-fossa scheme.
• If these relationships are not present, the choice is between
1. Distorting coronal axial form to accommodate the preferred occlusal
scheme, and
2. Altering the occlusal structure to accommodate normal axial form.
 Cont’d

Cusp-fossa scheme.
• Significant deviation from normal axial form by overcontouring invariably
results in periodontal disease.
• Altering axial form by undercontouring rarely causes such problems.
• Depending on the specific spatial relationship between the antagonists, the
cusp–marginal ridge scheme may be a better choice in such situations.
 Cont’d

Cusp-fossa scheme.
• However, the decision is not always a clear one.
• Tooth size and position variations among patients produce a continuum between
the optimal cusp–marginal ridge and cusp-fossa schemes.
• Common sense dictates using the scheme that produces the best overall functional
and esthetic result.
• In many cases, this can be determined only by trial and error.
• The placement of cones before any other occlusal waxing is often the most
expedient way to accomplish this.
 Cont’d

Cusp-fossa scheme.
 Cont’d
Features of Cusp–Marginal Ridge Scheme: Functional Cusp Articulation
Tooth Functional Cusp Opposing Fossa Opposing Marginal Ridge (Same tooth unless
otherwise specified)
Maxilla
First premolar Limgual Distal -
Second premolar Limgual Distal -
First molar Mesiolimgual Central- -
Distolingual - Distal & Mesial of Second Molar
Second molar Mesiolingual Central- -
Distolingual - Distal
Mandible
First premolar Buccal - Mesial
Second premolar Buccal - Distal and Mesial of first premolar
First molar Mesiobuccal - Distal and Mesial of second premolar
Distobuccal Central -
Second molar Mesiobuccal - Distal and mesial of the first molar
Distobuccal Central -
 Cusp-Fossa Scheme: Functional Cusp Articulation Cont’d
Tooth Centric Cusp Opposing Marginal Ridge (Same Tooth
unless Otherwise Specified)
Maxilla
First premolar Lingual Distal
Second premolar Lingual Distal
First molar Mesiolngual Central
Distolingual Distal
Second molar Mesiolngual Central
Distolingual Distal
Mandible
First premolar Buccal Mesial
Second premolar Buccal Mesia;l
First molar Mesiobuccal Mesial
Distobuccal Central
Distal Distal
Second molar Mesiobuccal Mesial
Distobuccal Central
 Cont’d

Cusp Height and Location

• The position and height of the cusps are
determine with wax cones.
• This is done so that necessary
modifications can be made rapidly.
• Add wax cones for each cusp, and mark
the central fossae of opposing teeth to
help position the cusps correctly.
 Cont’d

Cusp Height and Location

• Position the centric or functional cusps (mandibular buccal and maxillary
lingual) so that they occlude along the buccolingual center of the opposing
tooth.
• The actual cusp tips do not contact the opposing tooth.
• Greater stability and reduced wear are possible with small points of contact
distributed around the cusp tips.
 Cont’d

Cusp Height and Location

• Use the mesiodistal location of the cones to
determine the type of occlusal scheme to be
attempted: cusp–marginal ridge or cusp-fossa.
• The cones should be positioned so that they
follow the anteroposterior curve.
• The mandibular cusps should become taller
farther distally, and the maxillary cusps should
become shorter.
 Cont’d

Cusp Height and Location

• The cusps should also follow a mediolateral curve (sometimes referred to as
the curve of Wilson).
• When viewed from the front, the nonfunctional cusps are slightly shorter
than the centric cusps.
• All eccentric movements should be reproduced on the articulator; if
unwanted contact results in protrusive, working, and nonworking excursions,
they should be eliminated by either reduction or repositioning of the cones.
 Cont’d

Cusp Height and Location

• The cusp’s height is determined by the
anteroposterior curve (curve of Spee).
 Cont’d

Cusp Height and Location

• Marking the central fossae of opposing
teeth helps position the functional cusps
correctly.
 Cont’d

Cusp Height and Location

• All cones are positioned and tested for
interferences in all excursions.
 Cont’d

Cusp Height and Location

• The wax additive technique is especially
useful when multiple restorations are
provided simultaneously.
 Cont’d

Waxing Posterior Teeth – Occlusal Surfaces -

Completion of Axial Contours.
• Complete the axial contours (marginal ridges and Completed axial contours.
cuspal ridges. The maxillary buccal cusp ridges.

• Be especially careful not to alter the location or

height of the cusps.
• After each addition of wax, check for occlusal
contact by closing the articulator.
• Do not increase the occlusal vertical dimension.
 Cont’d

Waxing Posterior Teeth - Completion of Axial

Contours.
• The buccal, mesial, lingual, and distal surfaces have
been completed.
• The wax pattern should appear identical to an intact
tooth.
• When viewed from the buccal perspective, each cusp
should have a distinct profile, with the cusp tip highest
and a gentle slope down to the marginal ridges.
 Cont’d

Waxing Posterior Teeth - Completion of Axial

Contours.
• Adjacent marginal ridges should be of the same height.
• Occlusal contacts in excursive movements must also be evaluated.
• If there is unwanted contact, grooves can be created in the cuspal ridges to
allow the passage of opposing cusps.
 Cont’d

Waxing Posterior Teeth - Triangular Ridges

• Give each cusp a triangular ridge that runs toward
the center of the occlusal surface.
• The apex (or point) of the triangle should be at the
cusp tip, and the base should be in the center of the
occlusal surface.
• Make the bases of the buccal and lingual triangular
ridges convex mesiodistally and buccolingually.
 Cont’d

Waxing Posterior Teeth - Triangular Ridges

• As each ridge is added, close the articulator.
• Where the occlusal surface meets an opposing tooth, note
the small depression and adjust this to form a convex
surface so that pinpoint contact exists.
• The triangular ridges are dusted with zinc stearate or
powdered wax.
• The cusps should still have their correct sharp contour
and should not be rounded by improper polishing.
 Cont’d

Waxing Posterior Teeth - Secondary Ridges

• Make two secondary or supplemental ridges adjacent
to each triangular ridge.
• All cusps should have a single triangular ridge and
two secondary ridges.
 Cont’d

Waxing Posterior Teeth - Secondary Ridges

• The degree of specific delineation between the
triangular and secondary ridges varies, depending
on the prominence of the cusp within the
occlusal surface of the tooth that is being waxed.
 Cont’d

Waxing Posterior Teeth - Secondary Ridges

• Make the secondary ridges convex with grooves
where they meet the convexities of the triangular
ridges.
• The most mesial and most distal secondary ridges
are often contiguous with the marginal ridges.
 Cont’d

Waxing Posterior Teeth - Secondary Ridges

• If the ridges have been carefully formed, only a
small amount of finishing is needed at this stage.
• Any pits can be filled with wax and the grooves
carefully smoothed.
• Initially, obtaining smooth transitions between the
occlusal components may be difficult.
 Cont’d

Waxing Posterior Teeth - Secondary Ridges

• Smoothing from the grooves onto the
individual occlusal features, rather than back
and forth, prevents unnecessary
accumulations of wax residue in the grooves.
 Cont’d

Waxing Posterior Teeth - Secondary Ridges

• The occlusal surfaces are redusted with zinc
stearate or powdered wax, and the occlusal
contacts are checked.
• If a contact has inadvertently been polished
away, it can be quickly re-formed by the addition
of a drop of wax, closing of the articulator to
verify that contact was restored, and subsequent
reflowing and reshaping of the occlusal feature
to reestablish a convex contour.
 Cont’d

Waxing Posterior Teeth - Margin Finishing

• To optimize the adaptation of the wax pattern (and the cast restoration) to
the die, the margins must be reflowed and refinished immediately before the
wax pattern is invested.
• The two principal objectives are:
1. Minimizing dissolution of the luting agent and
2. Facilitating plaque control.
 Cont’d

Waxing Posterior Teeth - Margin Finishing

• If a zone of superior adaptation (i.e., minimum marginal gap
width) between the casting and the prepared tooth surface is
created, cement dissolution is reduced and the exposure of the
rough cement surface is minimized.
• To obtain this superior adaptation, the pattern should be
reflowed over a band approximately 1 mm wide, measured
from the margin onto the prepared surface.
 Cont’d

Waxing Posterior Teeth - Margin Finishing

• Plaque control is facilitated when the transition from cast restoration to
tooth is smooth, without any sudden directional change.
• The axial surface of the restoration must be highly polished.
• Because the use of any metal polishing compound or abrasive material
results in removal of restoration material, metal finishing procedures should
be kept to a minimum near the margin.
 Cont’d

Waxing Posterior Teeth - Margin Finishing

• The best way to prepare for this step is to ensure
superior smoothness of the wax pattern when the
reflowing process is complete.
• This should be verified under magnification with
loupes or a binocular microscope.
 Cont’d

Waxing Posterior Teeth – Reflowing the

margins.
• After waxing, a marginal discrepancy is normally apparent
(arrow).
• This must be corrected before investment.
• A large, well-heated instrument is used to melt completely
through the wax.
• Then continue around the preparation margin and add
wax to fill the depression.
• When the pattern has cooled, the marginal excess is
carefully trimmed or burnished.
THANKS