The Art of Occlusal and Esthetic Waxing

By Rowida Abdalla

This book is a concise but comprehensive guide for understanding the basic principles of occlusion and esthetics that are necessary to perfect wax-ups on mounted casts. The author defines important occlusal terminology and describes tooth morphology with a focus on how these features affect function. The esthetic principles that affect smile design and are important for achieving harmony are also discussed. The second half of this book provides an overview of the waxing armamentarium and step-by-step waxing instructions for maxillary and mandibular posterior teeth in occlusion as well as esthetic wax-ups. With useful photographs and illustrations throughout, The Art of Occlusal and Esthetic Waxing has the practical information that will help readers perfect their wax-ups and understand the significance of morphologic features on proper function.

• Language: English
• Publisher: Quintessence Publishing Co, Inc
• Release date: Oct 1, 2019
• ISBN: 9780867158120

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About the book

This book is a concise but comprehensive guide for understanding the basic principles of occlusion and esthetics that are necessary to perfect wax-ups on mounted casts. The author defines important occlusal terminology and describes tooth morphology with a focus on how these features affect function. The esthetic principles that affect smile design and are important for achieving harmony are also discussed. The second half of this book provides an overview of the waxing armamentarium and step-by-step waxing instructions for maxillary and mandibular posterior teeth in occlusion as well as esthetic wax-ups. With useful photographs and illustrations throughout, The Art of Occlusal and Esthetic Waxing has the practical information that will help readers perfect their wax-ups and understand the significance of morphologic features on proper function.

The Art of Occlusal and Esthetic Waxing

title

Library of Congress Cataloging-in-Publication Data

Names: Abdalla, Rowida, author.

Title: The art of occlusal and esthetic waxing / Rowida Abdalla.

Description: Batavia, IL : Quintessence Publishing Co, Inc., [2019] | Includes bibliographical references and index.

Identifiers: LCCN 2019008202 | ISBN 9780867158113 (spiral bound)

Subjects: | MESH: Inlay Casting Wax | Dental Impression Technique | Dental Occlusion | Tooth--anatomy & histology | Waxes | Outline

Classification: LCC RK652.5 | NLM WU 18.2 | DDC 617.6/75--dc23

LC record available at https://lccn.loc.gov/2019008202

©2019 Quintessence Publishing Co, Inc

Quintessence Publishing Co, Inc

411N Raddant Road

Batavia, IL 60510

www.quintpub.com

5 4 3 2 1

All rights reserved. This book or any part thereof may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, or otherwise, without prior written permission of the publisher.

Editor: Zachary Kocanda

Design: Sue Zubek

Production: Angelina Schmelter

Printed in the USA

This book is dedicated to my wonderful family, who supported me in every possible way and at every step of my career. I owe my life and all my success to them. My loving mother and father taught me to be passionate and hardworking and dedicated their entire lives to making me a better person, dentist, and teacher. My amazing siblings Dina and Amr are my source of laughter and happiness. Thank you for being my rock, my inspiration, my biggest support system, and my #1 fans.

Preface

1Introduction to Occlusion

Functions of Teeth

Important Definitions

Tooth Morphology

Tooth Alignment

Occlusion

2Principles of Esthetics

Achieving Harmony with the Face

Achieving Harmony with the Lips

Achieving Harmony with the Gingiva

Dental Esthetics (Microesthetics)

3The Dental Articulator

What Is an Articulator?

Uses of Articulators

Interocclusal Records

Articulator Parameters

Types of Articulators

Steps for Mounting Casts

4Waxing Mandibular Posterior Teeth in Occlusion

Waxing Armamentarium

Waxing Steps for Teeth Nos. 29 and 30

5Waxing Maxillary Posterior Teeth in Occlusion

Waxing Steps for Teeth Nos. 13 and 14

6Esthetic Wax-Ups

What Is an Esthetic Wax-Up?

Benefits of an Esthetic Wax-Up

Waxing Armamentarium

Waxing Steps for an Esthetic Wax-Up

Same Cast, Different Smiles

References

This book is directed toward dental students and is meant to provide a concise and simple guide for understanding the basic principles of occlusion and esthetics that are necessary to perfect occlusal and esthetic wax-ups on mounted casts. Acquiring and improving these skills prepares students for a successful career in dentistry. Certain morphologic aspects that relate to occlusal and esthetic wax-ups are described in detail with an emphasis on how these features affect function, although this book does not describe the morphology of all tooth surfaces; other textbooks are available for the study of tooth morphology. The second half of this book provides step-by-step waxing instructions for maxillary and mandibular posterior teeth in occlusion on mounted casts as well as esthetic wax-ups. In my previous book, Waxing for Dental Students, we covered the basic instrumentation and waxing techniques on dentoform teeth, and I recommend using both books together to perfect the art of waxing teeth.

Acknowledgments

I would like to thank Yara Mahmoud, DDS, MS, PhD, Fixed Prosthodontics Department, Misr International University, Cairo, Egypt, for the graphic illustrations. I would also like to thank Amr Omar, DDS, MS, Fixed Prosthodontics Department, Misr International University, Cairo, Egypt, for his essential contributions to this book.

Functions of Teeth

The main functions of teeth are mastication, speech, and esthetics. Waxing teeth should be perfected in a way that allows the final restoration to maintain and improve the ability to perform these functions. Teeth do not perform these functions alone; they work in harmony with the other components of the masticatory system, namely the arches, the temporomandibular joints, muscles involved both directly and indirectly in mastication, and the vessels and nerves supplying these tissues. All components of the masticatory system are under neurologic control. The masticatory system can be defined as the functional unit of the body primarily responsible for mastication, speaking, and swallowing.1 This chapter focuses on one component of the masticatory system, the teeth, as this is the main component that can be controlled by the dentist. All the teeth in the mouth assist in performing these three functions. Posterior teeth are mainly important for mastication, but they still affect esthetics and speech indirectly, as their proper alignment provides support for the adjacent soft tissues and muscles of the face and maintains the vertical dimension of occlusion (ie, the distance between the maxilla and the mandible when teeth are in occlusion; Fig 1-1). Thus, proper form and position of posterior teeth influence the overall facial appearance, prevent tooth migration, and maintain the stability of the dentition. Anterior teeth mainly function in providing beautiful esthetics and proper pronunciation while still assisting in mastication through incising and biting foods as well as guiding the mandible through lateral movements. The ability of the teeth to achieve their functions is based mainly on three factors: (1) tooth morphology, (2) tooth alignment, and (3) occlusion (ie, the way the opposing teeth fit together, which is largely dependent on the first two factors).

Fig 1-1 Vertical dimension of occlusion (arrows).

Important Definitions2-4

Centric relation The relationship between maxillary and mandibular teeth when the mandibular condyles are in the most physiologic orthopedically stable position, which is the most superoanterior position in the articular fossae. This position is independent of tooth contact and does not necessarily coincide with maximal intercuspation. In this position, the muscles of mastication function more harmoniously and with less intensity.

Maximal intercuspation The complete intercuspation of the opposing teeth, sometimes referred to as the best fit of the teeth independent of the condylar position. This position is dictated by the teeth themselves, determined when the patient habitually self-closes into complete tooth intercuspation. Maximal intercuspation coincides with centric relation in only 10% of the population.

Protrusive mandibular movement The movement of the mandible forward from the intercuspal position.

Retrusive mandibular movement The movement of the mandible posteriorly from the intercuspal position.

Lateral mandibular movement The movement of the mandible to the right and left sides from the intercuspal position.

Mandibular excursive movements Movement occurring when the mandible moves away from maximal intercuspation in any direction, which includes protrusive, retrusive, and lateral mandibular movements.

Working side The side toward which the mandible moves in lateral excursion.

Nonworking side The side away from the direction of mandibular movement in lateral excursion.

Axial loading The process of directing forces along the long axes of teeth, which are the most tolerated forces by teeth.

Tooth Morphology4-8

The following description of tooth morphology is mainly focused on the tooth surfaces that are created during occlusal waxing, which first-year dental students are expected to learn to perfect their wax-ups and understand the significance of the morphologic features on proper function. A description of the morphologic features needed to create anterior esthetic wax-ups is available in the second chapter of this book.

Morphology of the occlusal thirds of posterior teeth (occlusal surfaces)

Occlusal surfaces are formed of several elevations and depressions. These elevations and depressions form an uneven surface; therefore, when an elevation on an occlusal surface comes in contact with a depression on the occlusal surface of the opposing tooth during mastication, the food is efficiently ground. Proper knowledge of the specific form of these elevations and depressions is of great importance during occlusal waxing and tooth restoration to achieve proper masticatory function. In addition to their role in grinding food, occlusal surfaces should be restored in a way that achieves