Occlusion Exercise #19 & #20: Additive Wax Technique Pauline Hayes Garrett, D.D.S. Department of Endodontics, Prosthodontics, and Restorative Dentistry University of Maryland, Baltimore

Articulate Casts: in Maximum Intercuspation

Class 1 Occlusion Note: Ideal cusp- fossa/ embrasure relationship

Canine Guidance Note: There is no interference of the posterior teeth in excursive movements

Mandibular Arch Triangular ridges are red Marginal ridges are blue Cusps tips are marked by the circles Mesial and Distal cusp ridges are green

Prepare the casts Lines drawn on the facial aspect that bisect the cusp tips

Prepare the casts Lines drawn on the lingual aspect that bisect the cusp tips

Prepare the casts Lines are drawn over the occlusal aspect of the teeth It is important to follow the orientation of the triangular ridges when drawing these lines

Prepare the casts Horizontal lines delineate how far the cast should be cut down prior to starting the waxing.

Prepare the casts Preparation of the casts for waxing Cast should be cut down gingival to the buccal groove on the molar

Prepare the casts Two line are now drawn on the occlusal aspect that represent the bucco-occlusal and linguo-occlusal lines Undercuts will be placed on this surface in the areas will the cusp tips should be positioned The undercuts on the cast will be placed with a #8 round lab bur with the slow speed handpiece

Cusp Tips: Cone for the buccal cusp tip of #20 In an excursive movement there should be no contact

Cusp Tips: All cones are in place on the mandibular teeth in the areas of the buccal and lingual cusp tips

Triangular Ridges: The inner and outer aspects of the teeth are filled in with red wax Note the orientation of the triangular ridges

Marginal Ridges Teeth are complete except for the addition of the marginal ridges The mesial and distal cusp ridges are created by using blue wax

Waxing Completed Mandibular teeth are waxed to completion Note the ability to see all the various colors of wax that were utilized to create the tooth

Check Occlusion with zinc Stearate Initial dusting with the zinc stearate

Check Contacts Contacts shown with Zinc Stearate

Check Contacts Heavy occlusal contact noted by the red arrow Remember the contacts should be in the correct location and of equal size and shape

Check contacts Zinc Stearate powder indicates an contact on the distal aspect of the cusp tip. Is this contact misplaced??

Check Contacts Contacts on the marginal ridges of the premolar and the molar Ideally this contact should be in a more buccal position

Check Contacts Note contacts in the central fossa region on the molar What opposing structure created this mark?

Check Contacts The casts are placed in a working movement. Note the areas where the maxillary teeth contact the wax-up. Should there be contacts??

Check Contacts Red pointer marks an interference on the buccal cusp