cosmetic dentistry - beauty & science

22 I I patient communication _ diagnostic mock-up nostic template or a diagnostic mock-up. It is an advantageous diagnostic tool and a great com- munication method to help the patient visualise the anticipated outcome in three dimensions and intra-orally,withlittleclinicalchairtimerequired. The diagnostic mock-up technique entails mak- ing a silicone matrix from the diagnostic wax-up and filling it with an auto-cure resin temporary material before placing it intra-orally. The diag- nostic mock-up is therefore a replica of the ideal wax-up of the desired restorative outcome. It is very practical when no major enameloplasty is required, since this would not allow the place- ment of the silicone matrix. This technique is especially useful for diastema closure, given that closing the spaces may in some instances change the patient’s appearance dramatically. A diagnostic mock-up is very simple to create. During the first patient visit, impressions are taken to create a diagnostic wax-up. A silicone impression is made from the diagnostic wax-up usingapolyvinylsiloxaneputtymaterialtocreate amatrix.Atthenextappointment,petroleumjelly is generously applied to the patient’s teeth and surrounding gingiva and gently thinned with air. An auto-cure resin used for provisional material is placed into the silicone matrix impression and placed on the patient’s teeth until fully poly- merised. The excess material is then removed at the gingival margin using a #12 blade or a flame carbide or diamond bur. The patient can imme- diately see and appreciate the proposed result. The diagnostic mock-up can be removed simply by detaching the material with a spoon or other hand instrument. The value of the diagnostic mock-up cannot be overemphasised because it can be achieved very quickly and relatively inexpensively. It also provides an opportunity for the operator to verify the contours of the restorations planned with the diagnostic wax-up, as well as the occlusal plane, the length and angulation of the teeth, their re- lation with the upper and lower lips at rest and when the patient smiles, the phonetics and the Fig. 10_Pre-op photograph of patient’s smile (Case II). Fig. 11_Pre-op intra-oral view (Case II). Fig. 12_Diagnostic mock-up (Case II). Fig. 13_Intra-oral view of diagnostic mock-up (Case II). Fig. 14_Post-op photograph of patient’s smile (Case II). Fig. 15_Post-op intra-oral view (Case II). cosmeticdentistry 3_2012 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 10 Fig. 11