C ase Report

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EASY ESTHETIC MOCK-UP

Ahmad Bunashi DDS Prosthodontist, Farwania Dental Specialty Center Ministry of Health, Kuwait.
Correspondence: Ahmad Bunashi DDS Bayan 72053 State of Kuwait. Email: drbunashi@gmail.com
ABSTRACT
Comunicting anticipated results between dentist and patient is impairative for successful veneer treatment. This
article describes a technique that allows for proper comunication of eshtetic result with ease .
Keywords: Esthetics, Mock-up, Veneers, bis-acrylic material.

Introduction:

4.

Veneers play a major role in esthetically improving teeth in

dentistry. They improve esthetics and are conservative in
the same time, preserving tooth structure. This feature has
made veneers a restoration of choice by many dentists when
performing esthetic rehabilitation. However, in these cases,
the challenge has always been meeting patients demands
and esthetic expectations.1,2,3 Perception of esthetics varies
from patient to doctor and miscommunication regarding
anticipated result can be frustrating to both ending in a
failure.4,5,6 Adequate communication is crucial.
Several techniques to overcome such a problem have been
suggested in the literature vi z before and after
photographs,7 diagnostic wax setups,8,9,10 composite resin
mock-up,11,12 computer imaging simulation13 or acrylic resin
mock-up. This case report describes a technique were the
outcome of the treatment can be communicated to the patient
utilizing diagnostic wax setups and bis-acrylic material.
Technique:
1.
2.

3.

Obtain diagnostic model of the patient and mount

models on an articulator (Fig.1).
Start and complete diagnostic wax up. Design
patients smile based on preliminary information
gathered at initial visit (Fig.2).
Make a putty index duplicating the wax up:

Create a palatal window (Figs. 3 and 4):

a.

Using #11 blade, cut and remove, from

the putty index, the palatal side of the
teeth to be restored.

b.

Extend the window to the adjacent tooth

on each distal side.

c.

Do not include the incisal edges in the

window. Maintain incisal overlap with the
putty index.

5.

Trim both distal wing parts of the index so only

the imprint of teeth is kept. Remove all soft tissue
imprints to minimize interference when seated in
the mouth.

6.

Trim the imprint of cervical soft tissue of the teeth

to be restored so that only about 1mm of cervical
soft tissue is kept.

7.

Try the index in the patients mouth and verify

seating.

8.

Line the imprint of teeth with Bis-acrylic material

and seat swiftly in the patients mouth (Fig. 5).

9.

Using a cotton roll, swipe away the excess material

quickly from the palatal side before material starts
to harden (Fig. 6).

a.

Extend the putty index few teeth distal to

teeth intended for restoration.

10. Allow for setting of bis-acrylic and then remove

the putty index.

b.

Extend the putty to capture few

millimeters of the soft tissue.

11. Check for adaptation. Remove any over-flashes

of material with composite polishing burs.

c.

Make the putty index thick enough to

allow for rigidity.

12. Allow patient to view and try the Mock-up of

anticipated final result (Fig.7).

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Ahmad Bunashi

13. Remove the mock-up by chipping it away with a

proper instrument. ( viz;excavators, or explorer)
Discussion:
A mock-up review of anticipated final restoration is an
important tool of communication between the doctor and
the patient. This technique allows for a Mock-up to be
fabricated with great ease and short clinical time. This
technique has several advantages:
1.

Does not require sophisticated software or

digital imaging.

2.

Requires minimum chair time for setting of

material and trimming

3.

Excellent immediate adaptation to tooth

surface without the need for relines or
adjustments.

4.

Patient can physically experience the

anticipated results at hand.

5.

Patients remarks are more objective since

patients are physically trying a mock-up of
the anticipated restorations.

6.

Bis-acrylic mock-up can be removed with

relative ease with minor risk of locking into
teeth embrassures.

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Also, it must be kept in mind that this technique is intended

when facial veneers are the restoration planned for. Tooth
modification is not intended or will be minimal if any.
Anticipated restoration is bonded over underlying
unmodified tooth structure. The discussed mock-up
technique will not serve its purpose when correction of
rotated teeth, mal-angled teeth or when considerable
amount of tooth structure removal is needed. In such
situation, the mock-up created using this technique may
not convey an accurate representation of the anticipated
restoration. In such cases, tooth modification is completed
and full coverage provisionals are more appropriate.

The Bis-acrylate material has a great advantage over

polymethy methacrylate (PMMC), a commonly used
provisional restoration, because it sets initially in rubbery
stage which allows ease of manipulation and less risk of
locking into teeth embrasures.14,15 It is very brittle15 and can
be easily chipped off the teeth with an excavator or any
adequate instrument. It is also the experience of the author
that this mock-up can be left clipped on patients teeth for
a day. This allows patients to try them among friends and
family making the trial experience more realistic and their
feed back more objective. It is not recommended to keep
them for more than a day due to possible hygiene problems.
Disadvantages:
One great shortcoming of this technique, it is only good
for one time trial. Bis-acrylic brittleness will not allow the
created mock-up to be removed and re-inserted again.
Attempting to remove the mock-up will most likely cause it
to break. Relative high cost of material is another
disadvantage. Bis-acrylate material is more expensive in
comparison to PMMC.

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Easy Esthetic Mock-up

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Conclusion:
A method to communicate the anticipated esthetic result to
a patient is very important. Several techiques have been
discussed in the literature. The technique described in this
article provides a method to communicate those anticipated
results to patients with ease at the chair-side utilizing bisacrylate material.
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Source of Support : Nil, Conflict of Interest : Nil

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