Professional Documents
Culture Documents
Third Edition
Shillingburg, Herbert T.
Guide to occlusal waxing / Herbert T. Shillingburg, Jr., Edwin L. Wilson, Jr., Jack T.
Morrison.--3rd ed.
p. ; cm.
Includes bibliographical references.
ISBN 0-86715-385-7
1. Waxing (Dentistry) 2. Occlusion (Dentistry). I. Wilson, Edwin L. II. Morrison, Jack
T. III. Title
[DNLM: 1. Denture Design--methods. 2. Dental Occlusion. 3. Tooth--anatomy &
histology. 4. Waxes. WU 500 S556g 2000]
RK658 .S47 2000
617.6’9--dc21 99-054300
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.
Printed in Canada
Frontmatter_01 7/23/13 4:18 PM Page 5
Contents
Preface 7
Mandibular Teeth 42
central incisors 42
lateral incisors 44
canines 46
first premolars 48
second premolars (H form) 50
second premolars (Y form) 52
first molars 54
second molars 56
References 58
5
Frontmatter_01 7/23/13 4:18 PM Page 7
Preface
7
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Students frequently ask the question, fossae are the negative. The ridges,
“Why put all those grooves on the when properly formed, are convex in all
occlusal surface? Why not put simple directions, and contacts with opposing
inclined planes on a flat table?” To teeth are numerous (Fig 1).
answer the question, it is necessary first The convex surfaces of ridges produce a
to analyze the features of the occlusal distributed contact pattern with small
surface of the tooth. This surface is com- contacts. In this way, occlusal forces are
prised of positive and negative features: distributed over a wide area of the
the cusp tips and ridges make up the occlusal surface, minimizing stress and
positive features, while the grooves and wear. Contact areas that are small and
Fig 1 There are numerous occlusal contacts (arrows) on an occlusal surface that is cor-
rectly waxed. The lingual surface of the mandibular first molar has been cut away to show
the occlusion with the maxillary first molar.
9
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A B
Fig 2 Properly formed occlusal morphology allows for small centric contacts (A) and com-
plete disclusion in excursions (B).
A B
Fig 3 Occlusal morphology made with only inclined planes produces large contacts in cen-
tric occlusion (A) with a likelihood that there will be continued contact in excursions (B).
10
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A B
Fig 4 Well-formed ridges and grooves will be more convex and functional (A) than will the
occlusal surface in which grooves have been carved into a flat plane (B).
bordered by marked depressions (ie, produced by flat surface against flat sur-
grooves) allow for complete and rapid dis- face. The difference is real: patients who
clusion in excursive movements (Fig 2). have restorations with flat surfaces
On the other hand, occluding surfaces replaced by those with ridges and
that are flat are more likely to produce grooves will often comment on the
large contact areas (Fig 3). Broad, flat reduced effort required for chewing
contacting areas are more likely to food.
remain in apposition without disclusion
when mandibular excursions occur. The Triangular Ridges
friction resulting from teeth continuing The most important features on an
to touch during excursions will often occlusal surface are the ridges. The
cause greater wear. seams along which the ridges meet form
Because of the reduced contact surface the grooves and the fossae of the
area resulting from an occlusal surface occlusal surface. Many novice waxers
comprised of convex ridges bordered by attempt to create occlusal morphology
grooves, the restoration is more effi- by cutting V-shaped furrows into flat
cient. Ridge against ridge produces a inclined planes on the occlusal surface
shearing action that is more effective of a wax pattern (Fig 4). The results are
than the pounding or crushing action rarely, if ever, satisfactory.
11
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A B
Fig 5 The triangular ridge is triangular (A) and is bounded by converging grooves (B) (after
Burch6).
The triangular ridge is the major ridge The grooves themselves perform an
or lobe of every cusp. It extends from important function in occlusal restora-
the cusp tip to the central groove (Fig 5 tion. If they are adequate in width and
A). It is essentially triangular: narrow at depth, and if they transverse the
the cusp tip and wide at its base in the occlusal surface in the proper direc-
central groove. The grooves to the tions, they will permit the unimpeded
mesial and distal of it converge toward passage of opposing cusps in excursive
the cusp tip (Fig 5B).6 movements. The grooves in a wax pat-
When viewed in either a faciolingual tern are refined by moving the articu-
section or a mesiodistal section, the tri- lated casts through the various excur-
angular ridge is convex (Fig 6). If the tri- sions in order to detect any interfer-
angular ridges are placed correctly, the ences which should be removed from
correct groove pattern will occur as a the walls of the grooves (ie, the sides of
natural by-product. the ridges.
12
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Fig 6 The triangular ridge is convex in faciolingual section (A) or in mesiodistal section (B)
(after Burch6).
13
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Fig 7 An increased vertical overlap of anterior teeth allows longer posterior cusp length
(A). Decreased vertical overlap requires a decrease in posterior cusp length (B).
14
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mandible. This in turn affects cusp The greater the vertical overlap of the
placement and height, and groove direc- anterior teeth, the longer the posterior
tion and depth, which will be tolerable cusps may be (Fig 7). Conversely, the
in the posterior restoration. Restoration less the vertical overlap, the shorter the
of anterior teeth must be undertaken cusps of posterior teeth must be. The
carefully, since changes in the morpho- greater the horizontal overlap of the
logical features of these teeth can anterior teeth, the shorter the cusps of
change the anterior guidance, with pos- posterior teeth must be (Fig 8). The
sible deleterious effect on the posterior cusps may be longer when the horizon-
occlusion. tal overlap is small.
15
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There are two wax-added techniques with the functional cusps (maxillary lin-
for waxing the occlusal surface of a gual and mandibular buccal). Marginal
restoration and two basic occlusal ridges and cusp ridges are added next,
schemes that can be formed. The first followed by axial ridges. The full axial
wax-added technique was developed by contours are finished, providing a bor-
E. V. Payne.1 This same method, using a der around the entire occlusal table
wax of a different color for each of the called the “fish’s mouth.” Triangular
features, has been widely promulgated ridges are then added, and any voids are
by H. C. Lundeen to teach functional filled in to complete the occlusal surface.
waxing.2 Buccal cusps are developed This method is most often associated
first, progressing from cones to buccal with the cusp-fossa relation in which
ridges, mesial and distal cusp ridges each functional cusp is nestled into the
(axial contours), and then triangular occlusal fossa of the opposing tooth (Fig
ridges, before starting the same 10). It is a tooth-to-tooth arrangement
sequence on the lingual cusps. Marginal that gives excellent distribution of
ridges are finally added to connect the occlusal forces and stability to the teeth.
two, and supplemental anatomy is Because it varies from the scheme usu-
refined. ally found in a natural occlusion, it can
This technique is usually associated be used only when restoring several
with the cusp-marginal ridge occlusion contiguous teeth and the teeth opposing
scheme in which the functional cusp con- them.
tacts the opposing occlusal surfaces on The Payne/Lundeen technique is com-
the marginal ridges of the opposing pair monly associated with the cusp-margin-
of teeth, or in a fossa (Fig 9). It is basical- al ridge occlusion; the Thomas tech-
ly a one-tooth-to-two-teeth arrange- nique, with the cusp-fossa occlusion. It
ment. Because the majority of natural should be borne in mind, however, that
dentitions have this type of occlusion, it is the method and the occlusal arrange-
commonly used for the single restora- ment are not inseparable. Although the
tions and limited occlusal restorations Thomas technique was meant for the
most frequently seen in daily practice. cusp-fossa scheme, it can be used for
The other wax-added technique is the developing a cusp-marginal ridge
invention of P. K. Thomas.3 All cusp occlusal relationship simply by altering
cones are positioned initially, starting cusp placement.
17
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6
5
4
3
2
Fig 9a
18
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6
5
Fig 9b
19
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7
6
5
4
3
2
1
Fig 10a
20
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1
2
3
4
Fig 10b
21
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Fig 11 Cones (yellow) are placed for all cusps with a PKT No. 1. Functional cusps are locat-
ed first.
Fig 12 Form the marginal ridges and cusp ridges (blue) with a PKT No. 1.
A brief review of waxing is presented are located first, using a PKT No. 1. They
here to expedite student progress should be positioned so they will contact
through a wax pattern. A more detailed the appropriate fossa or marginal ridge
presentation of all aspects of fabricating of the opposing tooth. Next, the non-
wax patterns can be found elsewhere.7 functional cusps are placed (Fig 11). On
The functional cusps (lingual of the the maxillary teeth, the nonfunctional
maxillary and buccal of the mandibular) cusps should be short enough to miss
22
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Fig 13 Axial ridges (red) are placed over the cusps with a PKT No. 1.
contacting the buccal cusps of the occlusal surface is dusted with zinc
mandibular teeth during excursions. On stearate and the articulated casts are
the mandibular teeth, the lingual cusps moved through the various excursions.
should be slightly shorter than the buc- The pathways which would normally
cal. The lingual cusps of mandibular be followed by the cusps of the respec-
molars should also be placed as far to tive opposing teeth are shown in the
the lingual and as far from each other as illustrations of the individual teeth
possible. (pages 28 to 57).
The marginal ridges and cups ridges The maxillary lingual ridges or
(both mesial and distal) are added next, mandibular buccal ridges are then
using a PKT No. 1 (Fig 12). The highest waxed in to provide the silhouette of the
points on the occlusal surfaces are the final contour of the respective axial sur-
tips of the cusp cones. The marginal face (Fig 13). Next, use the PKT No. 1 to
ridges should never be higher than the fill in any voids or discrepancies
cusps. The cusp tips and the edges of between the crests of the cusp ridges
the marginal ridge should be as sharp and the facial or lingual axial contours.
as possible. The buccolingual dimen- Smooth the axial surfaces with a PKT
sion of each occlusal table formed by No. 4 to complete the “fish’s mouth,” so
the ridges should be approximately named because of the appearance of the
55% of the overall buccolingual cusp and marginal ridges at this point
dimension of the respective tooth. The (Fig 14).
23
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Fig 14 Finish filling in the axial contours (green) and smooth them with a PKT No. 4.
Build up the triangular ridge for each the cusp tip. The ridges should be con-
of the cusps with the PKT No. 1 (Fig 15). vex both buccolingually and mesiodis-
The line along which the bases of these tally to provide point contacts with the
ridges meet will be the central groove of opposing cusps. Check the occlusion in
the occlusal surface. Remember! The the intercuspal position, and in excur-
bases must be broader than the apex at sions as well.
24
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Fig 16 The ridges are rounded and finished with a PKT No.5.
All voids remaining on the occlusal the ridges (Fig 16). Developmental and
surface are eliminated with a PKT No. 2. supplemental grooves are smoothed
Supplemental anatomy is formed by the with a PKT No. 3 (Fig 17). Dust the wax
junction between the triangular ridge patterns with zinc stearate and check
and the adjacent cusp or marginal the occlusal contacts in the intercuspal
ridges. The PKT No. 5 is used to refine and excursive positions.
25
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27
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Maxillary Teeth
28
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Maxillary Teeth
29
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Maxillary Teeth
30
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Maxillary Teeth
31
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Maxillary Teeth
32
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Maxillary Teeth
33
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Maxillary Teeth
34
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Maxillary Teeth
• Primary • Secondary
35
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Maxillary Teeth
36
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Maxillary Teeth
• Primary • Secondary
37
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Maxillary Teeth
38
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Maxillary Teeth
• Primary • Secondary
39
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Maxillary Teeth
40
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Maxillary Teeth
• Primary • Secondary
41
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Mandibular Teeth
42
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Mandibular Teeth
43
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Mandibular Teeth
44
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Mandibular Teeth
45
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Mandibular Teeth
46
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Mandibular Teeth
47
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Mandibular Teeth
48
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Mandibular Teeth
• Primary • Secondary
49
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Mandibular Teeth
50
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Mandibular Teeth
• Primary • Secondary
51
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Mandibular Teeth
52
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Mandibular Teeth
• Primary • Secondary
53
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Mandibular Teeth
54
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Mandibular Teeth
• Primary • Secondary
55
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Mandibular Teeth
56
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Mandibular Teeth
• Primary • Secondary
57
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References
1. Huffman RW. Part six, occlusal morpholo- 5. Linek HA. Tooth Carving Manual.
gy. In: Guichet NF. Procedures for Occlusal Pasadena: Wood and Jones, 1949.
Treatment—A Teaching Atlas. Anaheim: 6. Burch JG. Introduction to Coronal Tooth
Denar, 1968:98. Contour. Worthington, Ohio, 1975.
2. Lundeen HC. Introduction to Occlusal 7. Shillingburg HT, Hobo S, Whitsett LD,
Anatomy. Lexington, 1969. Jacobi R, Brackett SE. Fundamentals of
3. Thomas PK. Syllabus on Full Mouth Fixed Prosthodontics, ed 3. Chicago:
Waxing Technique for Rehabilitation. San Quintessence, 1997.
Diego: Instant Printing Service, 1967.
4. Zeisz RC, Nuckolls J. Dental Anatomy. St.
Louis: Mosby, 1949.
58