In order to ensure the best possible quality of temporary and final restorations, a step-by-step verification process needs to take place in the case submission stage of the workflow. This article outlines the requirements needed for a full-arch wax-up made by 3Sixty.

Case Requirements

When you request a wax-up design, you will need to send us a number of items either via 3Sixty Courier or by mail; depending on each individual case. Here is a breakdown of what is required for each case:

4 or more teeth per arch

You will need:

• CBCT scan + PVS impressions OR intraoral scans of both arches.
• Full mouth bite registration; physical or digital scan.
• If a change in the VDO is required, a second bite registration with the opened (i.e. new) VDO.

Free-end saddle

For example: 6 remaining anterior teeth with missing posterior segment– unilaterally or bilaterally. You will need:

• CBCT scan + PVS impressions OR intraoral scans of both arches.
• Full mouth bite registering the lingual and palatal anatomy.
  • Tip: prepare a large ball of putty PVS impression and use it as if you are registering a bite, but have most of the material adapted on the lingual and palatal soft tissue. Then ask the patient to bite in centric occlusion and push his tongue towards the PVS material to record the lingual and palatal anatomy properly.
• If there is a removable partial denture, 2 impressions will be required; with and without the denture.
• If a change in the VDO is required, a second bite registration with the opened (i.e. new) VDO.

Less than 4 teeth per arch

Patients with enough occlusal stoppers to record a bite (i.e. 1 anterior and 1 posterior on each side) will require the following:

• CBCT scan + PVS impressions OR intraoral scans of both arches.
• Full mouth bite registration; physical or digital scan.
• If there is a removable partial denture, 2 impressions will be required; with and without the denture.
• If a change in the VDO is required, a second bite registration with the opened (i.e. new) VDO.

Patients without enough occlusal stoppers will require the following:

If a partial denture is available

• Dual Scan Protocol with the partial denture.
• PVS impressions OR intraoral scans of both arches with and without the partial denture.

If a partial denture is unavailable

Dual Scan Protocol as follows:

1. Send primary impressions or intraoral scans to a local lab.
2. A bite block should be fabricated and sent back for bite registration at the local lab.
3. A try-in will be fabricated and sent back from the local lab for confirmation to be used in the Dual Scan Protocol. 
4. Then you will send us the following:

• • Dual scan CBCT with the partial denture.
  • PVS impressions OR intraoral scans of both arches with and without the partial denture.

Completely edentulous

If a denture is available

• Dual Scan Protocol with the denture.
• PVS impressions OR intraoral scans of the denture.
• Full mouth bite registration; physical or digital scan.

If a denture is unavailable

Dual Scan Protocol as follows:

1. Send primary impressions or intraoral scans to 3Sixty.
2. A bite block will be fabricated and sent back for bite registration.
3. A try-in will be fabricated and sent back for confirmation to be used in the Dual Scan Protocol. 
4. Then you will send us the following:

• • Dual scan CBCT.
  • PVS impressions OR intraoral scans of the denture.
  • Full mouth bite registration; physical or digital scan.

Wax-Up Design Checklist

This a list of items that we need to check and verify before starting to work on the wax-up design:

1. Good quality CBCT scan

• • No motion artifact.
  • Minimal scatter
  • Scan shows all bone anatomy including nasal spine and chin (i.e. not cut-off). 
  • Date of acquisition is between 6 – 9 months.

2. STL files of models OR intraoral scans

• • Good quality intraoral scan/impression (i.e. no broken teeth, no ditches, complete anatomy is recorded).
  • STL matches CBCT scan properly.

3. STL files for patient’s bite in occlusion.

4. Intraoral and extraoral photos of the patient.

• • Refer to 3Sixty Digital Smile Design Guidelines.

5. Filled “Prosthetic Form”.