ESTHETIC WAX-UP CHECKLIST
Doctor's Name:
Patient's Name:
Start Date:
Due Date:
Tooth # 's Type of Restorations
  1. Central incisor size:
    Length mm.    Width mm.
  2. Move the midline:
    Align    mm. Right    or      mm. Left
  3. Free gingival line.:
    Maintain position.
    Modify position mm. apically.
  4. Incisor shape or smile:
    Guide #
  5. Horizontal plane:
    Change to coincide with desktop (mounted models).
    Leave as is
    Other modifications
  6. Occlusal plane:
    Develop ideal plane with plane analyzer
    Leave as is.
  7. Vertical dimension:
    Position at the level of centric occlusion.
    Open vertical   mm.     
    Anteriorly, or    posteriorly.
  8. Buccal corridor:
    Change to idealize
    Leave as is.
  9. Photos included:
    Face                  1:2 Smile
    1:2 Retracted    Occlusal
  10. Other: ___________________________________________.