Comparison of Techniques for Obtaining Centric Relation Based on the Reproducibility of the Condylar Positions in Centric Relation—A Systematic Review

Abstract

The objective of this systematic review was to compare centric relation (CR) techniques that belong to the same method of obtaining CR (guided, graphical, or physiological method), to verify which CR technique within each method of obtaining CR generates the greatest reproducibility of the condylar positions (or mandibular position) in CR. The PubMed, Cochrane Library, SciELO, Scopus, and Web of Science databases were searched for articles published up to May 5, 2021. The search terms were combinations of “dental centric relation” (MeSH), with each of the following terms (individually): “reproducibility of findings” (MeSH); “jaw relation record” (MeSH); “chin point”; “gothic arch”; “bimanual manipulation”; “swallowing” (MeSH); and “jig.” Inclusion criteria: clinical studies in English; individuals without temporomandibular dysfunction and with complete or almost complete dentition or complete edentulous; and comparison between CR techniques belonging to the same method of obtaining CR based on the reproducibility of condylar positions in CR. For each method of obtaining the CR, the following CR techniques were considered: guided method (chin point guidance and bimanual manipulation); graphic method (intraoral and extraoral gothic arch tracing); and physiologic method (swallowing and tongue retrusion along the palate). A total of 1692 articles were screened. After the inclusion and exclusion criteria were applied, six articles were included in this review. None of the included studies evaluated edentulous individuals. All included articles compared CR techniques of the guided method. Three articles concluded that the bimanual technique showed greater reproducibility of the condylar positions in CR than the chin point guidance technique, two articles showed equivalence between these techniques, and 1 article concluded that the chin point guidance technique showed greater reproducibility of the condylar positions in CR than the bimanual technique. Thus, in this systematic review, the bimanual technique was often superior (generated greater reproducibility of the CR) or at least equivalent to the chin point guidance technique. Therefore, for individuals with complete dentition and without temporomandibular disorders, the bimanual technique is more recommended.

Oral Health-Related Quality of Life, Dry Mouth Sensation, and Level of Anxiety in Elderly Patients Rehabilitated with New Removable Dentures

“…In 2010, the world population aged 65 years and over was estimated to be 524 million (∼8% of the total world population in 2010). 1 2 3 4 By 2050, it is estimated that that number will be higher than 1.5 billion, representing approximately 16% of the total global population. 1 2 3 4 This number of elderly will represent approximately 16% of the total global population by 2050.…”

“…1 2 3 4 By 2050, it is estimated that that number will be higher than 1.5 billion, representing approximately 16% of the total global population. 1 2 3 4 This number of elderly will represent approximately 16% of the total global population by 2050. 1 2 3 4 Furthermore, complete edentulism may be related to individuals aged 50 years or older.…”

“…1 2 3 4 This number of elderly will represent approximately 16% of the total global population by 2050. 1 2 3 4 Furthermore, complete edentulism may be related to individuals aged 50 years or older. 1 2 3 4 It is noteworthy that the loss of all teeth is usually a gradual process.…”

Centric relation: A needed reference position

“…There is consensus that CR is at the apex of a gothic arch tracing 2 and is a useful tool to record CR 5,11 . This confirms the utilization of CR as a repeatable reference position for mounting casts on an articulator and to be utilized as a starting position in developing an occlusal scheme 2 .…”

“…There is no evidence to support the premise that there is an ideal condyle/fossa position. Interestingly, de Moraes Melo Neto et al 11 titled their article Comparison of Techniques for Obtaining Centric Relation Based on the Reproducibility of the Condylar Positions in Centric Relation , but all the evaluated techniques were intermaxillary. Condyles and fossae are not symmetrical, vary in size, and are surrounded by soft tissue whose anatomy and physiology differ from patient to patient.…”