Comparison of the replicability of routinely used centric relation registration techniques

Abstract

The results of this study showed that of the 3 centric relation methods evaluated, the bimanual manipulation method positioned the condyles in the temporomandibular joint with a more consistent repeatability than the other 2 methods, whereas the Gothic arch was the least consistent method.

Condylar positions generated by five centric relation recording techniques

“…The current centric relation definition claims to be both a reference point of mandibular location relative to the maxilla and the most musculoskeletally stable position where the condylar head is in a superior and anterior position in the articular fossae [15]. Ensuring that a CR registration produced condylar locations compliant with this definition requires the use of computed tomography or magnetic resonance imagining (MRI) due to its physiologic nature, which is impractical for routine treatment [16].…”

“…Yet, the complex anatomy of the TMJ makes this analysis difficult as well. This joint is an atypical diarthrodial joint capable of simultaneous rotational and translational movements [ that right and left condyles be evaluated independently [16].…”

“…Techniques that do not use the subjects' functional movement against an anterior stop produce similar condylar positions [16].…”

“…There is no established range of acceptable condylar position variability for CR interocclusal records. For this reason, repeatability data can only be compared between techniques and not to any previously established standard [16]. For all techniques and subjects, CR condylar positions fell within 2mm from the CO position anterior-posteriorly and 3 mm vertically.…”

Reproducibility of Centric Relation Techniques by means of Condyle Position Analysis

“…This strong consistency might be the result of a better subject "deprogramming" procedure prior to the CR record registration. Numerous scientific publications (21,26,32,(33)(34)(35)(36) have pointed out that bimanual mandibular manipulation with anterior deprogrammer is one of the most reliable and reproducible methods of determining CR in dentistry. However, there are also scientific publications that oppose this finding, as the one conducted by Paixão et al (37).…”