What Materials and Reproducible Techniques May Be Used in Recording Centric Relation? Best Evidence Consensus Statement

Abstract

Purpose The purpose of this Best Evidence Consensus Statement was to evaluate the existing literature relative to two focus questions: What are the techniques used and their reproducibility in recording centric relation (CR) in a dentate and partially dentate population and what effect do different recording materials have on the reproducibility of CR? Materials and Methods Keywords used in the initial search were: CR, interocclusal records, CR accuracy, CR reproducibility, and CR technique. The search was then limited to Systematic Reviews, Randomized Controlled Studies, Meta‐analyses, and Clinical Trials. Results Initial search related to the selected search terms resulted in more than 3500 articles. When subsequent search was limited to Systematic Reviews, Randomized Controlled Studies, and Meta‐Analysis and Clinical Trials, this resulted in 291 articles selected for further analysis. Conclusions Techniques using chin point guidance, bimanual manipulation, power centric, Gothic arch tracing, leaf gauge, and anterior deprogramming devices to record CR can all be comparable in precision and clinical accuracy in regards to clinical relevance. Practitioner experience and familiarity with a particular technique is critical for accuracy when recording CR. Polyvinyl siloxane and polyether consistently performed better in the broad range of studies on recording materials. Virtual capture of CR could serve as a comparable recording medium but requires further clinical study.

Reliability and Time Efficiency of Digital vs. Analog Bite Registration Technique for the Manufacture of Full-Arch Fixed Implant Prostheses

“…Although this deviation also affects the accuracy of bite registration, the clinical impact will be less compared to the influence on the fit and marginal adaptation of the final prosthesis. Intraoral scanners register the static relationship of the maxillary and mandibular jaw with a similar or even better accuracy than the conventional physical interocclusal record [ 46 , 47 , 48 , 49 , 50 ]. Ren et al found a mean distortion of 280 µm in occlusal relation for digital impressions of partially edentulous casts [ 51 ].…”

“…In comparison, Eriksson et al reported a distortion varying from 170 to 2650 µm after mounting the gypsum casts the conventional way [ 52 ]. However, similar to the conventional bite registration, the clinician’s experience with the IOS system is critical for the accuracy when recording the CR position [ 50 ].…”

Preliminary evaluation of Kovacs digital occlusal splint in the treatment of temporomandibular disorders: A single‐centre, cross‐sectional study

“…Besides, KDOS also applies a special masticatory deprogramming process to obtain a stable therapeutic jaw position, which by traditional methods includes chin point guidance, bimanual manipulation and leaf gauges, etc. Besides, traditional methods of obtaining stable therapeutic jaw position are more dependent on the clinician's experience, 17 and the jaw position may require frequent adjustment during splint wearing. The jaw position obtained by masticatory deprogramming process in KDOS treatment is more objective, avoiding constant jaw position adjustment, thus reduced both clinician's time and patient's recovery time.…”

Selecting a Virtual Articulator: An Analysis of the Factors Available with Mechanical Articulators and their Potential Need for Inclusion with Virtual Articulators

“…A recent Best Evidence Consensus Statement reported that "Variance occurs due to different recording materials, techniques, as well as a circadian influence when recording CR." 11 In vitro studies have been performed on the accuracy of virtual interocclusal records (VIRs). Yee et al reported that "The overall interarch global distortion of all three model scanner-CAD systems was low and did not exceed 0.6%."…”

“…Accuracy, determined by the stability of the recording material, the precision of fitting the casts into the material, and the technique utilized to mount the records in an articulator have always been a concern. A recent Best Evidence Consensus Statement reported that “Variance occurs due to different recording materials, techniques, as well as a circadian influence when recording CR.” 11 …”