Dr. R D. Das 1,Dr. Sailee Bhogwekar 2

1 MDS Prosthodontics, Private Practitioner,

Anjali Dental Clinic & Dental Speciality Centre, Mumbai

2 Assistant Professor, Department of Prosthodontics,

TPCT’s Terna Dental College, Navi Mumbai


Keywords:

Centric Relation, deprogrammer.

Citations: Das RD & Bhogwekar S. Clinical tip to record Centric Relation. J Prosthodont Dent Mater 2022;3(1):95-96.


The function of mastication in any dynamic prosthetic occlusion for full mouth rehabilitation depends largely on the accuracy of the maxilla - mandibular relations particularly an accurate horizontal jaw relation. Controversies in centric relation hasn’t undermined its clinical importance, though it is the single important factor in establishing a new occlusion. The correspondence of the centric relation position and maximum intercuspation provides occluso-articular stability and avoids overloading. This is of utmost importance for preventing Occlusion related TMJ disorders.

Centric relation is defined as a maxillomandibular relationship, independent of tooth contact, in which the condyles articulate in the anterior-superior position against the posterior slopes of the articular eminences; in this position, the mandible is restricted to a purely rotary movement; from this unstrained, physiologic, maxillomandibular relationship, the patient can make vertical, lateral or protrusive movements; it is a clinically useful, repeatable reference position.

Studies concerning full-mouth rehabilitation associated with restoring the OVD have shown that it is preferable to plan such cases in a Centric Relation position. CR has been well-described in the literature and, although easy to understand, clinical success is often elusive. A partial list of appliances and techniques to find the centric relation, includes the Lucia Jig, the leaf gauge, and the bilateral manipulation technique. However, anyone who has attempted to mount cases in CR knows that some patients can be extremely difficult to manage regarding accurate bite relationships.

The deprogrammer has been found to be an effective device for achieving these bite registrations. Here are some clinical steps to be followed for recording centric relation.

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References:

1. Wiens JP, Goldstein GR, Andrawis M, Choi M, Priebe JW. Defining centric relation. J Prosthet Dent. 2018 Jul;120(1):114-122.
2. Ferro KJ, Morgano SM, Driscoll CF, Freilich MA, Guckes AD, Knoernschild KL et al.The Glossary of Prosthodontic Terms: 9th Edition. J Prosthet Dent 2017;117(5S):e1-e105.
3. Zonnenberg AJJ, Türp JC, Greene CS. Centric relation critically revisited-What are the clinical implications? J Oral Rehabil. 2021 Sep;48(9):1050-1055.
4. Wood GN. Centric occlusion, centric relation, and the mandibular posture. J Prosthet Dent 1968 Oct;20(4):292-306.
5. Hunter BD 2nd, Toth RW. Centric relation registration using an anterior deprogrammer in dentate patients. J Prosthodont. 1999 Mar;8(1):59-61.