A form and function concept of occlusion and the maxillomandibular relationship

A fixed retruded positional concept for the mandible is traceable historically to early dental prosthodontic attempts to obtain duplicable interocclusal records. The original method, derived for relating the maxillary and mandibular jaws for edentulous patients, later gained acceptance as a physiologic entity for patients with teeth as well as for those who were edentulous. Ultimately, static centric relation led to entirely reproducible systems, involving all mandibular movements, which endeavored to match occlusal contacts with a fixed condylar envelope of motion. A fixed or static interpretation of centric relation has become the common touchstone for virtually all the subspecialties of dentistry, regardless of the relative matching and spatial relationships of the jaws,and, as such, misdirects diagnosis and treatment. An attempt has been made to demonstrate that the temporomandibular articulation has a wide range of adaptability as well as a remodeling capacity and that it assumes its position as a result of the interplay of intercuspation of teeth and the neuromusculature. A dynamic concept of centric relation is presented as a quasifixed position of temporary duration which exists in the form of an equilibrium established by the balance of the neuromusculature and ligaments. The adoption of a dynamic or alterable concept of centric relation allows for diagnosis and treatment which is rationalin theory and workable in fact.