Centric relation registration: intra- and interexaminer agreement after a calibration program

Area of Science:

• Dental Occlusion
• Temporomandibular Disorders (TMD)
• Prosthodontics

Background:

• Centric relation (CR) is a key maxillomandibular position for dental and prosthetic treatments.
• Clinical use and recording of CR are controversial, particularly in patients with temporomandibular disorders (TMD).
• Reproducibility of CR recording techniques is a significant clinical concern.

Purpose of the Study:

• To evaluate the effectiveness of a training program on intra- and interexaminer agreement for CR recording.
• To assess the impact of training on recording frontal and sagittal deviations, pain, and initial occlusal contact in CR.
• To compare agreement levels between symptomatic (TMD) and asymptomatic individuals.

Main Methods:

• Forty participants (TMD and asymptomatic groups) were assessed by three calibrated examiners.
• Examiners used Dawson's bilateral manipulation technique with and without an anterior stop.
• Intra- and interexaminer agreement were analyzed using Kendall and Kappa tests after a 30-day interval in a blind design.

Main Results:

• Good intra- and interexaminer agreement were observed for CR recording after the training program.
• Highest agreement was found for frontal deviations and pain assessment during manipulation.
• Sagittal deviations exhibited the lowest agreement, indicating a need for focused attention.

Conclusions:

• A calibration and training program can significantly enhance intra- and interexaminer agreement in recording centric relation.
• While effective overall, specific aspects like sagittal deviations require cautious interpretation.
• The findings support the utility of standardized training for improving CR recording reliability in clinical practice.